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The relationship between maternal obesity and diabetes during pregnancy on offspring kidney structure and function in humans: a systematic review

Published online by Cambridge University Press:  09 November 2018

Y. Q. Lee ,
C. E. Collins ,
A. Gordon ,
K. M. Rae  and
K. G. Pringle
Y. Q. Lee
Affiliation:
School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia Priority Research Centre for Reproductive Sciences, University of Newcastle, Newcastle, NSW, Australia
C. E. Collins
Affiliation:
School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, Australia
A. Gordon
Affiliation:
Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
K. M. Rae
Affiliation:
Priority Research Centre for Reproductive Sciences, University of Newcastle, Newcastle, NSW, Australia Gomeroi gaaynggal Centre, Faculty of Health and Medicine, University of Newcastle, Tamworth, NSW, Australia Department of Rural Health, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Tamworth, NSW, Australia Priority Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, NSW, Australia
K. G. Pringle*
Affiliation:
School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, University of Newcastle, Newcastle, NSW, Australia Priority Research Centre for Reproductive Sciences, University of Newcastle, Newcastle, NSW, Australia Gomeroi gaaynggal Centre, Faculty of Health and Medicine, University of Newcastle, Tamworth, NSW, Australia
*
Address for correspondence: Dr. K. G. Pringle, Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia. E-mail: kirsty.pringle@newcastle.edu.au
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Abstract

Evidence from animal models indicates that exposure to an obesogenic or hyperglycemic intrauterine environment adversely impacts offspring kidney development and renal function. However, evidence from human studies has not been evaluated systematically. Therefore, the aim of this systematic review was to synthesize current research in humans that has examined the relationship between gestational obesity and/or diabetes and offspring kidney structure and function. Systematic electronic database searches were conducted of five relevant databases (CINAHL, Cochrane, EMBASE, MEDLINE and Scopus). Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were followed, and articles screened by two independent reviewers generated nine eligible papers for inclusion. Six studies were assessed as being of ‘neutral’ quality, two of ‘negative’ and one ‘positive’ quality. Observational studies suggest that offspring exposed to a hyperglycemic intrauterine environment are more likely to display markers of renal dysfunction and are at higher risk of end-stage renal disease. There was limited and inconsistent evidence for a link between exposure to an obesogenic intrauterine environment and offspring renal outcomes. Offspring renal outcome measures across studies were diverse, with a large variation in offspring age at follow-up, limiting comparability across studies. The collective current body of evidence suggests that intrauterine exposure to maternal obesity and/or diabetes adversely impacts renal programming in offspring, with an increased risk of kidney disease in adulthood. Further high-quality, longitudinal, prospective cohort studies that measure indicators of offspring renal development and function, including fetal kidney volume and albuminuria, at standardized follow-up time points, are warranted.

Keywords

diabeteskidney diseaseobesitypregnancy
Type
Review
Information
Journal of Developmental Origins of Health and Disease , Volume 10 , Issue 4 , August 2019 , pp. 406 - 419
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2018 

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