Ethnicity, Obesity, and Pregnancy Outcomes on Fetal Programming

A number of diseases over the life course such as cardiovascular disease, diabetes, asthma, cancer, allergies, and neurocognitive impairment occur at differing rates among people of different ethnicities. There is growing evidence to suggest that this is a consequence of fetal programming. Gestational diabetes mellitus (GDM) and hypertensive conditions in pregnancy such as gestational hypertension and preeclampsia both occur at elevated rates in women of certain ethnicities. Women of different ethnicities also experience higher rates of adverse pregnancy outcomes and interventions including preterm birth, low birth weight/small for gestational age, and cesarean birth. All of the outcomes listed above have been linked to fetal programming and may explain the increased rates of chronic diseases among people of different ethnicities. Compounding the issue further are the increasing rates of maternal obesity experienced among women in high-income nations. Emerging evidence has suggested that the associations between obesity, adverse pregnancy outcomes, and life course diseases may also be additive in some ethnicities. Further research is needed to uncover specific mechanisms.