Placental cytokine secretion induces a pro-inflammatory state during pregnancy. This metabolic state is exacerbated by additional cytokines secreted by enlarged adipocytes in obese pregnant women. The inflammatory state leads to an increase in circulating free fatty acids and an insulin-resistant state. This pro-inflammatory, insulin-resistant state in a mother may affect placental function and fetal growth and development. Accumulating evidence suggests that the fetal fuel supply is enhanced, leading to accelerated growth and excessive fetal fat stores. Currently, obese pregnant women are not given any specific advice for reducing the pro-inflammatory response and insulin resistance. However, studies in both non-pregnant and pregnant adults suggest that moderate physical activity and increased intakes of dietary fiber and the proportion of polyunsaturated fatty acids attenuate these metabolic abnormalities and thereby potentially improve pregnancy outcomes.

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