Table 1: Summary of animal study findings associated with periconception and early gestation maternal weight loss.

HPA axis development and function
(i) Altered placental 11betaHSD activity and cortisol : cortisone in fetal circulation [20, 21]
(ii) Accelerated activation of fetal HPA axis in late gestation [2225]
(iii) Preterm birth [2325]
(iv) Enhanced HPA axis response to CRH stimulation at 2 months [26]
(v) Blunted cortisol response to CRH and AVP stimulation in adult offspring [27]
(vi) Increased adrenal gland size in males and females and greater stress response in adult female offspring accompanied by epigenetic changes to adrenal IGF2/H19 gene [28]

Growth, body composition, and energy regulating pathways
(i) Altered relationships between maternal weight and fetoplacental growth in early pregnancy [29]
(ii) Altered fetal growth response to late gestation stressors [30]
(iii) Epigenetic changes in POMC and GR genes in fetal hypothalamus [31]
(iv) Reduced fat mass in offspring of overweight ewes [32]
(v) Greater percent fat mass and smaller relative heart, lungs, and adrenals in male offspring [33]
(vi) Decreased voluntary physical activity in adult offspring [34]

Glucose-insulin axis
(i) Impaired pregnancy insulin resistance [35]
(ii) Increased fetal insulin response to glucose in late gestation [36]
(iii) Altered thermogenic, insulin, and fatty acid oxidation signalling in fetal perirenal fat depot [37]
(iv) Altered glucose-insulin metabolism in adult males [38]
(v) Epigenetic modification of hepatic insulin-signalling molecules [39]
(vi) Impaired glucose tolerance in adult offspring [40]

Cardiovascular function
(i) Increased late gestation fetal blood pressure [41]
(ii) Enhanced vasoconstriction in adult female coronary arteries and endothelial dysfunction in femoral resistance vessels [42]