Graphical Abstract.

Intrauterine exposure to maternal obesity leads to offspring cardiovascular dysfunction through mechanisms including sympathetic hyper-reactivity, metabolic inflexibility, and mitochondrial dysfunction, as well as oxidative stress. Cardiovascular dysfunction originates in foetal life and persists into postnatal life through persistent epigenetic modifications. Interventions and secondary challenges may occur pre- and post-natally, which may impact progression to overt cardiovascular disease in adulthood. Created with BioRender.com.