Maternal Exercise and Nutrition Function as Interconnected Regulators of Embryonic Organogenesis and Fetal Development

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The intrauterine environment plays a critical role in shaping lifelong health, forming the foundation of the Developmental Origins of Health and Disease (DOHaD) paradigm. Increasing evidence suggests that maternal lifestyle factors, particularly physical activity and nutrition, can actively influence embryonic development; however, how exercise and dietary signals interact to regulate developmental programming remains insufficiently understood. In this review, we summarize emerging evidence that maternal exercise and nutrition function as interconnected regulators of embryonic organogenesis through coordinated maternal–placental–fetal communication. Exercise-induced metabolic, endocrine, and immunological adaptations are highly dependent on maternal nutritional status, while dietary composition provides essential substrates and signaling molecules that modulate exercise-mediated benefits. Through regulation of placental function, exerkines, microbiota-derived metabolites, epigenetic modifications, and nutrient-sensing pathways, the integrated exercise–nutrition axis shapes the development of multiple embryonic organ systems and influences offspring health trajectories. We further discuss current challenges in defining optimal combinations of maternal exercise patterns and nutritional strategies, highlighting the need to move beyond isolated interventions toward precision lifestyle approaches during pregnancy. This perspective establishes maternal exercise and nutrition as synergistic modulators of developmental programming and provides a conceptual framework for understanding how combined lifestyle interventions may enhance offspring developmental resilience and reduce the risk of chronic disease across generations.