Bringer Jacques, Galtier Florence, Raingeard Isabelle, Boulot Pierre, Renard Eric
Maladies Endocriniennes, Hôpital Lapeyronie, CHRU Montpellier.
Bull Acad Natl Med. 2008 Apr;192(4):673-87; discussion 687-8.
As the prevalence of obesity grows in western countries, maternal obesity is becoming an increasingly frequent high-risk obstetrical situation. Obese women have a higher incidence of pregnancy complications (gestational diabetes, hypertension, toxaemia, etc.) and of adverse fetal outcomes (macrosomia, neural tube defects, perinatal mortality). Cesarean section is more frequent in obese women, resulting in a higher risk of anaesthetic and post-operative complications. Maternofetal complications are proportional to the degree of obesity, and even moderate overweight amplifies the risk. Long-term complications include worsening of maternal obesity, maternal type 2 diabetes, and childhood obesity and metabolic disorders. Before conception, these patients should receive tailored weight-loss advice and be screened for obesity complications. Food intake during pregnancy should be tailored to achieve the minimum maternal weight gain required for normal fetal growth. Long-term follow-up is required to prevent worsening of maternal obesity after delivery, and the child's growth curve should be closely watched
随着西方国家肥胖症患病率的上升,孕产妇肥胖正日益成为一种常见的高危产科情况。肥胖女性发生妊娠并发症(妊娠期糖尿病、高血压、毒血症等)以及不良胎儿结局(巨大儿、神经管缺陷、围产期死亡率)的几率更高。肥胖女性剖宫产更为常见,导致麻醉和术后并发症的风险更高。母婴并发症与肥胖程度成正比,即使是中度超重也会增加风险。长期并发症包括孕产妇肥胖加重、孕产妇2型糖尿病以及儿童肥胖和代谢紊乱。在受孕前,这些患者应接受量身定制的减肥建议,并接受肥胖并发症筛查。孕期的食物摄入量应进行调整,以实现胎儿正常生长所需的最低母体体重增加。需要进行长期随访,以防止产后孕产妇肥胖加重,并且应密切监测儿童的生长曲线。