Department of Metabolic Medicine, 1st floor Mint Wing, Imperial College School of Medicine at St Mary's Hospital, London W2 1NY, UK.
Semin Fetal Neonatal Med. 2010 Apr;15(2):77-82. doi: 10.1016/j.siny.2009.10.003. Epub 2009 Nov 28.
The prevalence of obesity is high and rising worldwide. The greatest prevalence of obesity is found in the western world and in urban developing countries. There is an increased maternal mortality associated with maternal obesity. There are increased risks of most maternal complications in pregnancy including pre-eclampsia, gestational and pre-existing type 2 diabetes mellitus and thromboembolic disorders. There is an increased perinatal mortality associated with maternal obesity; there are increased risks of congenital malformation, fetal macrosomia and indeed risks for the fetus as a child and adult in the years to come. There are increased risks of complications of pregnancy including caesarean section, traumatic delivery and a reduced chance of breastfeeding. Maternal obesity in pregnancy predicts long-term risks for that mother. The management includes increased surveillance for these risks and lifestyle modulation during pregnancy. This includes dietary measures and encouraging modest increase in exercise. Ideally, the mother should achieve closer to an ideal body mass index prior to pregnancy using lifestyle intervention but possibly with pharmacological therapy or bariatric surgery. The ideal weight gain for an obese mother is less than the ideal weight gain for a lean mother.
肥胖的患病率在全球范围内居高不下，且呈上升趋势。肥胖症的最大患病率出现在西方国家和城市发展中国家。与肥胖相关的产妇死亡率增加。妊娠期间大多数产妇并发症的风险增加，包括先兆子痫、妊娠糖尿病和血栓栓塞性疾病。与肥胖相关的围产期死亡率增加；先天畸形、胎儿巨大儿的风险增加，而且在未来的几年里，胎儿作为儿童和成人的风险也增加。妊娠并发症的风险增加，包括剖宫产、创伤性分娩以及母乳喂养的机会减少。妊娠期间的母体肥胖预示着母亲的长期风险。管理包括增加对这些风险的监测和妊娠期间的生活方式调节。这包括饮食措施和鼓励适度增加运动。理想情况下，母亲应该在妊娠前通过生活方式干预来接近理想的体重指数，但也可能需要药物治疗或减肥手术。肥胖母亲的理想体重增加量应低于瘦母亲的理想体重增加量。
