Division of Women's Health, King's College London, London SE1 7EH, United Kingdom.
Pediatr Res. 2011 Feb;69(2):175-80. doi: 10.1203/PDR.0b013e3182055ede.
Obesity among pregnant women is becoming one of the most important women's health issues. Obesity is associated with increased risk of almost all pregnancy complications: gestational hypertension, preeclampsia, gestational diabetes mellitus, delivery of large-for-GA infants, and higher incidence of congenital defects all occur more frequently than in women with a normal BMI. Evidence shows that a child of an obese mother may suffer from exposure to a suboptimal in utero environment and that early life adversities may extend into adulthood. In September 2009, ILSI Europe convened a workshop with multidisciplinary expertise to review practices and science base of health and nutrition of obese pregnant women, with focus on the long-term health of the child. The consensus viewpoint of the workshop identified gaps and gave recommendations for future research on gestational weight gain, gestational diabetes, and research methodologies. The evidence available on short- and long-term health impact for mother and child currently favors actions directed at controlling prepregnancy weight and preventing obesity in women of reproductive ages. More randomized controlled trials are needed to evaluate the effects of nutritional and behavioral interventions in pregnancy outcomes. Moreover, suggestions that maternal obesity may transfer obesity risk to child through non-Mendelian (e.g. epigenetic) mechanisms require more long-term investigation.
孕妇肥胖正成为最重要的妇女健康问题之一。肥胖与几乎所有妊娠并发症的风险增加有关：妊娠期高血压、先兆子痫、妊娠糖尿病、巨大儿分娩以及先天性缺陷的发生率均高于 BMI 正常的妇女。有证据表明，肥胖母亲的孩子可能因暴露于宫内环境不佳而受到影响，并且早期生活逆境可能会持续到成年期。2009 年 9 月，ILSI 欧洲召集了一次多学科专业知识研讨会，以审查肥胖孕妇健康和营养的实践和科学依据，重点是儿童的长期健康。研讨会的共识观点确定了差距，并为未来关于妊娠期体重增加、妊娠期糖尿病和研究方法的研究提出了建议。目前，有关母婴短期和长期健康影响的证据支持采取行动控制孕前体重和预防育龄妇女肥胖。需要更多的随机对照试验来评估营养和行为干预对妊娠结局的影响。此外，关于母体肥胖可能通过非孟德尔（例如表观遗传）机制将肥胖风险传递给儿童的说法需要进一步长期研究。
