Guelinckx I, Devlieger R, Vansant G
Department of Public Health Medicine, KULeuven, Kapucijnenvoer 35-B 3000 Leuven.
Verh K Acad Geneeskd Belg. 2010;72(5-6):253-76.
This PhD thesis indicated by a literature review and a prospective study that maternal obesity is associated with serious complications for both mother and child. This is a problem since already 9% of the pregnant women at the antenatal department of the University Hospital Leuven was obese during 2006. A prospective study with 142 women showed that maternal obesity is also associated with a lower diet quality during pregnancy compared to normal weight pregnant women. To reduce the high prevalence of excessive gestational weight gain among obese pregnant women and to improve their low diet quality, a randomized controlled trial with 2 intervention groups with a different intensity of nutritional guidance was set up. Both interventions improved dietary habits, but affecting physical activity level and gestational weight gain remains a challenge. During this thesis 2 practical tools for all pregnant women and their health care providers were developed: weight gain percentile charts for each body mass index category and a website giving information on nutrition, physical activity, and weight gain during pregnancy. Besides obese pregnant women, pregnant women with a history of bariatric surgery are also a high-risk population. Even though the obesity related pregnancy complications decrease after the surgery induced weight loss, other complications such as internal hernias and nutritional deficiencies with potential lethal consequences have been identified. A multidisciplinary follow-up during pregnancy with routine screening for nutritional deficiencies with attention for the fat-soluble vitamins and patient tailored nutritional supplementation seems required.
本博士论文通过文献综述和前瞻性研究表明，母亲肥胖与母婴双方的严重并发症相关。这是个问题，因为2006年鲁汶大学医院产前科已有9%的孕妇肥胖。一项针对142名女性的前瞻性研究表明，与体重正常的孕妇相比，母亲肥胖还与孕期饮食质量较低有关。为降低肥胖孕妇中孕期体重过度增加的高发生率，并改善她们较低的饮食质量，开展了一项随机对照试验，设立了两个营养指导强度不同的干预组。两种干预措施均改善了饮食习惯，但影响身体活动水平和孕期体重增加仍是一项挑战。在撰写本论文期间，为所有孕妇及其医护人员开发了两种实用工具：针对每个体重指数类别的体重增加百分位图，以及一个提供孕期营养、身体活动和体重增加信息的网站。除肥胖孕妇外，有减肥手术史的孕妇也是高危人群。尽管手术后体重减轻，与肥胖相关的妊娠并发症减少，但已发现其他并发症，如内疝和有潜在致命后果的营养缺乏症。孕期似乎需要进行多学科随访，并对营养缺乏症进行常规筛查，同时关注脂溶性维生素，并根据患者情况进行营养补充。
