World Diabetes Foundation, Bagsvaerd, Denmark.
Pregnancy and Non-Communicable Diseases Committee, FIGO, London, UK.
Int J Gynaecol Obstet. 2020 Aug;150(2):151-158. doi: 10.1002/ijgo.13198. Epub 2020 Jun 2.
An integrated approach to population health, disease surveillance, and preventive care will dominate the health agenda in the post COVID-19 world. Because of their huge burden and the vulnerability imposed during a health crisis, prevention and care of non-communicable diseases (NCDs) will need to be prioritized even further. Maternal and child health are inextricably linked with NCDs and their risk factors. The intergenerational impact of poor maternal nutrition and health conditions during pregnancy, particularly NCD-related pregnancy complications, can be considered as a multiplier of the ongoing pandemic of NCDs. The economic cost of poor maternal health and NCD-related pregnancy complications is likely very high, but is not adequately researched or documented in the context of long-term population health. Interventions to address NCDs in pregnancy have beneficial effects on short-term pregnancy outcomes; but even more importantly, identifying "at-risk" mothers and offspring opens up the opportunity for targeted early preventive action. Preventive actions to address obesity, hypertension, type 2 diabetes, and cardiovascular diseases have a common lifestyle approach-identifying any one of these problems in pregnancy provides an opportunity to address them all. Cost-benefit analyses that only focus on the short-term and on one condition do not capture the full value of downstream, long-term benefits for population health. This requires urgent attention from FIGO.
在后 COVID-19 世界中,综合的人口健康、疾病监测和预防保健方法将主导卫生议程。由于非传染性疾病(NCD)的巨大负担和在卫生危机期间造成的脆弱性,预防和治疗 NCD 将需要进一步优先考虑。母婴健康与 NCD 及其危险因素密切相关。孕产妇营养不良和孕期健康状况不佳的代际影响,特别是与 NCD 相关的妊娠并发症,可以被视为 NCD 持续流行的一个乘数。不良孕产妇健康和 NCD 相关妊娠并发症的经济成本可能非常高,但在长期人口健康方面,这方面的研究或记录并不充分。针对孕期 NCD 的干预措施对短期妊娠结局有有益影响;但更重要的是,识别“高危”母亲和后代为有针对性的早期预防措施提供了机会。针对肥胖、高血压、2 型糖尿病和心血管疾病的预防措施具有共同的生活方式方法——在孕期发现其中任何一个问题,都为解决所有问题提供了机会。仅关注短期和单一情况的成本效益分析无法捕捉到人口健康的下游长期效益的全部价值。这需要 FIGO 的紧急关注。