Uticaj maternalne gojaznosti na tok i ishod trudnoće i perinatalne komplikacije
Ključne reči:
gojaznost, prekoncepcijska gojaznost, prekomerni prirast telesne težine u trudnoći, faktori rizika u trudnoći, komplikacije u trudnoći
Sažetak
Učestalost gojaznosti je u porastu među ženama i muškarcima reproduktivne životne dobi i gojaznost je označena kao jedan od najznačajnih pretnji po zdravje čoveka u 21. veku. Trudnoća komplikovana gojaznošću smatra se visokorizičnom trudnoćom. Prekoncepcijska gojaznost i prekomern prirast u telesnoj težini u toku trudnoće su dva nezavisna riziko faktora po tok i ishod trudnoće, ali mogu imati i kumulativni efekat. Prekoncepcijska gojaznost je atropometrijski parametar sa najjačim stepenom korelacije sa perinatalnim komplikacija. Maternalna gojaznost nosi potencijalne antepartalne, intrapartalne i postpartalne komplikacije, poput hipertenzije u trudnoći, preeklampsije, gestacijskog dijabetes melitusa, prevremenog porođaja, tromboembolijskih komplikacija, distocije u porođaju, povećane učestalosti instrumentalno završenog porođaja i porođaja završenog carskim rezom. Fetalne komplikacije koje mogu da budu udružene sa koplikacijama maternalne gojaznosti su makrozomija ploda, povećana učestalost kongenitalnih anomalija, poput povećane učestalosti spine bifide i anomalija kardiovaskularnog sistema, prematuriteta i neonatalne smrt.
Smatra se da maternalna gojaznost predstavlja značajnu odrednicu u fetalnom programiranju, te da može biti precipitirajući faktor za nastanak oboljenja u toku života novorođenčeta.
Prekocpecijska gojaznost i prekomerni prirast u telesnoj težini u toku trudnoće potencijalno su promeljivi faktori rizika u trudnoći. Za razliku od mnogih koplikacija u trudnoće koje ne mogu da se predvide i stoga preveniraju, mogućnost kontrole telesne težine pre koncepcije i prirasta telesne težine u toku same trudnoće, naglašavaju značaj adekvatnog pristupa budućim majkama po ovom važnom, potencijalno promeljivom faktoru rizika.
Reference
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2. Satpathy HK, Fleming A, Frey D, Barsoom M, Satpathy C, Khandalavala J. Maternal Obesity and Pregnancy. Postgrad Med. 2008 Sep; 120(3):E01-9.
3. Heerman WJ, Bian A, Shintani A, Barkin SL. Interaction between maternal prepregnancy body mass index and gestational weight gain shapes infant growth. Acad Pediatr. 2014 Sep-Oct; 14(5):463-70.
4. World Health Orgaization. Body mass index – BMI. Available from: https://www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi [Accessed 9th July 2020].
5. National Heart, Lung, and Blood Institute. Calculate Your Body Mass Index. Available from: https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm [Accessed 9th July 2020].
6. Resnik R, Lockwood C, Moore T, Greene M, Copel J, Silver R, editors. Creasy and Resnik's Maternal- Fetal Medicine: Principles and Practice. 8th ed. Philadelphia: Elsevier; 2018.
7. Soma-Pillay P, Nelson-Piercy C, Mebazaa A, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovasc J Afr. 2016; 27(2): 89–94.
8. Mamun AA, Callaway LK, O'Callaghan MJ, Williams GM, Najman JM, Alati R, et al. A Lawlor. Associations of maternal pre-pregnancy obesity and excess pregnancy weight gains with adverse pregnancy outcomes and length of hospital stay. BMC Pregnancy Childbirth. 2011 Sep; 11:62.
9. Poston L, Caleyachetty R, Cnattingius S, et al. Preconceptional and maternal obesity: epidemiology and health consequences. Lancet Diabetes Endocrinol. 2016 Dec; 4(12):1025-1036.
10. Messinis IE, Messini CI, Dafopoulos K. Chapter 3 - Obesity in polycystic ovary syndrome and infertility. In: Mahmood TA, Arulkumaran S, Chervenak FA (eds). Obesity and Gynecology. 2nd edition. Amsterdam, Netherlands: Elsevier; 2020. p.23-34.
11. Cavalcante MB, Sarno M, Peixoto AB, Araujo Júnior E, Barini R. Obesity and recurrent miscarriage: A systematic review and meta-analysis. J Obstet Gynaecol Res. 2019 Jan; 45(1):30-38.
12. Simnah, HN. Antepartum Care of the Obese Patient. Clin. Obstet. Gynecol. 2016; 59(1):148-157.
13. Ahlqvist HV, Persson M, Magnusson C, Berglind D. Elective and nonelective cesarean section and obesity among young adult male offspring: A Swedish population–based cohort study. PLoS Med. 2019; https://doi.org/10.1371/journal.pmed.1002996.
14. Taylor C, Dominguez J, Habib A. Obesity And Obstetric Anesthesia: Current Insights. Local Reg Anesth. 2019; 12: 111–124.
15. Blondon M, Harrington LB, Boehlen F, Robert-Ebadi H, Righini M, Smith NL. Pre-pregnancy BMI, delivery BMI, gestational weight gain and the risk of postpartum venous thrombosis. Thromb. Res. 2016; 145:151-156.
16. Ramji N, Quinlan J, Murphy P, Crane J. The Impact of Maternal Obesity on Breastfeeding. J Obstet Gynaecol Can. 2016; 38(8): 703-711.
17. Howell K, Powell T. Effects of maternal obesity on placental function and fetal development. Reproduction. 2017; 153(3):97–108.
18. Zhang C, Wu Y, Li S, Zhang D. Maternal prepregnancy obesity and the risk of shoulder dystocia: a meta‐analysis. 2017; https://doi.org/10.1111/1471-0528.14841.
19. Sanchez CE, Barry C, Sabhlok A, Russell K, Majors A, Kollins SH, et al. Maternal pre-pregnancy obesity and child neurodevelopmental outcomes: a meta-analysis. Obes Rev. 2018; 19(4):464-484.
20. Godfrey KM, Reynolds RM, Prescott SL, Nyirenda M, Jaddoe VW, Eriksson JG, et al. Influence of maternal obesity on the long-term health of offspring. Lancet Diabetes Endocrinol. 2017; 5(1):53-64.
21. Rasmussen S, Chu S, PhD, Kim S, Schmid K, Lau J. Maternal obesity and risk of neural tube defects: a metaanalysis. Am. J. Obstet. Gynecol . 2008; 198(6): 611-619.
22. Case A, Ramadhani T, Canfield M, Beverly L, Wood R. Folic Acid Supplementation Among Diabetic, Overweight, or Obese Women of Childbearing Age. J Obstet Gynecol Neonatal Nurs. 2007; 36(4): 335-341.
23. Damm P, Houshmand-Oeregaard A, Kelstrup L, Lauenborg J, Mathiesen ER, Clausen TD. Gestational diabetes mellitus and long-term consequences for mother and offspring: a view from Denmark. Diabetologia. 2016; 59(7):1396-1399.
24. Gasse C, Boutin A, Demers S, Chaillet N, Bujold E. Body mass index and the risk of hypertensive disorders of pregnancy: the great obstetrical syndromes (GOS) study. J Matern Fetal Neonatal Med. 2019 Apr; 32(7):1063-1068.
25. Fan C, Wu Z, Tang Y, Huang X, Wang S. Prepregnancy body mass index and the risk of preeclampsia: a meta-analysis of cohort studies. Int J Clin Exp Pathol.2016; 9(3):3070-82.
26. Drife J. Deep venous thrombosis and pulmonary embolism in obese women. Best Pract Res Clin Obstet Gynaecol. 2015; 29(3):365-376.
27. McDonald SD, Han Z, Mulla S, Beyene J; Knowledge Synthesis Group. Overweight and obesity in mothers and risk of preterm birth and low birth weight infants: systematic review and meta-analyses. BMJ. 2010; 341:c3428.
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29. Krieger Y, Walfisch A, Sheiner E. Surgical site infection following cesarean deliveries: trends and risk factors. J Matern Fetal Neonatal Med. 2017 Jan; 30(1):8-12.
30. Smid MC, Vladutiu CJ, Dotters-Katz SK, Boggess KA, Manuck TA, Stamilio DM. Maternal obesity and major intraoperative complications during cesarean delivery. Am J Obstet Gynecol. 2017 Jun; 216(6):614.e1-614.e7.
31. Åmark H, Sirotkina M, Westgren M, Papadogiannakis N, Persson M. Is obesity in pregnancy associated with signs of chronic fetal hypoxia?. Acta Obstet Gynecol Scand. 2020 Jun; 00: 1– 8.
32. Kominiarek MA, Peaceman AM. Gestational weight gain. Am J Obstet Gynecol. 2017 Dec; 217(6):642-651.
33. Toma R, Aoki S, Fujiwara K, Hirahara F. Associations of pre-pregnancy obesity with adverse pregnancy outcomes and the optimal gestational weight gain in Japanese women. Clin Exp Obstet Gynecol. 2017;44(2): 190-194.
34. Smid MC, Kominiarek M. Child neurodevelopmental outcomes by pre-pregnancy body mass index and adequacy and timing of gestational weight gain. Am. J. Obstet. Gynecol. 2018 Jan; 218(1): S390.
35. Bogaerts A, Ameye L, Martens E, Devlieger R. Weight loss in obese pregnant women and risk for adverse perinatal outcomes. Obstet Gynecol. 2015; 125(3):566-575.
36. Agarwal P, Morriseau T, Kereliuk S, Doucette C, Wicklow B, Dolinsky V. Maternal obesity, diabetes during pregnancy and epigenetic mechanisms that influence the developmental origins of cardiometabolic disease in the offspring. Crit Rev Clin Lab Sci. 2018; 55(2): 71-101.
37. McPherson NO, Fullston T, Aitken RJ, Lane M. Paternal Obesity, Interventions, and Mechanistic Pathways to Impaired Health in Offspring. Ann Nutr Metab. 2014;64:231-238.
38. The International Weight Management in Pregnancy (i-WIP) Collaborative Group. Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials. 2017; 358: j3119.
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2020/09/15
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