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Adipositas und Schwangerschaft

Obesity and pregnancy

  • Leitthema
  • Published:
Der Diabetologe Aims and scope

Zusammenfassung

Hintergrund

Adipositas bei Schwangeren stellt ein zunehmendes Problem dar, das mit z. T. gravierenden geburtshilflichen Problemen einhergeht. Betroffene Frauen mit Kinderwunsch sollten hierüber aufgeklärt werden, um sie zur Gewichtsabnahme vor der Schwangerschaft zu motivieren.

Risiken von Übergewicht bei Kinderwunsch

Sie nehmen mit dem BMI (Body-Mass-Index) der Frauen zu. Die Fertilität ist bei Adipositas reduziert. Bei adipösen Schwangeren ist das Risiko für einen Abort und kongenitale Fehlbildungen erhöht. Im Lauf der Schwangerschaft kommen Hypertonus, Gestationsdiabetes und hohe Frühgeburtenrate hinzu. Zudem steigt das Risiko, makrosome Kinder zu gebären. Häufig wird eine Entbindung per Sectio erforderlich.

Präventive Maßnahmen

Eine Gewichtsabnahme vor der Schwangerschaft ist wünschenswert. Vorbestehende Begleiterkrankungen müssen präkonzeptionell erfasst und behandelt werden. Schwangere nach bariatrischen Operationen haben einen signifikant günstigeren Schwangerschaftsverlauf als Frauen mit vergleichbarem BMI vor der Operation. Die Schwangerschaft muss jedoch engmaschig überwacht werden.

Abstract

Background

Obesity in pregnancy is an increasing problem which can be associated with multiple severe obstetrical problems. Women with a desire to become pregnant should be counseled about the adverse effect of obesity on fertility and pregnancy and be encouraged to lose weight before conception.

Risks of obesity on fertility

Risk increases with increasing BMI (body mass index). Fertility is reduced and after successful conception there is a higher risk for spontaneous abortion and congenital malformations. During pregnancy, there is a higher incidence of hypertension, gestational diabetes, and preterm delivery. In addition, the risk for fetal macrosomia increases. Delivery by C-section is often required.

Prevention

Weight loss prior to pregnancy is desired. Preexisting comorbidities must be detected preconceptually and treated. Women who have undergone bariatric surgery have a significantly more favorable outcome than women with comparable BMI before surgery. However, these pregnancies should be closely monitored.

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Authors and Affiliations

  1. Berliner Diabeteszentrum für Schwangere, Klinik für Gynäkologie und Geburtshilfe, Perinatalzentrum, St. Joseph Krankenhaus Berlin, Wüsthoffstraße 15, 12101, Berlin, Deutschland

    U. Schäfer-Graf

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Correspondence to U. Schäfer-Graf.

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U. Schäfer-Graf erhielt Vortragshonorare von Novo Nordisk, Sanofi und Berlin Chemie.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Schäfer-Graf, U. Adipositas und Schwangerschaft. Diabetologe 12, 6–12 (2016). https://doi.org/10.1007/s11428-015-0051-8

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  • DOI: https://doi.org/10.1007/s11428-015-0051-8

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