Overweight and Obesity before, during and after Pregnancy

Abstract

Overweight and obesity have become a global health problem. Obesity and excessive weight gain during pregnancy have a serious impact on maternal, fetal and neonatal outcomes. Pre-conceptional obesity and excessive weight gain during pregnancy are associated with weight gain in women following childbirth leading to associated risks such as metabolic syndrome, cardiovascular disease and diabetes. Long-term risks for the offspring are an increased risk for early cardiovascular events, metabolic syndrome and decreased life expectancy as adults. German health care has not yet adequately responded to this development. There are no clinical guidelines for obesity before, during or after pregnancy, there are no concerted actions amongst midwives, obstetricians, health advisors, politicians and the media. Research projects on effective interventions are lacking although health care concepts would be urgently needed to reduce future metabolic and cardiovascular risks for women and children as well as to minimize the associated costs for the society.

Zusammenfassung

Adipositas ist inzwischen ein globales gesundheitliches Problem. Adipositas und starke Gewichtszunahme in der Schwangerschaft haben in Industrieländern zu einer Zunahme von Komplikationen während der Gravidität geführt, die mütterliches und kindliches Outcome beeinträchtigen. Nicht nur die präkonzeptionelle Adipositas, sondern auch die übermäßige Gewichtszunahme während der Gravidität sind verantwortlich für eine Gewichtszunahme von Frauen nach der Geburt sowie den assoziierten Risiken wie metabolisches Syndrom, kardiovaskuläre Erkrankungen und Diabetes, aber auch für Langzeitrisiken der Kinder wie Adipositas, höhere Morbidität und frühere Sterblichkeit als Erwachsene. In Deutschland hat man bisher nicht adäquat auf diese Entwicklung reagiert – es gibt weder klinische Richtlinien für die Schwangerschaft, noch konzertierte Aktionen von Hebammen, Geburtsmedizinern, Gesundheitsberatern, Politik und Medien. Untersuchungsprojekte über effektive Interventionen fehlen. Dies alles wäre jedoch erforderlich, um die gesundheitlichen Risiken für Frauen und Kinder sowie die damit verbundenen Kosten für das Gesundheitssystem und letztlich für unsere Gesellschaft einzuschränken.

Key words

obesity during pregnancy - metabolic syndrome - diabetes - prevention

Schlüsselwörter

Adipositas in der Schwangerschaft - Metabolisches Syndrom - Diabetes - Prävention

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