A review of maternal overweight and obesity and its impact on cardiometabolic outcomes during pregnancy and postpartum.
A review of maternal overweight and obesity and its impact on cardiometabolic outcomes during pregnancy and postpartum.
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DOI：
10.1177/2633494120986544
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发表时间：
2021-01
影响因子：
3.4
通讯作者：
Moran LJ
中科院分区：
文献类型：
--
作者：
Grieger JA;Hutchesson MJ;Cooray SD;Bahri Khomami M;Zaman S;Segan L;Teede H;Moran LJ
孕妇超重和肥胖的比率以及妊娠期体重过度增加的比率正在增加。妊娠并发症，包括妊娠糖尿病、妊娠期高血压、先兆子痫和早产或生长受限婴儿的分娩，对于超重和肥胖的妇女以及怀孕期间体重增加过多的妇女来说都更高。多囊卵巢综合征等其他疾病也与超重和肥胖以及妊娠并发症恶化密切相关。所有这些情况都使妇女今后患心脏代谢疾病的风险增加。如果超重和肥胖，以及过度的妊娠期体重增加，可以减少育龄妇女，那么与妊娠并发症相关的多种合并症也可能在分娩后的几年内减少。这篇叙述性综述强调了母亲超重和肥胖与妊娠期体重增加、妊娠期糖尿病、先兆子痫、多囊卵巢综合征和早产或生长受限婴儿分娩之间的关系。这篇综述还讨论了这些不良条件如何与出生后的心脏代谢疾病联系在一起。我们报告说，虽然肥胖和妊娠期体重增加之间的独立关联在许多评估的不良状况中是明显的，但体重指数或妊娠期体重增加是否是其中许多不良状况的更强驱动因素目前尚不清楚。妊娠期糖尿病、妊娠期高血压、先兆子痫、早产和多囊卵巢综合征与心脏代谢疾病风险增加的机制是多因素的，但与超重和肥胖中也发现的心血管和炎症途径有关。产后心血管风险评估和后续护理的必要性仍然被忽视。对患有妊娠相关并发症的妇女进行这种早期发现和干预将大大降低患心血管疾病的风险。
The rates of maternal overweight and obesity, but also excess gestational weight gain, are increasing. Pregnancy complications, including gestational diabetes mellitus, gestational hypertension, pre-eclampsia and delivery of a preterm or growth restricted baby, are higher for both women with overweight and obesity and women who gain excess weight during their pregnancy. Other conditions such as polycystic ovary syndrome are also strongly linked to overweight and obesity and worsened pregnancy complications. All of these conditions place women at increased risk for future cardiometabolic diseases. If overweight and obesity, but also excess gestational weight gain, can be reduced in women of reproductive age, then multiple comorbidities associated with pregnancy complications may also be reduced in the years after childbirth. This narrative review highlights the association between maternal overweight and obesity and gestational weight gain, with gestational diabetes, pre-eclampsia, polycystic ovary syndrome and delivery of a preterm or growth restricted baby. This review also addresses how these adverse conditions are linked to cardiometabolic diseases after birth. We report that while the independent associations between obesity and gestational weight gain are evident across many of the adverse conditions assessed, whether body mass index or gestational weight gain is a stronger driving factor for many of these is currently unclear. Mechanisms linking gestational diabetes mellitus, gestational hypertension, pre-eclampsia, preterm delivery and polycystic ovary syndrome to heightened risk for cardiometabolic diseases are multifactorial but relate to cardiovascular and inflammatory pathways that are also found in overweight and obesity. The need for post-partum cardiovascular risk assessment and follow-up care remains overlooked. Such early detection and intervention for women with pregnancy-related complications will significantly attenuate risk for cardiovascular disease.
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DOI：
10.1111/1471-0528.15040
发表时间：
2018-07
期刊：
BJOG : an international journal of obstetrics and gynaecology
影响因子：
--
作者：
Catov JM;Muldoon MF;Reis SE;Ness RB;Nguyen LN;Yamal JM;Hwang H;Parks WT
通讯作者：
Parks WT
影响因子：
16.2
作者：
Black MH;Sacks DA;Xiang AH;Lawrence JM
通讯作者：
Lawrence JM
影响因子：
8
作者：
Boney, CM;Verma, A;Vohr, BR
通讯作者：
Vohr, BR
影响因子：
11.4
作者：
Cheney, Kate;Farber, Rachel;Black, Kirsten I.
通讯作者：
Black, Kirsten I.
影响因子：
5.5
作者：
Chen, Liwei;Shi, Lu;Chao, Shin Margaret
通讯作者：
Chao, Shin Margaret