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首页> 外文期刊>Reproductive toxicology >Prenatal origin of obesity and their complications: Gestational diabetes, maternal overweight and the paradoxical effects of fetal growth restriction and macrosomia.
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Prenatal origin of obesity and their complications: Gestational diabetes, maternal overweight and the paradoxical effects of fetal growth restriction and macrosomia.

机译：肥胖的产前起源及其并发症：妊娠期糖尿病，孕妇超重以及胎儿生长受限和巨大儿的悖论效应。

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摘要

Pregestational (PGDM) and gestational (GDM) diabetes may be associated with a variety of fetal effects including increased rate of spontaneous abortions, intrauterine fetal death, congenital anomalies, neurodevelopmental problems and increased risk of perinatal complications. Additional problems of concern are fetal growth disturbances causing increased or decreased birth weight. Optimal control of maternal blood glucose is known to reduce these changes. Among the long lasting effects of these phenomena are a high rate of overweight and obesity at childhood and a high tendency to develop the "metabolic syndrome" characterized by hypertension, cardio-vascular complications and type 2 diabetes. Similarly, maternal overweight and obesity during pregnancy or excessive weight gain are also associated with increased obesity and complications in the offspring. Although there are different causes for fetal growth restriction (FGR) or for fetal excessive growth (macrosomis), paradoxically both are associated with the "metabolic syndrome" and its long term consequences. The exact mechanism(s) underlying these long term effects on growth are not fully elucidated, but they involve insulin resistance, fetal hyperleptinemia, hypothalamic changes and most probably epigenetic changes. Preventive measures to avoid the metabolic syndrome and its complications seem to be a tight dietary control and physical activity in the children born to obese or diabetic mothers or who had antenatal growth disturbances for other known or unknown reasons.
机译：妊娠（PGDM）和妊娠（GDM）糖尿病可能与多种胎儿影响有关，包括自然流产率增加，子宫内胎儿死亡，先天性异常，神经发育问题以及围产期并发症的风险增加。另一个令人关注的问题是胎儿生长障碍导致出生体重增加或减少。母体血糖的最佳控制可减少这些变化。这些现象的长期影响包括儿童时期超重和肥胖的高发生率，以及以高血压，心血管并发症和2型糖尿病为特征的“代谢综合征”的发展趋势。同样，孕期孕妇超重和肥胖或体重增加过多也与肥胖和后代并发症增加有关。尽管造成胎儿生长受限（FGR）或造成胎儿过度生长（巨人症）的原因不同，但矛盾的是，两者均与“代谢综合征”及其长期后果有关。这些长期影响生长的确切机制尚未完全阐明，但涉及胰岛素抵抗，胎儿高瘦素血症，下丘脑改变以及最有可能的表观遗传改变。预防代谢综合征及其并发症的预防措施似乎是肥胖或糖尿病母亲或因其他已知或未知原因患有产前生长障碍的孩子的严格饮食控制和身体活动。

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