Möglichkeiten der Ernährungstherapie bei übergewichtigen schwangeren Frauen

Zusammenfassung

Übergewicht und Adipositas bei Frauen in gebährfähigem Alter sowie eine übermäßige Gewichtszunahme während der Schwangerschaft sind eindeutig assoziiert mit Schwan gerschaftskomplikationen (Präeklampsie, Gestationsdiabetes), Makrosomie und dem Risiko für das Neugeborene, im späteren Leben chronische Erkrankungen zu entwickeln. In diesem Zusammenhang ist nicht nur das Körpergewicht, sondern auch die kindliche Fettmasse bei Geburt ein wich-tiger prädiktiver Faktor für die Entstehung von Adipositas im Erwachsenenalter. Aktuelle Studien belegen, dass eine Lebensstilintervention bestehend aus einer Ernährungstherapie und körperlicher Betätigung günstige Effekte auf das mütterliche und kindliche Outcome haben. Die Empfehlungen zur Gewichtszunahme während der Schwangerschaft orientieren sich am Body-Mass-Index (BMI) vor der Schwangerschaft. Für eine adäquate Behandlung des Ge stationsdiabetes wäre die Einführung frühzeitiger Scree-ningmaßnahmen im Rahmen der Mutterschaftsrichtlinien wünschenswert. Aktuelle Ernährungsempfehlungen basieren derzeit auf wenigen Studiendaten, eine ausgewogene Ernährungsweise mit niedrigem glykämischen Index, die zu einem moderaten Gewichtsanstieg von maximal sechs bis acht Kilogramm führt, scheint bei adipösen schwangeren Frauen jedoch vorteilhaft zu sein.

Summary

Overweight and obesity in women of childbearing age as well as an excessive weight gain during pregnancy are clearly associated with complications during pregnancy (preeclampsia, gestational diabetes mellitus), macrosomia and the risk for the newborn of developing chronic diseases in later life. Therefore not only the body weight of the newborn, but also the neonatal fat mass has an impact for the onset of obesity. Recent studies suggest the beneficial effect of life style intervention programmes as a combination of nutritional medical therapy and physical activity. In future recommendations, weight gain during pregnancy, based on pre-pregnant BMI, has to be considered more consequently. An implementation of early screening tools within the maternity guidelines would be desirable for an adequate treatment of gestational diabetes mellitus. Evidence-based dietary recommendations for obese pregnant women are not available at the moment, but a balanced, low glycaemic index diet, which leads to a moderate weight gain of 6-8 kg during pregnancy, diet could be beneficial for obese pregnant women.

Schlüsselwörter

Übergewicht - Adipositas - Schwangerschaft - Gewichtszunahme - pränatale und neonatale Komplikationen - Ernährungsempfehlungen

Keywords

Overweight - obesity - pregnancy - weight gain - prenatal and neonatal complications - dietary recommendations

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