Pränatale Prävention von Adipositas

Zusammenfassung

Das Adipositasrisiko von Kindern kann bereits vor deren Geburt programmiert werden. Präkonzeptionelles Übergewicht/Adipositas der Mutter, Rauchen in der Schwangerschaft, erhöhte Gewichtszunahme in der Schwangerschaft und Gestationsdiabetes sind pränatale Risikofaktoren, die durch eine Reihe von Kohortenstudien beschrieben wurden.

Die Effektstärke jedes einzelnen Faktors auf das Adipositasrisiko der Nachkommen sowie seine Prävalenz variieren dabei. Die so genannte populationsattributable Risikofraktion berücksichtigt Effektstärke und Prävalenz der Risikofaktoren und ermöglicht es so, abzuschätzen, für welchen Faktor ein stärkerer potenzieller Einfluss auf die Adipositasprävalenz in der Bevölkerung erwartet werden kann. Die aktuelle Datenlage zeigt, dass der größte Anteil am pränatal determinierten Adipositasrisiko durch präkonzeptionelle Adipositas der Mutter erklärt wird. Daher erscheinen Präventionsprogramme, die auf adipöse junge Frauen mit Kinderwunsch abzielen, am ehesten Erfolg versprechend für eine relevante Reduktion der Adipositasprävalenz bei Kindern, wenngleich viele Fragen zum Mechanismus der Risikofaktoren und Effektivität etwaiger Interventionen ungeklärt sind.

Summary

The risk for childhood obesity is supposed to be programmed before children’s birth. Several cohort studies identified maternal overweight/ obesity before pregnancy, smoking during pregnancy, gestational weight gain and gestational diabetes as important prenatal risk factors for childhood obesity.

Effect sizes of the risk factors and their prevalence in the population vary. The population attributable risk fraction takes both effect size and prevalence of the respective risk factor into account and thereby allows to estimate the potential effect of removing of the respective risk factors on the obesity risk in the population.

The current data show that maternal obesity before pregnancy is the most important prenatal determined risk factor for childhood obesity. Therefore, prevention programs targeting obese young women wishing to become pregnant appear to have the highest potential to reduce the obesity prevalence in children. However, the mechanisms underlying for the risk factors is not well understood and effectiveness of possible interventions is unclear.

Schlüsselwörter

Adipositas - pränatale Prävention

Keywords

Obesity - prenatal prevention

• Literatur

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