德国指南"怀孕中的肥胖":与国际方法的比较
Markus Schmidt1, U M Schaefer-Graf2
1Department of Gynecology and Obstetrics, Sana Clinics Duisburg, Zu den Rehwiesen 3, 47055, Duisburg, Germany. Markus.schmidt@sana.de.
Archives of gynecology and obstetrics
|January 5, 2024
概括
孕妇的肥胖需要专门的护理,因为怀孕,怀孕和分娩的风险. 指南提供基于证据的建议,用于管理肥胖妇女的高风险怀孕.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 公共卫生 公共卫生
背景情况:
- 肥胖是一个日益严重的全球健康问题,严重影响生育年龄的女性.
- 肥胖会对受孕,妊娠进展和新生儿的结果产生不利影响.
- 标准的产前护理越来越多地包含肥胖孕妇的管理策略.
研究的目的:
- 为了比较国家关于在怀孕期间管理肥胖的指导方针.
- 确定基于证据的建议,以改善对肥胖孕妇的护理.
- 突出国际准则中的差异和共同点.
主要方法:
- 关于肥胖和怀孕的主要国际指南的比较分析.
- 包括美国妇产科医生学院 (2021年),皇家妇产科医生学院 (2018年) 和加拿大妇产科医生协会 (2019年) 的指南.
- 与德国关于肥胖和怀孕的指南进行比较.
主要成果:
- 指导方针显示了微小的差异,但没有重大矛盾.
- 在高剂量叶酸和维生素D补充剂的建议中发现了差异.
- 在妊娠糖尿病查时间,胎儿生长监测和出生地点建议方面存在差异.
- 对于子宫内死亡风险的产业诱导协议有所不同,一般适用于BMI ≥40 kg/m2.
- 产后管理通常允许更长的分娩时间,并进行足够的胎儿监测.
- 产后护理建议包括鼓励生活方式;加拿大指南特别要求对产后抑郁症进行查.
结论:
- 所有审查的指南都将肥胖妇女的怀孕归类为高风险.
- 在计划怀孕的肥胖女性中,普遍强调预孕咨询.
- 对于肥胖孕妇的产前,产后和产后护理,需要特别考虑.
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