孕妇超重和肥胖对子代神经和精神发育异常的影响及管理建议  

Influence of Maternal Overweight and Obesity on Child Neurological and Mental Development Disorders and Maternal Weight Management Recommendations

作　　者：杨冬[1] 段娜 李燕娜[1] 张军[1] YANG Dong;DUAN Na;LI Yanna;ZHANG Jun(Department of Obstetrics and Gynecology,Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院妇产科,北京市100029

出　　处：《中国全科医学》2020年第32期4027-4033,4046,共8页Chinese General Practice

摘　　要：流行病学研究发现孕期营养过剩、孕妇超重和肥胖可能影响子代神经系统及精神心理发育,本文通过总结和分析孕妇超重和肥胖对子代神经、精神发育异常的影响及机制进展,发现孕妇超重和肥胖可能增加子代罹患智力发育障碍、孤独症谱系障碍、注意缺陷多动障碍、焦虑与抑郁、精神分裂症、进食障碍和食物成瘾的风险,但是宫内环境影响子代神经精神系统发育的机制尚不明确,可能涉及氧化应激和炎性反应、大脑发育过程中胰岛素及葡萄糖和瘦素信号系统失调、多巴胺和5-羟色胺系统失调及反馈环路受损、以及脑源性神经营养因子介导的突触可塑性受损等。孕期体质量的合理管理可能会改善孕妇超重和肥胖对子代神经系统的不良影响,加强育龄女性社区保健工作是协助管理超重和肥胖孕妇的重要环节。Epidemiological studies have provided evidence that maternal overnutrition,overweight and obesity may affect child neurological and mental development.We overviewed and analyzed the recent prevalence of maternal overweight and obesity,and the adverse effects of maternal obesity on child neurological and mental development disorders,that is,which may lead to an increased risk of child intellectual developmental disorders,autism spectrum disorder,attention deficit hyperactivity disorder,anxiety and depression,schizophrenia,eating disorders and food addiction.Relevant mechanisms were also overviewed,but the mechanism concerning maternal intrauterine environment influencing child neurological and mental development disorders is yet not clear,which might involve increased oxidative stress and neuroinflammation,dysregulated insulin,glucose,and leptin signaling during brain development,dysregulated dopamine and 5-hydroxytryptamine systems and damaged feedback loop,and impairment of synaptic plasticity.Rational management of body weight during pregnancy may reduce the possible adverse consequences of maternal obesity and overweight on child's nervous system.Intensive community health care during pregnancy is an important intervention to manage obese and overweight pregnant women.

关 键 词：超重 肥胖症 妊娠 子代 神经系统发育异常 精神异常 影响因素 

分 类 号：R723.14[医药卫生—儿科] R74[医药卫生—临床医学]