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16.08.2023 | Intrauterine Wachstumsrestriktion | Leitthema

Prävention ungünstiger metabolischer Prägung bei intrauteriner Wachstumsrestriktion

verfasst von: Dr. Kai-Dietrich Nüsken, Anne Tauscher, Jörg Dötsch, Holger Stepan, Eva Nüsken

Erschienen in: Die Diabetologie | Ausgabe 6/2023

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Zusammenfassung

Eine intrauterine Wachstumsrestriktion („intrauterine growth restriction“ [IUGR]) tritt in etwa 5–8 % aller Schwangerschaften auf und ist häufig auf eine intrauterine Mangelversorgung zurückzuführen. Entscheidend für die Diagnose ist nicht das Geburtsgewicht, sondern ein die Perzentilen kreuzendes, reduziertes intrauterines Wachstum. Da eine IUGR das Risiko für metabolische und nichtmetabolische Folgeerkrankungen erhöht, sollte die Diagnose nicht nur von der geburtshilflichen zur neonatologischen Station übergeben werden, sondern auch später behandelnden KollegInnen aus Allgemeinpädiatrie, Allgemeinmedizin und Innerer Medizin bekannt sein. Die tatsächliche Manifestation von Folgeerkrankungen hängt stark von weiteren Einflussfaktoren während des gesamten Lebens ab. Insbesondere in der postnatalen Entwicklungsphase können sich individuell angepasste Umweltbedingungen (z. B. Dauer der Stillzeit, Zusammensetzung der frühkindlichen Ernährung) langfristig präventiv auswirken.

In der vorliegenden Übersichtsarbeit wird zunächst auf Ätiologie, Diagnostik und Management der IUGR eingegangen. Zudem werden epidemiologische und experimentelle Daten dargestellt, die den Zusammenhang zwischen IUGR und späterer metabolischer Erkrankung illustrieren. Hieraus abgeleitet werden die Möglichkeiten präkonzeptioneller und pränataler präventiver Maßnahmen diskutiert und Ansätze postnataler Strategien zur Prävention metabolischer Folgeerkrankungen erläutert.

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Titel: Prävention ungünstiger metabolischer Prägung bei intrauteriner Wachstumsrestriktion
verfasst von: Dr. Kai-Dietrich Nüsken
Anne Tauscher
Jörg Dötsch
Holger Stepan
Eva Nüsken
Publikationsdatum: 16.08.2023
Verlag: Springer Medizin
Schlagwörter: Intrauterine Wachstumsrestriktion
Typ-2-Diabetes
Mangelernährung
Übergewicht
Fettleber
Erschienen in: Die Diabetologie / Ausgabe 6/2023
Print ISSN: 2731-7447
Elektronische ISSN: 2731-7455
DOI: https://doi.org/10.1007/s11428-023-01079-4

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