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Le nouveau-né de mère obèse

The newborn of an obese mother

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Revue de médecine périnatale

Résumé

La grossesse chez la femme obèse augmente le risque de mort fœtale tardive, de décès néonatal précoce et de prématurité, particulièrement chez les femmes nullipares. Le risque de malformations fœtales est augmenté chez les femmes obèses et concerne les anomalies du tube neural, mais également d’autres organes comme le cœeur et le tube digestif. L’obésité maternelle modifie la croissance fœtale par l’augmentation de l’apport placentaire de nutriments; l’effet est une augmentation de la masse grasse. Le risque de morbidité néonatale tel que l’asphyxie périnatale, la détresse respiratoire et les traumatismes obstétricaux augmentent avec l’indice de masse corporelle maternel. La macrosomie et les morbidités maternelles associées à l’obésité, telles que l’hypertension et le diabète, contribuent probablement pour une part à l’augmentation de ces risques. De nombreuses données expérimentales ou épidémiologiques suggèrent que l’obésité pendant la grossesse, tout comme le diabète, contribue au déterminisme fœtal des maladies cardiovasculaires, de la résistance à l’insuline ou du diabète de type 2 et de l’obésité dès l’enfance et à l’âge adulte.

Abstract

Pregnancy in obese women increases the risk of late-term foetal demise, early neonatal death and prematurity, particularly in nulliparous women. The risk of birth defects is increased in obese women, and includes not only neural tube defects but also affects other organs, such as the heart and the digestive tract. Maternal obesity changes foetal growth through an increase in nutrients being passed through the placenta; the effect is an increase in body fat. The risk of neonatal morbidity, such as perinatal asphyxia, respiratory distress and obstetric trauma increases with maternal BMI. Macrosomia and maternal morbidity associated with obesity, such as hypertension and diabetes, are likely to partially contribute to the increase in these risks. Numerous experimental and epidemiological data suggests that obesity during pregnancy, as with diabetes, contributes to foetal susceptibility towards cardiovascular diseases, insulin resistance or type 2 diabetes and childhood and adult obesity.

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  1. Service de néonatologie, pôle de périnatalité, hôpital Armand-Trousseau, Sorbonne Université, UPMC, université Paris-VI, 26, avenue du Docteur-Arnold-Netter, F-75571, Paris cedex 12, France

    D. Mitanchez

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Mitanchez, D. Le nouveau-né de mère obèse. Rev. med. perinat. 8, 192–198 (2016). https://doi.org/10.1007/s12611-016-0384-6

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