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Risk factors pathological GUMT

Besides initial mass, certainly, playing the major role in deter - minatsii GUMT, certain corrective amendments in weight change at pregnancy can bring others medicobiological and social and economic fakto - ry.

To biological, in particular, it is possible to carry growth of the woman: high usually type more, and - it is less than woman of small growth [152, 168]. It is necessary to notice, that in «WeightGainDuringPregnancy» (2009) growth is excluded from number of factors modifying mass [243]. There are data and about nasledst - vennoj to the nature of pathological augmentation of weight. It is shown, that exist

Certain associations between presence of those or other genes and probability of a pathological gain of mass at patients with gestatsionnym diabetes. At the same time at uncomplicated diabetes of pregnancy of communication GUMT with maternal and fruit genetic determinants of adiposity it is not revealed [268, 330].

One more important medicobiological factor rendering vlija - nie on metabolic processes in a human body, is the age. Because in a modern society the tendency to more pozd - it realisation of genesial function is accurately traced, negative influence age izme - neny a metabolism on a pregnancy current gets a special urgency. So, some researchers carry advanced age of pregnant women to risk factors of a pathological increase of weight. Depression occurring with the years chuv - stvitelnosti peripheric tissues and their receptors to insulin action can serve as a risk factor excessive GUMT [65, 289, 424]. Add - telnym with the burdening moment can be and that by 35 years of the woman authentically suffer excess weight at which, as is known, chrez - measured GUMT meets more often [324 is more often, 390].

On the other hand, it is shown, as juvenile pregnant women have high risk of an excessive gain of weight – to 30 % of teenagers type for the period gestatsii 20 kg and more. Authors bind this fact to not generated metabolism and weak motivation at teenagers [302]. Besides, unlike the senior wives - shchin which after sorts come back to the initial weight is more often, podro - stki with excessive GUMT in 1-1,5 years have IMT on 10 kg/m2 and more in comparison with initial [206, 324]. It is shown, that primapara the patient - ki type excess of weight, than multigiving birth [251, 339] is more often.

The expressed forms of an early toxicosis with loss more than 5 % initial mas - sy bodies are quite often accompanied by an insufficient increase of mass, even nesmot - rja on higher caloric content of consumed nutrition [115, 301].

Besides medicobiological factors, on level gestatsionnogo uve - lichenija masses influence renders also social and economic position of wives -

shchiny. So, according to some authors, married women have an adequate increase of weight, while lonely and dissolved, on - against, insufficient or superfluous [317] is more often. Probably, it is bound with emotsio - nalnym discomfort and low social support of these women [344]. In families with the low income of the woman type larger weight that is caused not - by a high-grade food and insufficient level of physical activity, koto - rye provide a positive power balance [322].

High educational level as it is paradoxical, assotsiirovan with high frequency of a superfluous increase, and, on the contrary, having little education wives - shchiny quite often have insufficient GUMT [182, 203].

At the same time issledova - nie N.Holowko from co-workers. (2013), shows opposite results – 48 % of women with initial and secondary education have added more rekomen - blown, that in 1,3-1,8 times more often, than at finished HIGH SCHOOLS [226].

From the exogenous factors defining a metabolism, one of the major is smoking. To third of young women are subject to this harmful privych - ke, and the majority does not refuse it even during pregnancy. Data about size gestatsionnoj increases of mass of a body at smokers are ambiguous. Results are defined, basically, whether the woman has stopped smoking during pregnancy. Some authors do not find essential influence ku - renija on increases of weight [339]. Others come to conclusion, that the termination to a hen - nija in 5 times enlarges risk of a superfluous gain of mass [152, 166]. Among about - dolzhajushchih smoking on the average increases of mass more low, and the risk insufficient GUMT is enlarged in 1,3 times that negative impact on growth of a foetus [189] makes. Thus many researchers underline, that the probability of a birth malovesnogo the child does not depend on size gestatsionnoj increases of mass of a body at mother and kalorazha consumed nutrition. At comparison of group of smokers and smokers with rather identical augmentation of mass kalorazh nutrition has rendered - sja above at smokers, but it did not reduce probability of a birth of the child with for - derzhkoj development [189, 374]. Taking into account toxic action of a tobacco smoke on fetoplacental system birth prevention malovesnogo the child at

Smoking mother demands augmentation of mass at 19-27 kg, that, in turn, gro - zit a delay of a postnatal reduction of mass of a body [319]. Therefore the advantage of a log hut - of an exact gain of mass of a body of mother in interests of a foetus appears rather with - hypochondriac as tobacco action is not limited only to influence on a physical fetation [293, 314, 331].

Besides, it is necessary to consider, that refusal of smoking can have potentsial - nye dangers, but already concerning mother. The smoking termination, according to some researches, in 2-5 times enlarges risk of an excessive increase of weight [145, 152, 364]. It is possible to consider as the positive moment and that smokers zhenshchi - ny enter pregnancy a lot of mass less often and less often have it is nuju an increase, that along with other pathogenetic mechanisms reduces risk of development gestoza [239, 168, 378].

However, despite such protective effect in the relation gestoza, ku - renie can promote development gestatsionnogo a diabetes. Issle - dovanie, spent by the American scientists within the limits of studying of possibilities of use of calcium for preeclampsia preventive maintenance, has shown formation expressed insulinorezistentnosti at a tobacco smoking [211].

In the literature we have met interesting data about risk augmentation pato - logic GUMT at treatment of pregnant women by iron preparations. Authors ob - jasnjajut such paradox that «excess of atoms of iron can result and in intensifying oxidising fosforilirovanija in tissues, that is accompanied uve - licheniem a stock of energy in the form of ATF (and, as consequence, by an increase of mass of a body), unlike oxygen-free disintegration of fibers, Adepses and carbohydrates» [89].

Despite influence which can render listed above fak - tory, from the biological point of view, any change of mass of a body is defined by balance arriving with nutrition and energy spent at physical activity. But, if for nonpregnant this statement is an axiom at pregnant women business is differently. Even at an ideal power balance of normal pregnancy the prevalence of anabolic processes over kataboli - cheskimi is inherent, that is accompanied by augmentation of weight of the woman [19]. Besides, dock -

zano, that level of physical activity brings the insignificant contribution to the general energotraty an organism, therefore he does not play an essential role in gestatsion - nomas mass accumulation, including fatty [172, 414]. At the same time, to a being - et and other point of view. In the foreign literature there is an opinion that regular moderate exercise stresses at pregnancy support - vajut optimum weight during pregnancy and after a delivery at the expense of reduction of an increase of mass on the average on 3 kg [383]. Researches have shown, that in 1 and 2 trimesters of pregnancy of a difference between physically active and neak - tivnymi women practically are not present. The physical divergence brings the basic contribution to augmentation of fatty mass in late durations of gestation [167, 325]. Other authors, on the contrary, underline importance of changes in the second trimester gestatsii: Intensive employment by physical culture rez - to reduce at this time risk of a pathological increase of mass that can be bound about augmentation of a power consumption [382]. Such difference of results, from our point of view, can speak methodological features of researches. For example, at adiposity and excess of mass of a body augmentation physical the assets - nosti leads also to depression insulinorezistentnosti and, accordingly, to reduction of risk of an excessive gain of weight. At women with normal mass of a body this pattern is not traced [258]. At the same time, the question on a cart - mozhnosti employment by physical culture during pregnancy remains diskutabel - nym. In 5 from 11 researches generalised by the regular analysis Kokrej - novskoj databases, it is shown, that fitness significantly improves maternal and perinatalnye outcomes, including at the expense of optimisation of increases of weight. Including one of them has shown, that the women sharply reducing on - gruzki to the extremity of pregnancy gave birth to larger children at big razme - rah placentas [248].

But if concerning physical activity at pregnancy of opinion of researchers disperse, that concerning it pregravidarnogo level prak - ticheski all authors are unanimous - a disadvantage of physical activity to bere - mennosti which test depending on age of 20-25 % of women de -

torodnogo age, is a serious risk factor pathological at - bavki body masses [167, 302, 334]. This fact, possibly, is mediated close svja - zju masses of a body and physical activity out of pregnancy. As with offensive of pregnancy activity of women progressively decreases, and its deficiency test to 85 % of women [190].

From all factors influencing on gestatsionnuju an increase of mass of a body, neso - mnenno, the most essential contribution to it brings a food. It is known, that bere - mennost does not demand the big augmentation kalorazha nutrition, in larger degree the optimum diet should provide future mother and feeding woman with enough micro-and makronutrientov [146, 276, 310]. Despite it, for last decades the sharp augmentation power value of a ration both in whole in population, and among pregnant women [309, 408] is noted. Besides, even at adequate energopotreblenii actual pi - tanie pregnant women often has disadvantages: deficiency of fibers (to 30 %) and phytogenesis Adepses (to 25 %). The special attention is deserved by the patient with superfluous mass of a body and adiposity.

Important role in formation of alimentary disturbances at it is pregnant - sti plays a stereotype of behaviour of the patient, developed during a life [334]. In the families which are not adhering to norms of a healthy food, pregnant women not only type larger weight during time gestatsii, but also are inclined to a delay of mass after sorts with the subsequent development of adiposity [420]. The given tendency is similar and for those who consumes too many calories, and, on the contrary, is inadequate og - ranichivaet itself in nutrition, i.e. fasts [316]. Disturbances of alimentary behaviour at them it is quite often characterised by augmentation of appetite and hyperalimentation excesses during evening and night time of days, reduction of quantity of food intakes less than 3 times/days [32, 40, 358]. Such defects as it has been shown earlier, lead dos - tovernomu to rising of mass of a body, level leptina and S-peptida to blood on an empty stomach [17].

It is necessary to notice, that pregnancy as a whole renders salutary vlija - nie on a food regularity. If before pregnancy only couples -

vert the surveyed are observed by a diet to the third trimester prak - ticheski all (88 %) enlarge frequency rate of a food to 4-6 times a day, and third (38 %) thus correctly distributes an alimentary load [18].

A wrong food with superfluous consumption of Adepses can sprovo - tsirovat gestatsionnyj diabetes irrespective of initial weight of the woman [196]. The high-caloric diet of mother during pregnancy can lead to adiposity at children. In researches nejrofiziologov, spent to University - sitete Rockefeller, it is shown, that excess of triglycerides in blood of mother provo - tsiruet production of the proteins responsible for stimulation of appetite in a brain of a foetus [141].

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A source: Pokusaeva Vita Nikolaevna. PATHOLOGICAL AUGMENTATION of MASS of the BODY AT PREGNANCY: the PATHOGENESIS, PERINATALNYE, GRAVIDARNYE And postgravidarnye COMPLICATIONS. The dissertation on competition of a scientific degree of the doctor of medical sciences. Smolensk - 2014. 2014

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