公衆衛生74巻6号

2010年06月発行

特集 肥満とやせ

女性のやせと次世代への健康影響

著者： 堤誠司¹ 高田恵子¹ 倉智博久¹

所属機関： ¹山形大学医学部産科婦人科学教室

ページ範囲：P.484 - P.487

はじめに

　母体の妊娠前の体型と出生した児の転帰については国内外より数多くの報告がなされ，妊娠前のbody mass index(BMI)が高すぎても低すぎても，母児双方における合併症の危険性が上昇することが知られている．すなわち，妊娠する世代の女性の体型を標準に保つことが非常に重要である．

　妊娠前の肥満は妊娠糖尿病¹⁾，妊娠高血圧症候群²⁾，肩甲難産³⁾，帝王切開⁴⁾などのリスクを上昇させる．一方，「やせ」妊婦は安産であることが多いが，妊娠前のやせは早産⁵⁾や低出生体重児⁶⁾のリスクを上昇させる．

　近年の多くの疫学研究より，母体の妊娠前の体型は出産時の合併症に影響するのみならず，子どもの将来の生活習慣病が，受精時，胎芽期，胎児期，乳幼児期にその素因が形成され，その後の環境の作用を受けて疾病として発症することが明らかになりつつある．

参考文献

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13) Barker D, et al:Type 2(non-insulin-dependent)diabetes mellitus, hypertension and hyperlipidaemia(syndrome X);relation to reduced fetal growth. Diabetologia 36:62-67, 1993

14) Silver L, et al:Intrauterine growth restriction is accompanied by decreased renal volume in the human fetus. Am J Obstet gynecol 188:1320-1325, 2003

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16) Pham T, et al:Uteroplacental insufficiency increase apoptosis and alters p53 gene methylation in the full-term IUGR rat kidney. Am J Physiol Regul Integr Comp Physiol 285:R962-R970, 2003

17) Sinclair K, et al:DNA methylation, insulin resistance, and blood pressure in offspring determined by maternal periconceptional B vitamin and methionine status. PNAS 104:19351-19356, 2007

18) 厚生労働省　http://www.mhlw.go.jp/houdou/2009/11/dl/h1109-1b.pdf

19) 厚生労働省　http://www.mhlw.go.jp/toukei/list/81-1.html