Adipositas und fertilität. Auswirkungen einer "globalen epidemie" auf die menschliche reproduktion

Epidemiologic studies demonstrated that the prevalence of overweight and obesity is increasing in all age groups and social classes around the world. Obesity is regarded as a worldwide epidemic. The increasing body weight results from a combination of environmental and genetic influences. Today, several indices for quantifying obesity exist with the body mass index (BMI) being the most often used parameter. Overweight and obesity are regarded as health disturbances that lead to increased morbidity and mortality and in addition interfere with fertility. The reproductive axis is closely linked with the nutritional state of the organism. Especially an increase in abdominal adipose tissue interacts by messengers of fat cell metabolism with important homeostatic regulators of other organ systems. These neuroendocrine, endocrine, and metabolic modifications result in a tendency towards anovulation, a reduction in fecundity, and an increased risk for abortions. Furthermore pregnancies of obese patients show an increased risk of hypertensive disorders, a higher rate of gestational diabetes, a higher rate of fetal macrosomia, and a higher rate of cesarean deliveries.