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(Über‑)Ernährung und Einfluss auf die Funktion der Plazenta

Veränderungen im maternofetalen Austausch bei Adipositas und Gestationsdiabetes

(Over‑)Nutrition and its impact on placenta function

Changes in maternal–fetal exchange in obesity and gestational diabetes

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Die Diabetologie Aims and scope

Zusammenfassung

Für eine optimale Entwicklung des Fetus ist ein adäquater Austausch von Nährstoffen über die Plazenta unabdingbar. Die Schwangerschaft stellt ein höchst sensitives Zeitfenster dar, in dem Fehlernährung, Adipositas sowie damit einhergehende Stoffwechselveränderungen wie Diabetes mellitus die fetale und kindliche Gesundheit lebenslang prägen können. Eine entscheidende Rolle in diesem Kontext übernimmt die Plazenta, welche als erstes maternofetales Kontaktorgan zum einen die durch mütterliches Übergewicht/Adipositas und/oder Gestationsdiabetes veränderten Nährstoffe an den Fetus weitergibt, zum anderen auf in diesem Zusammenhang veränderte Nährstofftransportmechanismen zurückgreifen muss. Der kindliche Organismus wird durch diese unphysiologischen Bedingungen geprägt. Eine solche Fehlprogrammierung der kindlichen Organfunktionen und Stoffwechselregulationen stellt die Basis für sich später bei den Nachkommen entwickelnde chronische Krankheiten dar wie Adipositas, Diabetes mellitus oder kardiovaskuläre Erkrankungen. In diesem Beitrag wird ein aktueller Überblick über Ernährungsempfehlungen in der Schwangerschaft, Funktion und Nährstofftransport in der Plazenta, maternofetale Transportprozesse sowie Aspekte der plazentaren immunologischen Prozesse gegeben – stets mit speziellem Fokus auf Veränderungen bei Gestationsdiabetes und Adipositas.

Abstract

An adequate exchange of nutrients via the placenta is of particular importance for optimal growth of an unborn fetus. Therefore, pregnancy represents a highly sensitive time frame where an inadequate or unbalanced diet together with overweight/obesity or related metabolic conditions such as gestational diabetes can impact infant health for life. Of particular importance is the placenta as the first fetal–maternal contact organ. Both nutrient availability and placental nutrient transporters are characterized by the obesogenic/diabetic phenotype of the mother and impact fetal development. Disturbed fetal programming of organ function and metabolic processes will increase the risk for later development of chronic diseases such as obesity, type 2 diabetes or cardiovascular disease. In this review, current dietary guidelines during pregnancy, function and nutrient transport in the placenta, fetal–maternal exchange, and aspects involving placental immunological pathways are presented with a particular focus on changes induced by obesity and/or gestational diabetes.

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Authors and Affiliations

  1. Department Umweltimmunologie, Helmholtz-Zentrum für Umweltforschung – UFZ, Leipzig, Deutschland

    Kristin M. Junge &  Ana C. Zenclussen

  2. Institut für Agrar- und Ernährungswissenschaften, Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland

    Kristin M. Junge

  3. Perinatale Immunologie, Sächsischer Inkubator für klinische Translation (SIKT), Medizinische Fakultät, Universität Leipzig, Leipzig, Deutschland

    Ana C. Zenclussen

  4. Universitätsklinik für Frauenheilkunde und Geburtshilfe, Medizinische Universität Graz, Graz, Österreich

    Gernot Desoye

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  1. Kristin M. Junge
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  2. Ana C. Zenclussen
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  3. Gernot Desoye
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Correspondence to Kristin M. Junge or Gernot Desoye.

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K. Junge, A.C. Zenclussen und G. Desoye geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Junge, K.M., Zenclussen, A.C. & Desoye, G. (Über‑)Ernährung und Einfluss auf die Funktion der Plazenta. Diabetologie 19, 747–757 (2023). https://doi.org/10.1007/s11428-023-01087-4

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