The impact of maternal obesity on fertility, pregnancy and labour

Uvod: Indeks telesne mase ? 30 vpliva na reproduktivno zdravje. Pojavijo se menstrualne disfunkcije, kar lahko vodi do neplodnosti. Povišan indeks telesne mase lahko vodi do zapletov med nosečnostjo, ki se lahko pokažejo kot hipertenzivna bolezen in gestacijski diabetes. Pride lahko tudi do spontanih splavov ali mrtvorojenega ploda, pri materi pa se lahko pojavi preeklampsija. Pri večini nosečnic lahko pride do nosečnosti preko porodnega termina, pogostejša je potreba po sproženju ali stimulaciji poroda. Porodnice z indeksom telesne mase ? 30 imajo tudi večje tveganje za poporodno krvavitev. Namen: Namen diplomskega dela je raziskati in ugotoviti, kako visok indeks telesne mase bodočih mater vpliva na plodnost, nosečnost in tudi na potek poroda, ter ugotoviti, ali so študenti babištva in zdravstvene nege tekom izobraževanja na Zdravstveni fakulteti Univerze v Ljubljani dobili dovolj znanja iz tega področja, da lahko svetujejo bodočim materam. Metode dela: V teoretičnem delu smo uporabili deskriptivno metodo raziskovanja. V empiričnem delu diplomskega dela smo uporabili kvantitativno metodo raziskovanja. Oblikovan je bil anketni vprašalnik, sestavljen iz devetnajst vprašanj zaprtega tipa. V raziskavi so sodelovali študenti 1., 2. in 3. letnika dodiplomskega visokošolskega študijskega programa babištvo in zdravstvena nega. Rezultati: Ugotovili smo, da indeks telesne mase ? 30 vpliva na menstrualni ciklus in pojav sindroma policističnih jajčnikov, s čimer se zmanjša plodnost. Prav tako indeks telesne mase ? 30 vpliva na večjo pojavnost spontanih splavov, mrtvorojenosti in razvojnih nepravilnosti pri novorojenčku. Pri porodu se lahko pojavijo številni zapleti, kot so: prezgoden porod ali porod po 42. tednu nosečnosti, oteženo spremljanje popadkov, več možnosti za carski rez in instrumentalni porod, poporodne krvavitve in težave z epiduralno anestezijo. Študenti babištva in zdravstvene nege imajo premalo znanja za obravnavo žensk v rodni dobi z indeksom telesne mase ? 30. Razprava in zaključek: Povišan indeks telesne mase zmanjša zmožnost zanositve in predstavlja dejavnik tveganja za pojav številnih zapletov med nosečnostjo in porodom. Na podlagi vseh ugotovitev je tako nujno potrebna primerna učinkovita obravnava bodočih mater in očetov s povišanim indeksom telesne mase. Ključnega pomena za to pa je ustrezna stopnja znanja s tega področja, ki pa jo, po rezultatih raziskave, trenutni študentje zdravstvene nege in babištva ne premorejo v zadostni meri.Introduction: Body mass index ⡥ 30 affects reproductive health. Menstrual dysfunctions occur, which can lead to infertility. An elevated body mass index can lead to complications during pregnancy, which can result in hypertensive disease and gestational diabetes. Spontaneous abortions or stillbirths may also occur, and the mother may develop preeclampsia. In most pregnant women, pregnancy may be prolonged, childbirth may stop, and the need to induce childbirth is more frequent. Pregnant women with a body mass index ⡥ 30 also have a higher risk of postpartum hemorrhage. Purpose: The aim of the diploma work is to research and determine how a high body mass index of expectant mothers affects fertility, pregnancy, and labour. In addition, we want to find out whether students of midwifery and nursing have acquired enough knowledge in this field during their education at the Faculty of Health Sciences of the University of Ljubljana to be able to advise expectant mothers. Methods: In the theoretical part, we used a descriptive research method. In the empirical part of the thesis, we used a quantitative research method. A questionnaire consisting of nineteen closed-ended questions was designed. Students of the 1st, 2nd, and 3rd year of the undergraduate higher education study program Midwifery and Nursing at the First-cycle higher professional education study programme Nursing of the University of Ljubljana participated in the research. Results: We established that body mass index ⡥ 30 affects the menstrual cycle and the occurrence of polycystic ovary syndrome, which reduces fertility. What is more, body mass index ⡥ 30 affects the higher incidence of spontaneous abortions, stillbirths and developmental abnormalities in the child. Many complications can occur during childbirth, such as premature birth or birth after 42 weeks of pregnancy, difficult monitoring of contractions, higher chances of cesarean section and instrumental childbirth, postpartum hemorrhage and problems with epidural anesthesia. We also established that students of midwifery and healthcare have insufficient knowledge of treating women of childbearing age with a body mass index ⡥ 30. Discussion and conclusion: An elevated BMI reduces the ability to conceive and is a risk factor for the occurrence of many complications during pregnancy and childbirth. Based on all the findings, appropriate and effective treatment of expectant mothers and fathers with elevated body mass index is urgently needed. Therefore, the appropriate level of knowledge in this field is vital, which, according to the results of the research, current students do not possess to a sufficient extent