4 курс / Акушерство и гинекология / Гинекология 2010 №05
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но-плацентарную систему, предотвращает формирование врожденных пороков развития.
Особенность питания российских женщин во время беременности – недостаточное поступление эссенциальных микронутриентов при избыточном поступлении углеводов (картофель, хлеб) и насыщенных жиров (сливочное масло, сметана, свинина). Такого рода питание не способствует ни здоровью матери, ни рождению здорового ребенка. Более того, дефицит витаминов и микроэлементов на фоне избытка углеводов и насыщенных жиров провоцирует ожирение и диабет, являющиеся наиважнейшими факторами риска макросомии. Ятрогенные причины макросомии включают употребление адреномиметиков и кортикостероидных препаратов. Для профилактики макросомии следует использовать персонализированный подход к фармакотерапии, ограничить потребление углеводов и насыщенных жиров до беременности и тем более во время нее. Для беременных с ожирением и диабетом необходимо разработать индивидуальную диету, особо строгую во второй половине беременности. В диету важно включить достаточное количество зеленолистых растений, несладких свежих фруктов (гранат, яблоки, апельсины), паровой рыбы и нежирного молока. Дополнение диеты регулярным приемом высококачественных витаминно-минеральных комплексов (например, препарат Элевит Пронаталь, характеризующийся высоким уровнем доказательности в акушерстве) будет являться способом профилактики нарушения углеводного обмена у беременной и макросомии плода.
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