RU-2861703-C2 - METHOD FOR PERINATAL PREVENTION OF OBESITY IN CHILDREN BORN TO MOTHERS WITH TYPE 1 DIABETES MELLITUS OR GESTATIONAL DIABETES AND/OR OBESITY

Abstract

FIELD: medicine. SUBSTANCE: invention relates to obstetrics and paediatrics, endocrinology, and can be used for preventing obesity in children born to mothers with type 1 diabetes mellitus or gestational diabetes and/or obesity. The first stage is carried out in the antenatal clinic by conducting lectures by doctors. The cycle of lectures is divided into 3 blocks according to trimesters. The second stage is the polyclinic stage, where lectures are conducted by a paediatrician. A chatbot for assessing the physical development of children is started. On days 3-4 of the child’s life, a laboratory assessment of blood levels of leptin and leptin receptors is performed. Throughout the early neonatal period, blood glucose levels are monitored, the child’s height and weight are measured, and the weight and height Z-score is assessed. EFFECT: reducing the incidence of obesity among the child population by monitoring the development of the newborn, educating mothers, and monitoring the most significant indicators in children. 1 cl, 3 dwg, 6 tbl, 2 ex

Inventors

• Alaverdian Lilit Samvelovna

Dates

Publication Date

20260507

Application Date

20240730

Claims (3)

1. A method for perinatal prevention of obesity in children born to mothers with type 1 diabetes mellitus or gestational diabetes and/or obesity, including the following steps:
2. The first stage is carried out in the antenatal clinic through lectures by obstetricians-gynecologists, pediatricians, endocrinologists, and a clinical psychologist. The lecture cycle is divided into 3 blocks by trimester, where they teach how to reduce the risks of complications during pregnancy, childbirth, and the postpartum period, and how to prevent the development of diabetic fetopathy in the fetus;
3. The second stage is the outpatient clinic, where a pediatrician conducts lectures discussing issues of child growth and development, as well as the proper introduction of complementary foods. At this stage, a chatbot is also launched to assess the physical development of children directly by parents. On the 3rd-4th day of the child's life, a laboratory assessment of leptin levels and leptin receptors in the blood is carried out. Throughout the early neonatal period, glucose levels are monitored, and the child's height and weight are measured with a Z-score for weight and height.

Description

The invention relates to the field of medicine, namely to obstetrics and pediatrics, endocrinology, and concerns methods for preventing obesity among the child population. Physical and neuropsychic development are among the most important criteria for children's health, which depend on many internal and external factors [1, 2]. Research conducted in recent years in various regions of Russia and abroad indicates a progressive increase in the prevalence of type 2 diabetes mellitus and obesity not only among adults but also among children [3, 4, 5, 1]. The high medical and social significance of these diseases and associated conditions that develop in childhood and the fact that their influence persists into later periods of life explains the relevance of research in this area. The reasons for the high prevalence of diseases with impaired glucose and lipid metabolism, as well as associated pathological conditions, most often include changes in diet, excessive consumption of fatty and sweet foods, decreased physical activity, and many other factors. Among all the well-known causes contributing to the development of obesity and diabetes, hidden causes associated with the early period of development - in utero and infancy - have become more clearly visible. The mechanisms of their action are determined by the processes of metabolic programming [6]. It is believed that the influence of maternal endocrine pathology during pregnancy on the fetus extends far beyond the perinatal period, increasing the risk of obesity and the emergence of health problems in childhood and adulthood [7, 6]. As early as 1957, Hayles and Barker proposed the “thrifty phenotype hypothesis”, explaining how insufficient availability of nutrients or poor nutrition in utero lead to impaired fetal growth and program structural and metabolic responses in the developing fetus [7]. Over 30 years, this hypothesis has evolved, covering the periconceptual period up to infancy, and describes how adverse effects arising at critical moments of development can affect the function and / or structure of organ systems in adulthood [7, 8]. Today, this hypothesis is called the “Origins of Health and Disease Hypothesis” (DOHaD). [7, 6, 2] In this regard, the understanding of the influence of the mother's endocrine status not only on the growth and development of the fetus-newborn-infant, but also on the development of its metabolism is increasingly expanding. It is generally accepted that among all endocrine diseases, diabetes mellitus and obesity have the most adverse effects not only on the course of pregnancy, but also on the intrauterine development of the fetus and adaptive capabilities [7, 2]. Key pathogenetic factors determining fetal-newborn-infant metabolism are adipokines, which play an important role in regulating not only lipid and glucose metabolism, but also in the development of insulin resistance [3, 9, 5]. Adipokines include leptin, adiponectin, resistin, visfatin, etc. The synthesis and secretion of adiponectin is stimulated by insulin and insulin-like growth factor-1 (IGF-1). It is known that leptin, ghrelin, and IGF-1 begin to perform their functions already in the prenatal period, and they not only pass from the mother to the fetus, but are also synthesized by the placenta, and in the later stages of pregnancy, by the fetus itself. Therefore, it is of interest to study not only these indicators, but also their relationship with metabolic indicators in pregnant women suffering from obesity and diabetes and the anthropometabolic characteristics of newborns and young children. Traditionally, a large number of studies have been devoted to the study of the condition of the fetus and newborns from mothers with type 1 diabetes mellitus and obesity [2, 3, 4, 5, 6, 10, 11]. In recent years, the number of publications devoted to children born to mothers with GDM has been increasing [2, 3, 6, 8, 9, 12, 11, 13, 14]. A number of endocrine, carbohydrate and water-electrolyte disorders that determine the course of the neonatal period have been identified. However, the literature practically does not discuss the issues of the health of these children in subsequent age periods. An analysis of the literature shows that the number of studies concerning the follow-up observation of this group of children is very limited [2, 4, 8, 14], and only a few of them have conducted a comparative analysis of the impact of various endocrine pathologies on the fetus and newborn. The goal is to reduce the incidence of obesity among the child population. This objective is achieved through careful monitoring of the development of the fetus-newborn-child, beginning with the pregnancy of a woman suffering from diabetes and obesity, as well as the implementation of monitoring algorithms for children at high risk of developing obesity and diabetes from the moment of birth, and the formation, through training, in mothers from the moment of pregnancy of a conscious approach to the