ABSTRACT
Perinatal Morbidity and Mortality ..................................... 102 5.2.4 Foetal and Neonatal Short-Term Outcomes ..................................... 103
5.2.4.1 Foetal Overgrowth ............................................................. 103 5.2.4.2 Shoulder Dystocia and Brachial Plexus Injury .................. 104 5.2.4.3 Respiratory Distress Syndrome ......................................... 105 5.2.4.4 Neonatal Hypoglycaemia ................................................... 105 5.2.4.5 Hyperbilirubinaemia and Jaundice .................................... 106 5.2.4.6 Polycythaemia .................................................................... 106 5.2.4.7 Calcium and Magnesium Abnormalities ........................... 106 5.2.4.8 Preterm Delivery ................................................................ 106
5.2.5 Foetal and Neonatal Long-Term Outcomes ...................................... 107 5.2.5.1 The Concepts of Foetal Programming and Metabolic
Memory .............................................................................. 107 5.2.5.2 Metabolic Syndrome, Obesity, and Type 2 Diabetes ......... 107 5.2.5.3 Cardiovascular Risk ........................................................... 108
5.3 Summary ...................................................................................................... 108 References .............................................................................................................. 109
In 1988, Reaven1 proposed that resistance to insulin-stimulated glucose uptake (insulin resistance) and secondary hyperinsulinaemia are involved in the aetiology of three major related diseases: cardiovascular disease, type 2 diabetes mellitus, and hypertension. He coined the term syndrome X, which was later modified to metabolic syndrome. Metabolic syndrome describes a group of abnormalities that increase the risk for cardiovascular disease: resistance to insulin-stimulated glucose uptake, glucose intolerance, hyperinsulinaemia, increased triglyceride, decreased HDL cholesterol, and hypertension. Obesity is the most important risk factor for metabolic syndrome. In the National Health and Nutrition Examination Survey (NHANES) metabolic syndrome was present in 4.6, 22.4, and 59.6% of normal weight, overweight, and obese men, respectively.2 Insulin resistance and hyperinsulinaemia may be the basic common ground of elevated blood pressure and type 2 diabetes mellitus. Both diseases predispose to long-term cardiovascular complications.
