Bewegung in Schwangerschaft und Stillperiode bei mütterlichem Übergewicht

 

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Zusammenfassung

Hintergrund: Regelmäßige körperliche Aktivität ist eine wichtige Komponente einer gesunden Schwangerschaft. Sport während einer Schwangerschaft auszuüben, führt aber häufig zur Verunsicherung und zu den Fragen: Wie viel und welchen Sport soll eine Schwangere ausüben? Während der Schwangerschaft führen erhebliche physiologische Veränderungen in der Hämodynamik, im Respirationstrakt, im muskuloskelettalen System, im Glucose-Stoffwechsel und im weiteren Endokrinium sowie in der Psyche zu tief greifenden Veränderungen, die sich mannigfaltig auf die Fitness und die sportliche Leistungsfähigkeit auswirken.

Diskussion: Es ist erwiesen, dass Frauen, die am meisten körperlich aktiv sind, die geringste Prävalenz an Gestationsdiabetes (GDM) aufweisen und darüber hinaus eine geringere Inzidenz von Adipositas und Diabetes Typ II bei Mutter und Kind festgestellt werden kann. Körperlich aktive Frauen entwickeln neben dem GDM auch seltener eine Präeklampsie. Der protektive Effekt von körperlicher Aktivität kann durch ein verbessertes Wachstum und eine verbesserte Vaskularisierung der Plazenta, durch einen verminderten oxidativen Stress, eine reduzierte Inflammation und eine Anpassung der krankheitsbezogenen endothelialen Dysfunktion erklärt werden. Eine Adipositas der Mutter erhöht die Infertilität und die Fehlgeburtsrate, und Gewichtsreduktionsprogramme mit Ernährungs- und Bewegungsmodulen sind eine kostengünstige Fertilitätsbehandlung, die darüber hinaus auch die Wahrscheinlichkeit von auftretenden gesundheitlichen Problemen während der Schwangerschaft reduziert. Ein hoher Fitnessgrat vor der Schwangerschaft und regelmäßige körperliche Aktivität nach der Konzeption können eine übermäßige Gewichtszunahme verhindern und den Gewichtsstatus nach der Schwangerschaft günstig beeinflussen.

Schlussfolgerungen: Unter Berücksichtigung allgemeiner Trainingshinweise, Vorsichtsmaßnahmen und Kontraindikationen ist ein moderates individuelles Training wünschenswert um die physische und psychische Fitness zu schulen. Viele Sportarten wie Joggen, Nordic Walking, Schwimmen und Radfahren können ohne Risiko und zur Gesundheit der zukünftigen Mutter und des Kindes durchgeführt werden.

Abstract

Background: Regular physical activity is an important component of a health pregnancy. Being physically active during pregnancy often creates uncertainty and leads to numerous questions: How much and which kind of sports is possible? In pregnant woman a lot of physiological changes are taking place in haemodynamics, in the respiratory system, in the muculoskeletal system, in the glucose metabolism, and in further endocrinological feedback systems besides the psyche and bring about changes in fitness and physical performance.

Discussion: There is evidence that the most active women show the lowest prevalence for gestational diabetes (GDM) and, moreover a lower incidence for obesity and diabetes in both mother and child. Physically active women rarely develop not only GDM but also pre-eclampsia. The protective effect of physical activity can be explained by an enhanced placental growth and vascularity, by decreased oxidative stress, reduced inflammation and an adaption of the disease-related endothelial dysfunction. Maternal obesity increases the frequencies of infertility and miscarriage. Weight loss programmes with nutritional advice and activity counsellings represent a cost-effective infertility treatment. Moreover the possibility of health problems during pregnancy are limited thereby. A high degree of fitness before pregnancy and regular physical activity before conception can prevent the excessive weight gain during pregnancy and influence the weight at the very best.

Conclusions: Considering common recommendations for training, as well as careful measures and contraindications, a moderate individual training to maintain physical and psychic fitness is desirable. Many kinds of sports like jogging, nordic walking, swimming and cycling, for example, can be carried out in a pregnancy without any risks and furthermore promote the health of the future mother and child.

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Korrespondenzadresse

Priv. Doz. Dr. med. Ulrike Korsten-Reck

Abteilung Rehabilitative und Präventive Sportmedizin

Medizinische Universität

Hugstetterstraße 55

79106 Freiburg

Phone: +49/761/270 7477

Fax: +49/761/270 7470

Email: ulrike.korsten-reck@uniklinik-freiburg.de