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Das Fetale Tabaksyndrom – Ein Statement der Österreichischen Gesellschaften für Allgemein- und Familienmedizin (ÖGAM), Gynäkologie und Geburtshilfe (ÖGGG), Hygiene, Mikrobiologie und Präventivmedizin (ÖGHMP), Kinder- und Jugendheilkunde (ÖGKJ) sowie Pneumologie (ÖGP)

The Fetal Tobacco Syndrome – A statement of the Austrian Societies for General- and Family Medicine (ÖGAM), Gynecology and Obstetrics (ÖGGG), Hygiene, Microbiology and Preventive Medicine (ÖGHMP), Pediatrics and Adolescence Medicine (ÖGKJ) as well as Pneumology (ÖGP)

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Summary

Over more than 50 years, the nocuous effects of smoking in pregnancy on the fetus are well known. In the first years of science the focus was primarily on restricted fetal growth while in more recent years over 10.000 studies investigated the incomparably big sum of detrimental effects for the unborn's health. In this statement we want to present the recent scientific findings on this topic. The statement is aimed to show all doctors who treat pregnant women the present situation and evidence. In the beginning we give a short overview about the epidemiological situation in Europe. Then we present step by step the health effects with regards to pathophysiology and clinics. Furthermore the reader will learn about possibilities for smoking cessation in pregnancy. The problem of passive-smoking in pregnancy will be dealt with in a separate chapter. At present there is strong evidence that pregnant smoking has a detrimental effect on birth-weight, placenta-associated disease, stillbirth, sudden infant death syndrome (SIDS), childhood overweight, clefts, lung function, asthma, cardiovascular diseases and mental developmental disorders. These factors can be summarized by the term Fetal Tobacco Syndrome. There is supply for more studies for less investigated health effects. Pregnancy is a chance to stop smoking as most women show a high motivation in this period. Hence doctors of all disciplines should inform pregnant women about the detrimental effects of smoking on their unborn child and show them possibilities for smoking cessation.

Zusammenfassung

Seit über 50 Jahren sind die schädigenden Wirkungen des Rauchens in der Schwangerschaft auf den Fetus bekannt. Während in den ersten Jahren v.a. der negative Einfluss auf das Wachstum untersucht wurde, zeigten über 10.000 Studien der letzten Jahre und Jahrzehnte die ungleich größere Fülle an Gesundheitsschäden auf das Ungeborene. In diesem Statement soll der aktuelle Stand der Forschung zu diesem Thema beleuchtet werden. Das Statement richtet sich dabei an alle ÄrztInnen, welche in der Betreuung von Schwangeren eingebunden sind, um ihnen die aktuelle Datenlage vor Augen zu führen. Es wird zunächst ein epidemiologischer Überblick über die derzeitige Situation in Europa gegeben, sowie einzelne Gesundheitsschäden aus pathophysiologischer und klinischer Sicht beleuchtet. Weiters werden dem Leser aktuelle Möglichkeiten der Prävention im Sinne einer Raucherentwöhnung der Schwangeren aufgezeigt. Dem Thema Passivrauchen in der Schwangerschaft wird ein eigenes Kapitel gewidmet. Aus heutiger Sicht kann davon ausgegangen werden, dass Rauchen in der Schwangerschaft einen starken und konsistenten negativen Einfluss auf das Geburtsgewicht, Plazenta-assoziierte Erkrankungen, Tot- und Frühgeburten, fetales Wachstum, plötzlichen Kindestot (SIDS), Übergewicht im späteren Kindesalter, Spaltbildungen, Lungenfunktion, Asthma bronchiale, kardiovaskuläre Erkrankungen sowie mentale Entwicklungsverzögerung und Verhaltensauffälligkeiten hat. Diese Faktoren sind aus heutiger Sicht unter dem Begriff "Fetales Tabaksyndrom" zu subsummieren. Einflüsse auf andere Gesundheitsaspekte sind weniger gut belegt und es sind noch weitere Studien nötig. Die Schwangerschaft stellt für viele Frauen eine sehr große Motivation dar, mit dem Rauchen aufzuhören. Mediziner unterschiedlicher Disziplinen sind daher gefordert, Frauen auf die schädigenden Effekte des Rauchens und die Möglichkeiten der RaucherInnenentwöhnung hinzuweisen und kompetent zu informieren.

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Correspondence to Fritz Horak Jr..

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Fritz Horak Jr., Tamas Fazekas and Angela Zacharasiewicz geteilte Erstautorenschaft der ersten drei Autoren.

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Horak, F., Fazekas, T., Zacharasiewicz, A. et al. Das Fetale Tabaksyndrom – Ein Statement der Österreichischen Gesellschaften für Allgemein- und Familienmedizin (ÖGAM), Gynäkologie und Geburtshilfe (ÖGGG), Hygiene, Mikrobiologie und Präventivmedizin (ÖGHMP), Kinder- und Jugendheilkunde (ÖGKJ) sowie Pneumologie (ÖGP). Wien Klin Wochenschr 124, 129–145 (2012). https://doi.org/10.1007/s00508-011-0106-9

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