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Der Gynäkologe

, 44:847 | Cite as

Schwangerschaft und Sport

Teil 1: Folgen für Mutter und Kind
  • U. Korsten-ReckEmail author
Frauengesundheit in der Praxis

Zusammenfassung

Körperlich aktiv zu sein während der Schwangerschaft führt noch immer zu Verunsicherung und zu Fragen: Wie viel und welchen Sport soll eine Schwangere ausüben, welche Folgen entstehen für Mutter und Kind? Während der Schwangerschaft führen erhebliche physiologische Veränderungen in der Hämodynamik, im Respirationstrakt, im muskuloskelettalen System, im Glukosestoffwechsel und im weiteren Endokrinium sowie in der Psyche zu tief greifenden Veränderungen, die sich mannigfaltig auf die Fitness und die sportliche Leistungsfähigkeit auswirken. Unter Berücksichtigung allgemeiner Trainingshinweise, Vorsichtsmaßnahmen und Kontraindikationen ist ein Training entsprechend dem Fitnessgrad der Mutter zum Erhalt physischer und psychischer Fitness möglich und wünschenswert. Viele Sportarten (Joggen, Nordic Walking, Schwimmen, Radfahren u. a.) können in einer Schwangerschaft ohne Risiko betrieben werden. Die Auflockerung des Bindegewebes und die konsekutiven Bandinstabilitäten müssen sorgfältig bezüglich der aeroben Belastbarkeit berücksichtigt werden. Die Verletzungsgefahren bestehen bei fortgeschrittener Schwangerschaft in einer direkten Traumatisierung des Feten. Durch regelmäßige körperliche Aktivität wird ein gesünderer Lebensstil gepflegt, weiter wird schwangerschaftsbedingten Erkrankungen und deren Folgen vorgebeugt.

Schlüsselwörter

Schwangerschaftskomplikationen Glukosestoffwechsel Anpassungsvorgänge Sauerstoffbilanz Gestationsdiabetes 

Pregnancy and sports

Part 1: Sequelae for mother and child

Abstract

Being physically active during pregnancy often leads to uncertainty and questions: how much and which kinds of sport are possible? Changes in fitness and physical performance in pregnant women arise due to many physiological changes in hemodynamics, the respiratory system, the musculoskeletal system, glucose metabolism, endocrinological feedback and also in the psyche. Considering general recommendations for training, careful measures and contraindications, moderate or even vigorous training is possible depending on the individual mother’s fitness and desirable to maintain physical and emotional fitness. Many kinds of sport such as jogging, nordic walking, swimming and cycling can be carried on during pregnancy without risk and promote the health of both mother and child. However, the mother’s increasing weight and the resultant instability of ligaments must be kept carefully in mind to create a moderate aerobic workload. The danger of injury is present in later pregnancy and may lead to fetal trauma. For the pregnant woman a serious injury also includes the risks involved in the diagnostics and therapy. Regular physical activity means paying regular attention to a healthy lifestyle. This prevents diabetes, obesity, hypertension, thromboembolic deseases and their consequences in the mother’s life but also the child’s well-being.

Keywords

Pregnancy, complications Glucose metabolism Adaptive procedure Oxygen balance Gestation diabetes 

Notes

Interessenkonflikt

Die korrespondierende Autorin gibt an, dass kein Interessenkonflikt besteht.

Literatur

  1. 1.
    Clapp JF (2000) Exercise during pregnancy. A clinical update. Clin Sports Med 19(2):273–286PubMedCrossRefGoogle Scholar
  2. 2.
    Huch R (1987) Pregnancy and professional activity. Arch Gynecol Obstet 242(1–4):599–609 242(1–4):599–609Google Scholar
  3. 3.
    Wurster KG (1998) Sport in der Schwangerschaft und Stillzeit. In: Die Besonderheiten des Sports bei Mädchen und Frauen. Sportärtzeschaft WürttembergGoogle Scholar
  4. 4.
    Korsten-Reck U, Marquardt K, Wurster KG (2009) Schwangerschaft und Sport (Pregnancy and Sports). Deutsche Zeitung für Sportmed 60(5):117–121Google Scholar
  5. 5.
    Zhang C, Solomon CG, Manson JE, Hu FB (2006) A prospective study of pregravid physical activity and sedentary behaviors in relation to the risk for gestational diabetes mellitus. Arch Intern Med 166(5):543–548PubMedCrossRefGoogle Scholar
  6. 6.
    Clapp JF III, Kim H, Burciu B et al (2002) Continuing regular exercise during pregnancy: effect of exercise volume on fetoplacental growth. Am J Obstet Gynecol 186(1):142–147PubMedCrossRefGoogle Scholar
  7. 7.
    Fleten C, Stigum H, Magnus P, Nystad W (2010) Exercise during pregnancy, maternal prepregnancy body mass index, and birth weight. Obstet Gynecol 115(2 Pt 1):331–337PubMedCrossRefGoogle Scholar
  8. 8.
    Juhl M, Olsen J, Andersen PK et al (2010) Physical exercise during pregnancy and fetal growth measures: a study within the Danish National Birth Cohort. Am J Obstet Gynecol 202(1):63–68PubMedCrossRefGoogle Scholar
  9. 9.
    Longo LD (1983) Maternal blood volume and cardiac output during pregnancy: a hypothesis of endocrinologic control. Am J Physiol Cell Physiol 245(5):720–729Google Scholar
  10. 10.
    Artal R (1988) Fetal bradycardia induced by maternal exercise. Med Sci Sports Exerc 20(6):611–613 20(6):611–613Google Scholar
  11. 11.
    Artal R, O’Toole M (2003) Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br J Sports Med 37(1):6–12PubMedCrossRefGoogle Scholar
  12. 12.
    Artal R (2003) Exercise: the alternative therapeutic intervention for gestational diabetes. Clin Obstet Gynecol 46(2):479–487PubMedCrossRefGoogle Scholar
  13. 13.
    Clapp JF (1991) Exercise and fetal health. J Dev Physiol 15(1):9–14PubMedGoogle Scholar
  14. 14.
    Kagan KO, Kuhn U (2004) Sports and pregnancy. Herz 29(4):426–434PubMedCrossRefGoogle Scholar
  15. 15.
    Kemkes-Matthes B (2001) Changes in the blood coagulation system in pregnancy. Z Kardiol 90(Supp 4):45–48PubMedCrossRefGoogle Scholar
  16. 16.
    Plagemann A, Davidowa H, Harder T, DudenhausenJW (2006) Developmental programming of the hypothalamus: a matter of insulin. A comment on: Horvath TL, Bruning JC (Hrsg) Developmental programming of the hypothalamus: a matter of fat. Nat Med 12:52–53 12(52):53Google Scholar
  17. 17.
    Plagemann A (2005) Perinatal programming and functional teratogenesis: impact on body weight regulation and obesity. Physiol Behav 86(5):661–668PubMedCrossRefGoogle Scholar
  18. 18.
    Schaefer-Graf UM KH (2006) Diagnosis and new approaches in the therapy of gestational diabetes mellitus. Curr Diabetes Rev 2(3):343–352PubMedCrossRefGoogle Scholar
  19. 19.
    Hegaard HK, Pedersen BK, Nielsen BB, Damm P (2007) Leisure time physical activity during pregnancy and impact on gestational diabetes mellitus, pre-eclampsia, preterm delivery and birth weight: a review. Acta Obstet Gynecol Scand Review 86(11):1290–1296CrossRefGoogle Scholar
  20. 20.
    Perkins CC, Pivanik JM, Paneth N, Stein AD (2007) Physical activity and fetal growth during pregnancy. Obstet Gynecol 109(1):81–87 109(1):81–87Google Scholar
  21. 21.
    Barker DJ (1998) In utero programming of chronic disease. Clin Sci (Lond) 95(2):115–128Google Scholar
  22. 22.
    Ahlsson F, Gustafsson J, Tuvemo T, Lundgren M (2007) Females born large for gestational age have a doubled risk of giving birth to large for gestational age infants. Acta Paediatr 96(3):358–362PubMedCrossRefGoogle Scholar
  23. 23.
    Clapp JF III (1996) Morphometric and neurodevelopmental outcome at age five years of the offspring of women who continued to exercise regularly throughout pregnancy. J Pediatr 129(6):856–863PubMedCrossRefGoogle Scholar
  24. 24.
    Oken E, Gillman MW (2003) Fetal origins of obesity. Obes Res 11(4):496–506PubMedCrossRefGoogle Scholar
  25. 25.
    Hopkins SA, Baldi JC, Cutfield WS et al (2010) Exercise training in pregnancy reduces offspring size without changes in maternal insulin sensitivity. J Clin Endocrinol Metab 95(5):2080–2088PubMedCrossRefGoogle Scholar
  26. 26.
    Artal R, O’Toole M (2003) Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br J Sports Med 37(1):6–12PubMedCrossRefGoogle Scholar
  27. 27.
    Hartmann S, Bung P (1999) Physical exercise during pregnancy – physiological considerations and recommendations. J Perinat Med 27(3):204–215PubMedCrossRefGoogle Scholar
  28. 28.
    Wolfe LA, Davies GA (2003) Canadian guidelines for exercise in pregnancy. Clin Obstet Gynecol 46(2):488–495PubMedCrossRefGoogle Scholar
  29. 29.
    Haakstad LA, Voldner N, Henriksen T, Bø K (2007) Physical activity level and weight gain in a cohort of pregnant Norwegian women. Acta Obstet Gynecol Scand 86(5):559–564PubMedCrossRefGoogle Scholar
  30. 30.
    Clapp JF (2003) The effects of maternal exercise on fetal oxygenation and feto-placental growth. Eur J Obstet Gynecol Reprod Biol 110 (Suppl 1):S 80–S 85CrossRefGoogle Scholar
  31. 31.
    American College of Obsttricians and Gynecologists (2002) COG Committee Opinion. Exercise during pregnancy and the postpartum period. Int J Gynaecol Obstet (77):79–81Google Scholar
  32. 32.
    Larsson L, Lindqvist PG (2005) Low-impact exercise during pregnancy – a study of safety. Acta Obstet Gynecol Scand 84(1):34–38PubMedGoogle Scholar
  33. 33.
    Kennelly MM, McCaffrey N, McLoughlin P et al (2002) Fetal heart rate response to strenuous maternal exercise: not a predictor of fetal distress. Am J Obstet Gynecol 187(3):811–816PubMedCrossRefGoogle Scholar
  34. 34.
    Riemann MK, Kanstrup Hansen IK (2000) Effects on the foetus of exercise in pregnancy. Scand J Med Sci Sports 10(1):12–19PubMedCrossRefGoogle Scholar
  35. 35.
    Hegaard HK, Kajaergaard H, Moller EF, Wachmann H, Ottesen B (2006) Leisure time physical activity is associated with a reduced risk of preterm delivery. Acta Obstet Gynecol Scand 85(6):675–681PubMedCrossRefGoogle Scholar
  36. 36.
    ACOG Committee opinion (2002) Exercise during pregnancy and the postpartum period. Obstet Gynecol 99(1):171–173CrossRefGoogle Scholar
  37. 37.
    Zavorsky GS, Longo LD (2011) Exercise guidelines in pregnancy: new perspectives. Sports Med 41(5):345–360PubMedCrossRefGoogle Scholar
  38. 38.
    Brankston GN, Mitchell BF, Ryan EA, Okun NB (2004) Resistance exercise decreases the need for insulin in overweight women with gestational diabetes mellitus. Am J Obstet Gynecol 190(1):188–193 190(1):188–193Google Scholar
  39. 39.
    Katan MB, Ludwig DS (2010) Extra calories cause weight gain – but how much? JAMA 303(1):65–66PubMedCrossRefGoogle Scholar
  40. 40.
    Davies GA, Wolfe LA, Mottola MF, MacKinnon C (2003) Joint SOGC/CSEP clinical practice guideline: exercise in pregnancy and the postpartum period 3. Can J Appl Physiol 28(3):330–341PubMedCrossRefGoogle Scholar
  41. 41.
    Plagemann, Dudenhausen (2010) Adipositas als Risiko in der Perinatalmedizin, Springer, Berlin Heidelberg New York TokioGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Abteilung Rehabilitative und Präventive SportmedizinMedizinische UniversitätFreiburgDeutschland

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