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Adipositas - Ursachen, Folgeerkrankungen, Therapie 2019; 13(02): 65-70
DOI: 10.1055/a-0840-7822
Review
© Georg Thieme Verlag KG Stuttgart · New York

Schwangerschaft und Geburt bei Adipositas

Pregnancy and Delivery with obesity
Johannes Stubert
Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock
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Publikationsverlauf

Publikationsdatum:
14. Mai 2019 (online)

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Zusammenfassung

Eine Adipositas in der Schwangerschaft findet sich bei 10 bis 18 % aller Frauen in Deutschland. Sie trägt maßgeblich zu einer erhöhten Morbidität bei und wirkt sich sowohl auf das mütterliche als auch fetale Schwangerschaftsoutcome ungünstig aus. Besonders bei hochgradiger Adipositas ist eine intensive Überwachung der Schwangerschaft notwendig. Die Schwangerschaft begleitende Ernährungs- und Trainingsinterventionen können zwar dazu beitragen, die intragravide Gewichtszunahme zu reduzieren, wirken sich aber nur unwesentlich auf geburtshilflich relevante Risiken wie Gestationsdiabetes, hypertensive Schwangerschaftserkrankungen oder eine fetale Makrosomie aus. Umso bedeutsamer ist die Gewichtsoptimierung im Vorfeld einer geplanten Schwangerschaft. Bei Frauen mit Zustand nach bariatrischer Operation sind besondere Risikoaspekte zu berücksichtigen.

Abstract

The prevalence of obesity during pregnancy is between 10 to 18 % in Germany. It essentially contributes to an increased morbidity by an impairment of maternal as well as fetal outcome. Especially women with high grade obesity need an intensified observation during pregnancy. Interventions during pregnancy by diet or physical exercises can help to reduce the weight gain during pregnancy, but have only little effects on important obstetric risks like gestational diabetes, hypertensive pregnancy disorders or fetal macrosomia. An optimizing of the body weight before onset of pregnancy is much more important. In women after bariatric surgery special aspects of risks have to be considered.

Schlüsselwörter

Adipositas - Schwangerschaft - bariatrische Operation - Gestationsdiabetes - fetale Makrosomie - Präeklampsie - Sectio caesarea

Key words

Obesity - pregnancy - bariatric surgery - gestational diabetes - fetal macrosomia - preeclampsia - caesarean section
 

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