[Physical activity in pregnancy and in breast-feeding period in obese mothers].
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.


CONCLUSIONS
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.
Korsten-Reck
U
U
Medizinische Universitätsklinik, Abt. Rehabilitative und Präventive Sportmedizin, Freiburg. ulrike.korsten-reck@uniklinikfreiburg.de
D001786:Blood Glucose / Q000378:metabolism; D001942:Breast Feeding; D016640:Diabetes, Gestational / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy; D004967:Estrogens / Q000097:blood; D015444:Exercise / Q000502:physiology; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D009141:Musculoskeletal System / Q000503:physiopathology; D009765:Obesity / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D010807:Physical Endurance / Q000502:physiology; D011225:Pre-Eclampsia / Q000517:prevention & control / Q000628:therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011644:Puerperal Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012065:Relaxin / Q000097:blood; D012307:Risk Factors
D001786:Blood Glucose; D004967:Estrogens; D012065:Relaxin