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Fortbildung

Tabakkonsum und Tabakentwöhnung in der Schwangerschaft

Smoking and Smoking Cessation During Pregnancy

Published Online:September 14, 2010https://doi.org/10.1024/0939-5911/a000031

Abstract

Allgemeine Problemstellung: Rauchen ist der wichtigste reversible Risikofaktor für nicht erfolgreich verlaufende Schwangerschaften. In Deutschland rauchen 1/3 aller Frauen bei Schwangerschaftsbeginn und noch etwa 1/5 zum Zeitpunkt der Geburt. Konsequenzen des Tabakkonsums: Zu den negativen Auswirkungen des Tabakkonsums gehört eine erhöhte Wahrscheinlichkeit für unerfüllten Kinderwunsch, Extrauteringravidität, Fehlgeburt, Plazenta praevia und vorzeitige Lösung, mehr Früh- und Mangelgeburten sowie eine erhöhte perinatale Mortalität und Morbidität. Kinder von Raucherinnen haben ein höheres Risiko für plötzlichen Kindstod (SIDS), Atemwegserkrankungen, Verhaltensstörungen (insbesondere ADHS), Übergewicht und eigene Tabakabhängigkeit. Schlussfolgerungen: Jede rauchende Schwangere sollte eine Beratung und psychologische Unterstützung zum Rauchstopp erhalten. Zusätzlich Nikotinsubstitution kann bei Unfähigkeit zur Abstinenz den Effekt der Intervention verstärken.


General situation: Smoking is the most important modifiable risk factor associated with adverse outcomes of pregnancy. One-third of all women in Germany are smokers at the beginning of a pregnancy, and at least 20% still smoke at the time of birth. Consequences of tobacco smoking: There is a clear association between smoking and ectopic pregnancy, spontaneous pregnancy loss, placenta praevia and placental abruption, preterm delivery, low birthweight, as well as increased perinatal morbidity and mortality. Among postnatal problems we find an elevated risk of sudden infant death syndrome (SIDS), respiratory infections, asthma, behavioral problems (above all ADHS), obesity, and nicotine addiction in the offspring. Conclusions: Motivational counseling and psychological support should be offered to every pregnant woman who smokes. Should a stable tobacco abstinence not be achieved, additional nicotine substitution can be offered to enhance the effectiveness of interventions.

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