妊娠晚期步行锻炼对低危初产妇妊娠结局的影响

Effects of walking exercise during late trimester on pregnancy outcome of low-risk primipara

目的：探讨妊娠晚期步行锻炼对低危初产妇妊娠结局的影响。方法通过前瞻性随机对照研究，随机选取2012年7月至2013年6月于中国医科大学附属盛京医院定期产前检查的孕妇中符合条件并知情同意的123个病例，参与实施本研究制定的步行锻炼方案。同时随机选择同期妊娠的另116例一般情况相似的孕妇作为对照组。对2组间的分娩方式、妊娠34周后平均体重增长速度（ kg/周）、产程时长、产时疼痛感知、新生儿体重和新生儿出生状态等情况进行统计学分析。结果在研究过程中，试验组中途退出13例，对照组中途退出8例。试验组和对照组的剖宫产率分别为12.7％和18.5％，妊娠34周后体重增长速度分别为（0.41±0.13）kg/周和（0.56±0.09）kg/周，产时疼痛评分分别为6.1±1.9和7.6±2.3，产程时长分别为（12±4）h和（15±6）h，新生儿出生体重分别为（3.4±0.3）kg和（3.7±0.6）kg，巨大儿比率分别为4.5％和7.4％，差异有统计学意义（P＜0.05）。两组的胎膜早破发生率分别为15.5％和13.9％，早产发生率分别为5.5％和4.6％，新生儿窒息率分别为2.7％和3.7％，差异均无统计学意义（均P＞0.05）。结论妊娠晚期步行锻炼，简单安全易行有效，可以改善低危初产妇的妊娠结局，建议推广。

Objective To explore the effects of walking exercise during late trimester on pregnancy outcome of low-risk primipara.Methods A prospective randomized controlled study was conducted for 123 cases of low-risk primipara who had regular prenatal care at Shengjing Hospital , China Medical University from July 2012 to June 2013.And informed consent was obtained.The control group included 116 cases of other low-risk primipara in the same period.Except that the experimental group had regular structured walking exercise from 34 weeks of gestational age to delivery , other consulting guidance were the same as the control group.The inter-group differences , such as delivery mode , mean body weight gain per week after 34 weeks of gestation , duration of labor , labor pain perception , neonatal weight and neonatal birth condition , were detected and analyzed.Results Finally there were 13 and 8 dropouts in experimental and control groups respectively.For two groups , the rate of caesarean section was 12.7% and 18.5%, the mean body weight gain per week after 34 weeks of gestational age （0.41 ±0.13） and （0.56 ±0.09） kg, the labor pain score are 6.1 ±1.9 and 7.6 ±2.3, the duration of labor （12 ±4） and （15 ±6） h, the neonatal birth weight （3.4 ±0.3） and （3.7 ±0.6） kg and the rate of macrosomia 4.5%and 7.4%respectively.The differences had statistical significance （ P 〈0.05 ）.The rate of preterm birth was 5.5% and 4.6%, the rate of premature rupture of membrane 15.5% and 13.9% and the rate of neonatal asphyxia 2.7% and 3.7%respectively.The differences had no statistical significance （ all P〉0.05）.Conclusion Simple, safe and effective, walking exercise during late trimester may improve the pregnancy outcomes of low-risk primipara.