孕晚期抗阻运动对代谢指标影响的研究

Effects of resistance exercise on metabolic parameters in late pregnancy

目的探讨孕晚期规律的中等强度抗阻运动和代谢指标的关系。方法通过调查问卷方法搜集2020年5月至2020年11月在广东省妇幼保健院产科门诊建档产检的孕28~30周无规律运动习惯的单胎孕妇共300例,随机分为运动组和对照组各150例。运动组给予抗阻运动指导,对照组仅给予正常妊娠运动建议,追踪至分娩。收集两组入组和分娩时体重、血压、血糖、血脂指标和新生儿出生体重等资料。结果在进行规律的中等强度抗阻运动(10.0±1.5)周后,与对照组相比,运动组空腹胰岛素[(8.9±4.3)mmol/L vs.(11.6±4.5)mmol/L]、胰岛素抵抗指数[(1.7±0.9)vs.(2.3±1.1)]、糖化血红蛋白[(4.5±0.6)%vs.(5.0±0.7)%]和甘油三酯水平[(2.7±1.3)mmol/L vs.(2.9±1.0)mmol/L]均低于对照组,分娩前心率[(79.9±9.3)次/min vs.(77.2±9.9)次/min]和高密度脂蛋白胆固醇水平[(1.7±0.4)mmol/L vs.(1.5±0.3)mmol/L]高于对照组。校正分娩前水平后,两组分娩前心率、空腹胰岛素、胰岛素抵抗指数(HOMA-IR)差异仍有统计学意义。对照组分娩前体重、体重指数(BMI)、收缩压、心率、空腹胰岛素、胰岛素抵抗指数、糖化血红蛋白、低密度脂蛋白胆固醇水平较入组时升高,差异有统计学意义。运动组体重、BMI、收缩压和高密度脂蛋白胆固醇水平较入组时升高,空腹血糖较入组时下降,差异有统计学意义。两组胎膜早破、早产、妊娠期高血压、妊娠期糖尿病、剖宫产、小于胎龄儿、巨大儿、大于孕龄儿发生率差异未见统计学意义。结论孕晚期中等强度的抗阻运动有利于代谢指标的稳定,未发现进行这种运动会增加孕期合并症、并发症发生和影响新生儿体重。

Objective To investigate the relationship between regular moderate resistance exercise and metabolic parameters in late pregnancy.Methods In this randomized controlled study,a total of 300 single pregnant women with irregular exercise at 28-30 weeks of gestation were collected by questionnaire in Guangdong Women and Children Hospital from May to November 2020. Then they were randomly assigned to the exercise group and the control group with150 in each group. The exercise group was given resistance exercise instruction,while the control group was only given exercise advice for normal pregnancy.All women were followed up to deliveries.Data on weight,blood pressure,glucose,lipid parameters,and birth weight were collected in the two groups.Results After regular moderate resistance exercise for an average of(10.0±1.5)weeks,such parameters as fasting insulin(8.9±4.3)mmol/L vs.(11.6±4.5)mmol/L,insulin resistance index(1.7±0.9)vs.(2.3±1.1),glycated hemoglobin(4.5±0.6)% vs.(5.0±0.7)%and triglyceride levels(2.7±1.3)mmol/L vs.(2.9±1.0)mmol/L were lower in excecise group than those in the control group,and heart rate before delivery(79.9±9.3)times/min vs.(77.2±9.9)times/min and high-density lipoprotein cholesterol levels(1.7±0.4)mmol/L vs.(1.5±0.3)mmol/L were higher than those in the control group.After adjusting for predelivery levels,there were still significant differences in predelivery heart rate,fasting insulin,and insulin resistance index between the two groups. In the control group,body weight,body mass index,systolic blood pressure,heart rate,fasting insulin,insulin resistance index,glycated hemoglobin,and low-density lipoprotein cholesterol levels were significantly increased before delivery compared with those at the time of inclusion,and the differences were statistically significant.Maternal weight,body mass index,systolic blood pressure,and high-density lipoprotein cholesterol levels in the exercise group were significantly higher,while fasting blood glucose level was significantly lower than those at the time of inclusion,and there were statistical differences.There was no significant difference in the incidence of premature rupture of membranes,premature delivery,gestational hypertension,gestational diabetes,cesarean section,macrosomia,or the small/large for gestational age between the two groups.Conclusion Moderate resistance exercise in the late pregnancy is beneficial to the stability of metabolic parameters,and no increase in maternal complications or influence on neonatal weight is found.