孕期抗阻力运动对母婴结局的影响评价

Evaluation of the effects of resistance exercise during pregnancy on maternal and infant outcomes

目的 评价健康孕妇坚持抗阻力运动对母婴结局的影响,探讨孕期抗阻力运动的依从性、安全性和可行性。方法 219例产检的健康孕妇,随机分为步行组(102例)和训练组(117例),步行组采用餐后散步,训练组采用上下肢抗阻力训练;选择同期100例无规律运动且总静坐时间≥4 h/d,以静坐方式生活和工作的健康孕妇作为对照组。比较训练组和步行组孕妇坚持运动时间;训练组和步行组坚持运动时间≥4个月孕妇与对照组孕妇的不良孕产结局(先兆流产/先兆早产、非医源性早产、流产/死胎、新生儿窒息)发生情况、孕期体重增加幅度、新生儿体重情况(新生儿体重、巨大儿、低体重儿)、总产程、剖宫产率、产后出血量。结果 训练组孕妇坚持运动时间≥4个月占比为94.1%,高于步行组的65.8%,差异具有统计学意义(P<0.05)。三组孕妇先兆流产/先兆早产、非医源性早产、流产/死胎、新生儿窒息发生率比较差异无统计学意义(P>0.05)。训练组和步行组孕妇孕期体重增加幅度分别为(17.3±1.8)、(16.8±3.1)kg,巨大儿发生率分别为4.2%、6.5%,新生儿体重分别为(3113.7±512.0)、(3166.1±409.7)g,均低于对照组的(21.4±3.7)kg、17.0%、(3374.2±446.3)g,差异具有统计学意义(P<0.05);训练组和步行组低体重儿发生率与对照组比较差异均无统计学意义(P>0.05)。训练组和步行组孕妇孕期体重增加幅度、新生儿体重、巨大儿发生率、低体重儿发生率比较差异无统计学意义(P>0.05)。训练组与步行组孕妇总产程、剖宫产率、产后出血量比较差异无统计学意义(P>0.05);训练组和步行组孕妇的总产程(13.9±2.2)、(14.2±2.1)h短于对照组的(18.3±3.6)h,剖宫产率25.0%、24.6%低于对照组的39.0%,产后出血量(118.1±13.6)、(120.3±12.2)ml少于对照组的(134.7±14.6)ml,差异具有统计学意义(P<0.05)。结论 孕期抗阻力运动具有较好的依从性和安全性,坚持运动能够减少妊娠期并发症,改善母婴结局。

Objective To evaluate the effects of resistance exercise during pregnancy on maternal and infant outcomes, and explore the compliance, safety and feasibility of resistance exercise during pregnancy.Methods A total of 219 healthy pregnant women for prenatal examination were randomly divided into a walking group(102 cases) and a training group(117 cases), with the walking group using postprandial walking and the training group using upper and lower limb resistance training;100 healthy pregnant women who had no regular exercise and had a total sedentary time ≥4 h/d and lived and worked in a sedentary manner during the same period were selected as the control group. Comparison was made on exercise duration between the training group and walking group, as well as occurrence of adverse maternal outcomes(threatened preterm abortion/threatened preterm labor, non-iatrogenic preterm labor, abortion/stillbirth, neonatal asphyxia), maternal weight gain during pregnancy, neonatal weight(neonatal weight, macrosomia, low birth weight), total stage of labor, cesarean section rate, and amount of postpartum hemorrhage between pregnant women with exercise duration ≥4 months in the training and walking groups and those in the control group. Results The percentage of pregnant women with exercise duration ≥4 months was 94.1% in the training group, which was higher than 65.8% in the walking group,and the difference was statistically significant(P<0.05). There was no statistically significant difference in the incidence of threatened abortion/threatened preterm labor, non-iatrogenic preterm labor, abortion/stillbirth, and neonatal asphyxia among the three groups(P>0.05). The weight gain during pregnancy in the training group and walking group were(17.3±1.8) and(16.8±3.1) kg, and the incidence of fetal macrosomia were 4.2% and 6.5%,and the neonatal weight were(3113.7±512.0) and(3166.1±409.7) g, which were lower than(21.4±3.7) kg,17.0%,(3374.2±446.3) g in the control group, and the differences were statistically significant(P<0.05). There was no statistically significant difference in the incidence of low birth weight in both the training group and walking group compared to the control group(P>0.05). The differences between the two groups in weight gain during pregnancy, neonatal weight, incidence of macrosomia, and incidence of low birth weight were not statistically significant(P>0.05). There was no statistically significant difference between the training group and the walking group in terms of total stage of labor, cesarean section rate, and amount of postpartum hemorrhage(P>0.05).The total stage of labor of pregnant women in the training group and walking group were(13.9±2.2) and(14.2±2.1) h, which were shorter than(18.3±3.6) h in the control group;the cesarean section rate in the training group and walking group were 25.0% and 24.6%, which were lower than 39.0% in the control group;the amount of postpartum hemorrhage in the training group and walking group were(118.1±13.6) and(120.3±12.2) ml, which were less than(134.7±14.6) ml in the control group;the differences were statistically significant(P<0.05).Conclusion Resistance exercise during pregnancy has good compliance and safety, and resistance exercise can reduce complications during pregnancy and improve maternal and neonatal outcomes.