Dempsey Jennifer C, Sorensen Tanya K, Williams Michelle A, Lee I-Min, Miller Raymond S, Dashow Edward E, Luthy David A
Center for Perinatal Studies, Swedish Medical Center, Seattle, WA, USA.
Am J Epidemiol. 2004 Apr 1;159(7):663-70. doi: 10.1093/aje/kwh091.
Physical activity has been associated with a reduced risk of gestational diabetes mellitus, but inferences have been hampered by recall and selection bias. The authors examined the relation between recreational physical activity before and during pregnancy and risk of gestational diabetes mellitus in a prospective cohort study. In 1996-2000, 909 normotensive, nondiabetic women in Seattle and Tacoma, Washington, were questioned during early gestation about physical activity performed during the year before and 7 days prior to the interview during pregnancy. Compared with inactive women, women who participated in any physical activity during the year before experienced a 56% risk reduction (relative risk (RR) = 0.44, 95% confidence interval (CI): 0.21, 0.91). Women spending >/=4.2 hours/week engaged in physical activity experienced a 76% reduction in gestational diabetes mellitus risk (RR = 0.24, 95% CI: 0.10, 0.64), and those expending >/=21.1 metabolic equivalent-hours/week experienced a 74% reduction (RR = 0.26, 95% CI: 0.10, 0.65) compared with inactive women. Physical activity during pregnancy was also associated with reductions in gestational diabetes mellitus risk. Women who engaged in physical activity during both time periods experienced a 69% reduced risk (RR = 0.31, 95% CI: 0.12, 0.79). Findings suggest that efforts to increase maternal physical activity may contribute to substantial reductions in gestational diabetes mellitus risk.
身体活动与妊娠期糖尿病风险降低有关，但回忆偏倚和选择偏倚妨碍了相关推断。作者在一项前瞻性队列研究中检验了孕前和孕期的休闲身体活动与妊娠期糖尿病风险之间的关系。1996年至2000年，对华盛顿州西雅图和塔科马的909名血压正常、无糖尿病的女性在妊娠早期进行了询问，了解她们在孕前一年以及孕期访谈前7天的身体活动情况。与不活动的女性相比，孕前一年参与任何身体活动的女性风险降低了56%（相对风险（RR）=0.44，95%置信区间（CI）：0.21，0.91）。每周进行≥4.2小时身体活动的女性妊娠期糖尿病风险降低了76%（RR = 0.24，95%CI：0.10，0.64），与不活动的女性相比，每周消耗≥21.1代谢当量小时的女性风险降低了74%（RR = 0.26，95%CI：0.10，0.65）。孕期的身体活动也与妊娠期糖尿病风险降低有关。在两个时间段都进行身体活动的女性风险降低了69%（RR = 0.31，95%CI：0.12，0.79）。研究结果表明，增加孕妇身体活动的努力可能有助于大幅降低妊娠期糖尿病风险。
