Department of Obstetrics and Gynecology, UNICAMP Medical School, Campinas, Brazil.
BJOG. 2011 Nov;118(12):1455-63. doi: 10.1111/j.1471-0528.2011.03084.x. Epub 2011 Sep 6.
To evaluate the effectiveness and safety of physical exercise in terms of maternal/perinatal outcomes and the perception of quality of life (QoL) in pregnant obese and overweight women.
A randomised controlled clinical trial.
The Prenatal Outpatient Clinic of the Women's Integral Healthcare Centre (CAISM-UNICAMP) at the University of Campinas, Campinas, Brazil.
Eighty-two pregnant women (age ≥ 18 years; pre-gestational body mass index ≥ 26 kg/m(2) ; gestational age 14-24 weeks).
Women were randomised into two groups: women in one group exercised under supervision and received home exercise counselling (the 'study group'; n = 40) and women in the other group followed the routine prenatal care programme (the 'control group'; n = 42).
Primary outcomes were gestational weight gain during the programme and excessive maternal weight gain. Secondary outcomes were increased arterial blood pressure, perinatal outcomes and QoL (WHOQOL-BREF).
In the study group, 47% of pregnant women had weight gains above the recommended limit, compared with 57% of women in the control group (P = 0.43). There was no difference in gestational weight gain between the groups. Overweight pregnant women who exercised gained less weight during the entire pregnancy (10.0 ± 1.7 kg versus 16.4 ± 3.9 kg, respectively; P = 0.001) and after entry into the study (5.9 ± 4.3 kg versus 11.9 ± 1.5 kg, respectively; P = 0.021) compared with women in the control group. Arterial blood pressure was similar between the groups over time. There was no difference in perinatal outcome or QoL.
The exercise programme was not associated with control of gestational weight gain in our sample as a whole, but was beneficial for lower gestational weight gain in overweight women. Exercise was not associated with adverse perinatal outcomes and did not affect variation in arterial blood pressure or the perception of QoL.
评估运动对孕妇/围产结局的有效性和安全性，以及对肥胖和超重孕妇生活质量（QoL）的感知。
随机对照临床试验。
巴西坎皮纳斯大学妇女综合保健中心（CAISM-UNICAMP）的产前门诊。
82 名孕妇（年龄≥18 岁；孕前体重指数≥26kg/m2；孕龄 14-24 周）。
将孕妇随机分为两组：一组在监督下运动并接受家庭运动咨询（“研究组”；n=40），另一组接受常规产前保健计划（“对照组”；n=42）。
主要结局指标是方案期间的妊娠体重增加和过度母体体重增加。次要结局指标为动脉血压升高、围产结局和生活质量（WHOQOL-BREF）。
在研究组中，47%的孕妇体重增加超过推荐上限，而对照组中这一比例为 57%（P=0.43）。两组间妊娠体重增加无差异。运动的超重孕妇在整个孕期（10.0±1.7kg 与 16.4±3.9kg，分别；P=0.001）和进入研究后（5.9±4.3kg 与 11.9±1.5kg，分别；P=0.021）体重增加较少与对照组相比。随着时间的推移，两组间的动脉血压相似。围产结局或 QoL 无差异。
运动方案与我们整个样本的妊娠体重控制无关，但对超重妇女的较低妊娠体重增加有益。运动与不良围产结局无关，也不会影响动脉血压的变化或 QoL 的感知。
