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孕期闲暇时间体力活动与出生体重分布:作用在哪里?

Leisure-time physical activity in pregnancy and the birth weight distribution: where is the effect?

机构信息

Dept of Epidemiology, Michigan State University, East Lansing, MI, USA.

出版信息

J Phys Act Health. 2012 Nov;9(8):1168-77. doi: 10.1123/jpah.9.8.1168. Epub 2011 Dec 27.

Abstract

BACKGROUND

Leisure-time physical activity (LTPA) is recommended during pregnancy and has been associated with lower risk of delivering a large infant. We sought to characterize the effect of LTPA across the entire birth weight distribution.

METHODS

Women enrolled in the Pregnancy Outcomes and Community Health (POUCH) Study (1998-2004) were followed-up in 2007. Follow-up efforts were extensive for a subcohort and minimal for the remainder (nonsubcohort). Thus, 596 subcohort and 418 nonsubcohort women who delivered at term participated. Offspring were categorized as small-, appropriate-, or large-for-gestational-age (SGA, AGA, and LGA, respectively) based on gender and gestational age-specific birth weight z-scores (BWz). At follow-up, women recalled pregnancy LTPA and were classified as inactive, insufficiently active or meeting LTPA recommendations. Linear, logistic, and quantile regression analyses were conducted separately by subcohort status.

RESULTS

Meeting LTPA recommendations decreased odds of LGA significantly among the nonsubcohort (aOR = 0.30, 95% CI: 0.14-0.64) and nonsignificantly among the subcohort (aOR = 0.68, 95% CI: 0.34-1.34). In quantile regression, meeting LTPA recommendations reduced BWz among the upper quantiles in the nonsubcohort.

CONCLUSIONS

LTPA during pregnancy lowered odds of LGA and reduced BWz among the upper quantiles, without shifting the entire distribution. LTPA during pregnancy may be useful for reducing risks of large fetal size.

摘要

背景

孕期建议进行闲暇时间体育活动(LTPA),且该活动与较低的巨大儿风险相关。我们旨在描述整个出生体重分布中 LTPA 的作用。

方法

1998 年至 2004 年,参加妊娠结局和社区健康研究(POUCH)的女性在 2007 年进行了随访。对于一个亚组,随访工作非常广泛,而对于其余的(非亚组)则非常有限。因此,596 名亚组和 418 名非亚组足月分娩的女性参与了研究。根据性别和特定胎龄的出生体重 z 分数(BWz),将后代分为小于胎龄儿(SGA)、适于胎龄儿(AGA)和大于胎龄儿(LGA)。在随访时,女性回忆孕期的 LTPA,并分为不活动、活动不足或符合 LTPA 建议。通过亚组状态分别进行线性、逻辑和分位数回归分析。

结果

符合 LTPA 建议可显著降低非亚组(aOR=0.30,95%CI:0.14-0.64)和亚组(aOR=0.68,95%CI:0.34-1.34)中 LGA 的发生几率。在分位数回归中,符合 LTPA 建议可降低非亚组中较高分位数的 BWz。

结论

孕期 LTPA 降低了 LGA 的发生几率,并降低了较高分位数的 BWz,而没有改变整个分布。孕期 LTPA 可能有助于降低巨大胎儿的风险。

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