Department of Gynecology and Obstetrics, Division of Maternal-Fetal Medicine, Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, Maryland 21224, USA.
Obstet Gynecol. 2012 Mar;119(3):603-10. doi: 10.1097/AOG.0b013e31824760b5.
To evaluate acute fetal responses to individually prescribed exercise according to existing guidelines (U.S. Department of Health and Human Services) in active and inactive pregnant women.
Forty-five healthy pregnant women (15 nonexercisers, 15 regularly active, 15 highly active) were tested between 28 0/7 and 32 6/7 weeks of gestation. After a treadmill test to volitional fatigue, target heart rates were calculated for two subsequent 30-minute treadmill sessions: 1) moderate intensity (40-59% heart rate reserve); and 2) vigorous intensity (60-84%). All women performed the moderate test; only active women performed the vigorous test. Fetal well-being measures included umbilical artery Dopplers, fetal heart tracing and rate, and biophysical profile. Measures were obtained at rest and immediately postexercise.
Groups were similar in age, body mass index, and gestational age. Maternal resting heart rate in the highly active group (61.6 ± 7.2 beats per minute [bpm]) was significantly lower than the nonexercise (79.0 ± 11.6 bpm) and regularly active (71.9 ± 7.4 bpm) groups (P<.001). Treadmill time was longer in highly active (22.3 ± 2.9 minutes) than regularly active (16.6 ± 3.4) and nonexercise (12.1 ± 3.6) groups (P<.001), reflecting higher fitness. With moderate exercise, all umbilical artery Doppler indices were similar pre-exercise and postexercise among groups. With vigorous exercise, Dopplers were similar in regularly and highly active women with statistically significant decreases postexercise (P<.05). The group × time interaction was not significant. Postexercise fetal heart tracings met criteria for reactivity within 20 minutes after all tests. Biophysical profile scores were reassuring.
This study supports existing guidelines indicating pregnant women may begin or maintain an exercise program at moderate (inactive) or vigorous (active) intensities.
根据现有的指南（美国卫生与公众服务部），评估活跃和不活跃孕妇个体规定运动对胎儿的急性反应。
45 名健康孕妇（15 名不运动者、15 名定期活跃者、15 名高度活跃者）在妊娠 28 0/7 至 32 6/7 周之间进行测试。在跑步机测试至自愿疲劳后，计算了随后两次 30 分钟跑步机测试的目标心率：1）中等强度（心率储备的 40-59%）；2）剧烈强度（心率储备的 60-84%）。所有女性都进行了中等强度测试；只有活跃的女性进行了剧烈强度测试。胎儿健康测量包括脐动脉多普勒、胎儿心率跟踪和率以及生物物理概况。在休息时和运动后立即获得测量值。
组间在年龄、体重指数和孕龄方面相似。高度活跃组的母亲静息心率（61.6±7.2 次/分钟）明显低于不运动组（79.0±11.6 次/分钟）和定期活跃组（71.9±7.4 次/分钟）（P<.001）。高度活跃组的跑步机时间（22.3±2.9 分钟）明显长于定期活跃组（16.6±3.4 分钟）和不运动组（12.1±3.6 分钟）（P<.001），反映了更高的健康水平。中等强度运动时，各组的所有脐动脉多普勒指数在运动前后均相似。剧烈运动时，定期活跃和高度活跃的女性的多普勒相似，运动后有统计学意义的下降（P<.05）。组间×时间的交互作用不显著。所有测试后 20 分钟内，胎儿心率跟踪均符合反应性标准。生物物理概况评分令人安心。
本研究支持现有的指南，表明孕妇可以开始或维持中等（不活跃）或剧烈（活跃）强度的运动计划。
