Division of Gastroenterology, University of Washington, Seattle, Washington.
Department of Obstetrics and Gynecology, Madigan Army Medical Center, Tacoma, Washington.
Am J Perinatol. 2014 Jan;31(1):39-48. doi: 10.1055/s-0033-1334455. Epub 2013 Mar 1.
To evaluate the effect of a physical activity intervention upon the incidence of gallbladder sludge or stones during pregnancy.
Pregnant women without gallstones were randomized to an intervention to increase moderate to vigorous physical activity or control. Intervention group women received motivational materials and small-group instruction to increase physical activity. Gallbladder ultrasound and blood draws were obtained at entry, 18 weeks' gestation, and 36 weeks' gestation.
In all, 591 were randomized to the intervention and 605 women to control groups. Women in the intervention group reported modestly higher levels of physical activity compared with control women, and fewer women in the intervention group reported no physical activity during pregnancy. The incidence of gallbladder sludge or stones was similar in intervention and control groups at 18 weeks (4.8% versus 5.4%; relative risk 0.89; 95% confidence interval 0.53, 1.47) and 36 weeks (4.3% versus 3.3%; relative risk 1.31; 95% confidence interval 0.70, 2.54). Fasting glucose, lipid, insulin, leptin, and adiponectin levels were similar in the two groups, as was insulin sensitivity and the incidence of gestational diabetes.
An intervention to increase moderate to vigorous physical activity did not decrease the incidence of gallbladder sludge or stones during pregnancy and did not result in improvement in maternal metabolic measures.
评估体力活动干预对孕妇胆囊内泥沙样结石或结石形成的影响。
本研究将无胆囊结石的孕妇随机分为干预组和对照组，以增加中等至剧烈强度的体力活动，或保持对照组不变。干预组的女性接受了增加体力活动的激励性材料和小组指导。在入组时、妊娠 18 周和 36 周时进行胆囊超声和血液采集。
共有 591 名孕妇被随机分配到干预组，605 名孕妇被分配到对照组。与对照组相比，干预组的女性报告的体力活动水平略高，且报告妊娠期间无体力活动的女性较少。在 18 周（4.8%对 5.4%；相对风险 0.89；95%置信区间 0.53，1.47）和 36 周（4.3%对 3.3%；相对风险 1.31；95%置信区间 0.70，2.54）时，干预组和对照组的胆囊内泥沙样结石或结石的发生率相似。两组的空腹血糖、血脂、胰岛素、瘦素和脂联素水平相似，胰岛素敏感性和妊娠期糖尿病的发生率也相似。
增加中等至剧烈强度体力活动的干预措施并未降低孕妇胆囊内泥沙样结石或结石的发生率，也未改善产妇的代谢指标。
