Hawkins Marquis, Pekow Penelope, Chasan-Taber Lisa
Division of Biostatistics and Epidemiology, Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA.
Med Sci Sports Exerc. 2014 Feb;46(2):284-92. doi: 10.1249/MSS.0b013e3182a44767.
Elevated C-reactive protein (CRP) is associated with adverse pregnancy outcomes. In nonpregnant populations, physical activity has been inversely associated with CRP, but this association has not been evaluated during pregnancy. The purpose of this study was to evaluate the association between objectively measured physical activity, sedentary behavior, and CRP by pregnancy trimester.
We evaluated this association among 294 pregnant participants in the National Health and Nutrition Examination Survey (2003-2004 and 2005-2006). Physical activity (min·d(-1)) was assessed via accelerometer using established cut points. CRP (mg·L(-1)) was measured using a high sensitivity assay. Multivariable linear regression was used to determine the relationship between physical activity, sedentary behavior, and CRP by trimester of pregnancy.
Among women in the second trimester, after adjusting for age, body mass index, smoking status, and history of adverse pregnancy outcomes, light-intensity physical activity was associated with lower CRP (β = -0.002, P = 0.05). In unadjusted models, sedentary time and proportion of wear time spent sedentary were positively associated with CRP (β = 0.048, P = 0.02 and β = 2.36, P = 0.03, respectively); however, the relationship was no longer statistically significant in multivariable models (β = 0.33, P = 0.2 and β = 1.96, P = 0.08, respectively). Neither physical activity nor sedentary behavior was associated with CRP among women in the first or third trimester.
Objectively measured light-intensity physical activity had a protective effect on CRP among women in the second trimester of pregnancy. Findings highlight the need for longitudinal studies of pregnancy physical activity and CRP with careful control for clinical characteristics of the current pregnancy.
C反应蛋白（CRP）升高与不良妊娠结局相关。在非妊娠人群中，身体活动与CRP呈负相关，但这种关联在孕期尚未得到评估。本研究的目的是按孕期评估客观测量的身体活动、久坐行为与CRP之间的关联。
我们在国家健康与营养检查调查（2003 - 2004年和2005 - 2006年）的294名孕妇参与者中评估了这种关联。通过加速度计使用既定切点评估身体活动（分钟·天⁻¹）。使用高灵敏度检测法测量CRP（毫克·升⁻¹）。采用多变量线性回归确定孕期各阶段身体活动、久坐行为与CRP之间的关系。
在孕中期女性中，调整年龄、体重指数、吸烟状况和不良妊娠结局史后，轻度身体活动与较低的CRP相关（β = -0.002，P = 0.05）。在未调整模型中，久坐时间和久坐时间占佩戴时间的比例与CRP呈正相关（β = 0.048，P = 0.02和β = 2.36，P = 0.03）；然而，在多变量模型中这种关系不再具有统计学意义（β = 0.33，P = 0.2和β = 1.96，P = 0.08）。在孕早期或孕晚期女性中，身体活动和久坐行为均与CRP无关。
客观测量的轻度身体活动对孕中期女性的CRP有保护作用。研究结果强调需要对孕期身体活动和CRP进行纵向研究，并仔细控制当前妊娠的临床特征。
