Department of Exercise Science and Athletic Training, Northern Arizona University , USA.
J Sports Sci Med. 2006 Sep 1;5(3):449-58. eCollection 2006.
For pregnant women, exercise offers numerous benefits with little risk. The American College of Obstetricians and Gynecologists (ACOG) endorses aerobic exercise for all pregnant women without medical or obstetric complications. Nonetheless, only a small percentage of pregnant women meet exercise guidelines. We investigated the extent to which obstetricians (Obs) in private or small group practice in the USA actively recommend exercise to their pregnant patients. Surveys were sent to 300 Obs in 33 American cities, of which 83 were returned. 52% of respondents reported discussing exercise with 81-100% of their patients. Using a 7- point Likert scale (1 = never, 7 = always), Obs reported recommending aerobic exercise more often than resistance exercise (5.6 ± 1.5 versus 3.8 ± 1.6, p < 0.001). Obs do not routinely advise sedentary women to initiate exercise during pregnancy (mean 4.4 ± 1.8). Of the 67% of Obs who specify a target exercise duration, 95% recommend ≥ 16 min, consistent with ACOG guidelines. However, 62% of Obs reported that they regularly specify a maximum heart rate, even though ACOG guidelines do not. Half of respondents indicated that they advise a reduction in exercise load during the third trimester, even for uncomplicated pregnancies. Respondents' opinions were mixed regarding the extent to which exercise reduces gestational diabetes or preeclampsia risk and they believe more research on exercise during pregnancy is needed. Half of Obs do not routinely discuss exercise. The majority is hesitant to advise sedentary gravidae to start exercise and is conservative with respect to exercise intensity. Action may be needed to convince more Obs to routinely recommend exercise to all healthy patients. Key Points52% of surveyed obstetricians discuss exercise with 81-100% of pregnant patients.68% of surveyed obstetricians do not regularly advise sedentary pregnant women to initiate an exercise program.62% of surveyed obstetricians recommend pregnant patients not exceed a maximum heart rate during exercise, even though ACOG guidelines do not specify a maximum heart rate.Approximately half of surveyed obstetricians recommend a reduction in exercise load during the third trimester, even though ACOG guidelines do not.Regular exercise was thought by surveyed obstetricians to have some potential for reducing the risk of gestational diabetes, but little effect on risk of preeclampsia.
对于孕妇来说，运动益处多多，风险很小。美国妇产科医师学会（ACOG）支持所有没有医疗或产科并发症的孕妇进行有氧运动。尽管如此，只有一小部分孕妇符合运动指南。我们调查了美国私人或小团体执业的妇产科医生（Obs）主动向孕妇患者推荐运动的程度。我们向美国 33 个城市的 300 名 Obs 发送了调查，其中 83 名回复了。52%的受访者表示会与 81-100%的患者讨论运动。使用 7 分制（1 = 从不，7 = 总是），Obs 报告说他们推荐有氧运动的频率高于阻力运动（5.6 ± 1.5 比 3.8 ± 1.6，p < 0.001）。Obs 并没有常规建议久坐的女性在怀孕期间开始运动（平均 4.4 ± 1.8）。在指定运动时间目标的 67%的 Obs 中，95%的人建议≥ 16 分钟，这与 ACOG 指南一致。然而，62%的 Obs 报告说他们经常指定最大心率，尽管 ACOG 指南没有。一半的受访者表示，他们建议在孕晚期减少运动负荷，即使是对于没有并发症的妊娠。受访者对运动降低妊娠糖尿病或子痫前期风险的程度意见不一，他们认为需要更多的研究。一半的 Obs 不经常讨论运动。他们中的大多数人对建议久坐的孕妇开始运动犹豫不决，对运动强度也很保守。可能需要采取行动，说服更多的 Obs 定期向所有健康患者推荐运动。要点 52%的调查妇产科医生会与 81-100%的孕妇讨论运动。68%的调查妇产科医生不经常建议久坐的孕妇开始运动计划。62%的调查妇产科医生建议孕妇在运动时不要超过最大心率，尽管 ACOG 指南没有指定最大心率。大约一半的调查妇产科医生建议在孕晚期减少运动负荷，尽管 ACOG 指南没有。调查妇产科医生认为定期运动有一定降低妊娠糖尿病风险的潜力，但对子痫前期风险的影响很小。
