体能、血清松弛素与妊娠期时长
Physical fitness, serum relaxin and duration of gestation.
作者信息
Thorell Eva, Goldsmith Laura, Weiss Gerson, Kristiansson Per
机构信息
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, SE-75122, Sweden.
Department of Obstetrics, Gynecology and Women's Health, New Jersey Medical School of Rutgers University, Newark, NJ, 07103, USA.
出版信息
BMC Pregnancy Childbirth. 2015 Aug 14;15:168. doi: 10.1186/s12884-015-0607-z.
BACKGROUND
Women are recommended to perform regular exercise during pregnancy but the impact of physical fitness on duration of gestation and miscarriage is inconsistent. In addition, a dose-response relation between the amount of weekly exercise and increased risk of miscarriage in early pregnancy has been observed. Previous studies have mostly used an epidemiologic method. Larger studies using careful measurement of physical fitness are needed. Besides physical fitness, maternal circulating concentrations of the hormone relaxin have been associated with decreased duration of gestation.
METHODS
A prospective cohort including 20 women with miscarriage and 460 women with spontaneous onset of labour, recruited from maternal health care centres in central Sweden, were examined in early pregnancy regarding estimated absolute peak oxygen uptake (VO2 peak, est.) by cycle ergometer test, and maternal circulating serum relaxin concentrations.
RESULTS
Women with miscarriage displayed the highest level of absolute VO2 peak, est. (2.61 l/min) and the lowest serum relaxin concentrations (640 ng/l). Among women with spontaneous onset of labour, the mean absolute VO2 peak, est. increased successively from the lowest estimated oxygen uptake of 2.31 l/min among those with preterm birth (n = 28), to an oxygen uptake of 2.49 l/min among women with postterm birth (n = 31). An opposite trend was shown regarding serum relaxin concentrations from women with miscarriage to those with postterm birth. Serum relaxin concentrations, but not absolute VO2 peak, est. was significantly and independently associated with duration of gestation in women with miscarriages, and absolute VO2 peak, est., age and multiple pregnancy were independently associated with duration of gestation in women with spontaneous onset of labour.
CONCLUSIONS
Physical fitness appears to be a protective factor of established pregnancies and not significantly involved in the risk of early miscarriage. Additional studies are needed to more clearly define the role of relaxin in miscarriage.
背景
建议女性在孕期进行规律锻炼，但体能对妊娠期时长和流产的影响并不一致。此外，已观察到每周运动量与孕早期流产风险增加之间存在剂量反应关系。以往研究大多采用流行病学方法。需要开展更大型的研究，仔细测量体能。除了体能外，母体循环中激素松弛素的浓度也与妊娠期缩短有关。
方法
从瑞典中部的孕产妇保健中心招募了一个前瞻性队列，其中包括20名流产女性和460名自然分娩女性，在孕早期通过自行车测力计测试检查估计的绝对峰值摄氧量（估计VO2峰值），并检测母体循环血清松弛素浓度。
结果
流产女性的估计绝对VO2峰值水平最高（2.61升/分钟），血清松弛素浓度最低（640纳克/升）。在自然分娩的女性中，估计的平均绝对VO2峰值从早产女性（n = 28）中最低的估计摄氧量2.31升/分钟，依次增加到过期产女性（n = 31）中的摄氧量2.49升/分钟。从流产女性到过期产女性，血清松弛素浓度呈现相反趋势。血清松弛素浓度而非估计的绝对VO2峰值与流产女性的妊娠期时长显著且独立相关，而估计的绝对VO2峰值、年龄和多胎妊娠与自然分娩女性的妊娠期时长独立相关。
结论
体能似乎是已确诊妊娠的保护因素，与早期流产风险无显著关联。需要进一步研究以更明确地界定松弛素在流产中的作用。
Zotero 插件