Tinius Rachel A, Cahill Alison G, Cade W Todd
Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO, USA -
School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY, USA -
J Sports Med Phys Fitness. 2017 May;57(5):652-659. doi: 10.23736/S0022-4707.17.06222-3. Epub 2015 Nov 12.
Maternal obesity is associated with complications and adverse outcomes during the labor and delivery process. In pregnant women with a healthy body weight, maternal physical activity during pregnancy is associated with better obstetric outcomes; however, the effect of maternal physical activity during pregnancy on obstetric outcomes in obese women is not known. The purpose of the study was to determine the influence of self-reported physical activity levels on obstetric outcomes in pregnant obese women.
A retrospective chart review was performed on 48 active obese women and 48 inactive obese women (N.=96) who received prenatal care and delivered at the medical center during the past five years. Obstetric and neonatal outcomes were compared between the active and inactive groups.
Obese women who were active during pregnancy spent less total time in labor (13.4 hours vs. 19.2 hours, P=0.048) and were less likely to request an epidural (92% vs. 100%, P=0.04). When stratified by parity, active multiparous women spent significantly less total time in labor compared to inactive multiparous (6.2 hours vs. 16.7 hours, P=0.018). There were no statistical differences between groups in rates of cesarean deliveries or neonatal outcomes.
Maternal physical activity during pregnancy appears to improve obstetric outcomes in obese women, and this improvement may be more pronounced among multiparous women. Our finding is of particular importance as pregnant obese women are at higher risk for adverse labor and delivery outcomes.
孕妇肥胖与分娩过程中的并发症及不良结局相关。在体重正常的孕妇中，孕期进行身体活动与更好的产科结局相关；然而，孕期身体活动对肥胖女性产科结局的影响尚不清楚。本研究的目的是确定自我报告的身体活动水平对肥胖孕妇产科结局的影响。
对过去五年在该医疗中心接受产前护理并分娩的48名活跃肥胖女性和48名不活跃肥胖女性（N = 96）进行回顾性病历审查。比较活跃组和不活跃组的产科和新生儿结局。
孕期活跃的肥胖女性总产程时间较短（13.4小时对19.2小时，P = 0.048），且请求硬膜外麻醉的可能性较小（92%对100%，P = 0.04）。按产次分层时，活跃经产妇的总产程时间明显短于不活跃经产妇（6.2小时对16.7小时，P = 0.018）。两组在剖宫产率或新生儿结局方面无统计学差异。
孕期身体活动似乎可改善肥胖女性的产科结局，且这种改善在经产妇中可能更明显。我们的发现尤为重要，因为肥胖孕妇发生不良分娩结局的风险更高。
