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[孕晚期身体活动、孕前体重指数、孕期体重增加与妊娠结局之间的关系]

[The Relationship Among Physical Activity During the Third Trimester, Maternal Pre-Pregnancy Body Mass Index, Gestational Weight Gain, and Pregnancy Outcomes].

作者信息

Chen Chia-Hui, Tzeng Ya-Ling, Ying Tsung-Ho, Kuo Pi-Chao

机构信息

Department of Nursing, Asia University, Taiwan, ROC.

School of Nursing, China Medical University, Taiwan, ROC.

出版信息

Hu Li Za Zhi. 2017 Feb;64(1):80-89. doi: 10.6224/JN.64.1.80.

Abstract

BACKGROUND

Most pregnant women tend to reduce physical activities during pregnancy because they are uncertain of the amount of moderate-level physical activity they should do. As the influence of physical activity during the third trimester remains unclear, it is important to clarify the pregnancy outcomes of physical activity during pregnancy and weight management among Taiwanese women.

PURPOSE

To examine the potential association between physical activity during the third trimester of pregnancy and the birth weight or delivery mode of the baby in order to see whether weight gain during pregnancy affects birth weight and delivery mode and to estimate the associations between pre-pregnancy body mass index and birth weight.

METHODS

A prospective study was performed. Data were collected from 123 pregnant women, all between 28 and 40-weeks gestation, at a medical center in central Taiwan. The Chinese version of the 'pregnancy physical activity questionnaire' was used to collect data. Birth weight, delivery data, and the last weight measurement before delivery were retrieved from the medical records or via a postpartum telephone interview.

RESULTS

The results revealed that the amount of weight gained during pregnancy was a significant predictor of birth weight. Birth weight was not associated with pre-pregnancy body mass index or with physical activity and intensity of activity during the third trimester. Results provide no consistent evidence for an association between weight gain during pregnancy and the mode of delivery. Although no association was identified between total physical activity and delivery mode, the intensity of activity made a difference, with moderate-intensity activity of pregnant women increased 1 MET-hour/week. Thus, the odds of vaginal delivery over caesarean section increased by 1.017 times (COR = 1.014; p < .05; AOR = 1.017; p < .05).

CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The findings of the present study indicate that weight gain during pregnancy and moderate-intensity activity are both associated with birth weight and delivery mode. These findings provide evidence that health counseling during pregnancy as well as offering physical activity guidance may be done using a more empirical research base.

摘要

背景

大多数孕妇在孕期会减少身体活动,因为她们不确定自己应该进行的中等强度身体活动量。由于孕晚期身体活动的影响尚不清楚,因此明确台湾女性孕期身体活动和体重管理对妊娠结局的影响很重要。

目的

研究孕晚期身体活动与婴儿出生体重或分娩方式之间的潜在关联,以了解孕期体重增加是否会影响出生体重和分娩方式,并评估孕前体重指数与出生体重之间的关联。

方法

进行了一项前瞻性研究。在台湾中部的一家医疗中心收集了123名孕周在28至40周之间的孕妇的数据。使用中文版的“孕期身体活动问卷”收集数据。从病历或产后电话访谈中获取出生体重、分娩数据以及分娩前的最后一次体重测量值。

结果

结果显示,孕期体重增加量是出生体重的一个重要预测因素。出生体重与孕前体重指数、孕晚期的身体活动及活动强度均无关联。研究结果未提供孕期体重增加与分娩方式之间存在关联的一致证据。虽然未发现总体身体活动与分娩方式之间存在关联,但活动强度有影响,孕妇中等强度活动每增加1代谢当量小时/周。因此,阴道分娩相对剖宫产的几率增加1.017倍(校正比值比 = 1.014;p < 0.05;调整后比值比 = 1.017;p < 0.05)。

结论/对实践的启示:本研究结果表明,孕期体重增加和中等强度活动均与出生体重及分娩方式有关。这些发现为孕期健康咨询以及提供身体活动指导可基于更实证的研究依据提供了证据。

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