孕期监督性运动训练对超重及肥胖女性新生儿及母体结局的影响。ETIP试验的二次分析：一项随机对照试验。
Effect of supervised exercise training during pregnancy on neonatal and maternal outcomes among overweight and obese women. Secondary analyses of the ETIP trial: A randomised controlled trial.
作者信息
Garnæs Kirsti Krohn, Nyrnes Siri Ann, Salvesen Kjell Åsmund, Salvesen Øyvind, Mørkved Siv, Moholdt Trine
机构信息
Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
Department of Paediatrics, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
出版信息
PLoS One. 2017 Mar 21;12(3):e0173937. doi: 10.1371/journal.pone.0173937. eCollection 2017.
BACKGROUND
Maternal obesity associates with complications during pregnancy and childbirth. Our aim was to investigate if exercise during pregnancy in overweight/obese women could influence birth weight or other neonatal and maternal outcomes at delivery.
MATERIAL AND METHODS
This is a secondary analysis of a randomised controlled trial of exercise training in pregnancy for women with body mass index (BMI) ≥ 28 kg/m2. Ninety-one women (31.3 ± 4.3 years, BMI 34.5 ± 4.2 kg/m2) were allocated 1:1 to supervised exercise during pregnancy or to standard care. The exercise group was offered three weekly training sessions consisting of 35 minutes of moderate intensity walking/running followed by 25 minutes of strength training. Data from 74 women (exercise 38, control 36) were analysed at delivery.
RESULTS
Birth weight was 3719 ± 695 g in the exercise group and 3912 ± 413 g in the control group (CI -460.96, 74.89, p = 0.16). Birth weight > 4000 g was 35% in the exercise group and 52% in the control group (p = 0.16). Mean gestational age at delivery was 39.1 weeks in the exercise group and 39.5 weeks in the control group (CI -1.33, 0.43, p = 0.31). No significant between-group differences were found in neonatal body size, skinfold thickness, placental weight ratio, or Apgar score. The prevalence of caesarean section was 24% in the exercise group and 17% in the control group (CI 0.20, 2.05, p = 0.57). Mean length of hospital stay was 4.8 days in the exercise group and 4.5 days in the control group (CI -0.45, 1.00, p = 0.45).
CONCLUSIONS
Offering supervised exercise during pregnancy for overweight and obese women did not influence birth weight or other neonatal and maternal outcomes at delivery. However our trial was limited by low sample size and poor adherence to the exercise protocol, and further research is needed.
TRIAL REGISTRATION
ClinicalTrials.gov NCT01243554.
背景
孕妇肥胖与妊娠和分娩期间的并发症相关。我们的目的是调查超重/肥胖女性在孕期进行锻炼是否会影响出生体重或其他分娩时的新生儿及产妇结局。
材料与方法
这是一项对体重指数（BMI）≥28 kg/m² 的孕妇进行运动训练的随机对照试验的二次分析。91名女性（31.3 ± 4.3岁，BMI 34.5 ± 4.2 kg/m²）被1:1分配至孕期接受监督锻炼组或标准护理组。锻炼组每周接受三次训练，包括35分钟的中等强度步行/跑步，随后是25分钟的力量训练。对74名女性（锻炼组38名，对照组36名）分娩时的数据进行分析。
结果
锻炼组出生体重为3719 ± 695 g，对照组为3912 ± 413 g（可信区间 -460.96，74.89，p = 0.16）。锻炼组出生体重>4000 g的比例为35%，对照组为52%（p = 0.16）。锻炼组分娩时的平均孕周为39.1周，对照组为39.5周（可信区间 -1.33，0.43，p = 0.31）。在新生儿体型、皮褶厚度、胎盘重量比或阿氏评分方面，未发现组间有显著差异。锻炼组剖宫产率为24%，对照组为17%（可信区间0.20，2.05，p = 0.57）。锻炼组平均住院时间为4.8天，对照组为4.5天（可信区间 -0.45，1.00，p = 0.45）。
结论
为超重和肥胖女性在孕期提供监督锻炼对出生体重或其他分娩时的新生儿及产妇结局没有影响。然而，我们的试验受样本量小和对锻炼方案依从性差的限制，需要进一步研究。
试验注册
ClinicalTrials.gov NCT01243554。
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