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孕期运动与产程缩短有关。一项随机临床试验。

Exercise during pregnancy is associated with a shorter duration of labor. A randomized clinical trial.

作者信息

Barakat Ruben, Franco Evelia, Perales María, López Carmina, Mottola Michelle F

机构信息

AFIPE Research Group, Technical University of Madrid, Spain.

AFIPE Research Group, Technical University of Madrid, Spain.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2018 May;224:33-40. doi: 10.1016/j.ejogrb.2018.03.009. Epub 2018 Mar 6.

Abstract

OBJECTIVE

to examine the influence of an exercise program throughout pregnancy on the duration of labor in healthy pregnant women.

STUDY DESIGN

A randomized clinical trial was used (Identifier: NCT02109588). In all, 508 healthy pregnant women were randomly assigned between 9 and 11 weeks of gestation to either a Control Group (CG, N = 253) or an Exercise Group (EG, N = 255). A moderate aerobic exercise program throughout pregnancy (three weekly sessions) was used as the intervention. Mann-Whitney and Pearson χ tests were performed to analyze differences between groups. Survival techniques through the Kaplan-Meier method were used to estimate the median time to delivery of each group; and Gehan-Breslow-Wilcoxon tests were performed to compare survival distribution between the two arms. The primary outcome studied was the length of the stages of labor. Secondary outcomes included mode of delivery, gestational age, maternal weight gain, preterm delivery, use of epidural, birthweight, Apgar scores and arterial cord pH.

RESULTS

Women randomized to the EG had shorter first stage of labor (409 vs 462 min, p = 0.01), total duration of labor (450 vs 507 min, p = 0.01) as well as combined duration of first and second stages of labor (442 vs 499 min, p = 0.01). The probabilities of a woman being delivered at 250 min and 500 min (median times) were 19.1% and 62.5% in the experimental group vs 13.7% and 50.8% in the control group (Z = -2.37, p = 0.018). Results also revealed that women in the intervention group were less likely to use an epidural; and that the prevalence of neonate macrosomia was higher in the control group.

CONCLUSION

A supervised physical exercise program throughout pregnancy decreased the duration of the first phase of labor as well as total time of the first two phases together, leading to a decrease in total labor time.

摘要

目的

研究整个孕期的运动计划对健康孕妇产程的影响。

研究设计

采用随机临床试验(标识符:NCT02109588)。总共508名健康孕妇在妊娠9至11周时被随机分为对照组(CG,N = 253)或运动组(EG,N = 255)。整个孕期采用适度有氧运动计划(每周三次)作为干预措施。采用Mann-Whitney检验和Pearson χ检验分析组间差异。通过Kaplan-Meier方法使用生存技术来估计每组的中位分娩时间;并进行Gehan-Breslow-Wilcoxon检验以比较两组之间的生存分布。研究的主要结局是产程各阶段的时长。次要结局包括分娩方式、孕周、孕妇体重增加、早产、硬膜外麻醉的使用、出生体重、阿氏评分和脐动脉pH值。

结果

随机分配到运动组的女性第一产程较短(409分钟对462分钟,p = 0.01),总产程较短(450分钟对507分钟,p = 0.01),以及第一和第二产程的合并时长较短(442分钟对499分钟,p = 0.01)。在250分钟和500分钟(中位时间)分娩的女性概率在实验组分别为19.1%和62.5%,而在对照组分别为13.7%和50.8%(Z = -2.37,p = 0.018)。结果还显示,干预组的女性使用硬膜外麻醉的可能性较小;并且对照组巨大儿的患病率较高。

结论

整个孕期的有监督体育锻炼计划缩短了第一产程的时长以及前两个阶段的总时长,从而使总产程时间减少。

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