Kuhrt Katy, Harmon Mark, Hezelgrave Natasha L, Seed Paul T, Shennan Andrew H
Division of Women's Health, King's College London, St Thomas' Hospital, London, UK.
BMJ Open Sport Exerc Med. 2018 Apr 4;4(1):e000296. doi: 10.1136/bmjsem-2017-000296. eCollection 2018.
Increasingly, women of reproductive age participate in recreational running, but its impact on pregnancy outcome is unknown. We investigated whether running affects gestational age at delivery and birth weight as indicators of cervical integrity and placental function, respectively.
1293 female participants were recruited from parkrun, which organises weekly runs involving 1.25 million runners across 450 parks worldwide. Those under 16 or unable to provide outcome data were excluded. Women were categorised according to whether they continued to run during pregnancy or not. Those who continued were further stratified dependent on average weekly kilometres, and which trimester they ran until. Retrospectively collected primary outcomes were gestational age at delivery and birthweight centile. Other outcomes included assisted vaginal delivery rate and prematurity at clinically important gestations.
There was no significant difference in gestational age at delivery: 279.0 vs 279.6 days (mean difference 0.6 days, CI -1.3 to 2.4 days; P=0.55) or birthweight centile: 46.9%vs 44.9% (mean difference 2.0%, CI -1.3% to -5.3%; P=0.22) in women who stopped running and those who continued, respectively. Assisted vaginal delivery rate was increased in women who ran: 195/714 (27%) vs 128/579 (22%) (OR 1.32; CI 1.02 to 1.71; P=0.03).
Continuing to run during pregnancy does not appear to affect gestational age or birthweight centile, regardless of mean weekly distance or stage of pregnancy. Assisted vaginal delivery rates were higher in women who ran, possibly due to increased pelvic floor muscle tone. Randomised prospective analysis is necessary to further explore these findings.
育龄女性越来越多地参与到休闲跑步中,但其对妊娠结局的影响尚不清楚。我们分别以分娩孕周和出生体重作为宫颈完整性和胎盘功能的指标,研究了跑步是否会对其产生影响。
从公园跑活动中招募了1293名女性参与者,该活动每周组织跑步,全球450个公园中有125万跑步者参与。排除16岁以下或无法提供结局数据的女性。根据她们在孕期是否继续跑步进行分类。继续跑步的女性根据平均每周跑步公里数以及跑步持续到的孕期进一步分层。回顾性收集的主要结局指标为分娩孕周和出生体重百分位数。其他结局指标包括辅助阴道分娩率以及具有临床意义孕周时的早产情况。
停止跑步的女性和继续跑步的女性在分娩孕周上无显著差异:分别为279.0天和279.6天(平均差异0.6天,可信区间-1.3至2.4天;P=0.55),在出生体重百分位数上也无显著差异:分别为46.9%和44.9%(平均差异2.0%,可信区间-1.3%至-5.3%;P=0.22)。跑步女性的辅助阴道分娩率有所增加:714名中有195名(27%),而579名中有128名(22%)(比值比1.32;可信区间1.02至1.71;P=0.03)。
孕期继续跑步似乎不会影响分娩孕周或出生体重百分位数,无论平均每周跑步距离或孕期阶段如何。跑步女性的辅助阴道分娩率较高,可能是由于盆底肌肉张力增加。需要进行随机前瞻性分析以进一步探究这些发现。