Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan.
Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan.
Am J Epidemiol. 2018 Oct 1;187(10):2080-2082. doi: 10.1093/aje/kwy136.
Chahal et al. (Am J Epidemiol. 2018;187(10):2073-2079) assessed the risk of placental abruption due to physical exertion using a case-crossover design. The authors found an increased risk of placental abruption following increased physical exertion in the hour prior to the abruption. The risk was greater among women who were primarily sedentary during pregnancy or prior to becoming pregnant compared with those who were more physically active. The authors used a case-crossover design to assess the association of an intermittent exposure on an acute event. Chahal et al. address the limitations of the study, including the inability to control for time-varying confounders as well as the potential for recall bias. The public health implications of the study must be carefully evaluated given that physical activity prior to and during pregnancy can lead to healthy outcomes and is likely recommended. While the current study is unable to determine the type of physical exertion associated with placental abruption, future studies are recommended to determine the type of activity that presents increased risk. Additionally, studies among larger samples and in other countries will help determine the generalizability of the results.
查哈尔等人（《美国流行病学杂志》。2018；187（10）：2073-2079）使用病例交叉设计评估了体力活动导致胎盘早剥的风险。作者发现，在胎盘早剥前一小时内增加体力活动会增加胎盘早剥的风险。与那些更活跃的孕妇相比，在怀孕期间或怀孕前主要久坐不动的孕妇发生这种风险的几率更大。作者使用病例交叉设计来评估间歇性暴露与急性事件之间的关联。查哈尔等人指出了该研究的局限性，包括无法控制随时间变化的混杂因素以及可能存在的回忆偏倚。鉴于妊娠前和妊娠期间的体育活动可以带来健康的结果，并且可能被推荐，因此必须仔细评估该研究的公共卫生意义。虽然目前的研究无法确定与胎盘早剥相关的体力活动类型，但建议进行未来的研究以确定增加风险的活动类型。此外，在更大的样本和其他国家进行的研究将有助于确定结果的普遍性。
