AFIPE Research Group, Universidad Politécnica de Madrid, Madrid, Spain.
Department of Obstetrics and Gynecology, Hospital Universitario de Fuenlabrada, Madrid, Spain.
Mayo Clin Proc. 2019 Oct;94(10):1951-1959. doi: 10.1016/j.mayocp.2019.01.050.
To investigate the effect of supervised moderate to vigorous exercise on gestational weight gain, its related risks (gestational diabetes [GD]), macrosomia, and type of delivery), and the preventive effects on women who exceed the weight gain recommendations.
We conducted a single-center, 2-armed, randomized controlled trial between October 1, 2009, and June 30, 2011, in which 678 women were assessed and 345 were randomized by a central computer system to an intervention group (N=115) or a standard care group (N=230). The intervention exercise program consisted of 70 to 78 sessions (24 weeks, 3 times per week, 60-65 minutes per session, moderate to vigorous intensity). The standard care group received usual care. Excessive gestational weight (EGW) gain was calculated on the basis of the 2009 Institute of Medicine (IOM) recommendations.
Of the 345 women randomized for treatment, 44 were lost to follow-up, leaving 301 women for analysis (intervention, 100; standard care, 201). Fewer women in the intervention group exceeded IOM recommendations (22 [22.0%] vs 69 [34.3%]; P=.03), including overweight and obese women (15 of 35 [42.9%] vs 40 of 50 [80.0%]; P=.001). Analysis of women exceeding weight recommendations revealed that the 3 main related risks were directly related to EGW gain in the standard care group (GD, P=.003; macrosomia, P<.001; type of delivery, P<.001) but not in the intervention group (GD, P>.99; macrosomia, 0%; type of delivery, P=.46).
Supervised moderate to vigorous exercise performed throughout gestation was effective in the prevention of EGW gain even for women with a pregestational body mass index greater than 25 kg/m. It also prevented its related risks (GD, macrosomia, and type of delivery) including for women exceeding the IOM recommendations, so we suggest that being active outweighs the effect of possible weight gain.
ClinicalTrials.gov Identifier: NCT01477372.
研究监督下的适度至剧烈运动对妊娠体重增加的影响，及其相关风险（妊娠糖尿病[GD]）、巨大儿和分娩方式），并对超重的女性进行预防。
我们于 2009 年 10 月 1 日至 2011 年 6 月 30 日进行了一项单中心、2 臂、随机对照试验，评估了 678 名女性，其中 345 名通过中央计算机系统随机分为干预组（N=115）或标准护理组（N=230）。干预运动方案包括 70-78 次（24 周，每周 3 次，每次 60-65 分钟，中等到剧烈强度）。标准护理组接受常规护理。根据 2009 年美国医学研究所（IOM）的建议计算超重妊娠体重（EGW）增加。
在随机接受治疗的 345 名女性中，有 44 名失访，301 名女性进行了分析（干预组 100 名，标准护理组 201 名）。干预组中超过 IOM 建议的女性较少（22[22.0%]比 69[34.3%]；P=.03），包括超重和肥胖女性（35 名中的 15 名[42.9%]比 50 名中的 40 名[80.0%]；P=.001）。对超过体重建议的女性进行分析发现，3 个主要相关风险与标准护理组的 EGW 增加直接相关（GD，P=.003；巨大儿，P<.001；分娩方式，P<.001），但与干预组无关（GD，P>.99；巨大儿，0%；分娩方式，P=.46）。
整个孕期进行监督下的适度至剧烈运动对超重的预防是有效的，即使对于孕前体重指数大于 25 kg/m 的女性也是如此。它还预防了其相关风险（GD、巨大儿和分娩方式），包括对超出 IOM 建议的女性，因此我们建议保持活跃比可能的体重增加更重要。
ClinicalTrials.gov 标识符：NCT01477372。
