Perales María, Valenzuela Pedro L, Barakat Rubén, Alejo Lidia B, Cordero Yaiza, Peláez Mireia, Lucia Alejandro
Research Institute of Hospital 12 de Octubre ('i+12'), Madrid, Spain.
Faculty of Sport Science, Universidad Camilo José Cela, Madrid, Spain.
Int J Obes (Lond). 2021 Feb;45(2):342-347. doi: 10.1038/s41366-020-00669-2. Epub 2020 Sep 4.
Pregnancy exercise can prevent excessive gestational weight gain (EGWG), gestational diabetes mellitus (GDM) and hypertension (GH), but inter-individual variability has not been explored. We aimed to analyze the prevalence--and potential sociodemographic and medical predictors of--non-responsiveness to gestational exercise, and the association of non-responsiveness with adverse pregnancy outcomes. Among 688 women who completed a supervised light-to-moderate intensity exercise program (three ~1-h sessions/week including aerobic, resistance, and pelvic floor muscle training) until near-term, those who showed EGWG, GDM or GH were considered 'non-responders'. A low prevalence of non-responders was observed for GDM (3.6%) and GH (3.4%), but not for EGWG (24.2%). Pre-pregnancy obesity was the strongest predictor of non-responsiveness for GH (odds ratio 8.40 [95% confidence interval 3.10-22.78] and EGWG (5.37 [2.78-10.39]), whereas having a highest education level attenuated the risk of being non-responder for GDM (0.10 [0.02-0.49]). Non-responsiveness for EGWG was associated with a higher risk of prolonged labor length, instrumental/cesarean delivery, and macrosomia, and of lower Apgar scores. No association with negative delivery outcomes was found for GDM/GH. In summary, women with pre-pregnancy obesity might require from additional interventions beyond light-to-moderate intensity gestational exercise (e.g., diet and/or higher exercise loads) to ensure cardiometabolic benefits.
孕期运动可预防孕期体重过度增加（EGWG）、妊娠期糖尿病（GDM）和妊娠期高血压（GH），但个体间差异尚未得到研究。我们旨在分析对孕期运动无反应的患病率及其潜在的社会人口学和医学预测因素，以及无反应与不良妊娠结局之间的关联。在688名完成了一项由专人指导的轻至中等强度运动计划（每周三次，每次约1小时，包括有氧运动、阻力训练和盆底肌肉训练）直至接近足月的女性中，那些出现EGWG、GDM或GH的女性被视为“无反应者”。GDM（3.6%）和GH（3.4%）的无反应者患病率较低，但EGWG（24.2%）并非如此。孕前肥胖是GH（优势比8.40[95%置信区间3.10 - 22.78]）和EGWG（5.37[2.78 - 10.39]）无反应的最强预测因素，而最高学历可降低GDM无反应的风险（0.10[0.02 - 0.49]）。EGWG无反应与产程延长、器械助产/剖宫产、巨大儿风险增加以及阿氏评分较低相关。未发现GDM/GH与不良分娩结局有关。总之，孕前肥胖的女性可能需要在轻至中等强度的孕期运动之外采取额外的干预措施（如饮食和/或更高的运动负荷），以确保获得心脏代谢方面的益处。
