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孕期运动对种族/民族健康差异和生育结局的影响。

The influence of exercise during pregnancy on racial/ethnic health disparities and birth outcomes.

机构信息

Department of Business, East Carolina University (ECU), 1851 MacGregor Downs Rd, MS#701, Greenville, NC, 27834, USA.

Department of Kinesiology, ECU, Greenville, NC, USA.

出版信息

BMC Pregnancy Childbirth. 2021 Mar 26;21(1):258. doi: 10.1186/s12884-021-03717-5.

Abstract

BACKGROUND

Non-Hispanic black (NHB) pregnant women disproportionately experience adverse birth outcomes compared to Non-Hispanic white (NHW) pregnant women. The positive effects of prenatal exercise on maternal and neonatal health may mitigate these disparities. This study evaluated the influence of prenatal exercise on racial/ethnic disparities in gestational age (GA), birthweight (BW), and risks of preterm birth (PTB), cesarean section (CS), and low-birthweight (LBW) neonates.

METHODS

This study performed a secondary data analysis using data from a 24-week, two-arm exercise intervention trial (ENHANCED by Mom). Women with singleton pregnancies (< 16 weeks), aged 18-40 years, BMI between 18.5-34.99 kg/m, and no preexisting health conditions were eligible. The aerobic exercisers (EX) participated in 150 min of moderate-intensity weekly exercise while non-exercising controls (CON) attended low-intensity stretching/breathing sessions. Data on GA, PTB (< 37 weeks), BW, LBW (< 2.5 kg), and delivery mode were collected. Poisson, median and linear regressions were performed.

RESULTS

Participants with complete data (n = 125) were eligible for analyses (EX: n = 58, CON: n = 67). NHB pregnant women delivered lighter neonates (β = - 0.43 kg, 95% CI: - 0.68, - 0.18, p = 0.001). After adjusting for prenatal exercise, racial/ethnic disparities in BW were reduced (β = - 0.39 kg, 95% CI: - 0.65, - 0.13, p = 0.004). Prenatal exercise reduced borderline significant racial/ethnic disparities in PTB (p = 0.053) and GA (p = 0.07) with no effects found for CS and LBW.

CONCLUSIONS

The findings of this study demonstrate that prenatal exercise may attenuate the racial/ethnic disparities observed in neonatal BW, and possibly GA and PTB. Larger, diverse samples and inclusion of maternal biomarkers (e.g., cytokines) are encouraged to further evaluate these relationships.

摘要

背景

与非西班牙裔白人(NHW)孕妇相比,非西班牙裔黑人(NHB)孕妇的不良妊娠结局比例更高。产前运动对母婴健康的积极影响可能会减轻这些差异。本研究评估了产前运动对种族/民族在孕龄(GA)、出生体重(BW)以及早产(PTB)、剖宫产(CS)和低出生体重(LBW)新生儿风险方面差异的影响。

方法

本研究使用一项为期 24 周、双臂运动干预试验(通过妈妈增强)的二次数据分析。纳入标准为单胎妊娠(<16 周)、年龄 18-40 岁、BMI 在 18.5-34.99kg/m2 之间、无既往健康状况的孕妇。有氧运动组(EX)每周参加 150 分钟的中等强度运动,而不运动对照组(CON)则参加低强度伸展/呼吸课程。收集 GA、PTB(<37 周)、BW、LBW(<2.5kg)和分娩方式的数据。进行泊松、中位数和线性回归分析。

结果

有完整数据的参与者(n=125)符合分析条件(EX:n=58,CON:n=67)。NHB 孕妇分娩的新生儿体重较轻(β=-0.43kg,95%CI:-0.68,-0.18,p=0.001)。调整产前运动后,BW 的种族/民族差异减少(β=-0.39kg,95%CI:-0.65,-0.13,p=0.004)。产前运动减少了 PTB(p=0.053)和 GA(p=0.07)方面的种族/民族差异,但对 CS 和 LBW 没有影响。

结论

本研究结果表明,产前运动可能会减轻新生儿 BW 方面观察到的种族/民族差异,并且可能会减轻 GA 和 PTB 方面的差异。鼓励使用更大、更多样化的样本并纳入母体生物标志物(例如细胞因子)来进一步评估这些关系。

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