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孕期体温调节:一项关于热环境中运动时母体体温过高风险的对照试验

Thermoregulation During Pregnancy: a Controlled Trial Investigating the Risk of Maternal Hyperthermia During Exercise in the Heat.

作者信息

Smallcombe James W, Puhenthirar Agalyaa, Casasola William, Inoue Daniela S, Chaseling Georgia K, Ravanelli Nicholas, Edwards Kate M, Jay Ollie

机构信息

Thermal Ergonomics Laboratory, Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.

Exeter Medical School, University of Exeter, Exeter, UK.

出版信息

Sports Med. 2021 Dec;51(12):2655-2664. doi: 10.1007/s40279-021-01504-y. Epub 2021 Jun 24.

Abstract

OBJECTIVES

Despite the well-established benefits of exercise, pregnant women are discouraged from physical activity in hot/humid conditions to avoid hyperthermia (core temperature (T) ≥ 39.0 °C). Recent epidemiological evidence also demonstrates greater risk of negative birth outcomes following heat exposure during pregnancy, possibly due to thermoregulatory impairments. We aimed to determine (1) the risk of pregnant women exceeding a T of 39.0 °C during moderate-intensity exercise in the heat; and (2) if any thermoregulatory impairments are evident in pregnant (P) versus non-pregnant (NP) women.

METHODS

Thirty participants (15 pregnant in their second trimester or third trimester) completed two separate exercise-heat exposures in a climate chamber (32 °C, 45%RH). On separate occasions, each participant cycled on a semi-recumbent cycle ergometer for 45 min at a workload representative of a moderate-intensity (1) non-weight-bearing (NON-WB), or (2) weight-bearing (WB) activity. Thermoregulatory responses were monitored throughout.

RESULTS

The highest rectal temperature observed in a pregnant individual was 37.93 °C. Mean end-exercise rectal temperature did not differ between groups (P:37.53 ± 0.22 °C, NP:37.52 ± 0.34 °C, P = 0.954) in the WB trial, but was lower in the P group (P:37.48 ± 0.25 °C, vs NP:37.73 ± 0.38 °C, P = 0.041) in the NON-WB trial. Whole-body sweat loss was unaltered by pregnancy during WB (P:266 ± 62 g, NP:264 ± 77 g; P = 0.953) and NON-WB P:265 ± 51 g, NP:300 ± 75 g; P = 0.145) exercise. Pregnant participants reported higher ratings of thermal sensation (felt hotter) than their non-pregnant counterparts in the WB trial (P = 0.002) but not in the NON-WB trial, (P = 0.079).

CONCLUSION

Pregnant women can perform 45 min of moderate-intensity exercise at 32 °C, 45%RH with very low apparent risk of excessive maternal hyperthermia. No thermoregulatory impairments with pregnancy were observed.

摘要

目的

尽管运动已被证实有诸多益处,但孕妇在炎热/潮湿环境中仍不被鼓励进行体育活动,以避免体温过高(核心体温(T)≥39.0°C)。近期的流行病学证据还表明,孕期受热后出现不良分娩结局的风险更高,这可能是由于体温调节功能受损所致。我们旨在确定:(1)孕妇在炎热环境中进行中等强度运动时,体温超过39.0°C的风险;(2)与非孕妇(NP)相比,孕妇(P)是否存在明显的体温调节功能受损情况。

方法

30名参与者(15名处于孕中期或孕晚期)在气候舱(32°C,45%相对湿度)中完成了两次单独的运动-受热暴露试验。在不同时间,每位参与者在半卧位自行车测力计上以代表中等强度的工作量骑行45分钟,分别进行(1)非负重(NON-WB)或(2)负重(WB)活动。全程监测体温调节反应。

结果

在孕妇中观察到的最高直肠温度为37.93°C。在负重试验中,两组运动结束时的平均直肠温度无差异(P组:37.53±0.22°C,NP组:37.52±0.34°C,P = 0.954),但在非负重试验中,P组较低(P组:37.48±0.25°C,NP组:37.73±0.38°C,P = 0.041)。在负重(P组:266±62克,NP组:264±77克;P = 0.953)和非负重运动(P组:265±51克,NP组:300±75克;P = 0.145)期间,孕期全身出汗量未受影响。在负重试验中,孕妇报告的热感觉评分(感觉更热)高于非孕妇(P = 0.002),但在非负重试验中并非如此(P = 0.079)。

结论

孕妇在32°C、45%相对湿度下可进行45分钟的中等强度运动,出现母体体温过高的明显风险极低。未观察到孕期体温调节功能受损情况。

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