妊娠和产后恢复期对健康女性身体健康的影响：一项对接受 6 周和 12 周恢复期的现役女兵的队列研究。

The effect of pregnancy and the duration of postpartum convalescence on the physical fitness of healthy women: A cohort study of active duty servicewomen receiving 6 weeks versus 12 weeks convalescence.

机构信息

Fort Benning Heat Center, Martin Army Community Hospital, Fort Benning, Georgia, United States of America.

Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland, United States of America.

出版信息

PLoS One. 2021 Jul 28;16(7):e0255248. doi: 10.1371/journal.pone.0255248. eCollection 2021.

DOI:10.1371/journal.pone.0255248

PMID:34320030

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8318247/

Abstract

INTRODUCTION

Pregnancy profoundly affects cardiovascular and musculoskeletal performance requiring up to 12 months for recovery in healthy individuals.

OBJECTIVE

To assess the effects of extending postpartum convalescence from 6 to 12 weeks on the physical fitness of Active Duty (AD) soldiers as measured by the Army Physical Fitness Test (APFT) and Body Mass Index (BMI).

METHODS

We conducted a retrospective study of AD soldiers who delivered their singleton pregnancy of ≥ 32weeks gestation at a tertiary medical center. Pre- and post-pregnancy APFT results as well as demographic, pregnancy, and postpartum data were collected. Changes in APFT raw scores, body composition measures, and failure rates across the 6-week and 12-week convalescent cohorts were assessed. Multivariable regressions were utilized to associate risk factors with failure.

RESULTS

Four hundred sixty women met inclusion criteria; N = 358 in the 6 week cohort and N = 102 in the 12 week cohort. Demographic variables were similar between the cohorts. APFT failure rates across pregnancy increased more than 3-fold in both groups, but no significant differences were found between groups in the decrement of performance or weight gain. With the combined cohort, multivariable regression analysis showed failure on the postpartum APFT to be independently associated with failure on the pre-pregnancy APFT (OR = 16.92, 95% CI 4.96-57.77), failure on pre-pregnancy BMI (OR = 8.44, 95% CI 2.23-31.92), elevated BMI at 6-8 weeks postpartum (OR = 4.02, 95% CI 1.42-11.35) and not breastfeeding at 2 months (OR = 3.23, 95% CI 1.48-7.02). Within 36 months of delivery date, 75% of women had achieved pre-pregnancy levels of fitness.

CONCLUSION

An additional 6 weeks of convalescence did not adversely affect physical performance or BMI measures in AD Army women following pregnancy. Modifiable factors such as pre- and post-pregnancy conditioning and weight, weight gain in pregnancy and always breastfeeding were found to be significant in recovery of physical fitness postpartum.

摘要

简介

怀孕会极大地影响心血管和肌肉骨骼的功能，健康个体需要 12 个月才能恢复。

目的

评估将产后恢复期从 6 周延长至 12 周对现役士兵（AD）身体状况的影响，通过陆军体能测试（APFT）和体重指数（BMI）来衡量。

方法

我们对在三级医疗中心分娩≥32 周妊娠单胎的 AD 士兵进行了回顾性研究。收集了孕前和孕后的 APFT 结果以及人口统计学、妊娠和产后数据。评估了 6 周和 12 周康复队列中 APFT 原始分数、身体成分测量值和失败率的变化。利用多变量回归将危险因素与失败相关联。

结果

460 名女性符合纳入标准；6 周队列 N = 358，12 周队列 N = 102。队列间人口统计学变量相似。两组在妊娠期间 APFT 失败率均增加了 3 倍以上，但两组在表现或体重增加方面的下降均无显著差异。在联合队列中，多变量回归分析显示，产后 APFT 失败与孕前 APFT 失败独立相关（OR = 16.92，95%CI 4.96-57.77）、孕前 BMI 失败（OR = 8.44，95%CI 2.23-31.92）、产后 6-8 周 BMI 升高（OR = 4.02，95%CI 1.42-11.35）和产后 2 个月未母乳喂养（OR = 3.23，95%CI 1.48-7.02）。产后 36 个月内，75%的女性达到了孕前的体能水平。