Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA.
Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA.
Pediatr Res. 2024 Jan;95(1):334-341. doi: 10.1038/s41390-023-02768-y. Epub 2023 Aug 5.
The relationship between maternal physical activity (PA)/sitting and birth defects is largely unexplored. We examined whether pre-pregnancy PA/sitting were associated with having a pregnancy affected by a birth defect.
We used data from two United States population-based case-control studies: 2008-2011 deliveries from the National Birth Defects Prevention Study (NBDPS; 9 states) and 2014-2018 deliveries from the Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS; 7 states). Cases with one of 12 non-cardiac birth defects (n = 3798) were identified through population-based registries. Controls (n = 2682) were live-born infants without major birth defects randomly sampled using vital/hospital records. Mothers self-reported pre-pregnancy PA/sitting. Unconditional logistic regression models estimated associations between PA/sitting categories and the 12 birth defects.
Mothers engaging in pre-pregnancy PA was associated with a reduced odds of five (spina bifida, cleft palate, anorectal atresia, hypospadias, transverse limb deficiency) and a higher odds of two (anencephaly, gastroschisis) birth defects. Mothers spending less time sitting in pre-pregnancy was associated with a reduced odds of two (anorectal atresia, hypospadias) and a higher odds of one (cleft lip with or without cleft palate) birth defect.
Reasonable next steps include replication of these findings, improved exposure assessment, and elucidation of biologic mechanisms.
Using data from two population-based case-control studies, we found that mothers engaging in different types of physical activity in the 3 months before pregnancy had an infant with a reduced odds of five and a higher odds of two birth defects. Mothers spending less time sitting in the 3 months before pregnancy had an infant with a reduced odds of two and a higher odds of one birth defect. Clarification and confirmation from additional studies are needed using more precise exposure measures, distinguishing occupational from leisure-time physical activity, and elucidation of mechanisms supporting these associations.
母体体力活动（PA）/久坐与出生缺陷之间的关系在很大程度上尚未得到探索。我们研究了孕前 PA/久坐是否与妊娠缺陷有关。
我们使用了两项美国基于人群的病例对照研究的数据：2008-2011 年来自国家出生缺陷预防研究（NBDPS；9 个州）的分娩数据和 2014-2018 年来自出生缺陷研究评估妊娠暴露（BD-STEPS；7 个州）的分娩数据。通过人群登记处确定了 12 种非心脏出生缺陷（n=3798）的病例。对照（n=2682）是通过生命/医院记录随机抽样的无重大出生缺陷的活产儿。母亲自我报告了孕前 PA/久坐情况。非条件逻辑回归模型估计了 PA/久坐类别与 12 种出生缺陷之间的关联。
孕前进行 PA 的母亲发生五种（脊柱裂、腭裂、肛门直肠闭锁、尿道下裂、横肢缺失）出生缺陷的几率降低，发生两种（无脑畸形、腹裂）出生缺陷的几率升高。孕前久坐时间减少的母亲发生两种（肛门直肠闭锁、尿道下裂）出生缺陷的几率降低，发生一种（唇裂伴或不伴腭裂）出生缺陷的几率升高。
合理的下一步包括复制这些发现、改进暴露评估以及阐明生物学机制。
使用两项基于人群的病例对照研究的数据，我们发现，在怀孕前的 3 个月内，从事不同类型体力活动的母亲所生婴儿发生五种出生缺陷的几率降低，发生两种出生缺陷的几率升高。在怀孕前的 3 个月内久坐时间减少的母亲所生婴儿发生两种出生缺陷的几率降低，发生一种出生缺陷的几率升高。需要通过使用更精确的暴露测量方法、区分职业性与休闲性体力活动、阐明支持这些关联的机制，从其他研究中获得进一步的澄清和确认。
