Claiborne Alex, Jevtovic Filip, May Linda E
Department of Kinesiology, East Carolina University, Greenville, North Carolina, USA.
Human Performance Laboratory, East Carolina University, Greenville, North Carolina, USA.
Birth Defects Res. 2023 Oct 15;115(17):1581-1597. doi: 10.1002/bdr2.2249. Epub 2023 Sep 22.
The current recommendations for prenatal exercise dose align with those from the American College of Sports Medicine; 150 min of moderate intensity every week of pregnancy. However, recent works suggest there may be a dose-dependent beneficial effect for mother and offspring; maternal and offspring health outcomes respond differently to low, medium, and high doses of prenatal exercise. It is, therefore, our aim to summarize the published evidence (years 1950-2023) for five metrics of prenatal exercise training commonly reported, that is, "FITT-V": Frequency (number of sessions), Intensity (metabolic equivalents "METs"), Time (duration of sessions), Type (exercise mode), Volume (exercise MET*mins). The target audience includes clinicians and health care professionals, as well as exercise professionals and physiologists. Data suggest that moderate exercise frequency (3-4 times weekly) appears safe and efficacious for mother and offspring, while there is contradictory evidence for the safety and further benefit of increased frequency beyond 5 sessions per week. Moderate (3-6 METs) and vigorous (>6 METs) intensity prenatal exercise have been shown to promote maternal and offspring health, while little research has been performed on low-intensity (<3 METs) exercise. Exercise sessions lasting less than 1 hr are safe for mother and fetus, while longer-duration exercise should be carefully considered and monitored. Taken together, aerobic, resistance, or a combination of exercise types is well tolerated at medium-to-high volumes and offers a variety of type-specific benefits. Still, research is needed to define (1) the "minimum" effective dose of exercise for mother and offspring health, as well as (2) the maximum tolerable dose from which more benefits may be seen. Additionally, there is a lack of randomized controlled trials addressing exercise doses during the three trimesters of pregnancy. Further, the protocols adopted in research studies should be more standardized and tested for efficacy in different populations of gravid women.
目前关于产前运动剂量的建议与美国运动医学学院的建议一致；孕期每周进行150分钟的中等强度运动。然而，最近的研究表明，产前运动对母亲和后代可能存在剂量依赖性的有益影响；母亲和后代的健康结果对低、中、高剂量的产前运动反应不同。因此，我们的目的是总结1950年至2023年期间发表的关于产前运动训练通常报告的五个指标的证据，即“FITT-V”：频率（训练次数）、强度（代谢当量“METs”）、时间（每次训练的持续时间）、类型（运动模式）、运动量（运动MET*分钟）。目标受众包括临床医生和医疗保健专业人员，以及运动专业人员和生理学家。数据表明，中等运动频率（每周3 - 4次）对母亲和后代似乎是安全有效的，而对于每周超过5次的频率增加的安全性和进一步益处存在相互矛盾的证据。中等强度（3 - 6 METs）和高强度（>6 METs）的产前运动已被证明可促进母亲和后代的健康，而对低强度（<3 METs）运动的研究较少。持续时间少于1小时的运动对母亲和胎儿是安全的，而持续时间较长的运动应仔细考虑并进行监测。总体而言，中等至高运动量的有氧、抗阻或运动类型组合耐受性良好，并提供各种特定类型的益处。不过，仍需要研究来确定（1）对母亲和后代健康的运动“最小”有效剂量，以及（2）可能看到更多益处的最大耐受剂量。此外，缺乏针对孕期三个阶段运动剂量的随机对照试验。此外，研究中采用的方案应更加标准化，并在不同孕妇群体中进行疗效测试。
