Lindberger Emelie, Ahlsson Fredrik, Johansson Henrik, Pitsillos Tryfonas, Sundström Poromaa Inger, Wikman Anna, Wikström Anna-Karin
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Acta Obstet Gynecol Scand. 2024 Dec;103(12):2522-2531. doi: 10.1111/aogs.14983. Epub 2024 Oct 21.
Physical activity during pregnancy is beneficial for the woman and the fetus. However, non-objective methods are often used to measure physical activity levels during pregnancy. This study aimed to evaluate objectively measured maternal early to mid-pregnancy sedentary behavior and physical activity in relation to infant well-being.
This cohort study included 1153 pregnant women and was performed at Uppsala University Hospital, Uppsala, Sweden, between 2016 and 2023. Sedentary behavior and physical activity levels were measured by accelerometers during 4-7 days in early to mid-pregnancy. Outcome measures were infant birthweight standard deviation score, small-for-gestational-age, large-for-gestational-age, preterm birth (<37 weeks' gestation), spontaneous preterm birth, iatrogenic preterm birth, Apgar <7 at 5 min of age, umbilical artery pH ≤7.05, and admission to the neonatal intensive care unit (NICU).
There were no associations of sedentary behavior and physical activity levels with infant birthweight standard deviation score, small-for-gestational-age, or large-for-gestational-age. After adjustment for BMI, age, smoking, parity, maternal country of birth, and a composite of pre-pregnancy disease, the most sedentary women had higher odds of preterm birth (adjusted odds ratio (AOR) 2.47, 95% confidence interval (CI) 1.17-5.24, p = 0.018), and NICU admission (AOR 1.93, CI 1.11-3.37, p = 0.021) than the least sedentary women. The most physically active women had lower adjusted odds for NICU admission (AOR 0.45, CI 0.26-0.80, p = 0.006) than the least physically active women.
Objectively measured levels of sedentary behavior and physical activity in early to mid-pregnancy were not associated with standardized infant birth size. Sedentary behavior was associated with an increased likelihood of preterm birth and NICU admission, while high level of physical activity was associated with a decreased likelihood of admission to NICU.
孕期进行体育活动对孕妇和胎儿均有益处。然而，孕期体育活动水平的测量方法往往缺乏客观性。本研究旨在客观评估孕早期至孕中期孕妇的久坐行为和体育活动与婴儿健康状况之间的关系。
本队列研究纳入了1153名孕妇，于2016年至2023年在瑞典乌普萨拉大学医院开展。通过加速度计在孕早期至孕中期的4至7天内测量久坐行为和体育活动水平。观察指标包括婴儿出生体重标准差评分、小于胎龄儿、大于胎龄儿、早产（妊娠<37周）、自发性早产、医源性早产、出生后5分钟阿氏评分<7分、脐动脉pH值≤7.05以及入住新生儿重症监护病房（NICU）。
久坐行为和体育活动水平与婴儿出生体重标准差评分、小于胎龄儿或大于胎龄儿之间均无关联。在对体重指数、年龄、吸烟状况、产次、产妇出生国家以及孕前疾病综合因素进行调整后，久坐时间最长的女性发生早产（调整后的优势比[AOR]为2.47，95%置信区间[CI]为1.17 - 5.24，p = 0.018）和入住NICU（AOR为1.93，CI为1.11 - 3.37，p = 0.021）的几率高于久坐时间最短的女性。体育活动量最大的女性入住NICU的调整后优势比（AOR为0.45，CI为0.26 - 0.80，p = 0.006）低于体育活动量最小的女性。
客观测量的孕早期至孕中期久坐行为和体育活动水平与婴儿标准化出生大小无关。久坐行为与早产和入住NICU的可能性增加相关，而高水平的体育活动与入住NICU的可能性降低相关。
