Gou Wanglong, Xiao Congmei, Liang Xinxiu, Miao Zelei, Shi Meiqi, Wu Yingying, Lu Sha, Wang Xuhong, Fu Yuanqing, Hu Wensheng, Zheng Ju-Sheng
Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China.
Research Center for Industries of the Future, School of Life Sciences, Westlake University, Hangzhou, China.
JAMA Netw Open. 2024 Dec 2;7(12):e2451799. doi: 10.1001/jamanetworkopen.2024.51799.
Physical activity, as a modifiable factor, emerges as a primary intervention strategy for the prevention and management of gestational diabetes (GD). Among women with GD, the association of physical activity during pregnancy with preterm birth remains unclear.
To examine the association of accelerometer-derived physical activity metrics and patterns with preterm birth among women with GD.
DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study recruited pregnant women with GD in Hangzhou, China, from August 2019 to August 2023 as part of the Westlake Precision Birth Cohort study. Statistical analysis was performed between August and November 2023.
Wearable accelerometer-derived physical activity metrics and patterns. Measurements of physical activity via wearable accelerometer were performed at a median (IQR) of 25.4 (24.6-26.6) weeks' gestation.
Preterm birth was determined through the examination of delivery records. Incident preterm birth was defined as the delivery of infants before completing 37 weeks of gestation.
Among the 1427 women meeting the inclusion criteria, the mean (SD) age was 31.3 (3.8) years, and there were 80 cases of preterm birth. An increase in moderate-to-vigorous intensity physical activity (MVPA) and the fraction of physical activity energy expenditure derived from MVPA exhibited an inverse association with preterm birth, with an odds ratio per 30 minutes of 0.64 (95% CI, 0.42-0.98) and an odds ratio per SD of 0.69 (95% CI, 0.55-0.88). In the dose-response analysis, there was a progressive decrease in the odds of preterm birth with increasing duration of MVPA per day, reaching a plateau at approximately 74 minutes per day. Furthermore, the findings indicated that active MVPA (MVPA ≥30 minutes per day), whether it was concentrated into a few days or followed a more regular pattern, had similar beneficial association with preterm birth.
In this prospective cohort study, MVPA during pregnancy exhibited an inverse association with preterm birth among women with GD. Concentrated physical activity was associated with similar benefits in reducing preterm birth risk as regular physical activity.
体育活动作为一个可改变的因素，已成为预防和管理妊娠期糖尿病（GD）的主要干预策略。在患有妊娠期糖尿病的女性中，孕期体育活动与早产之间的关联仍不明确。
研究在患有妊娠期糖尿病的女性中，通过加速度计得出的体育活动指标和模式与早产之间的关联。
设计、背景和参与者：这项前瞻性队列研究于2019年8月至2023年8月在中国杭州招募患有妊娠期糖尿病的孕妇，作为西湖精准出生队列研究的一部分。于2023年8月至11月进行统计分析。
通过可穿戴式加速度计得出的体育活动指标和模式。在妊娠25.4（24.6 - 26.6）周的中位数（四分位间距）时，通过可穿戴式加速度计进行体育活动测量。
通过检查分娩记录确定早产情况。偶发性早产定义为婴儿在妊娠37周前出生。
在1427名符合纳入标准的女性中，平均（标准差）年龄为31.3（3.8）岁，有80例早产。中度至剧烈强度体育活动（MVPA）以及MVPA在体育活动能量消耗中所占比例的增加与早产呈负相关，每30分钟的比值比为0.64（95%置信区间，0.42 - 0.98），每标准差的比值比为0.69（95%置信区间，0.55 - 0.88）。在剂量反应分析中，随着每天MVPA持续时间的增加，早产几率逐渐降低，在每天约74分钟时达到平稳状态。此外，研究结果表明，活跃的MVPA（每天MVPA≥30分钟），无论是集中在几天内还是遵循更规律的模式，与早产都有相似的有益关联。
在这项前瞻性队列研究中，孕期的MVPA在患有妊娠期糖尿病的女性中与早产呈负相关。集中进行体育活动与规律体育活动在降低早产风险方面具有相似的益处。
