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体力活动对经阴道分娩女性母婴结局的影响——单中心前瞻性队列研究

Impact of physical activity on maternal and neonatal outcomes among women with vaginal births-single center prospective cohort study.

作者信息

Szablewska Anna Weronika, Zaja̧c Bartosz

机构信息

Department of Obstetric and Gynecological Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdańsk, Gdańsk, Poland.

Laboratory of Functional Diagnostics, Central Scientific and Research Laboratory, University of Physical Education in Kraków, Kraków, Poland.

出版信息

Front Med (Lausanne). 2025 Jun 3;12:1606471. doi: 10.3389/fmed.2025.1606471. eCollection 2025.

Abstract

BACKGROUND

Optimal levels of physical activity during pregnancy are associated with numerous health benefits for both the mother and fetus. Additionally, maternal exercise has been linked to improved cardiovascular fitness, reduced lower back pain, enhanced mental wellbeing and favorable neonatal outcomes, including a lower risk of macrosomia and improved placental function. However, both insufficient and excessive physical activity levels may have adverse effects, highlighting the need for a balanced approach.

OBJECTIVE

The aim of this study was to evaluate the impact of physical activity before and during pregnancy on maternal perinatal outcomes and neonatal condition. The hypothesis proposes that physical activity at the level recommended by the World Health Organization (WHO) does not negatively affect maternal or neonatal outcomes.

METHODS

This single-center prospective cohort study was conducted at a tertiary care hospital in northern Poland. Participants were recruited from antenatal outpatient clinics and classified based on their physical activity levels before and during pregnancy according to WHO as well as Canadian and the American College of Obstetricians and Gynecologists' guidelines. Data collection occurred in two stages: first, through a questionnaire including socio-demographic data and the Polish version of the Get Active Questionnaire for Pregnancy, and second, by analyzing biomedical data routinely collected during childbirth. A total of 115 cases were included in the final analysis. Statistical analyses comprised logistic and linear regression model implementation, as well as the Student's -test, Welch's -test and the Mann-Whitney -test, with the level of statistical significance set at < 0.001.

RESULTS

No statistically significant effects of physical activity before or during pregnancy were observed on platelet count, hemoglobin levels, C-reactive protein concentrations, labor duration, BMI changes, anesthesia use, perineal trauma, or neonatal outcomes (including birth mass, length, head circumference, chest circumference, APGAR scores, and umbilical cord blood parameters).

CONCLUSION

Physical activity before and during pregnancy does not negatively impact maternal or neonatal outcomes. These findings support current physical activity recommendations during pregnancy, emphasizing the need for further research on the mechanisms underlying hematological changes associated with exercise.

摘要

背景

孕期的最佳身体活动水平对母亲和胎儿都有诸多健康益处。此外,母亲运动与心血管健康改善、下背痛减轻、心理健康增强以及良好的新生儿结局相关,包括巨大儿风险降低和胎盘功能改善。然而,身体活动水平不足和过度都可能产生不利影响,这凸显了采取平衡方法的必要性。

目的

本研究旨在评估孕前及孕期身体活动对母亲围产期结局和新生儿状况的影响。该假设提出,世界卫生组织(WHO)推荐水平的身体活动不会对母亲或新生儿结局产生负面影响。

方法

这项单中心前瞻性队列研究在波兰北部的一家三级护理医院进行。参与者从产前门诊招募,并根据WHO以及加拿大和美国妇产科医师学会的指南,依据其孕前及孕期的身体活动水平进行分类。数据收集分两个阶段进行:首先,通过一份包括社会人口统计学数据和波兰版孕期活动问卷的问卷进行收集;其次,通过分析分娩期间常规收集的生物医学数据进行收集。最终分析纳入了115例病例。统计分析包括实施逻辑回归和线性回归模型,以及学生t检验、韦尔奇t检验和曼-惠特尼U检验,统计学显著性水平设定为P < 0.001。

结果

未观察到孕前或孕期身体活动对血小板计数、血红蛋白水平、C反应蛋白浓度、产程、体重指数变化、麻醉使用、会阴创伤或新生儿结局(包括出生体重、身长、头围、胸围、阿氏评分和脐血参数)有统计学显著影响。

结论

孕前及孕期身体活动不会对母亲或新生儿结局产生负面影响。这些发现支持当前孕期身体活动建议,强调需要进一步研究与运动相关的血液学变化背后的机制。

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