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从一次分娩到下一次分娩:剖宫产如何影响产妇在后续孕期的身体活动及健康——一项前瞻性队列研究。

From one birth to the next: how cesarean section affects maternal physical activity and health in later pregnancy-A prospective cohort study.

作者信息

Szablewska Anna Weronika, Zając Bartosz, Santos-Rocha Rita

机构信息

Department of Obstetric and Gynaecological 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 Culture in Krakow, Kraków, Poland.

出版信息

Front Public Health. 2025 Aug 13;13:1657089. doi: 10.3389/fpubh.2025.1657089. eCollection 2025.

Abstract

BACKGROUND

Cesarean section (CS) is a common surgical procedure in obstetrics, and its prevalence has been increasing globally. While the immediate outcomes of CS are well-documented, its long-term effects, particularly on maternal health, remain an area of active research. One of the critical concerns is the impact of a previous CS on gestational body mass gain (GBMG), physical activity (PA) and the likelihood of undergoing another CS in subsequent pregnancies.

OBJECTIVE

The aim of this study is to evaluate the potential association of a previous CS on GBMG, PA levels and the likelihood of repeat cesarean delivery in a cohort of multiparous women.

METHODS

This prospective cohort study, enrolling 109 Caucasian women, was conducted at a tertiary care hospital in northern Poland. Participants were recruited from antenatal outpatient clinics. The participants were divided into two groups: those who underwent previous CS and those who had vaginal delivery. Data collection was conducted in two phases. In the first phase, socio-demographic information was gathered, and participants were asked to complete the Polish version of the Get Active Questionnaire for Pregnancy. In the second phase, biomedical data routinely collected during childbirth were obtained.

RESULTS

Women with a history of CS were found to have a significantly higher likelihood of excessive gestational GBMG and were more likely to undergo another cesarean delivery in subsequent pregnancies. However, no significant differences were observed between groups in terms of insufficient GBMG or PA levels before and during pregnancy.

CONCLUSIONS

The results allow to suggest that previous CS is associated with an increased risk of excessive GBMG and repeat cesarean delivery. However, it does not appear to have direct impact on PA levels during pregnancy. These findings emphasize the importance of monitoring GBMG and promoting healthy lifestyle behaviors to improve maternal and outcomes, particularly in women with a history of CS. Future research is needed to explore the long-term effects of CS on maternal health and its influence on subsequent pregnancies.

摘要

背景

剖宫产是产科常见的外科手术,其在全球的发生率一直在上升。虽然剖宫产的近期结局已有充分记录,但其长期影响,尤其是对孕产妇健康的影响,仍是一个活跃的研究领域。一个关键问题是既往剖宫产对孕期体重增加(GBMG)、身体活动(PA)以及后续妊娠再次剖宫产可能性的影响。

目的

本研究旨在评估既往剖宫产与多产妇女队列中GBMG、PA水平及再次剖宫产可能性之间的潜在关联。

方法

这项前瞻性队列研究在波兰北部的一家三级医疗医院开展,招募了109名白人女性。参与者从产前门诊招募。参与者被分为两组:既往接受剖宫产的妇女和经阴道分娩的妇女。数据收集分两个阶段进行。在第一阶段,收集社会人口学信息,并要求参与者完成波兰语版的《孕期积极问卷》。在第二阶段,获取分娩期间常规收集的生物医学数据。

结果

有剖宫产史的女性孕期GBMG过度增加的可能性显著更高,且在后续妊娠中更有可能再次接受剖宫产。然而,两组在孕期前后GBMG不足或PA水平方面未观察到显著差异。

结论

研究结果表明,既往剖宫产与GBMG过度增加及再次剖宫产的风险增加有关。然而,它似乎对孕期PA水平没有直接影响。这些发现强调了监测GBMG和促进健康生活方式行为以改善孕产妇结局的重要性,特别是对于有剖宫产史的女性。未来需要进一步研究剖宫产对孕产妇健康的长期影响及其对后续妊娠的影响。

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