Hatch M C, Shu X O, McLean D E, Levin B, Begg M, Reuss L, Susser M
Division of Epidemiology, Columbia University School of Public Health, New York, NY 10032.
Am J Epidemiol. 1993 May 15;137(10):1105-14. doi: 10.1093/oxfordjournals.aje.a116614.
The value of exercise during pregnancy is controversial; both benefits and risks have been hypothesized. As empiric evidence is scant, the issue was investigated in a prospective study that assessed the impact on fetal growth of maternal exercise in each trimester of pregnancy. A cohort of over 800 prenatal patients was recruited from obstetric practices in Pennsylvania and New York between January 1987 and June 1989. Subjects were interviewed at entry into care and recontacted at 28 and 36 weeks of gestation. In women with prior adverse outcomes or a lack of conditioning, the associations between maternal exercise and fetal growth were equivocal. In fit, low-risk, prenatal patients, exercise was positively associated with fetal growth. With low-moderate exercise levels, the adjusted mean birth weights were about 100 g higher than in nonexercisers (117 g; 95% confidence interval 17 to 217 g). With heavier exercise, larger birth weight increments were seen, close to 300 g in those who exercised throughout pregnancy at levels of about 2,000 kcal/week in energy expenditure (276 g; 95% confidence interval 54 to 497 g). These results suggest that the guidelines issued by the American College of Obstetricians and Gynecologists may be too stringent for well-conditioned, low-risk, prenatal patients. Additional research to define safe limits more precisely seems warranted.
孕期运动的价值存在争议；人们已假定其既有益处也有风险。由于实证证据不足，在一项前瞻性研究中对该问题进行了调查，该研究评估了孕期各阶段母体运动对胎儿生长的影响。1987年1月至1989年6月期间，从宾夕法尼亚州和纽约州的产科诊所招募了800多名产前患者。受试者在开始接受护理时接受访谈，并在妊娠28周和36周时再次联系。在有既往不良结局或缺乏运动习惯的女性中，母体运动与胎儿生长之间的关联不明确。在健康、低风险的产前患者中，运动与胎儿生长呈正相关。运动水平为低至中度时，调整后的平均出生体重比不运动者高约100克（117克；95%置信区间为17至217克）。运动强度更大时，出生体重增加幅度更大，在整个孕期以约2000千卡/周的能量消耗水平运动的人群中，出生体重增加近300克（276克；95%置信区间为54至497克）。这些结果表明，美国妇产科医师学会发布的指南对于健康状况良好、低风险的产前患者可能过于严格。进行更多研究以更精确地界定安全限度似乎是有必要的。
