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孕中、晚期中度及以上体力活动水平与孕期增重的关系研究

Moderate-to-vigorous Physical Activities and Gestational Weight Gains during the Second and Last Trimesters of Pregnancy

  • 摘要: 目的 调查了解成都地区孕中、晚期妇女中度及以上体力活动(MVPA)水平,并探讨MVPA水平与孕期增重及增重速率的关系。方法 采用前瞻性研究方法,选取362例成都市妇幼医疗机构产前门诊24~28周单胎健康孕妇作为研究对象,通过问卷调查收集其孕前体质量及生活方式等基本信息。分别于孕24~28周和32~36周测量孕妇体质量,计算孕中期、孕晚期增重及增重速率;同时,采用丹麦自填式体力活动量表收集孕中、晚期体力活动强度及持续时间。采用多重线性回归模型分析孕中、晚期MVPA水平与孕期增重及增重速率的关系。结果 孕中、晚期每日平均MVPA时间分别为(1.61±1.61) h和(0.76±0.93) h,差异有统计学意义(t=9.056, P<0.001)。孕中、晚期MVPA达标率分别为74.6%和60.5%,差异有统计学意义(χ2=16.387, P<0.001)。孕早中期和孕晚期平均增重为(7.36±3.78) kg和(5.80±2.57) kg,平均增重速率为(0.30±0.15) kg/周和(0.51±0.22) kg/周。体力活动中活跃组孕晚期增重(5.34±2.91) kg低于不活跃组(6.26±2.54) kg,差异有统计学意义(P<0.05);中活跃组孕晚期增重速率(0.48±0.26) kg/周也低于不活跃组(0.56±0.20) kg/周,差异有统计学意义(P<0.05)。单因素分析结果显示:年龄、孕周、民族、孕前体质量指数(BMI)、是否患妊娠期糖尿病(GDM)、孕前吸烟习惯、孕前是否就业是孕早中期、晚期增重及增重速率的潜在影响因素(P<0.05)。控制孕妇年龄、膳食能量摄入量、孕前BMI等混杂因素后,多重线性回归分析显示:与不活跃组孕晚期增重相比,低活跃组孕晚期增重减少,β(95%CI)值为-0.358(-0.691~-0.026);中活跃组孕晚期增重减少,β(95%CI)值为-0.762(-1.486~-0.037);与不活跃组孕晚期增重速率相比,中活跃组孕晚期增重速率降低,β(95%CI)值为-0.071(-0.133~-0.008)。结论 成都地区孕中、晚期妇女中度及以上体力活动不足问题突出,适量的中度及以上体力活动可降低孕晚期增重及增重速率。

     

    Abstract: Objective To determine the level of moderate-to-vigorous physical activities (MVPA) and its relationship with gestational weight gains (GWG) in the second and the last trimesters of pregnancy. Methods A prospective study was conducted in Chengdu on 362 healthy pregnant women at the 24-28 gestation weeks who delivered a singleton. Demographic data and pre-pregnancy body mass were collected using a questionnaire. Weight gains at the gestation weeks of 24-28 and 32-36 were measured for the first two trimesters and the last trimester of pregnancy. The Denmark self-reported physical activity scale was used for measuring the duration and intensity of physical activities. Multiple linear regression models were established to determine the relationship between MVPA and GWG. Results The last trimester had lower average daily MVPA 〔(0.76±0.93) h〕 compared with the second trimester 〔(1.61±1.61) h, t=9.056, P<0.001〕. About 74.6% of the participants met the PA recommendations for the second trimester, compared with 60.5% for the last trimester (χ2=16.387, P<0.001). The participants experienced an average GWG of (7.36±3.78) kg during the first two trimesters, and (5.80±2.57) kg during the last trimester, corresponding to a growth rate of (0.30±0.15) kg/week for the first two trimesters and (0.51±CM(155mm 0.22) kg/week for the last trimester. Compared with the most inactive group, the participants with medium PAexperienced less GWG 〔(5.34±2.91) kg vs.(6.26±2.54) kg, P<0.05〕 and a lower GWG rate 〔(0.48±0.26) kg/week vs.(0.56±0.20) kg/week, P<0.05〕 during the last trimester. Age, gestational week, ethnicity, pre-pregnant BMI, GDM, pre-pregnant smoking and employment were associated with GWG and the GWG rates during the first two trimesters and the third trimester (P<0.05). Compared with the most inactive group, low 〔-0.358(-0.691--0.026)〕 and medium 〔-0.762(-1.486- -0.037)〕 PA were associated with lower GWG during the last trimester. Moderate PA was associated with a lower GWG rate 〔-0.071(-0.133--0.008)〕 after adjustment for gestational age, energy intake, pre-pregnancy BMI and other potential confounders. Conclusion Insufficient physical activities are a serious problem in the pregnant women of Chengdu over the last two trimesters. Appropriate MVPA in the last trimester of pregnancy may reduce GWG and GWG rates.

     

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