孕中期身体活动与剖宫产关系的队列研究

  目的   探究孕中期妇女不同类型和强度的身体活动对剖宫产的影响。   方法   以中国孕产妇队列研究协和项目中的672名孕妇为研究对象, 采用孕期身体活动问卷(pregnancy physical activity questionnaire, PPAQ)调查孕中期妇女身体活动情况, 随访获得研究对象的分娩方式。采用多因素非条件Logistic回归分析模型对数据进行统计分析。   结果   273名孕妇(40.63%)的分娩方式为剖宫产。调整年龄、孕前体重指数(body mass index, BMI)、产史等因素后, 相比于不参加运动锻炼的孕妇, 运动锻炼较高水平的孕妇剖宫产发生风险较低(OR=0.564, 95% CI:0.338~0.941);相对于参加低水平中重度身体活动的孕妇, 参与较高水平中重度身体活动的孕妇剖宫产发生风险较低(OR=0.652, 95% CI:0.437~0.972)。   结论   运动锻炼和中重度身体活动是剖宫产的保护因素, 应进一步加强孕期运动的健康教育, 鼓励孕妇在孕期进行适宜的身体活动。

Association of physical activity and cesarean section in the second trimester of pregnancy:a cohort study

Objective To explore the associations between cesarean section with different types and intensity of physical activity in the second trimester pregnant women.Methods Six hundred and seventy-two participants from the Chinese pregnant women cohort study(CPWCS)were analyzed.The pregnancy physical activity questionnaire(PPAQ)was used to collect the status of physical activities in pregnant women.The participants were followed up and the data of delivery way was collected.Logistic regression model was conducted to analyze the associations.Results A total of 273 pregnant women(40.63%)were delivered by cesarean section.After adjusting age,pre-pregnancy BMI and history of childbirth,results of Logistic regression model showed that pregnant women with higher levels of exercise had a lower risk of cesarean section than those who did not participate in exercise(OR=0.564,95%CI:0.338-0.941).In terms of physical activity intensity,pregnant women who participated in the higher level of moderate to vigorous physical activity had a lower risk of cesarean section than those who participated in the lower level(OR=0.642,95%CI:0.437-0.972).Conclusions Exercise and moderate to vigorous physical activity are protective factors for cesarean section.Health education should be further strengthened to encourage pregnant women to carry out appropriate physical activity during pregnancy.