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妊娠期规律运动对孕前高体重指数产妇的远期影响:随机对照试验的一年后随访 被引量:1

Long-term effects of regular exercise during pregnancy on overweight and obese gravidas: one-year follow-up of a previous randomized controlled trial
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摘要 目的探究妊娠期规律运动对孕前高体重指数产妇的远期影响。 方法本课题组2014年12月至2016年7月开展了一项自孕早期起规律运动对预防孕前高体重指数无合并症孕妇发生妊娠期糖尿病的作用的随机对照试验,共入组265例孕前高体重指数[body mass index(BMI)≥24.0 kg/m^2]孕妇,随机分为运动组(132例)及对照组(133例)。本研究于2016年3月至2017年8月对该队列入组产妇在产后1年进行随访,比较随访时体重、体脂、75 g口服葡萄糖耐量试验(oral glucose tolerance test, OGTT)中空腹及服糖后2 h血糖、稳态模型胰岛素抵抗指数和血脂水平;采用国际体力活动问卷(International Physical Activity Questionnaire, IPAQ)对产妇产后1年体力活动水平进行评价,采用改良的成人饮食行为评价量表对产妇产后1年饮食习惯进行评价,采用产后抑郁筛查量表(Postpartum Depression Screen Scale, PDSS)对产妇进行抑郁分级。统计学分析采用两独立样本t检验、Mann-Whitney U检验和χ^2检验。 结果2组产妇产后1年的总随访率为51.7%(137/265),其中运动组为64.4%(85/132),对照组为39.1%(52/133)。运动组与对照组相比,随访时的体重回降程度、体脂百分率、75 g OGTT服糖后2 h血糖、糖耐量异常比例、稳态模型胰岛素抵抗指数[分别为1.0(-1.3~4.7)与2.3(-6.0~5.0) kg、(37.51±4.90)%与(38.04±4.54)%、(7.32±1.61)与(7.30±2.80) mmol/L、28.8%(17/59)与30.0%(9/30)、2.86±1.92与2.92±1.77]比较差异均无统计学意义(t、Z或χ2值分别为-0.940,0.312,3.415,0.005,1.743,P值均>0.05),75 g OGTT空腹血糖[分别为(5.28±0.43)与(5.53±0.92) mmol/L]差异有统计学意义(t=9.268,P=0.003)。运动组与对照组产妇产后1年的总体力活动水平、饮食习惯总分和PDSS评分[分别为219(99~504)与195(99~351)、79.00(72.50~87.50)与76.00(70.00~82.00)分、55.00(41.00~77.00)与70.00(46.25~84.75)分]比较差异亦无统计学意义(Z值分别为-0.808,-1.822,-1.620,P值均>0.05);� ObjectiveTo investigate the long-term effects of regular exercise during pregnancy on overweight and obese gravidas. MethodsThis study was based on a previous randomized controlled trial (RCT) regarding Effect of Regular Exercise Commenced in Early Pregnancy on the Incidence of Gestational Diabetes Mellitus in Overweight and Obese Pregnant Women conducted at Peking University First Hospital from December 2014 to July 2016. Totally 265 women whose prepregnant body mass index (BMI)≥24.0 kg/m^2 were enrolled in the RCT and were randomly assigned to exercise group (n=132) and control group (n=133). This study was a follow-up of all the participants at one year after delivery from March 2016 to August 2017. Body weight, body fat, fasting and 2 h glucose level in 75 g oral glucose tolerance test (OGTT), insulin resistance index and lipid profiles were compared. We also evaluated their physical activities with International Physical Activity Questionnaire (IPAQ), their dietary habits with modified Adult Dietary Behavior Assessment Scale and depression condition with Postpartum Depression Screen Scale (PDSS). Two independent samples t-test, Mann-Whitney U test and Chi-square test were used for statistical analysis. ResultsThe overall follow-up rate was 51.7%(137/265), while 64.4%(85/132) in the exercise group and 39.1%(52/133) in the control group. No significant difference in body weight loss [2.3 (-6.0 to 5.0) vs 1.0 (-1.3 to 4.7) kg], body fat percentage [(38.04±4.54)% vs (37.51±4.90)%], 2 h glucose level in 75 g OGTT [(7.30±2.80) vs (7.32±1.61) mmol/L], abnormal glucose tolerance ratio [30.0%(9/30) vs 28.8%(17/59)] or insulin resistance index (2.92±1.77 vs 2.86±1.92) was found between the control and exercise group (t or Z=-0.940, 0.312, 3.415, 0.005, 1.743, all P>0.05). However, the fasting blood glucose in 75 g OGTT was higher in the control group [(5.53±0.92) vs (5.28±0.43) mmol/L, t=9.268, P=0.003]. The two groups showed no significant difference (exercise group vs control group) in physical activity le
作者 张晓明 许芊芊 王晨 魏玉梅 张玥 杨慧霞 Zhang Xiaoming;Xu Qianqian;Wang Chen;Wei Yumei;Zhang Yue;Yang Huixia(Department of Obstetrics and Gynecology, Peking University First Hospital,Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus, Beijing 100034, China)
出处 《中华围产医学杂志》 CAS CSCD 北大核心 2019年第4期227-232,共6页 Chinese Journal of Perinatal Medicine
基金 首都特色临床应用研究(Z151100004015088).
关键词 高体重指数 运动干预 产后 母儿远期结局 High body mass index Exercise intervention Postpartum Long-term outcomes of mothers and offspring
作者简介 杨慧霞,Email:yanghuixia@bjmu.edu.cn,电话:010-83573246.
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