Queen of the mountain: successful pregnancy while exercising up to 5,300 m.
Queen of the mountain: successful pregnancy while exercising up to 5,300 m.
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山地女王：在海拔 5,300 m 的高度锻炼中成功怀孕。
DOI：
10.1152/japplphysiol.00486.2018
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Moore,LornaG
中科院分区：
文献类型：
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作者：
Moore,LornaG
达文波特等人(5)在“极端怀孕：珠峰大本营的产妇体育活动”一文中报道了一名夏尔巴人孕妇妊娠晚期（31周）在3800 - 4200米高的地方度过了8天的孕期，同时在5300米高的地方进行了剧烈运动，那里的吸入氧张力只有海平面值的一半。作为一名优秀的耐力运动员，她在怀孕期间身体健康，在42周的时候生下了一个体重3.2公斤的女婴，没有任何健康问题。基础代谢率在怀孕期间增加~ 30%，将怀孕本身比作非常温和的运动。正如作者所指出的，主要的生理变化发生在怀孕期间，包括通气、血容量和心输出量增加30%，这些都有助于满足胎儿生长所需的氧气和营养需求。在从3440米上升到5160米的过程中，仔细的身体活动测量表明，怀孕的影响加上了高海拔的影响，她的通气率上升，潮末二氧化碳分压降至20出头，白天动脉氧饱和度达到83%的最低点，但血红蛋白、红细胞压积、血压和静息心率变化不大。观察到睡眠片段化，可能是由于阻塞性睡眠呼吸暂停，但未记录夜间氧饱和度。尽管运动是人类生活的一部分，但很少有关于高海拔怀孕期间运动影响的研究。目前对没有已知妊娠并发症风险的高海拔新生儿的建议是保守的，建议在运动前至少2-3天适应环境，每天不进行超过20-30分钟的中度至剧烈体育活动，并完全避免剧烈运动（10,11,24）。正如作者所指出的，除了本报告的资料外，没有关于终生居住在高海拔地区的资料。通过仔细监测体力活动的持续时间和强度，作者表明，这位夏尔巴人妇女在连续11天的3,440至5,000米的运动中，每天花费约30%或约4小时，同时进行中等到剧烈的运动。这些运动水平是低海拔地区建议的每天20-30分钟的两倍多，而且比居住在海平面的健康孕妇每天140-200分钟的运动水平还要高。的
In “Extreme pregnancy: maternal physical activity at Everest Base Camp,” Davenport et al.(5) report the case of a thirdtrimester (31 wk) Sherpa woman who spent her entire pregnancy at 3,800–4,200 m and 8 days while vigorously exercising up to 5,300 m where inspired oxygen tensions are only one-half the sea level value. An elite endurance athlete in good health throughout her pregnancy, she gave birth at 42 wk to a baby girl weighing 3.2 kg with no known health problems. Akin to the observation that Tibetans’ and Sherpas’ superior exercise ability at extreme altitude makes them “king” of the mountains (6), the ability to successfully reproduce the next generation under such conditions may render them “queen” of the mountain as well.Basal metabolic rate increases~ 30% during pregnancy, likening pregnancy itself to very mild exercise. As the authors point out, major physiological changes take place during pregnancy, including an~ 30% rise in ventilation, blood volume, and cardiac output that collectively help meet the increased oxygen and nutrient demands required for fueling fetal growth. Careful physical activity measurements during ascent from 3,440 to 5,160 m indicated that the effects of pregnancy were added to those of high altitude, with her ventilation rising and end-tidal PCO2 falling to the low 20s, daytime arterial O2 saturation reaching a nadir of 83%, but hemoglobin, hematocrit, blood pressure, and resting heart rate changing little. Sleep fragmentation was observed, possibly because of obstructive sleep apnea, but nocturnal O2 saturation was not recorded. Despite the fact that exercise is a regular part of human existence, there are very few studies on the effects of exercise during pregnancy at high altitude. Current recommendations for high-altitude newcomers at no known risk of maternal or fetal pregnancy complications are conservative, cautioning at least 2–3 days for acclimatization before exercising, not engaging in more than 20–30 min of moderate to vigorous physical activity per day, and avoiding heavy exercise altogether (10, 11, 24). As noted by the authors, no information apart from that of the present report is available for lifelong high-altitude residents. By carefully monitoring both the duration and intensity of physical activity, the authors show that this Sherpa woman spent~ 30% or~ 4 h during each of 11 consecutive days at 3,440 to 5,000 m while exercising at moderate to vigorous levels of activity. These exercise levels are more than two times the recommended 20–30 min/day at low altitude and greater, in a single day, than the 140–200 min/wk for healthy pregnant women residing at sea level. Of