Effect of a Physical Exercise Program During Pregnancy on Uteroplacental and Fetal Blood Flow and Fetal Growth A Randomized Controlled Trial
Effect of a Physical Exercise Program During Pregnancy on Uteroplacental and Fetal Blood Flow and Fetal Growth A Randomized Controlled Trial
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DOI：
10.1097/aog.0b013e31825de592
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发表时间：
2012-08-01
影响因子：
7.2
通讯作者：
Amorim, Melania M. R.
中科院分区：
文献类型：
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作者：
de Oliveria Melo, Adriana S.;Silva, Joao Luiz P.;Amorim, Melania M. R.
目的：评价有监督体育锻炼对孕妇体能、胎盘血流量和胎儿生长发育的影响。方法：采用随机对照试验，对3组孕妇进行比较。实验分为三组：13周开始运动(A组)、20周开始运动(B组)和对照组(无监督运动C组)。A组和B组的女性每周以中等强度步行三次。分别在第13周、第20周和第28周评估身体健康水平。每月评估胎儿生长发育和子宫胎盘血流量。出生体重登记在案。重复测量的方差分析用于在整个妊娠期间评估结果。用风险比衡量先兆子痫、胎儿生长受限、巨大儿、小于胎龄儿和大胎儿的相对风险。结果：所有被分析的妇女完成了项目的85%以上。根据第28周的评估，身体素质得到改善，平均最大耗氧量(VO2max)分别为27.3+/-4.3(A组)、28+/-3.3(B组)和25.5+/-3.8(C组；P=0.03)。平均出生体重分别为3,279+/-453g(A组)、3,285+/-477g(B组)和3,378+/-593g(C组；P=.53)。研究变量(先兆子痫、胎儿体重、血压、子宫动脉、脐动脉和大脑中动脉的搏动指数)与体力活动之间没有相关性。结论：中等强度步行提高了健康、怀孕、久坐的女性的身体健康水平，而不影响胎儿胎盘血流或胎儿生长。
OBJECTIVE: To estimate the effect of supervised physical exercise on maternal physical fitness, fetoplacental blood flow, and fetal growth.METHODS: This was a randomized controlled trial comparing three groups of pregnant women. Groups were as follows: exercise initiated at 13 weeks (group A); exercise initiated at 20 weeks (group B); and a control group (no supervised exercise; group C). The women in groups A and B walked at moderate intensity three times weekly. Physical fitness level was evaluated at weeks 13, 20, and 28. Fetal growth and uteroplacental blood flow were evaluated monthly. Birth weight was registered. Analysis of variance for repeat measures was used for outcomes evaluated throughout pregnancy. Risk ratio was used as a measure of the relative risk of preeclampsia, fetal growth restriction, macrosomia, small-for-gestational-age new-borns, and large-for-gestational-age newborns.RESULTS: All the women analyzed completed more than 85% of the program. According to the evaluation conducted at week 28, physical fitness improved, with mean maximal oxygen consumptions (VO2max) of 27.3 +/- 4.3 (group A), 28 +/- 3.3 (group B), and 25.5 +/- 3.8 (group C; P=.03). Mean birth weights were 3,279 +/- 453 g (group A), 3,285 +/- 477 g (group B), and 3,378 +/- 593 g (group C; P=.53), with no difference in the frequency of large for gestational age or small for gestational age. No association was found between the practice of physical activity and the variables investigated (preeclampsia, fetal weight, blood pressure, and pulsatility index of the uterine, umbilical, and middle cerebral arteries).CONCLUSION: Moderate-intensity walking improved the physical fitness level of healthy, pregnant, previously sedentary women without affecting fetoplacental blood flow or fetal growth.