Exercise During Pregnancy and Cesarean Delivery: North Carolina PRAMS, 2004-2005
Exercise During Pregnancy and Cesarean Delivery: North Carolina PRAMS, 2004-2005
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DOI：
10.1111/j.1523-536x.2009.00324.x
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发表时间：
2009-09-01
影响因子：
2.5
通讯作者：
Siega-Riz, Anna Maria
中科院分区：
文献类型：
--
作者：
Bovbjerg, Marit L.;Siega-Riz, Anna Maria
背景：目前美国的剖宫产率为31%。以前的研究表明，怀孕期间的运动可能与剖宫产的风险较低有关，但样本量小，方法往往不足。本研究使用2004年和2005年北卡罗来纳州妊娠风险评估监测系统（PRAMS）调查的数据，检查产前锻炼和分娩方式之间是否存在关联。研究方法：PRAMS产后问卷调查了1,955名没有剖腹产的妇女在怀孕最后3个月的运动频率，并与出生证明联系起来。结果如下：在1,342名足月分娩的妇女中，运动与该数据集中的分娩方式无关：与每周锻炼少于一次的妇女相比，每周锻炼一到四次的妇女和每周锻炼五次或五次以上的妇女剖宫产的风险都没有改变。（风险比[RR] [95%置信限] [CL]分别为0.89 [0.69-1.15]，1.04 [0.66-1.64]，经产次、胎龄、高血压校正）。在613名早产妇女中，结果也没有统计学显著性，但可以看到保护作用的明显趋势（RR [95% CL] 0.65 [0.38-1.13]，0.62 [0.29-1.33]）。结论：母亲在怀孕期间自我报告的运动频率与剖宫产风险降低无关。具有更好暴露确定性的更大规模研究可能提供更明确的答案。
Background: The current rate of cesarean delivery in the United States is 31 percent. Previous studies have suggested that exercise during pregnancy may be associated with a lower risk of cesarean delivery, but sample sizes were small and methods often inadequate. This study examined whether or not an association exists between prenatal exercise and delivery mode using data from the 2004 and 2005 North Carolina Pregnancy Risk Assessment Monitoring System (PRAMS) survey. Methods: PRAMS postpartum questionnaire responses about frequency of exercise during the last 3 months of pregnancy for 1,955 women without a prior cesarean delivery were linked to birth certificates. Results: Among 1,342 women delivering at term, exercise was not associated with delivery mode in this data set: compared with women exercising less than once a week, neither women exercising one to four times per week nor those exercising five times or more per week had an altered risk of cesarean (risk ratio [RR] [95% confidence limit] [CL] 0.89 [0.69-1.15], 1.04 [0.66-1.64], respectively, adjusted for parity, gestational age, hypertension). Among 613 women delivering preterm, the results were also not statistically significant, but a compelling trend toward a protective effect could be seen (RR [95% CL] 0.65 [0.38-1.13], 0.62 [0.29-1.33]). Conclusions: Maternal self-reported frequency of exercise during pregnancy was not associated with a reduced risk of cesarean delivery. Larger studies with better exposure ascertainment may provide a more definitive answer.