REGULAR EXERCISE AMONG WOMEN AT RISK FOR PREECLAMPSIA

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 先兆子痫--怀孕期间突然发生高血压沿着蛋白尿--是一种严重的并发症，几乎每20个怀孕中就有一个受到影响。 它是全世界孕产妇死亡的主要原因，影响到所有种族和社会经济群体的妇女。 不幸的是，目前没有明确的预防性治疗可用于这种不祥的疾病。 科学家们现在认为，先兆子痫是一种内皮疾病，部分原因是氧化应激。 因此，定期锻炼已成为一种潜在的预防措施。 这与每日低剂量阿司匹林或钙补充剂形成对比，后者未能证明显着效果，并可能产生不良反应。 本研究的目的是确定在怀孕期间中等强度的运动是否会降低先兆子痫的发生率，并评估假设解释运动对先兆子痫的影响的过程（涉及氧化应激和抗氧化过程）。 这是一项随机临床试验，共有250例妊娠受试者处于先兆子痫风险中。 合格受试者将进入导入期（即，合格期）妊娠14至18周。 基线数据包括人口统计学信息、健康史、日常体力活动、心血管健康水平、血压、血清铁、转铁蛋白、低密度脂蛋白、丙二醛、超氧化物歧化酶的血样。 在18周时，依从的受试者将被随机分配到锻炼（40分钟，70%VO2 max，5次/周）或假运动（对照组; 40分钟拉伸运动，5次/周）条件。 对于两组，将在第28周重复所有基线测量（结局I）。 受试者将在28周后继续运动方案，直到她的任期，只要安全和舒适。 分娩期间将再次采集血样（结局II）。 因产科原因接受剖宫产的受试者将在切口时提供少量皮下组织，以测量内皮超氧化物歧化酶。 将对病历进行审查，以获得其他结局数据（妊娠/出生结局和先兆子痫的诊断）。 相关性卡方检验和逻辑回归分析将用于说明运动的影响、先兆子痫的预测和其他妊娠结局。 将应用重复测量ANOVA来评估运动对各种生物标志物的影响。 将应用ANCOVA控制混杂因素。'

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Preeclampsia -the sudden onset of high blood pressure along with proteinuria during pregnancy- is a serious complication affecting nearly one in every 20 pregnancies. It is the main cause of maternal death worldwide, and affects women of all races and socioeconomic groups. Unfortunately, no definitive preventive treatment is currently available for this ominous disease. Scientists now believe that preeclampsia is a disease of the endothelium, due in part to oxidative stress. As such, regular exercise has emerged as a potential preventive measure. This contrasts to daily low dose aspirin or calcium supplement which have failed to demonstrate a significant effect and may have adverse effects. The purpose of this study is to determine if moderate intensity exercise during pregnancy will reduce the incidence of preeclampsia and to assess the process (involving oxidative stress and antioxidant process) hypothesized to explain the effect of exercise on preeclampsia. This is a randomized clinical trial with a total of 250 pregnant subjects at risk for preeclampsia. Eligible subjects will enter a run-in period (i.e., qualifying period) at 14 to 18 weeks gestation. Baseline data to be obtained include demographic information, health history, daily physical activities, cardiovascular fitness level, blood pressure, blood sample for serum iron, transferrin, low density lipoprotein, malondialdehyde, superoxide dismutase. At 18 weeks, compliant subjects will be randomly assigned to either the exercise (40 min., 70%VO2 max, 5x/week) or sham exercise (control group; 40 min. stretch exercise, 5x/week) condition. For both groups, all baseline measurements will be repeated at 28 weeks (Outcome I). Subjects will continue the exercise regimen after 28 weeks up to her term and as long as it is safe and comfortable. A blood sample will be collected again during labor (Outcome II). Subjects who undergo cesarean section for obstetrical reasons will provide a small amount of subcutaneous tissue at the time of incision to measure endothelial superoxide dismutase. Medical records will be reviewed for additional outcome data (pregnancy/birth outcomes and diagnosis of preeclampsia). Chi-square tests of association and logistic regression analysis will be applied to address the effect of exercise, prediction of preeclampsia, and other pregnancy outcomes. Repeated Measures ANOVA will be applied to assess the effect of exercise on various biological markers. ANCOVA will be applied to control confounding factors.'