A Prospective Study of the Association Between Vigorous Physical Activity During Pregnancy and Length of Gestation and Birthweight

详细信息    查看全文

• 作者：Anne Marie Z. Jukic (1) (2)
  Kelly R. Evenson (1)
  Julie L. Daniels (1) (3)
  Amy H. Herring (4) (5)
  Allen J. Wilcox (2)
  Katherine E. Hartmann (6)
  
• 关键词：Gestational age ; Preterm birth ; Exercise ; Frequency ; Duration
• 刊名：Maternal and Child Health Journal
• 出版年：2012
• 出版时间：July 2012
• 年：2012
• 卷：16
• 期：5
• 页码：1031-1044
• 全文大小：235KB
• 参考文献：1. Martin, J. A., Hamilton, B. E., Sutton, P. D., Ventura, S. J., Menacker, F., Kirmeyer, S., et al. (2009). Births: Final data for 2006. / Natational Vital Statics Report, 57(7). Accessed at http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_07.pdf.
  2. Shapiro-Mendoza, C. K., Tomashek, K. M., Kotelchuck, M., Barfield, W., Nannini, A., Weiss, J., et al. (2008). Effect of late-preterm birth and maternal medical conditions on newborn morbidity risk. / Pediatrics, / 121(2), e223–e232. CrossRef
  3. Tomashek, K. M., Shapiro-Mendoza, C. K., Davidoff, M. J., & Petrini, J. R. (2007). Differences in mortality between late-preterm and term singleton infants in the United States, 1995-002. / Journal of Pediatrics, / 151(5), 450-56. CrossRef
  4. Underwood, M. A., Danielsen, B., & Gilbert, W. M. (2007). Cost, causes and rates of rehospitalization of preterm infants. / Journal of Perinatology, / 27(10), 614-19. CrossRef
  5. Hohimer, A. R., Bissonnette, J. M., Metcalfe, J., & McKean, T. A. (1984). Effect of exercise on uterine blood flow in the pregnant Pygmy goat. / American Journal of Physiology, / 246(2 Pt 2), H207–H212.
  6. Lotgering, F. K., Gilbert, R. D., & Longo, L. D. (1983). Exercise responses in pregnant sheep: Oxygen consumption, uterine blood flow, and blood volume. / Journal of Applied Physiology, / 55(3), 834-41.
  7. Nesbitt, A. E., Murphy, R. J., & O’Hagan, K. P. (2005). Effect of gestational stage on uterine artery blood flow during exercise in rabbits. / Journal of Applied Physiology, / 99(6), 2159-165. CrossRef
  8. O’Hagan, K. P., & Alberts, J. A. (2003). Uterine artery blood flow and renal sympathetic nerve activity during exercise in rabbit pregnancy. / American Journal of Physiology: Regulatory, Integrative and Comparative Physiology, / 285(5), R1135–R1144.
  9. Baumann, H., Huch, A., & Huch, R. (1989). Doppler sonographic evaluation of exercise-induced blood flow velocity and waveform changes in fetal, uteroplacental and large maternal vessels in pregnant women. / Journal of Perinatal Medicine, / 17(4), 279-87. CrossRef
  10. Erkkola, R. U., Pirhonen, J. P., & Kivijarvi, A. K. (1992). Flow velocity waveforms in uterine and umbilical arteries during submaximal bicycle exercise in normal pregnancy. / Obstetrics and Gynecology, / 79(4), 611-15.
  11. Rauramo, I., & Forss, M. (1988). Effect of exercise on maternal hemodynamics and placental blood flow in healthy women. / Acta Obstetrics and Gynecology Scandinavian, / 67(1), 21-5. CrossRef
  12. Brenner, I. K., Wolfe, L. A., Monga, M., & McGrath, M. J. (1999). Physical conditioning effects on fetal heart rate responses to graded maternal exercise. / Medicine and Science in Sports and Exercise, / 31(6), 792-99. CrossRef
  13. Kennelly, M. M., Geary, M., McCaffrey, N., McLoughlin, P., Staines, A., & McKenna, P. (2002). Exercise-related changes in umbilical and uterine artery waveforms as assessed by Doppler ultrasound scans. / American Journal of Obstetrics and Gynecology, / 187(3), 661-66. CrossRef
  14. Kennelly, M. M., McCaffrey, N., McLoughlin, P., Lyons, S., & McKenna, P. (2002). Fetal heart rate response to strenuous maternal exercise: Not a predictor of fetal distress. / American Journal of Obstetrics and Gynecology, / 187(3), 811-16. CrossRef
  15. McMurray, R. G., Katz, V. L., Poe, M. P., & Hackney, A. C. (1995). Maternal and fetal responses to low-impact aerobic dance. / American Journal of Perinatology, / 12(4), 282-85. CrossRef
  16. Morrow, R. J., Ritchie, J. W., & Bull, S. B. (1989). Fetal and maternal hemodynamic responses to exercise in pregnancy assessed by Doppler ultrasonography. / American Journal of Obstetrics and Gynecology, / 160(1), 138-40.
  17. Lindqvist, P. G., Marsal, K., Merlo, J., & Pirhonen, J. P. (2003). Thermal response to submaximal exercise before, during and after pregnancy: A longitudinal study. / The Journal of Matern-Fetal Neonatal Medicine, / 13(3), 152-56. CrossRef
  18. Bonen, A., Campagna, P., Gilchrist, L., Young, D. C., & Beresford, P. (1992). Substrate and endocrine responses during exercise at selected stages of pregnancy. / Journal of Applied Physiology, / 73(1), 134-42.
  19. Bonen, A., Campagna, P. D., Gilchrist, L., & Beresford, P. (1995). Substrate and hormonal responses during exercise classes at selected stages of pregnancy. / Canadian Journal of Applied Physiology, / 20(4), 440-51. CrossRef
  20. Clapp, J. F., I I I, Wesley, M., & Sleamaker, R. H. (1987). Thermoregulatory and metabolic responses to jogging prior to and during pregnancy. / Medicine and Science in Sports and Exercise, / 19(2), 124-30.
  21. McMurray, R. G., Hackney, A. C., Guion, W. K., & Katz, V. L. (1996). Metabolic and hormonal responses to low-impact aerobic dance during pregnancy. / Medicine and Science in Sports and Exercise, / 28(1), 41-6. CrossRef
  22. Cunningham, F. G., Gilstrap, L. C., I. I. I., Gant, N. F., Hauth, J. C., Wenstrom, K. D., & Leveno, K. J. (2001). / Williams obstetrics (21st ed.). New York: McGraw-Hill, Medical Publishing Division.
  23. Chasan-Taber, L., Evenson, K. R., Sternfeld, B., & Kengeri, S. (2007). Assessment of recreational physical activity during pregnancy in epidemiologic studies of birthweight and length of gestation: Methodologic aspects. / Women and Health, / 45(4), 85-07. CrossRef
  24. Bonzini, M., Coggon, D., & Palmer, K. T. (2007). Risk of prematurity, low birthweight and pre-eclampsia in relation to working hours and physical activities: A systematic review. / Occupational and Environmental Medicine, / 64(4), 228-43. CrossRef
  25. Kramer, M. S., & McDonald, S. W. (2006). Aerobic exercise for women during pregnancy. / The Cochrane Database of Systematic Reviews, 3, CD000180.
  26. ACOG Committee Opinion. (2002). Number 267, January 2002: Exercise during pregnancy and the postpartum period. / Obstetrics and Gynecology, 99(1), 171-73.
  27. US Department of Health and Human Services. (2008). 2008 Physical activity guidelines for Americans. In / Department of Health and Human Services, p. 61.
  28. Promislow, J. H., Makarushka, C. M., Gorman, J. R., Howards, P. P., Savitz, D. A., & Hartmann, K. E. (2004). Recruitment for a community-based study of early pregnancy: The Right from the Start Study. / Pediatric and Perinatal Epidemiology, / 18(2), 143-52. CrossRef
  29. Evenson, K., & Wen, F. (2010). Measuring physical activity among pregnant women using a structured one-week recall questionnaire: Evidence for validity and reliability. / International Journal of Behavioral Nutrition Physical Activity, / 7(1), 21. CrossRef
  30. Borg, G. A. (1982). Psychophysical bases of perceived exertion. / Medicine and Science in Sports and Exercise, / 14(5), 377-81.
  31. Ainsworth, B. E., Haskell, W. L., Whitt, M. C., Irwin, M. L., Swartz, A. M., Strath, S. J., et al. (2000). Compendium of physical activities: An update of activity codes and MET intensities. / Medicine and Science in Sports and Exercise, / 32(9 Suppl), S498–S504.
  32. Ainsworth, B. E., Haskell, W. L., Leon, A. S., Jacobs, D. R., Jr., Montoye, H. J., Sallis, J. F., et al. (1993). Compendium of physical activities: Classification of energy costs of human physical activities. / Medicine and Science in Sports and Exercise, / 25(1), 71-0. CrossRef
  33. Greenland, S., Pearl, J., & Robins, J. M. (1999). Causal diagrams for epidemiologic research. / Epidemiology, / 10(1), 37-8. CrossRef
  34. Cole, S. R., & Ananth, C. V. (2001). Regression models for unconstrained, partially or fully constrained continuation odds ratios. / International Journal of Epidemiology, / 30(6), 1379-382. CrossRef
  35. Robinson, L. D., & Jewell, N. P. (1991). Some surprising results about covariate adjustment in logistic-regression models. / International Statistical Review, / 59(2), 227-40. CrossRef
  36. Lee, I. M., & Skerrett, P. J. (2001). Physical activity and all-cause mortality: What is the dose-response relation? / Medicine and Science in Sports and Exercise, 33(6 Suppl), S459–S71; discussion S493–S494.
  37. Alderman, B. W., Zhao, H., Holt, V. L., Watts, D. H., & Beresford, S. A. (1998). Maternal physical activity in pregnancy and infant size for gestational age. / Annals of Epidemiology, / 8(8), 513-19. CrossRef
  38. Botkin, C., & Driscoll, C. E. (1991). Maternal aerobic exercise: Newborn effects. / The Family Practice Research Journal, / 11(4), 387-93.
  39. Duncombe, D., Skouteris, H., Wertheim, E. H., Kelly, L., Fraser, V., & Paxton, S. J. (2006). Vigorous exercise and birth outcomes in a sample of recreational exercisers: A prospective study across pregnancy. / The Australian & New Zealand Journal of Obstetrics & Gynaecology, / 46(4), 288-92. CrossRef
  40. Haas, J. S., Fuentes-Afflick, E., Stewart, A. L., Jackson, R. A., Dean, M. L., Brawarsky, P., et al. (2005). Prepregnancy health status and the risk of preterm delivery. / Archives of Pediatrics and Adolescent Medicine, / 159(1), 58-3. CrossRef
  41. Hall, D. C., & Kaufmann, D. A. (1987). Effects of aerobic and strength conditioning on pregnancy outcomes. / American Journal of Obstetrics and Gynecology, / 157(5), 1199-203.
  42. Horns, P. N., Ratcliffe, L. P., Leggett, J. C., & Swanson, M. S. (1996). Pregnancy outcomes among active and sedentary primiparous women. / Journal of Obstetrics, Gynecology and Neonatal Nursing, 25(1), 49-4.
  43. Leiferman, J. A., & Evenson, K. R. (2003). The effect of regular leisure physical activity on birth outcomes. / Matern and Child Health Journal, / 7(1), 59-4. CrossRef
  44. Lokey, E. A., Tran, Z. V., Wells, C. L., Myers, B. C., & Tran, A. C. (1991). Effects of physical exercise on pregnancy outcomes: A meta-analytic review. / Medicine and Science in Sports and Exercise, / 23(11), 1234-239.
  45. Orr, S. T., James, S. A., Garry, J., Prince, C. B., & Newton, E. R. (2006). Exercise and pregnancy outcome among urban, low-income, black women. / Ethnicity and Disease, / 16(4), 933-37.
  46. Rice, P. L., & Fort, I. L. (1991). The relationship of maternal exercise on labor, delivery and health of the newborn. / The Journal of Sports Medicine and Physical Fitness, / 31(1), 95-9.
  47. Rose, N. C., Haddow, J. E., Palomaki, G. E., & Knight, G. J. (1991). Self-rated physical activity level during the second trimester and pregnancy outcome. / Obstetrics and Gynecology, / 78(6), 1078-080.
  48. Sternfeld, B., Quesenberry, C. P., Jr., Eskenazi, B., & Newman, L. A. (1995). Exercise during pregnancy and pregnancy outcome. / Medicine and Science in Sports and Exercise, / 27(5), 634-40.
  49. Both, M. I., Overvest, M. A., Wildhagen, M. F., Golding, J., & Wildschut, H. I. (2010). The association of daily physical activity and birth outcome: A population-based cohort study. / European Journal of Epidemiology, 25(6), 421-29.
  50. Hopkins, S. A., Baldi, J. C., Cutfield, W. S., McCowan, L., & Hofman, P. L. (2010). Exercise training in pregnancy reduces offspring size without changes in maternal insulin sensitivity. / The Journal of Clinical Endocrinology and Metabolism, / 95(5), 2080-088. CrossRef
  51. Badr, L. K., Abdallah, B., & Mahmoud, A. (2005). Precursors of preterm birth: Comparison of three ethnic groups in the middle East and the United States. / Journal of Obstetrics, Gynecology and Neonatal Nursing, / 34(4), 444-52. CrossRef
  52. Berkowitz, G. S., Kelsey, J. L., Holford, T. R., & Berkowitz, R. L. (1983). Physical activity and the risk of spontaneous preterm delivery. / The Journal of Reproductive Medicine, / 28(9), 581-88.
  53. Evenson, K. R., Siega-Riz, A. M., Savitz, D. A., Leiferman, J. A., & Thorp, J. M., Jr. (2002). Vigorous leisure activity and pregnancy outcome. / Epidemiology, / 13(6), 653-59. CrossRef
  54. Hatch, M., Levin, B., Shu, X. O., & Susser, M. (1998). Maternal leisure-time exercise and timely delivery. / American Journal of Public Health, / 88(10), 1528-533. CrossRef
  55. Magann, E. F., Evans, S. F., & Newnham, J. P. (1996). Employment, exertion, and pregnancy outcome: Assessment by kilocalories expended each day. / American Journal of Obstetrics and Gynecology, / 175(1), 182-87. CrossRef
  56. Misra, D. P., Strobino, D. M., Stashinko, E. E., Nagey, D. A., & Nanda, J. (1998). Effects of physical activity on preterm birth. / American Journal of Epidemiology, / 147(7), 628-35. CrossRef
  57. Juhl, M., Kogevinas, M., Andersen, P. K., Andersen, A. M., & Olsen, J. (2010). Is swimming during pregnancy a safe exercise? / Epidemiology, / 21(2), 253-58. CrossRef
  58. Domingues, M. R., Barros, A. J., & Matijasevich, A. (2008). Leisure time physical activity during pregnancy and preterm birth in Brazil. / International Journal of Gynaecology and Obstetrics, / 103(1), 9-5. CrossRef
  59. Hegaard, H. K., Hedegaard, M., Damm, P., Ottesen, B., Petersson, K., & Henriksen, T. B. (2008). Leisure time physical activity is associated with a reduced risk of preterm delivery. / American Journal of Obstetrics and Gynecology, 198(2), 180e1-80e5.
  60. Juhl, M., Andersen, P. K., Olsen, J., Madsen, M., Jorgensen, T., Nohr, E. A., et al. (2008). Physical exercise during pregnancy and the risk of preterm birth: A study within the Danish National Birth Cohort. / American Journal of Epidemiology, / 167(7), 859-66. CrossRef
  61. Takito, M. Y., & Benicio, M. H. (2010). Physical activity during pregnancy and fetal outcomes: A case-control study. / Revista de Saude Publica, / 44(1), 90-01. CrossRef
  62. Bergmann, A., Zygmunt, M., & Clapp, J. F., I. I. I. (2004). Running throughout pregnancy: Effect on placental villous vascular volume and cell proliferation. / Placenta, / 25(8-), 694-98. CrossRef
  63. Clapp, J. F. (2006). Influence of endurance exercise and diet on human placental development and fetal growth. / Placenta, / 27(6-), 527-34. CrossRef
  64. Nieuwenhuijsen, M. J., Northstone, K., & Golding, J. (2002). Swimming and birth weight. / Epidemiology, / 13(6), 725-28. CrossRef
  65. Collings, C. A., Curet, L. B., & Mullin, J. P. (1983). Maternal and fetal responses to a maternal aerobic exercise program. / American Journal of Obstetrics and Gynecology, / 145(6), 702-07.
  66. Hatch, M. C., Shu, X. O., McLean, D. E., Levin, B., Begg, M., Reuss, L., et al. (1993). Maternal exercise during pregnancy, physical fitness, and fetal growth. / American Journal of Epidemiology, / 137(10), 1105-114.
  67. Campbell, M. K., & Mottola, M. F. (2001). Recreational exercise and occupational activity during pregnancy and birth weight: A case-control study. / American Journal of Obstetrics and Gynecology, / 184(3), 403-08. CrossRef
  68. Clapp, J. F., I. I. I., & Capeless, E. L. (1990). Neonatal morphometrics after endurance exercise during pregnancy. / American Journal of Obstetrics and Gynecology, / 163(6 Pt 1), 1805-811.
  69. Perkins, C. C., Pivarnik, J. M., Paneth, N., & Stein, A. D. (2007). Physical activity and fetal growth during pregnancy. / Obstetrics and Gynecology, / 109(1), 81-7. CrossRef
  70. Juhl, M., Olsen, J., Andersen, P. K., Nohr, E. A., & Andersen, A. M. (2010). Physical exercise during pregnancy and fetal growth measures: A study within the Danish National Birth Cohort. / American Journal of Obstetrics and Gynecology, 202(1), 63e1-3e8.
  71. Hegaard, H. K., Petersson, K., Hedegaard, M., Ottesen, B., Dykes, A. K., Henriksen, T. B., et al. (2009). Sports and leisure-time physical activity in pregnancy and birth weight: A population-based study. / Scandinavian Journal of Medicine and Science in Sports, / 20(1), e96–e102. CrossRef
  72. Kardel, K. R., & Kase, T. (1998). Training in pregnant women: Effects on fetal development and birth. / American Journal of Obstetrics and Gynecology, / 178(2), 280-86. CrossRef
  73. Klebanoff, M. A., Shiono, P. H., & Carey, J. C. (1990). The effect of physical activity during pregnancy on preterm delivery and birth weight. / American Journal of Obstetrics and Gynecology, / 163(5 Pt 1), 1450-456.
  74. Fortier, I., Marcoux, S., & Brisson, J. (1995). Maternal work during pregnancy and the risks of delivering a small-for-gestational-age or preterm infant. / Scandinavian Journal of Work, Environment & Health, 21(6), 412-18.
  75. Launer, L. J., Villar, J., Kestler, E., & de Onis, M. (1990). The effect of maternal work on fetal growth and duration of pregnancy: A prospective study. / British Journal of Obstetrics Gynaecology, / 97(1), 62-0. CrossRef
  76. Nurminen, T., Lusa, S., Ilmarinen, J., & Kurppa, K. (1989). Physical work load, fetal development and course of pregnancy. / Scandinavian Journal of Work, Environment & Health, 15(6), 404-14.
  77. Tuntiseranee, P., Geater, A., Chongsuvivatwong, V., & Kor-anantakul, O. (1998). The effect of heavy maternal workload on fetal growth retardation and preterm delivery. A study among southern Thai women. / J Occupational and Environmental Medicine, / 40(11), 1013-021. CrossRef
  
• 作者单位：Anne Marie Z. Jukic (1) (2)
  Kelly R. Evenson (1)
  Julie L. Daniels (1) (3)
  Amy H. Herring (4) (5)
  Allen J. Wilcox (2)
  Katherine E. Hartmann (6)
  
  1. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
  2. Epidemiology Branch, National Institute of Environmental Health Sciences, PO Box 12233, MD A3-05, Durham, NC, 27709, USA
  3. Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
  4. Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
  5. Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
  6. Institute for Medicine and Public Health, Vanderbilt University, Nashville, TN, USA
  

文摘

Current US pregnancy-related physical activity recommendations do not provide specific guidance for vigorous intensity activity. We examined the associations between vigorous physical activity during pregnancy and length of gestation and birthweight. Methods: Women were recruited before 10?weeks gestation. At 13-6?weeks gestation, participants reported the type, frequency, and duration of their typical weekly vigorous physical activities. Activity domains included recreational, occupational, household, and child/adult care. Infant birth date was obtained from medical or vital records; if unavailable, self-report was used. Birthweight (from vital records) was studied among term births. We analyzed gestational age among 1,647 births using discrete-time survival analysis. We used logistic and linear regression to analyze preterm birth (birth at <37?weeks) and birthweight, respectively. Vigorous recreational activity was associated with longer gestation (any vs. none, hazard ratio (HR) [95% CI]: 0.85 [0.70, 1.05]) and we did not detect any dose–response association. Higher frequency of vigorous recreational activity sessions (adjusted for total volume of activity) was associated with a decreased odds of preterm birth (? sessions/week vs. 0 or 1, OR [95% CI]: 0.08 (0.006, 1.0). Birthweight was not associated with physical activity measures. In summary, vigorous physical activity does not appear to be detrimental to the timing of birth or birthweight. Our data support a reduced risk of preterm birth with vigorous recreational activity, particularly with increased frequency of recreational activity sessions. Future studies should investigate the components of physical activity (i.e., intensity, duration, and frequency) in relation to birth outcomes.