两种中等强度运动类型的母婴急性反应:一项随机临床试验

J. S. Tavares, A. Melo, S. Leite, A. Silva, J. Alves, V. O. Barros, A. Ramos, M. Amorim
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引用次数: 1

摘要

目的:比较两种体育锻炼方式对母体和胎儿的影响。设计:一项随机临床试验比较了120名孕妇,孕龄为35-37周,56名在固定自行车上锻炼(A组),64名在跑步机上锻炼(B组)。方法:对参与者进行了三个20分钟的监测阶段:休息,运动和恢复。监测胎儿心率(FHR)和产妇心率(MHR)。在休息和运动时评估葡萄糖和乳酸水平。结果:运动开始后,乳酸(L)在20分钟达到最大值,从未超过4 mmol/ L。与静息值相比,无论运动类型如何,运动期间FHR下降了22 bpm (p < 0.05),分别增加了32%和40.6% (p < 0.05)。运动期间的FHR下降伴随着其变异性的同时增加(p<0.001),然而在运动结束后不久观察到快速恢复到静息值。无论运动类型如何,两组血糖均下降(休息时85 mg/dl;运动时79 mg/dl,恢复时81 mg/dl;p < 0.001)。无低血糖病例。结论:运动后FHR变异性增加并迅速恢复到静息值,提示运动时FHR下降和心动过缓是胎儿对血流再分配的生理反应,维持胎儿健康。关键词:却锻炼;胎儿心率;葡萄糖;产妇心率;妊娠临床试验注册:ClinicalTrials.gov, www.clinicaltrials.gov, NCT01383889。
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Maternal-fetal acute responses to two moderate-intensity exercise types: a randomized clinical trial
Objective:  This study aims to compare maternal and fetal responses during two physical exercise types. Design:  A randomized clinical trial compared 120 pregnant women, gestational age of 35-37 weeks, 56 exercising on a stationary bicycle (Group A) and 64 on a treadmill (Group B). Methods: Participants were monitored for three 20-minute phases: resting, exercise and recovery.  Fetal heart rate (FHR) and maternal heart rate (MHR) were monitored.  Glucose and lactate levels were evaluated at rest and during exercise. Results:  After the beginning of exercise, maximum lactate (L) levels were reached at 20 minutes and never exceeded 4 mmol/l.  FHR decreased by 22 bpm during exercise in relation to resting values, irrespective of the exercise type (p 0.05), increasing at 20’ to 32% and 40.6%, respectively, (p>0.05).  The FHR decrease during exercise was accompanied by a simultaneous increase in its variability (p<0.001), nevertheless a rapid return to resting values was observed shortly after exercise end.  Glucose decreased in both groups irrespective of the exercise type (85 mg/dl at rest; 79 mg/dl during exercise and 81 mg/dl during recovery; p<0.001). There were no hypoglycemia cases. Conclusions: FHR variability increase and the rapid return to resting values after exercise suggests that the FHR fall and the presence of bradycardia during exercise is the fetal physiologic response to blood flow redistribution, with maintenance of fetal well-being. Key-words: Exercise; fetal heart rate; glucose; maternal heart rate; pregnancy Clinical Trial Registration: ClinicalTrials.gov, www.clinicaltrials.gov, NCT01383889.
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