孕期个体化运动指导对初产妇分娩方式的影响  

The effect of individualized exercise guidance during pregnancy on the mode of delivery in primipara

作　　者：王贵芳 刘利 孙崟 杨萱瑾 刘娜娜[1] 王亚新 张素菡 朱灿 马良坤[1] WANG Guifang;LIU Li;SUN Yin;YANG Xuanjin;LIU Nana;WANG Yaxin;ZHANG Suhan;ZHU Can;MA Liangkun(Department of Obstetrics and Gynecology,Chinese Academy of Medical Sciences and Peking Union Medical College/National Clinical Research Center for Obstetric and Gynecologic Diseases,Beijing 100370,China;Xindu Central Hospital,Hebei Xingtai 054000,China;School of Nursing,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院妇产科/国家妇产疾病临床医学研究中心,北京100370 [2]信都区中心医院,河北邢台054000 [3]中国医学科学院北京协和医学院护理学院,北京100730

出　　处：《中国妇幼健康研究》2024年第10期90-94,共5页Chinese Journal of Woman and Child Health Research

基　　金：中国医学科学院医学与健康科技创新工程项目(2020-I2M-2-009、2021-I2M-1-023);中国医学科学院中央级公益性科研院所基本科研业务费临床与转化医学研究基金项目(2019XK320007)。

摘　　要：目的探究孕期个体化运动指导对初产妇分娩方式的影响及可能的影响机制。方法招募2021年12月至2022年9月于河北省邢台市信都区中心医院规律产检及分娩的初产妇,排除伴有妊娠合并症和并发症、运动禁忌症者,共纳入160名孕妇,随机数表法分成干预组和对照组。两组孕妇均接受常规产科护理和健康宣教,干预组在此基础上接受专业老师制定的个体化运动方案。主要结局指标为分娩方式。结果干预组的剖宫产率为13.92%,对照组为34.18%,差异具有统计学意义(χ^(2)=7.80,P<0.05)。干预组的妊娠期平均体重增长值为(11.71±2.69)kg,对照组为(14.60±5.06)kg,干预组的妊娠期体重增长过度的发生率为26.58%,对照组为56.96%,差异均具有统计学意义(χ^(2)=15.02,P<0.05)。通过中介效应模型,发现分娩意愿介导了孕期个体化运动指导对分娩方式的影响(Z_(m)=1.86,P<0.05)。结论孕期个体化运动指导不仅有助于降低剖宫产率,还可以控制孕期体重合理增长,分娩意愿可能是运动干预降低剖宫产率的中介因素。Objective To explore the impact of individualized exercise guidance during pregnancy on the mode of delivery in primiparas and its potential mechanisms.Methods A total of 160 primiparas who had regular prenatal check-ups and deliveries at Xindu District Central Hospital of Xingtai City,Hebei Province were recruited from December 2021 to September 2022.Those with pregnancy complications,comorbidities,or contraindications to exercise were excluded.The participants were randomly divided into an intervention group and a control group using a random number table.Both groups of pregnant women received routine obstetric care and health education,and the intervention group received individualized exercise programs formulated by professional teachers on this basis.The primary outcome was the mode of delivery.Results The cesarean section rate in the intervention group was 13.92%,compared to 34.18%in the control group,with a statistically significant difference(χ^(2)=7.80,P<0.05).The average weight gain during pregnancy was 11.71±2.69kg in the intervention group and 14.60±5.06kg in the control group.The incidence of excessive weight gain during pregnancy was 26.58%in the intervention group and 56.96%in the control group,both showing statistically significant differences(χ^(2)=15.02,P<0.05).A mediation effect model revealed that delivery intention mediated the impact of individualized exercise guidance on the mode of delivery(Z_(m)=1.86,P<0.05).Conclusion Individualized exercise guidance during pregnancy can not only reduce the rate of cesarean section,but also control the reasonable increase of pregnancy weight.Delivery intention may serve as a mediating factor in the effect of exercise intervention on reducing the cesarean section rate.

关 键 词：妊娠期 运动干预 初产妇 剖宫产 中介效应 

分 类 号：R173[医药卫生—妇幼卫生保健]