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孕期体力活动、久坐行为与胎膜早破发生风险的相关性及剂量反应关系

湛永乐,  吴红果,  陈云利,  石英杰,  刘璇,  岳和欣,  景傲,  孟耀涵,  吕天琛,  曲翌敏,  马良坤,  马海会,  江宇

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文章导航 > 中华疾病控制杂志  > 2021 >  25(2): 138-142, 148
湛永乐, 吴红果, 陈云利, 石英杰, 刘璇, 岳和欣, 景傲, 孟耀涵, 吕天琛, 曲翌敏, 马良坤, 马海会, 江宇. 孕期体力活动、久坐行为与胎膜早破发生风险的相关性及剂量反应关系[J]. 中华疾病控制杂志, 2021, 25(2): 138-142, 148. doi: 10.16462/j.cnki.zhjbkz.2021.02.004
引用本文: 湛永乐, 吴红果, 陈云利, 石英杰, 刘璇, 岳和欣, 景傲, 孟耀涵, 吕天琛, 曲翌敏, 马良坤, 马海会, 江宇. 孕期体力活动、久坐行为与胎膜早破发生风险的相关性及剂量反应关系[J]. 中华疾病控制杂志, 2021, 25(2): 138-142, 148. doi: 10.16462/j.cnki.zhjbkz.2021.02.004
shu
ZHAN Yong-le, WU Hong-guo, CHEN Yun-li, SHI Ying-jie, LIU Xuan, YUE He-xin, JING Ao, MENG Yao-han, LYU Tian-chen, QU Yi-min, MA Liang-kun, MA Hai-hui, JIANG Yu. Association and dose-response relationship of physical activity and sedentary behavior with risk of premature rupture of membranes[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2021, 25(2): 138-142, 148. doi: 10.16462/j.cnki.zhjbkz.2021.02.004
Citation: ZHAN Yong-le, WU Hong-guo, CHEN Yun-li, SHI Ying-jie, LIU Xuan, YUE He-xin, JING Ao, MENG Yao-han, LYU Tian-chen, QU Yi-min, MA Liang-kun, MA Hai-hui, JIANG Yu. Association and dose-response relationship of physical activity and sedentary behavior with risk of premature rupture of membranes[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2021, 25(2): 138-142, 148. doi: 10.16462/j.cnki.zhjbkz.2021.02.004
shu

孕期体力活动、久坐行为与胎膜早破发生风险的相关性及剂量反应关系

doi: 10.16462/j.cnki.zhjbkz.2021.02.004
  • 1.

    100730 北京，中国医学科学院/北京协和医学院群医学及公共卫生学院流行病与生物统计学系

  • 2.

    467100 平顶山，郏县妇幼保健院围产期卫生科

  • 3.

    100005 北京，中国医学科学院/北京协和医学院北京协和医院妇产科

  • 4.

    101149 北京，北京市通州区妇幼保健院

湛永乐和吴红果为共同第一作者
基金项目: 

中国医学科学院医学与健康科技创新工程 2019-I2M-2-007

详细信息
    通讯作者:

    江宇，E-mail: jiangyu@pumc.edu.cn

    马海会，E-mail: 18001359093@163.com

  • 中图分类号: R715.3

Association and dose-response relationship of physical activity and sedentary behavior with risk of premature rupture of membranes

  • 1.

    Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China

  • 2.

    Department of Perinatal Health, Jiaxian Maternal and Child Health Care Hospital, Pingdingshan 467100, China

  • 3.

    Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100005, China

  • 4.

    Department of Obstetrics, Tongzhou Maternal and Child Health Hospital of Beijing, Beijing 101149, China

ZHAN Yong-le and WU Hong-guo contributed equally to this article
Funds: 

CAMS Innovation Fund for Medical Sciences 2019-I2M-2-007

More Information

    摘要
  • 摘要:   目的  探究孕期妇女体力活动(physical activity, PA)、久坐行为与胎膜早破(premature rupture of membranes, PROM)发生风险的相关性及剂量反应关系。  方法  采用国际体力活动短问卷收集中国孕产妇队列研究·协和项目中孕妇的体力活动状况和静坐时间(sedentary time, ST)，并随访收集研究对象PROM的诊断情况，采用Logistic回归分析模型和限制性立方样条模型进行数据分析，计算OR及95% CI值。  结果  共纳入研究对象6 848例。孕妇PROM的发生率为13.79%。在中/低强度PA方面，与低频组相比，高频组PROM的发生风险更高(中强度OR=1.50, 95% CI: 1.01~2.23；低强度OR=1.19, 95% CI: 1.04~1.73)；高强度PA频次每增加1 d/week，PROM发生风险增加13%(OR=1.13, 95% CI: 1.03~1.24)；ST每增加1 h/d，PROM发生风险增加2%(OR=1.02, 95% CI: 1.01~1.04)。剂量反应关系显示，高强度PA超过2 d/周，中强度超过5 d/周或低强度超过5 d/周均可增加PROM的发生风险(OR及95% CI均>1)。  结论  孕期高频体力活动和久坐行为是胎膜早破发生的危险因素，应鼓励孕妇进行适宜和中低强度体力活动的同时，减少静坐时间，以降低胎膜早破的发生风险。
    Abstract:   Objective  To investigate the association and dose-response relationship of physical activity (PA) and sedentary behavior with premature rupture of membranes (PROM).  Methods  Data were collected from the Chinese Pregnant Women Cohort Study. The International Physical Activity Questionnaire-Short Form was used to assess the frequency of PA and sedentary time (ST), and diagnosis of PROM was collected in the follow-up period. Logistic regression analysis model and restricted cubic spline (RCS) model were used for data analyses. The odds ratio (OR) with its 95% confidence interval (CI) was calculated.  Results  A total of 6 848 participants were included in this study. The incidence of PROM was 13.79% among pregnant women. Compared with low frequency group, women with high frequencies of moderate-intensity PA (OR=1.50, 95% CI: 1.01-2.23) and light-intensity PA (OR=1.19, 95% CI: 1.04-1.37) had higher risks of PROM respectively. The risk of PROM increased 13% (OR=1.13, 95% CI: 1.03-1.24) per 1 d/week increase of vigorous-intensity PA, while the risk increased 2% (OR=1.02, 95% CI: 1.01-1.04) per 1 h/d increase of ST. The RCS model showed that the risk for PROM was significant with frequencies of over 2 d/week of vigorous-intensity PA, over 5 d/week of moderate-intensity PA or over 5 d/week of light-intensity PA (all ORs with corresponding 95% CIs>1).  Conclusions  High frequency of physical activity and sedentary behavior are risk factors for PROM. Pregnant women are supposed to conduct physical activity with proper frequency and moderate intensity as well as decreasing sedentary time, so as to prevent the risk of PROM during pregnancy.
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  • 图  1  体力活动与胎膜早破的剂量反应关系

    Figure  1.  Dose-response relationships between physical activity and premature rupture of membranes

    下载: 全尺寸图片 幻灯片

    表  1  6 848名研究对象的基本特征[n(%)]

    Table  1.   Demographic characteristics of 6 848 participants [n(%)]

    基线特征 总例数 胎膜早破 χ2值 P值 Ptrend值
    是(n=944) 否(n=5 904)
    年龄组(岁) 14.85 0.002 0.395
      <25 1 003(14.65) 104(11.02) 899(15.23)
      25~ 3 360(49.07) 506(53.60) 2 854(48.34)
      30~ 1 815(26.50) 247(26.16) 1 568(26.56)
      ≥35 670(9.78) 87(9.22) 583(9.97)
    孕前BMI(kg/m2) 4.72 0.194 0.093
      <18.5 902(13.17) 128(13.56) 774(13.11)
      18.5~ 4 372(63.84) 616(65.25) 3 756(63.62)
      24.0~ 1 242(18.14) 167(17.69) 1 075(18.21)
      ≥28.0 332(4.85) 33(3.50) 299(5.06)
    民族 0.79 0.373
      汉族 6 457(94.29) 896(94.92) 5 561(94.19)
      少数民族 391(5.71) 48(5.08) 343(5.81)
    户口类型 20.85 <0.001
      城镇 3 192(46.61) 505(53.50) 2 687(45.51)
      农村 3 656(53.39) 439(46.50) 3 217(54.49)
    SES 30.13 <0.001 <0.001
      低 2 048(29.91) 219(23.20) 1 829(30.98)
      中 2 342(34.20) 323(34.22) 2 019(34.20)
      高 2 458(35.89) 402(42.58) 2 056(34.82)
    地区划分1 1.79 0.181
      北方 3 736(54.56) 534(56.57) 3 202(54.23)
      南方 3 112(45.44) 410(43.43) 2 702(45.77)
    地区划分2 26.76 <0.001 0.208
      东部 2 599(37.95) 377(39.94) 2 222(37.64)
      中部 2 388(34.87) 263(27.86) 2 125(35.99)
      西部 1 861(27.18) 304(32.20) 1 557(26.37)
    下载: 导出CSV

    表  2  体力活动与胎膜早破发生风险的相关性[n(%)]

    Table  2.   Association between physical activities and risk of premature rupture of membranes [n(%)]

    体力活动类型 总例数 胎膜早破
    例数 粗OR(95% CI)值 调整OR(95% CI)值
    高强度
      低频组 6 784(99.07) 932(98.73) 1.00 1.00
      高频组 64(0.93) 12(1.27) 1.45(0.77~2.73) 1.57(0.83~2.97)
    中强度
      低频组 6 688(97.66) 913(96.72) 1.00 1.00
      高频组 160(2.34) 31(3.28) 1.52(1.02~2.26) 1.50(1.01~2.23)
    低强度
      低频组 3 800(55.49) 483(51.17) 1.00 1.00
      高频组 3 048(44.51) 461(48.83) 1.22(1.07~1.40) 1.19(1.04~1.37)
    久坐组
      否 5 094(74.39) 676(71.61) 1.00 1.00
      是 1 754(25.61) 268(28.39) 1.18(1.01~1.37) 1.12(0.96~1.31)
    下载: 导出CSV
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