The status and influencing factors of physical activity among Chinese pregnant women during different pregnancies
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摘要:
目的 了解我国孕妇在不同孕期的身体活动水平，分析持续身体活动不足的影响因素。 方法 本研究以中国孕产妇队列研究·协和(Chinese Pregnant Women Cohort Study, CPWCS)项目中完成孕早期、孕中期、孕晚期随访的孕妇为研究对象。通过基线调查获取孕妇的一般信息，通过国际体育活动问卷对孕妇在三个孕期的身体活动水平进行评估。采用多因素Logistic回归分析模型分析孕期持续身体活动不足的危险因素。 结果 共计2 920名孕妇纳入研究，其中仅1 057名(36.2%)孕妇在三个孕期都达到了身体活动充足，有267名(9.1%)孕妇在三个孕期都处于低水平身体活动，即持续身体活动不足。Logistic回归分析模型分析结果显示：孕前肥胖(OR=1.985, 95% CI: 1.078~3.654, P=0.028)、家庭成员数>2人(OR=1.544, 95% CI: 1.122~2.123, P=0.008)和怀孕前吸烟(OR=2.395, 95% CI: 1.309~4.382, P=0.005)的孕妇更容易出现持续身体活动不足。 结论 我国孕期妇女的身体活动水平不足。应针对不同人群提供个性化的身体活动指导，发挥家庭成员对孕妇积极进行身体活动的支持作用，以帮助孕妇在怀孕期间安全有效地进行身体活动，促进孕妇和胎儿的健康。 Abstract:Objective To study the physical activity level of Chinese pregnant women in different trimesters, and analyze the influencing factors of constant physical inactivity. Methods The study objects were from Chinese Pregnant Women Cohort Study (CPWCS) who were followed-up in the first, second and third trimester. The general information of pregnant women was obtained through baseline survey, and the physical activity in each trimester was assessed through International Physical Activity Questionnaire (IPAQ) Short Form. Multivariable logistic regression was used to analyze the influencing factors of constant physical inactivity during pregnancy. Results A total of 2 920 pregnant women were included in the study, of which only 1 057 (36.2%) were physically active all through the pregnancy, and 267 (9.14%) were constant physical inactivity. Logistic regression analysis results showed that prepregnancy obesity (OR=1.985, 95% CI: 1.078-3.654, P=0.028), having more than 2 family members (OR=1.544, 95% CI: 1.122-2.123, P=0.008), and smoking before pregnancy (OR=2.395, 95% CI: 1.309-4.382, P=0.005) were risk factors of constant physical inactivity. Conclusions The physical activity of Chinese pregnant women was insufficient. To help pregnant women carry out physical activities safely and effectively during pregnancy, and promote the health status of pregnant women and fetuses, we should provide personalized physical activity guidance, and family members should take actions to support pregnant women to carry out physical activities. -
Key words:
- Pregnant women /
- Physical activity /
- Influencing factors /
- Cohort study
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表 1 孕妇的一般特征(n=2 920)
Table 1. General characteristics of pregnant women (n=2 920)
因素 例数(n) 百分比(%) 民族 汉族 2 770 94.86 少数民族 150 5.14 户口性质 非农业户口 1 416 48.49 农业户口 1 504 51.51 地区 北方 1 729 59.21 南方 1 191 40.79 年龄(岁) < 25 429 14.69 25~ 1 484 50.82 30~ 713 24.42 ≥35 294 10.07 孕前BMI(kg/m2) < 18.5 364 12.47 18.5~ 1 871 64.08 24.0~ 537 18.38 ≥28.0 148 5.07 家庭成员数(人) ≤2 954 32.67 >2 1 966 67.33 丈夫文化程度 初中及以下 414 14.18 高中 658 22.53 大专/本科 1 659 56.82 硕士及以上 189 6.47 孕妇工作情况 无工作 763 26.13 有工作 2 157 73.87 丈夫工作情况 无工作 204 6.99 有工作 2 716 93.01 家庭人均年收入(万元/人) ≤4 1 641 56.20 >4 1 279 43.80 孕前吸烟情况 不吸烟 2 841 97.29 吸烟 79 2.71 孕妇文化程度 初中及以下 366 12.53 高中 591 20.24 大专/本科 1 747 59.83 硕士及以上 216 7.40 
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表 2 孕妇各个孕期身体活动水平分布情况[n(%)]
Table 2. Physical activity levels in the first, second, and third trimester [n(%)]
身体活动水平 孕早期 孕中期 孕晚期 Friedman M检验 χ2值 P值 低水平 1 308(44.79) 884(30.27) 792(27.12) 263.403 < 0.001 中水平 1 472(50.41) 1 832(62.74) 1 885(64.55) 高水平 140(4.80) 204(6.99) 243(8.33)
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表 3 持续身体活动不足的影响因素的单因素分析[n(%)]
Table 3. Single factor analysis of the influencing factors of constant physical inactivity [n(%)]
因素 持续身体活动不足 χ2值 P值 Ptrend值 是 否 民族 0.249 0.618 汉族 255(9.21) 2 515(90.79) 少数民族 12(8.00) 138(92.00) 户口性质 2.192 0.139 非农业户口 141(9.96) 1 275(90.04) 农业户口 126(8.38) 1 378(91.62) 地区 0.014 0.906 北方 159(9.20) 1 570(90.80) 南方 108(9.07) 1 083(90.93) 年龄(岁) 0.938 0.816 0.479 < 25 39(9.09) 390(90.91) 25~ 129(8.69) 1 355(91.31) 30~ 70(9.82) 643(90.18) ≥35 29(9.86) 265(90.14) 孕前BMI(kg/m2) 7.767 0.051 0.012 < 18.5 30(8.29) 334(91.71) 18.5~ 158(8.44) 1 713(91.56) 24.0~ 58(10.80) 479(89.20) ≥28.0 21(14.19) 127(85.81) 孕妇文化程度 2.521 0.471 0.165 初中及以下 30(8.20) 336(91.80) 高中 49(8.29) 542(91.71) 大专/本科 163(9.33) 1 584(90.67) 硕士及以上 25(11.57) 191(88.43) 丈夫文化程度 0.146 0.986 0.776 初中及以下 36(8.70) 378(91.30) 高中 61(9.27) 597(90.73) 大专/本科 152(9.16) 1 507(90.84) 硕士及以上 18(9.52) 171(90.48) 孕妇工作情况 0.001 0.973 无工作 70(9.17) 693(90.83) 有工作 197(9.13) 1 960(9.87) 丈夫工作情况 0.847 0.357 无工作 15(7.35) 189(92.65) 有工作 252(9.28) 2 464(90.72) 家庭人均年收入(万元/人) 0.427 0.513 ≤4 145(8.84) 1 496(91.16) >4 122(9.54) 1 157(90.46) 家庭成员数(人) 3.796 0.051 ≤2 73(7.65) 881(92.35) >2 194(9.87) 1 772(90.13) 孕前吸烟情况 7.191 0.007 不吸烟 253(8.91) 2 588(91.09) 吸烟 14(17.72) 65(82.28)
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表 4 持续身体活动不足的影响因素的多因素Logistic回归分析
Table 4. Logistic regression analysis of influencing factors of constant physical inactivity
因素 β值 sx Wald χ2值 OR值(95% CI) P值 民族 汉族 1.000 少数民族 -0.157 0.311 0.254 0.855(0.465~1.572) 0.614 户口性质 非农业户口 1.000 农业户口 -0.120 0.149 0.647 0.887(0.662~1.188) 0.421 地区 南方 1.000 北方 0.058 0.137 0.178 1.060(0.809~1.387) 0.673 年龄(岁) < 25 1.000 25~ -0.114 0.199 0.331 0.892(0.604~1.318) 0.565 30~ -0.076 0.224 0.115 0.927(0.598~1.437) 0.734 ≥35 -0.093 0.274 0.115 0.911(0.532~1.560) 0.735 孕前BMI(kg/m2) < 18.5 1.000 18.5~ 0.031 0.212 0.021 1.031(0.680~1.564) 0.885 24.0~ 0.337 0.245 1.899 1.401(0.867~2.263) 0.168 ≥28.0 0.686 0.311 4.850 1.985(1.078~3.654) 0.028 孕妇文化程度 初中及以下 1.000 高中 0.041 0.273 0.022 1.042(0.610~1.777) 0.881 大专/本科 0.314 0.283 1.227 1.368(0.786~2.383) 0.268 硕士及以上 0.646 0.382 2.858 1.908(0.902~4.036) 0.091 丈夫文化程度 初中及以下 1.000 高中 -0.002 0.252 0.000 0.998(0.609~1.635) 0.994 大专/本科 -0.130 0.266 0.239 0.878(0.521~1.479) 0.625 硕士及以上 -0.246 0.390 0.398 0.782(0.364~1.679) 0.528 孕妇工作情况 无工作 1.000 有工作 -0.115 0.169 0.467 0.891(0.640~1.241) 0.494 丈夫工作情况 无工作 1.000 有工作 0.246 0.292 0.708 1.279(0.721~2.267) 0.400 家庭人均年收入(万元/人) ≤4 1.000 >4 0.221 0.154 2.065 1.247(0.923~1.686) 0.151 家庭成员数(人) ≤2 1.000 >2 0.434 0.163 7.132 1.544(1.122~2.123) 0.008 孕前吸烟情况 不吸烟 1.000 吸烟 0.873 0.308 8.028 2.395(1.309~4.382) 0.005
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