首页资讯孕期如何进行体育锻炼？——基于发达国家及组织孕期身体活动指南的启示

孕期如何进行体育锻炼？——基于发达国家及组织孕期身体活动指南的启示

来源：泰然健康网时间：2024年12月01日 01:26

摘要: 孕期体育锻炼不仅有助于改善孕妇的健康状况，也有助于促进其胎儿的健康成长。世界各国纷纷颁布了一系列孕妇身体活动指南，而我国缺乏对孕期体育锻炼的系统研究，也无专门针对孕妇身体活动的指南。为此，系统梳理近年来发达国家及组织颁布的孕期身体活动指南，发现美国妇产科医师学会、美国卫生与公众服务部、加拿大、英国、国际奥林匹克委员会等国家和组织均对孕妇体育锻炼提出详细建议，明确孕期体育锻炼的禁忌证及风险，阐释孕期体育锻炼的频率、持续时间、强度及类型，强调体育锻炼的预防与保护措施。基于国外经验，得出以下启示：良好的锻炼意识是孕妇体育锻炼的前提，系统的医学检查是孕妇体育锻炼的基础，科学的锻炼方法是孕妇体育锻炼的关键，安全的预防和保护措施是孕妇体育锻炼的保障。

Abstract: Physical activity during pregnancy helps not only improve women's health, but also promote the growth of their fetuses. While all the other countries issued a series of physical activity guidelines during pregnancy, China lacks the relevant research, without physical activity guidelines for pregnant women as well. The guidelines for physical activity during pregnancy issued by developed countries and social organizations in recent years hence are sorted out, trying to provide scientific guidance for pregnant women in China.It is found that the American College of Obstetrics and Gynecology(ACOG), the United States Department of Health (USDHHS), Canada, the United Kingdom, and the International Olympic Committee(IOC) have all put forward detailed recommendations on physical activity for pregnant women, which included the contraindications and risks of physical exercise, its frequency, duration, exercise intensity and types, and the emphasis on the prevention and protection measures of physical exercise.The conclusions are therefore drawn as follows: good exercise awareness is the prerequisite for pregnant women to exercise during pregnancy, systematic medical examination the basis, scientific exercise method the key and safe prevention and protection measures the guarantee.

图 1 孕妇体育锻炼与母婴健康之间的剂量效应关系[26]

Figure 1. Dose-response relationship between the quantity and quality of maternal exercise on maternal and fetal well-being

图 2 美国医护人员对孕妇体育锻炼的5A动机咨询程序

Figure 2. 5A's counseling strategy used by U.S. health care providers on physical activity during pregnancy

表 1 近年来发达国家及组织孕期身体活动指南概况

Table 1 Overview of the guidelines for physical activity during pregnancy in developed countries and organizations in recent years

国家/组织发布时间指南名称颁发组织适用人群加拿大 2019年《2019年加拿大孕期身体活动指南》 SOGC、CSEP 产科医生、妇科医生、运动生理专家、孕妇美国 2018年《美国国民身体活动指南（第二版）》 USDHHS 健康专业人员和政策制定者、普通大众 2017年《孕期和产后的身体活动和锻炼》 ACOG 产科医生、妇科医生、孕妇英国 2019年《孕妇身体活动指南》 ROCG 产科医生、妇科医生、孕妇 IOC 2018年《一般和优秀运动员孕期体育锻炼：2016—2017年国际奥委会专家组会议的证据总结》 IOC 健康专业人员、运动员孕妇注：SOGC为加拿大妇产医学会，CSEP为加拿大运动生理学会，USDHHS为美国卫生与公众服务部，ACOG为美国妇产科医师学会，ROCG为英国皇家妇产科医师学会，IOC为国际奥林匹克委员会。

表 2 孕期体育锻炼的禁忌证

Table 2 Contraindications of physical exercise during pregnancy

禁忌证加拿大英国 IOC ACOG 绝对禁忌证先兆子痫或妊娠高血压 + + + + 早产 + + + + 严重的呼吸道疾病 + + + + 多次妊娠 + + + + 持续的妊娠中期或晚期出血 + + + 前置胎盘 + + + + 心血管疾病 + + + + 子宫颈内口松弛症 + + + + 胎儿生长受限 + + + + 胎膜破裂 + + + + 严重高血压 + + + 甲状腺疾病 + + 1型糖尿病或其他严重系统性疾病 + + + + 不明原因的持续性阴道出血 + + 相对禁忌证贫血 + + + 宫颈扩张 + 癫痫 + + 复发性流产 + 心律失常 + + + 慢性支气管炎 + + + + 进食障碍 + 病态的肥胖 + + 烟瘾大 + + 久坐行为的生活方式 + + 自然流产 + + 营养不良 + + + 轻/中度心血管疾病 + 整形的限制 + + 其他重要健康问题 + 注：ACOG为美国妇产科医师学会，IOC为国际奥林匹克委员会；+表示指南有该指标建议。

表 3 孕期身体活动建议

Table 3 Suggestions for physical activity during pregnancy

身体活动加拿大英国 USDHHS ACOG 体育锻炼持续时间每周≥150 min、每次≥15 min 每周≥150 min、每次≥15 min 每周≥150 min 每天不少于20~30 min 体育锻炼频率每周至少3天或每天每周大多数天每周大多数天每周大多数天或每天体育锻炼强度低强度 + 中等强度 + + + + 较高强度 + + 心率 + + RPE + + 谈话测试 + + + 体育锻炼类型有氧运动 + + + + 越野滑雪 + 盆底锻炼 + 蹬自行车 + + 力量训练 + + + 拉伸运动 + + + 跳舞 + 步行 + + + 游泳 + + + 壁球 + 瑜伽/普拉提 + + + 注：USDHHS为美国卫生与公众服务部，ACOG为美国妇产科医师学会，RPE为主观疲劳感知评估；+表示指南有该指标建议。

表 4 孕期停止体育锻炼的症状

Table 4 Symptoms of stopping physical activity during pregnancy

症状加拿大英国 IOC ACOG 腹部疼痛 + + 羊水泄漏 + + + + 小腿疼痛或肿胀 + + + + 胸部疼痛 + + + + 胎儿活动减少 + 头晕或晕厥先兆 + + + + 呼吸困难 + + + + 阴道积液过多或胎膜破裂 + + 头疼 + + + 肌肉无力 + + + 早产 + 子宫收缩 + + + 阴道出血 + + + + 注：IOC为国际奥林匹克委员会，ACOG为美国妇产科医师学会；+表示指南有该指标建议。 [1]

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