徐清风

[摘要] 妊娠生理的改变可以使既往无糖尿病的孕妇发生妊娠期糖尿病，其属于高危妊娠，临床过程复雜，对母儿均有影响。大量研究证实妊娠期中等强度的运动有利于改善妊娠期糖尿病患者葡萄糖代谢异常，从而控制血糖，更好地为分娩做准备。同时妊娠期运动对改善孕妇的精神状态、缓解妊娠期不适也有一定帮助。该文主要阐述的妊娠期运动方式、运动原则，仅仅针对无运动禁忌证的妊娠期糖尿病孕妇，旨在提高妊娠期糖尿病患者对妊娠期运动的认识，为其制定运动方案提供指导。

[关键词] 妊娠期糖尿病;妊娠期运动;运动疗法

[Abstract] Changes in pregnancy physiology can cause gestational diabetes in pregnant women without diabetes， which is a high-risk pregnancy. The clinical process is complicated and affects both mother and child. A large number of studies have confirmed that moderate-intensity exercise during pregnancy， which is conducive to improving glucose metabolism abnormalities in patients with gestational diabetes， thereby controlling blood glucose and better preparing for delivery. At the same time， exercise during pregnancy will help improve the mental state of pregnant women and alleviate discomfort during pregnancy. This article mainly explains the exercise methods and exercise principles during pregnancy， only for pregnant women with gestational diabetes who have no sports contraindications. The purpose is to improve the awareness of gestational diabetes patients during pregnancy and provide guidance for the development of exercise programs.

[Key words] Gestational diabetes; Exercise during pregnancy; Exercise therapy

在妊娠早期和中期，随孕周的增加，一方面由于胎儿对营养物质需求量增加，另一方面受到传统观念的影响，很多孕妇通常会摄入过多的营养物质，加之运动意识不够使妊娠期体重增长超过正常范围，由此导致妊娠期代谢紊乱、妊娠期糖尿病（gestational diabetes mellitus，GDM）的发生率也逐年增加。据统计，我国妊娠期糖尿病的发病率已经达到17.5%，其对母婴均有较大的危害[1]。而合理的运动能够改善妊娠期代谢水平，对妊娠期糖尿病有重要的预防作用。赵金荣等[2]的研究表明妊娠期合理的有氧运动能够有效控制妊娠期体重，可降低血糖水平以及妊娠期糖尿病的发病率。美国妇产科医师学会（american college of obstetricians and Gynecologists，ACOG）颁布有关孕产期锻炼2015版指南推荐每日不少于30 min的运动，并且指出中等量运动对孕妇有利[3]。加拿大2018版妊娠期运动指南中指出合理的运动对产妇没有危害，运动在妊娠期糖尿病的防治过程中发挥了重要作用[4]。……