摘要：

目的 探究影響孕婦孕期體力活動的環(huán)境因素及作用路徑，為制訂針對性的運動干預策略提供參考。方法 采用便利抽樣法，于2021年5月—12月使用一般資料調查表、孕期身體活動問卷、國際跌倒效能量表、居家跌倒風險篩查量表、社會支持評定量表對浙江省某三級甲等婦產科醫(yī)院產科門診常規(guī)產前檢查的1 200名孕婦進行問卷調查。進行單因素分析、Spearman相關分析，并使用Mplus 7.4軟件構建并檢驗鏈式中介模型。結果 最終共納入1 118名孕婦，202名（18.07%）孕婦孕期體力活動達標。跌倒恐懼、居住環(huán)境、社會支持對孕婦孕期體力活動的直接效應成立，效應值分別為-0.168、0.326、0.381；居住環(huán)境通過跌倒恐懼的中介作用間接影響孕期體力活動，效應值為0.074，占總效應的18.50%；社會支持通過居住環(huán)境、跌倒恐懼的單獨中介作用及居住環(huán)境-跌倒恐懼的鏈式中介作用間接影響孕婦孕期體力活動，效應值為0.198，占總效應的34.20%。結論 孕婦孕期體力活動達標率較低，臨床醫(yī)護人員應重視跌倒恐懼、居住環(huán)境、社會支持對孕婦孕期體力活動的影響，實施科學、精準的運動管理，以提高孕婦孕期體力活動水平。

關鍵詞: 孕婦, 體力活動, 跌倒恐懼, 居住環(huán)境, 社會支持, 路徑分析, 圍產期護理

Abstract:

Objective To investigate the environmental factors of physical activity among pregnant women，so as to provide a basis for the formulation of targeted intervention programs. Methods Using convenient sampling method，from May to December 2021，we investigated 1200 pregnant women who were received routine prenatal examination in obstetric clinic of a tertiary hospital in Zhejiang province with the general information questionnaire，Pregnancy Physical Activity Questionnaire，F(xiàn)alls Efficacy Scale International，Home Falls and Accidents Screening Tool，and Social Support Rate Scale. Univariate analysis，Spearman correlation were used to analysis the data，and the structural equation model was established. Results A total of 1118 pregnant women were enrolled，and only 202（18.70%） of whom met the criteria of physical activity. Pathway analysis showed that fear of falling，residential environment and social support had a direct impact on the physical activity during pregnancy with an effect of -0.168，0.326 and 0.381，respectively. Residential environment also affected physical activity through the independent mediating effect of fear of falling with an effect of 0.074，accounting for 18.50% of the total effects. Social support also affected physical activity through the independent mediating effect of residential environment and fear of falling，and the chain mediating effect of residential environment and fear of falling，accounting for 34.20% of the total effects. Conclusion The rate of pregnant women met the criteria of physical activity is low. Medical staff should pay attention to the impact of fear of falling，residential environment and social support on physical activity during pregnancy，and take targeted measures to increase the level of activity，so as to improve the level of physical activity during pregnancy.

Key words: Pregnant Women, Physical Activity, Fear of Falling, Residential Environment, Social Support, Pathway Analysis, Perinatal Care

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