Ceysens G, Rouiller D, Boulvain M
Erasme Academic Hospital - Free University of Brussels, Department of Obstetrics and Gynaecology, Route de Lennik, 808, Brussels, Belgium B-1070.
Cochrane Database Syst Rev. 2006 Jul 19;2006(3):CD004225. doi: 10.1002/14651858.CD004225.pub2.
Diabetes in pregnancy may result in unfavourable maternal and neonatal outcomes. Exercise was proposed as an additional strategy to improve glycaemic control. The effect of exercise during pregnancies complicated by diabetes needs to be assessed.
To evaluate the effect of exercise programs, alone or in conjunction with other therapies, compared to no specific program or to other therapies, in pregnant women with diabetes on perinatal and maternal morbidity and on the frequency of prescription of insulin to control glycaemia. To compare the effectiveness of different types of exercise programs on perinatal and maternal morbidity.
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2005).
All known randomised controlled trials evaluating the effect of exercise in diabetic pregnant women on perinatal outcome and maternal morbidity.
We evaluated relevant studies for meeting the inclusion criteria and methodological quality. Three review authors abstracted the data. For all data analyses, we entered data based on the principle of intention to treat. We calculated relative risks and 95% confidence intervals for dichotomous data.
Four trials, involving 114 pregnant women with gestational diabetes, were included in the review. None included pregnant women with type 1 or type 2 diabetes. Women were recruited during the third trimester and the intervention was performed for about six weeks. The programs generally consisted in exercising three times a week for 20 to 45 minutes. We found no significant difference between exercise and the other regimen in all the outcomes evaluated.
AUTHORS' CONCLUSIONS: There is insufficient evidence to recommend, or advise against, diabetic pregnant women to enrol in exercise programs. Further trials, with larger sample size, involving women with gestational diabetes, and possibly type 1 and 2 diabetes, are needed to evaluate this intervention.
妊娠期糖尿病可能导致不良的母婴结局。运动被提议作为改善血糖控制的一项额外策略。需要评估糖尿病合并妊娠期间运动的效果。
评估与无特定方案或其他疗法相比，运动方案单独或与其他疗法联合使用，对糖尿病孕妇围产期和母亲发病率以及控制血糖所需胰岛素处方频率的影响。比较不同类型运动方案对围产期和母亲发病率的有效性。
我们检索了Cochrane妊娠与分娩组试验注册库（2005年12月31日）。
所有评估运动对糖尿病孕妇围产期结局和母亲发病率影响的已知随机对照试验。
我们评估相关研究是否符合纳入标准和方法学质量。三位综述作者提取数据。对于所有数据分析，我们根据意向性治疗原则录入数据。我们计算二分数据的相对风险和95%置信区间。
该综述纳入了4项试验，涉及114例妊娠期糖尿病孕妇。均未纳入1型或2型糖尿病孕妇。这些女性在孕晚期入组，干预持续约六周。方案通常包括每周锻炼三次，每次20至45分钟。在所有评估结局中，我们发现运动与其他治疗方案之间无显著差异。
没有足够证据推荐或建议糖尿病孕妇参加运动方案。需要进一步开展样本量更大的试验，纳入妊娠期糖尿病女性，可能还包括1型和2型糖尿病女性，以评估这一干预措施。
