Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA.
Diabetes Care. 2011 Jan;34(1):223-9. doi: 10.2337/dc10-1368. Epub 2010 Sep 27.
Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is associated with a substantially elevated risk of adverse health outcomes for both mothers and offspring. Physical activity may contribute to the prevention of GDM and thus is crucial for dissecting the vicious circle involving GDM, childhood obesity, and adulthood obesity, and diabetes. Therefore, we aimed to systematically review and synthesize the current evidence on the relation between physical activity and the development of GDM.
Medline, EMBASE, and Cochrane Reviews were searched from inception to 31 March 2010. Studies assessing the relationship between physical activity and subsequent development of GDM were included. Characteristics including study design, country, GDM diagnostic criteria, ascertainment of physical activity, timing of exposure (prepregnancy or early pregnancy), adjusted relative risks, CIs, and statistical methods were extracted independently by two reviewers.
Our search identified seven prepregnancy and five early pregnancy studies, including five prospective cohorts, two retrospective case-control studies, and two cross-sectional study designs. Prepregnancy physical activity was assessed in 34,929 total participants, which included 2,813 cases of GDM, giving a pooled odds ratio (OR) of 0.45 (95% CI 0.28-0.75) when the highest versus lowest categories were compared. Exercise in early pregnancy was assessed in 4,401 total participants, which included 361 cases of GDM, and was also significantly protective (0.76 [95% CI 0.70-0.83]).
Higher levels of physical activity before pregnancy or in early pregnancy are associated with a significantly lower risk of developing GDM.
妊娠糖尿病（GDM）是妊娠最常见的并发症之一，与母亲和后代不良健康结局的风险显著增加有关。身体活动可能有助于预防 GDM，因此对于剖析涉及 GDM、儿童肥胖和成年肥胖以及糖尿病的恶性循环至关重要。因此，我们旨在系统地回顾和综合目前关于身体活动与 GDM 发展之间关系的证据。
从 2010 年 3 月 31 日开始，我们在 Medline、EMBASE 和 Cochrane 综述中进行了搜索。纳入了评估身体活动与随后发生 GDM 之间关系的研究。特征包括研究设计、国家、GDM 诊断标准、身体活动的确定、暴露时间（孕前或孕早期）、调整后的相对风险、置信区间和统计方法，由两位审查员独立提取。
我们的搜索确定了 7 项孕前和 5 项孕早期研究，包括 5 项前瞻性队列研究、2 项回顾性病例对照研究和 2 项横断面研究设计。在 34929 名总参与者中评估了孕前身体活动，其中包括 2813 例 GDM，当最高与最低类别进行比较时，汇总的优势比（OR）为 0.45（95% CI 0.28-0.75）。在 4401 名总参与者中评估了孕早期的运动，其中包括 361 例 GDM，也具有显著的保护作用（0.76 [95% CI 0.70-0.83]）。
孕前或孕早期较高水平的身体活动与发生 GDM 的风险显著降低相关。
