Maternal, Fetal and Infant Research Centre, Institute of Nursing and Health Research, University of Ulster, Newtownabbey, Northern Ireland.
PLoS One. 2013 Jun 14;8(6):e66385. doi: 10.1371/journal.pone.0066385. Print 2013.
Physical activity (PA) typically declines throughout pregnancy. Low levels of PA are associated with excessive weight gain and subsequently increase risk of pre-eclampsia, gestational diabetes mellitus, hypertension disorders, delivery by caesarean section and stillbirth. Systematic reviews on PA during pregnancy have not explored the efficacy of behaviour change techniques or related theory in altering PA behaviour. This systematic review evaluated the content of PA interventions to reduce the decline of PA in pregnant women with a specific emphasis on the behaviour change techniques employed to elicit this change.
Literature searches were conducted in eight databases. Strict inclusion and exclusion criteria were employed. Two reviewers independently evaluated each intervention using the behaviour change techniques (BCT) taxonomy to identify the specific behaviour change techniques employed. Two reviewers independently assessed the risk of bias using the guidelines from the Cochrane Collaboration. Overall quality was determined using the GRADE approach.
A total of 1140 potentially eligible papers were identified from which 14 studies were selected for inclusion. Interventions included counselling (n = 6), structured exercise (n = 6) and education (n = 2). Common behaviour change techniques employed in these studies were goal setting and planning, feedback, repetition and substitution, shaping knowledge and comparison of behaviours. Regular face-to-face meetings were also commonly employed. PA change over time in intervention groups ranged from increases of 28% to decreases of 25%. In 8 out of 10 studies, which provided adequate data, participants in the intervention group were more physically active post intervention than controls.
Physical activity interventions incorporating behaviour change techniques help reduce the decline in PA throughout pregnancy. Range of behaviour change techniques can be implemented to reduce this decline including goals and planning, shaping knowledge and comparison of outcomes. A lack of high quality interventions hampers conclusions of intervention effectiveness.
体力活动（PA）通常在整个孕期下降。低水平的 PA 与体重过度增加有关，进而增加子痫前期、妊娠糖尿病、高血压疾病、剖宫产和死产的风险。关于孕期 PA 的系统评价尚未探讨行为改变技术或相关理论在改变 PA 行为方面的效果。本系统评价评估了减少孕妇 PA 下降的干预措施的内容，特别强调了用于引起这种变化的行为改变技术。
在八个数据库中进行了文献检索。严格采用纳入和排除标准。两位审查员使用行为改变技术（BCT）分类法独立评估每项干预措施，以确定所采用的具体行为改变技术。两位审查员独立使用 Cochrane 合作组织的指南评估偏倚风险。使用 GRADE 方法确定整体质量。
从 1140 篇潜在合格论文中确定了 14 项研究入选。干预措施包括咨询（n=6）、结构化运动（n=6）和教育（n=2）。这些研究中采用的常见行为改变技术包括目标设定和计划、反馈、重复和替代、塑造知识和行为比较。还经常采用定期面对面会议。干预组的 PA 随时间的变化范围从增加 28%到减少 25%。在 10 项提供了足够数据的研究中，有 8 项研究表明干预组的参与者在干预后比对照组更活跃。
包含行为改变技术的 PA 干预措施有助于减少整个孕期 PA 的下降。可以实施多种行为改变技术来减少这种下降，包括目标和计划、塑造知识和比较结果。缺乏高质量的干预措施限制了干预效果的结论。
