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孕期身体活动与妊娠期糖尿病发病风险的关系:一项随机对照试验的系统评价和荟萃分析。

Physical activity during pregnancy and the risk of gestational diabetes mellitus: a systematic review and meta-analysis of randomised controlled trials.

机构信息

West China Second University Hospital, Sichuan University, , Chengdu, Sichuan, China.

出版信息

Br J Sports Med. 2014 Feb;48(4):290-5. doi: 10.1136/bjsports-2013-092596. Epub 2013 Sep 13.

Abstract

OBJECTIVES

We performed a systematic review and meta-analysis to assess the effects of physical activity in preventing gestational diabetes mellitus (GDM).

SEARCH STRATEGY

We searched the literature in six electronic databases and bibliographies of relevant articles.

SELECTION CRITERIA

We included randomised controlled trials on pregnant women who did not have GDM and other complications previously and had increased physical activity as the only intervention. The risk of developing GDM was documented separately for the intervention and control groups.

DATA COLLECTION AND ANALYSIS

Two reviewers extracted data and assessed quality independently. Data from the included trials were combined using a fixed-effects model. The effect size was expressed as relative risk (RR) and 95% CI.

MAIN RESULTS

Of the 1110 studies identified, six randomised controlled trials met the inclusion criteria. In three trials, the incidence of GDM was lower in the intervention group than in the control group, whereas two trials showed a higher incidence of GDM in the intervention group and the remaining trial found no GDM in either the intervention or control group. The meta-analysis resulted in a relative risk (RR) of GDM of 0.91 (95% CI 0.57 to 1.44), suggesting no significant difference in the risk of developing GDM between the intervention and the control groups. No indication of publication bias was found.

CONCLUSIONS

Evidence was insufficient to suggest that physical activity during pregnancy might be effective to lower the risk of developing GDM.

摘要

目的

我们进行了一项系统评价和荟萃分析,以评估体力活动预防妊娠期糖尿病(GDM)的效果。

检索策略

我们在六个电子数据库和相关文章的参考文献中搜索了文献。

选择标准

我们纳入了先前没有 GDM 和其他并发症且仅增加体力活动作为唯一干预措施的孕妇的随机对照试验。分别为干预组和对照组记录发生 GDM 的风险。

数据收集和分析

两位评审员独立提取数据并评估质量。使用固定效应模型合并纳入试验的数据。效应大小表示为相对风险(RR)和 95%置信区间。

主要结果

在 1110 项研究中,有 6 项随机对照试验符合纳入标准。在 3 项试验中,干预组的 GDM 发生率低于对照组,而 2 项试验显示干预组的 GDM 发生率较高,其余试验在干预组或对照组均未发现 GDM。荟萃分析得出 GDM 的相对风险(RR)为 0.91(95%置信区间 0.57 至 1.44),表明干预组和对照组发生 GDM 的风险无显著差异。未发现发表偏倚的迹象。

结论

目前证据尚不足以表明孕期体力活动可能有效降低 GDM 的发病风险。

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