Post-Graduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3º piso, Bairro Centro, Pelotas, Rio Grande do Sul, CEP: 96020-220, Brazil, Pelotas, 96020-220, Rio Grande do Sul, Brasil.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
Sports Med. 2017 Feb;47(2):295-317. doi: 10.1007/s40279-016-0565-2.
Evidence suggests that leisure-time physical activity (LTPA) during pregnancy is associated with a reduced risk of preeclampsia, gestational diabetes mellitus (GDM), and preterm birth. However, these results are inconsistent when comparing cohort studies and randomized controlled trials (RCTs).
The purpose of our study was to compare the associations between LTPA in pregnancy and maternal (GDM, preeclampsia, and weight gain during pregnancy) and child health outcomes (preterm birth, birthweight, and fetal growth) between RCTs and cohort studies.
We performed a systematic search in PubMed, Web of Science, and EBSCO up to 31 August 2015. Inclusion criteria for experimental studies required randomized trials with a control group and exposure to a physical activity structured program. The inclusion criteria for cohort studies required information on LTPA during pregnancy as an exposure and at least one maternal-child health outcome. We assessed the methodological quality of all studies and performed a meta-analysis to produce summary estimates of the effects using random models.
We included 30 RCTs and 51 cohort studies. The meta-analysis of RCTs indicated that participation in LTPA was associated with lower weight gain during pregnancy, lower likelihood of GDM, and lower likelihood of delivering a large-for-gestational-age infant. Cohort studies indicated that participation in LTPA was associated with lower weight gain during pregnancy, lower likelihood of GDM, and lower risk of preterm delivery.
Our findings support the promotion of LTPA in pregnancy as a strategy to improve maternal and child health.
有证据表明，孕期休闲时间体力活动（LTPA）与子痫前期、妊娠糖尿病（GDM）和早产风险降低有关。然而，当比较队列研究和随机对照试验（RCT）时，这些结果并不一致。
本研究旨在比较孕期 LTPA 与母婴（GDM、子痫前期和孕期体重增加）和儿童健康结局（早产、出生体重和胎儿生长）之间的关联，比较 RCT 和队列研究。
我们在 PubMed、Web of Science 和 EBSCO 进行了系统检索，截至 2015 年 8 月 31 日。实验研究的纳入标准需要随机试验对照和暴露于结构化体力活动方案。队列研究的纳入标准需要孕期 LTPA 作为暴露的信息和至少一个母婴健康结局。我们评估了所有研究的方法学质量，并进行了荟萃分析，使用随机模型产生效应的综合估计值。
我们纳入了 30 项 RCT 和 51 项队列研究。RCT 的荟萃分析表明，参与 LTPA 与孕期体重增加减少、GDM 发生可能性降低和巨大儿出生可能性降低有关。队列研究表明，参与 LTPA 与孕期体重增加减少、GDM 发生可能性降低和早产风险降低有关。
我们的发现支持在孕期促进 LTPA，作为改善母婴健康的策略。
