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孕期运动预防妊娠期糖尿病的效果:一项系统评价与荟萃分析

Effect of exercise during pregnancy to prevent gestational diabetes mellitus: a systematic review and meta-analysis.

作者信息

Yu Ying, Xie Rongrong, Shen Cainuo, Shu Lianting

机构信息

a Obstetrics and Gynecology Department , Fenghua People's Hospital of Ningbo , Zhejiang , China.

b Obstetrics and Gynecology Department , Fenghua Maternal and Child Health Hospital , Zhejiang , China.

出版信息

J Matern Fetal Neonatal Med. 2018 Jun;31(12):1632-1637. doi: 10.1080/14767058.2017.1319929. Epub 2017 May 14.

Abstract

INTRODUCTION

Exercise showed some potential in preventing gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to evaluate the impact of exercise during pregnancy on gestational diabetes mellitus.

METHODS

PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the influence of exercise during pregnancy on gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was the incidence of gestational diabetes mellitus. Meta-analysis was performed using random-effect model.

RESULTS

Six RCTs involving 2164 patients were included in the meta-analysis. Compared with control intervention, exercise intervention was associated with significantly decreased incidence of gestational diabetes mellitus (Std. mean difference = 0.59; 95%CI = 0.39-.88; p = .01), but had no effect on gestational age at birth (Std. mean difference = -0.03; 95%CI = -0.12 to 0.07; p = .60), the number of preterm birth (OR = 0.85; 95%CI = 0.43-1.66; p = .63), glucose 2-h post-OGTT (Std. mean difference = -1.02; 95%CI = -2.75 to 0.71; p = .25), birth weight (Std. mean difference = -0.13; 95%CI = -0.26 to 0.01; p = .06), and Apgar score less than 7 (OR = .78; 95%CI = 0.21-2.91; p = .71).

CONCLUSIONS

Compared to control intervention, exercise intervention could significantly decrease the risk of gestational diabetes mellitus, but showed no impact on gestational age at birth, preterm birth, glucose 2-h post-OGTT, birth weight, and Apgar score less than 7.

摘要

引言

运动在预防妊娠期糖尿病方面显示出一定潜力。然而,结果仍存在争议。我们进行了一项系统评价和荟萃分析,以评估孕期运动对妊娠期糖尿病的影响。

方法

系统检索了PubMed、EMbase、Web of science、EBSCO和Cochrane图书馆数据库。纳入评估孕期运动对妊娠期糖尿病影响的随机对照试验(RCT)。两名研究者独立检索文章、提取数据并评估纳入研究的质量。主要结局是妊娠期糖尿病的发病率。采用随机效应模型进行荟萃分析。

结果

荟萃分析纳入了6项涉及2164例患者的RCT。与对照干预相比,运动干预与妊娠期糖尿病发病率显著降低相关(标准化均数差=0.59;95%置信区间=0.39 - 0.88;p = 0.01),但对出生孕周(标准化均数差=-0.03;95%置信区间=-0.12至0.07;p = 0.60)、早产数量(比值比=0.85;95%置信区间=0.43 - 1.66;p = 0.63)、口服葡萄糖耐量试验2小时血糖(标准化均数差=-1.02;95%置信区间=-2.75至0.71;p = 0.25)、出生体重(标准化均数差=-0.13;95%置信区间=-0.26至0.01;p = 0.06)及Apgar评分低于7分(比值比=0.78;95%置信区间=0.21 - 2.91;p = 0.71)无影响。

结论

与对照干预相比,运动干预可显著降低妊娠期糖尿病风险,但对出生孕周、早产、口服葡萄糖耐量试验2小时血糖、出生体重及Apgar评分低于7分无影响。

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