Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada.
R Samuel McLaughlin Foundation, Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Children's Health Research Institute, The University of Western Ontario, London, Ontario, Canada.
Br J Sports Med. 2019 Jan;53(2):108-115. doi: 10.1136/bjsports-2018-099773. Epub 2018 Oct 18.
To perform a systematic review of the relationship between prenatal exercise and fetal or newborn death.
Systematic review with random-effects meta-analysis and meta-regression.
Online databases were searched up to 6 January 2017.
Studies of all designs were included (except case studies) if they were published in English, Spanish or French and contained information on the population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone ["exercise-only"] or in combination with other intervention components [eg, dietary; "exercise + co-intervention"]), comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and outcome (miscarriage or perinatal mortality).
Forty-six studies (n=2 66 778) were included. There was 'very low' quality evidence suggesting no increased odds of miscarriage (23 studies, n=7125 women; OR 0.88, 95% CI 0.63 to 1.21, I=0%) or perinatal mortality (13 studies, n=6837 women, OR 0.86, 95% CI 0.49 to 1.52, I=0%) in pregnant women who exercised compared with those who did not. Stratification by subgroups did not affect odds of miscarriage or perinatal mortality. The meta-regressions identified no associations between volume, intensity or frequency of exercise and fetal or newborn death. As the majority of included studies examined the impact of moderate intensity exercise to a maximum duration of 60 min, we cannot comment on the effect of longer periods of exercise.
SUMMARY/CONCLUSIONS: Although the evidence in this field is of 'very low' quality, it suggests that prenatal exercise is not associated with increased odds of miscarriage or perinatal mortality. In plain terms, this suggests that generally speaking exercise is 'safe' with respect to miscarriage and perinatal mortality.
系统评价产前运动与胎儿或新生儿死亡之间的关系。
系统评价，采用随机效应荟萃分析和荟萃回归。
在线数据库检索截至 2017 年 1 月 6 日。
所有设计的研究均包括在内（除病例研究外），如果它们以英文、西班牙文或法文发表，并包含关于人群（无运动禁忌的孕妇）、干预措施（单独的主观或客观测量频率、强度、持续时间、运动量或运动类型[“仅运动”]或与其他干预措施相结合[例如饮食；“运动+联合干预”]）、比较因素（不运动或不同频率、强度、持续时间、运动量和运动类型）和结局（流产或围产儿死亡率）的信息。
共纳入 46 项研究（n=266778）。有“极低”质量证据表明，运动组孕妇流产（23 项研究，n=7125 名妇女；OR 0.88，95%CI 0.63 至 1.21，I=0%）或围产儿死亡率（13 项研究，n=6837 名妇女，OR 0.86，95%CI 0.49 至 1.52，I=0%）的几率均无增加。亚组分层对流产或围产儿死亡率的几率没有影响。荟萃回归未发现运动量、强度或运动频率与胎儿或新生儿死亡之间的关联。由于大多数纳入的研究都检查了中等强度运动对最长 60 分钟的影响，我们无法评论更长时间运动的效果。
总结/结论：尽管该领域的证据质量为“极低”，但它表明产前运动与流产或围产儿死亡率的几率增加无关。换句话说，这表明一般来说，运动在流产和围产儿死亡率方面是“安全”的。
