R Samuel McLaughlin Foundation- Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada.
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):82-89. doi: 10.1136/bjsports-2018-099919. Epub 2018 Oct 18.
Theoretical concerns regarding the supine position at rest due to the gravid uterus obstructing aorta and vena caval flow may impinge uterine blood flow (UBF) to the fetus and maternal venous return.
Systematic review.
Online databases up to 11 December 2017.
Eligible population (pregnant without contraindication to exercise), intervention (frequency, intensity, duration, volume or type of supine exercise), comparator (no exercise or exercise in left lateral rest position, upright posture or other supine exercise), outcomes (potentially adverse effects on maternal blood pressure, cardiac output, heart rate, oxygen saturation, fetal movements, UBF, fetal heart rate (FHR) patterns; adverse events such as bradycardia, low birth weight, intrauterine growth restriction, perinatal mortality and other adverse events as documented by study authors), and study design (except case studies and reviews) published in English, Spanish, French or Portuguese.
Seven studies (n=1759) were included. 'Very low' to 'low' quality evidence from three randomised controlled trials indicated no association between supervised exercise interventions that included supine exercise and low birth weight compared with no exercise. There was 'very low' to 'low' quality evidence from four observational studies that showed no adverse events in the mother; however, there were abnormal FHR patterns (as defined by study authors) in 20 of 65 (31%) fetuses during an acute bout of supine exercise. UBF decreased (13%) when women moved from left lateral rest to acute dynamic supine exercise.
There was insufficient evidence to ascertain whether maternal exercise in the supine position is safe or should be avoided during pregnancy.
由于妊娠子宫阻塞主动脉和腔静脉血流，理论上担心休息时的仰卧位会影响胎儿和母体静脉回流的子宫血流（UBF）。
系统评价。
截至 2017 年 12 月 11 日的在线数据库。
合格人群（无运动禁忌的孕妇），干预措施（仰卧运动的频率、强度、持续时间、量或类型），对照（无运动或左侧卧位休息、直立姿势或其他仰卧运动），结局（对母体血压、心输出量、心率、氧饱和度、胎儿运动、UBF、胎儿心率（FHR）模式的潜在不良影响；如心动过缓、低出生体重、宫内生长受限、围产儿死亡率和其他不良事件，由研究作者记录），以及发表在英语、西班牙语、法语或葡萄牙语的研究设计（除病例研究和综述外）。
纳入了 7 项研究（n=1759）。3 项随机对照试验的“极低”至“低”质量证据表明，与不运动相比，包括仰卧运动的监督运动干预与低出生体重之间没有关联。4 项观察性研究的“极低”至“低”质量证据表明，母亲没有不良事件；然而，在 65 名（31%）胎儿中，有 20 名（20%）胎儿在急性仰卧运动中出现 FHR 模式异常（由研究作者定义）。当女性从左侧卧位转为急性动态仰卧位时，UBF 减少（13%）。
目前尚无足够证据确定孕妇仰卧位运动是否安全或应在怀孕期间避免。
