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.
Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada.
Br J Sports Med. 2019 Jan;53(2):99-107. doi: 10.1136/bjsports-2018-099821. Epub 2018 Oct 18.
To perform a systematic review of the relationships between prenatal exercise and maternal harms including labour/delivery outcomes.
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), comparator (no exercise or different frequency, intensity, duration, volume and type of exercise, alone ["exercise-only"] or in combination with other intervention components [e.g., dietary; "exercise + co-intervention"]) and outcome (preterm/prelabour rupture of membranes, caesarean section, instrumental delivery, induction of labour, length of labour, vaginal tears, fatigue, injury, musculoskeletal trauma, maternal harms (author defined) and diastasis recti).
113 studies (n=52 858 women) were included. 'Moderate' quality evidence from exercise-only randomised controlled trials (RCTs) indicated a 24% reduction in the odds of instrumental delivery in women who exercised compared with women who did not (20 RCTs, n=3819; OR 0.76, 95% CI 0.63 to 0.92, I = 0 %). The remaining outcomes were not associated with exercise. Results from meta-regression did not identify a dose-response relationship between frequency, intensity, duration or volume of exercise and labour and delivery outcomes.
SUMMARY/CONCLUSIONS: Prenatal exercise reduced the odds of instrumental delivery in the general obstetrical population. There was no relationship between prenatal exercise and preterm/prelabour rupture of membranes, caesarean section, induction of labour, length of labour, vaginal tears, fatigue, injury, musculoskeletal trauma, maternal harms and diastasis recti.
系统评价产前运动与母体伤害之间的关系，包括分娩/分娩结局。
系统综述，随机效应荟萃分析和荟萃回归。
截至 2017 年 1 月 6 日，在线数据库进行了检索。
所有设计的研究均包括在内（病例研究除外），如果它们以英文、西班牙文或法文发表，并包含有关人群（无运动禁忌的孕妇）、干预（主观或客观测量的频率、强度、持续时间、体积或运动类型）、对照（无运动或不同频率、强度、持续时间、体积和运动类型，单独[“运动仅”]或与其他干预成分结合[例如，饮食；“运动+联合干预”]）和结局（早产/胎膜早破前、剖宫产、器械分娩、引产、分娩持续时间、阴道撕裂、疲劳、损伤、肌肉骨骼创伤、母体伤害（作者定义）和腹直肌分离）的信息。
纳入了 113 项研究（n=52858 名妇女）。来自运动仅随机对照试验（RCT）的“中等”质量证据表明，与不运动的妇女相比，运动的妇女器械分娩的几率降低了 24%（20 项 RCT，n=3819；OR 0.76，95%CI 0.63 至 0.92，I=0%）。其余结局与运动无关。荟萃回归的结果并未发现运动的频率、强度、持续时间或体积与分娩和分娩结局之间存在剂量反应关系。
总结/结论：产前运动降低了一般产科人群器械分娩的几率。产前运动与早产/胎膜早破前、剖宫产、引产、分娩持续时间、阴道撕裂、疲劳、损伤、肌肉骨骼创伤、母体伤害和腹直肌分离之间没有关系。
