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. 2018 Nov;52(21):1357-1366. doi: 10.1136/bjsports-2018-099829.
To perform a systematic review and meta-analysis to explore the relationship between prenatal exercise and glycaemic control.
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 and reviews) 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 acute or chronic exercise, alone ('exercise-only') or in combination with other intervention components (eg, dietary; 'exercise+cointervention') at any stage of pregnancy), comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and outcome (glycaemic control).
A total of 58 studies (n=8699) were included. There was 'very low' quality evidence showing that an acute bout of exercise was associated with a decrease in maternal blood glucose from before to during exercise (6 studies, n=123; mean difference (MD) -0.94 mmol/L, 95% CI -1.18 to -0.70, I=41%) and following exercise (n=333; MD -0.57 mmol/L, 95% CI -0.72 to -0.41, I=72%). Subgroup analysis showed that there were larger decreases in blood glucose following acute exercise in women with diabetes (n=26; MD -1.42, 95% CI -1.69 to -1.16, I=8%) compared with those without diabetes (n=285; MD -0.46, 95% CI -0.60 to -0.32, I=62%). Finally, chronic exercise-only interventions reduced fasting blood glucose compared with no exercise postintervention in women with diabetes (2 studies, n=70; MD -2.76, 95% CI -3.18 to -2.34, I=52%; 'low' quality of evidence), but not in those without diabetes (9 studies, n=2174; MD -0.05, 95% CI -0.16 to 0.05, I=79%).
Acute and chronic prenatal exercise reduced maternal circulating blood glucose concentrations, with a larger effect in women with diabetes.
系统回顾和荟萃分析以探讨产前运动与血糖控制之间的关系。
系统回顾，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。
所有设计的研究均入选（除病例研究和综述外），如果研究发表于英文、西班牙文或法文，并包含人群（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、量或急性或慢性运动的类型，单独（“仅运动”）或与其他干预成分（如饮食）相结合（“运动+联合干预”）在妊娠的任何阶段）、比较（不运动或不同频率、强度、持续时间、量和类型的运动）和结局（血糖控制）信息。
共纳入 58 项研究（n=8699）。有“极低”质量证据表明，单次急性运动可使母体运动期间和运动后血糖降低（6 项研究，n=123；平均差值（MD）-0.94mmol/L，95%CI-1.18 至-0.70，I=41%）。亚组分析显示，糖尿病妇女（n=26；MD-1.42mmol/L，95%CI-1.69 至-1.16，I=8%）急性运动后血糖下降幅度大于无糖尿病妇女（n=285；MD-0.46mmol/L，95%CI-0.60 至-0.32，I=62%）。最后，与无运动相比，仅慢性运动干预可降低糖尿病妇女的空腹血糖（2 项研究，n=70；MD-2.76mmol/L，95%CI-3.18 至-2.34，I=52%；证据质量“低”），但对无糖尿病妇女无影响（9 项研究，n=2174；MD-0.05mmol/L，95%CI-0.16 至 0.05，I=79%）。
产前急性和慢性运动降低了母体循环血糖浓度，糖尿病妇女的效果更大。
