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. 2018 Nov;52(21):1386-1396. doi: 10.1136/bjsports-2018-099836.
We aimed to identify the relationship between maternal prenatal exercise and birth complications, and neonatal and childhood morphometric, metabolic and developmental 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 eligible (except case studies and reviews) if published in English, Spanish or French, and contained information on the relevant population (pregnant women without contraindication to exercise), intervention (subjective/objective measures of frequency, intensity, duration, volume or type of exercise, alone ('exercise-only') or in combination with other intervention components (eg, dietary; 'exercise+cointervention')), comparator (no exercise or different frequency, intensity, duration, volume, type or trimester of exercise) and outcomes (preterm birth, gestational age at delivery, birth weight, low birth weight (<2500 g), high birth weight (>4000 g), small for gestational age, large for gestational age, intrauterine growth restriction, neonatal hypoglycaemia, metabolic acidosis (cord blood pH, base excess), hyperbilirubinaemia, Apgar scores, neonatal intensive care unit admittance, shoulder dystocia, brachial plexus injury, neonatal body composition (per cent body fat, body weight, body mass index (BMI), ponderal index), childhood obesity (per cent body fat, body weight, BMI) and developmental milestones (including cognitive, psychosocial, motor skills)).
A total of 135 studies (n=166 094) were included. There was 'high' quality evidence from exercise-only randomised controlled trials (RCTs) showing a 39% reduction in the odds of having a baby >4000 g (macrosomia: 15 RCTs, n=3670; OR 0.61, 95% CI 0.41 to 0.92) in women who exercised compared with women who did not exercise, without affecting the odds of growth-restricted, preterm or low birth weight babies. Prenatal exercise was not associated with the other neonatal or infant outcomes that were examined.
Prenatal exercise is safe and beneficial for the fetus. Maternal exercise was associated with reduced odds of macrosomia (abnormally large babies) and was not associated with neonatal complications or adverse childhood outcomes.
我们旨在确定孕妇产前运动与分娩并发症以及新生儿和儿童形态、代谢和发育结果之间的关系。
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。
所有设计类型的研究（除病例研究和综述外）都符合入选标准，研究发表于英文、西班牙文或法文，研究内容包含以下相关人群（无运动禁忌的孕妇）、干预措施（频率、强度、持续时间、运动量或运动类型的主观/客观测量值，单独运动（“仅运动”）或与其他干预措施联合应用（如饮食；“运动+联合干预”））、对照（不运动或不同频率、强度、持续时间、运动量、类型或孕期运动）和结局（早产、分娩时的胎龄、出生体重、低出生体重（<2500 克）、高出生体重（>4000 克）、小于胎龄儿、大于胎龄儿、宫内生长受限、新生儿低血糖、代谢性酸中毒（脐血 pH 值、碱剩余）、高胆红素血症、阿普加评分、新生儿重症监护病房入院、肩难产、臂丛神经损伤、新生儿身体成分（体脂百分比、体重、体重指数（BMI）、体质量指数）、儿童肥胖（体脂百分比、体重、BMI）和发育里程碑（包括认知、社会心理、运动技能））。
共纳入 135 项研究（n=166094）。“仅运动”随机对照试验（RCT）提供了“高质量”证据，表明与不运动的孕妇相比，运动的孕妇生下>4000 克（巨大儿：15 项 RCT，n=3670；OR 0.61，95%CI 0.41 至 0.92）的巨大儿的几率降低，而不影响生长受限、早产或低出生体重儿的几率。产前运动与研究中检查的其他新生儿或婴儿结局无关。
产前运动对胎儿安全且有益。孕妇运动与巨大儿（异常大的婴儿）几率降低相关，与新生儿并发症或不良儿童结局无关。
