Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sports and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, AB, CANADA.
Faculty of Kinesiology, Sports, and Recreation, University of Alberta, Edmonton, AB, CANADA.
Med Sci Sports Exerc. 2021 Aug 1;53(8):1739-1747. doi: 10.1249/MSS.0000000000002617.
This study aimed to evaluate postpartum maternal health and training outcomes of females who were competing or training as elite athletes before or during pregnancy.
Online databases were searched up to August 26, 2020. Studies of any design and language were eligible if they contained information on the relevant population (postpartum athletes [any period after pregnancy]), exposure (engaged in the highest level of sport immediately before or during pregnancy), comparators (sedentary/active controls), and outcomes: maternal (breastfeeding initiation and duration, postpartum weight retention or loss, bone mineral density, low back or pelvic girdle pain, incontinence [prevalence or severity of stress, urge or mixed urinary incontinence, fecal incontinence], injury, anemia, diastasis recti, breast pain, depression, anxiety) and training (<6 wk time to resume activity, training volume or intensity, performance level).
Eleven studies (n = 482 females, including 372 elite athletes) were included. We identified "very low" certainty evidence demonstrating a higher rate of return to sport before 6 wk postpartum among elite athletes compared with nonelite athletes (n = 145, odds ratio = 6.93, 95% confidence interval = 2.73-17.63, I2 = 11). "Very low" certainty evidence from three studies (n = 179) indicated 14 elite athletes obtained injuries postpartum (7 stress fractures, 9 "running injuries"). "Very low" certainty evidence from five studies (n = 262) reported that 101 (40.5%) elite athletes experienced improved performance postpartum.
Compared with controls, "very low" quality evidence suggests that elite athletes return to physical activity early in the postpartum period and may have an increased risk of injury. Additional high-quality evidence is needed to safely guide return to sport of elite athletes in the postpartum period.
本研究旨在评估在怀孕前或怀孕期间曾作为精英运动员参赛或训练的女性产后的母婴健康和训练结果。
截至 2020 年 8 月 26 日，我们在线数据库中进行了检索。如果研究包含了相关人群（产后运动员[产后任何时期]）、暴露情况（在怀孕前或怀孕期间从事最高水平的运动）、对照组（久坐/活跃对照组）和结局（母乳喂养开始和持续时间、产后体重保持或减轻、骨密度、下背部或骨盆带疼痛、尿失禁[压力性、急迫性或混合性尿失禁、粪便失禁]、损伤、贫血、腹直肌分离、乳房疼痛、抑郁、焦虑）和训练情况（<6 周恢复活动、训练量或强度、运动表现水平）的信息，则研究无论设计和语言如何，均符合纳入标准。
共纳入 11 项研究（n = 482 名女性，包括 372 名精英运动员）。我们发现，有“极低”确定性证据表明，与非精英运动员相比，精英运动员在产后 6 周内重返运动的比例更高（n = 145，优势比 = 6.93，95%置信区间 = 2.73-17.63，I ² = 11）。三项研究（n = 179）的“极低”确定性证据表明，14 名精英运动员产后受伤（7 例应力性骨折，9 例“跑步损伤”）。五项研究（n = 262）的“极低”确定性证据表明，262 名精英运动员中有 101 名（40.5%）产后运动表现得到改善。
与对照组相比，“极低”质量证据表明，精英运动员在产后早期恢复身体活动，并且受伤风险可能增加。需要更多高质量证据来安全指导精英运动员在产后恢复运动。
