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孕期身体活动对分娩类型、持续时间及硬膜外麻醉使用的影响:系统评价与荟萃分析

Influence of Physical Activity during Pregnancy on Type and Duration of Delivery, and Epidural Use: Systematic Review and Meta-Analysis.

作者信息

Zhang Dingfeng, Ruchat Stephanie-May, Silva-Jose Cristina, Gil-Ares Javier, Barakat Rubén, Sánchez-Polán Miguel

机构信息

AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain.

Department of Human Kinetics, Université du Québec à Trois, Trois-Rivières, QC G8T 0A1, Canada.

出版信息

J Clin Med. 2023 Aug 5;12(15):5139. doi: 10.3390/jcm12155139.

Abstract

Cesarean delivery may increase the need for anesthesia administration, thereby causing potential risks to both maternal and fetal health. This article aimed to investigate the effect of physical activity during pregnancy on the type of delivery, the duration of labor, and the use of epidurals (registration No.: CRD42022370646). Furthermore, 57 RCTs ( = 15301) were included showing that physical activity could decrease the risk of cesarean section (z = 3.22, = 0.001; RR = 0.87, 95% CI = 0.79, 0.95, I = 37%, P = 0.004), and 32 RCTs ( = 9468) showed significant decreases in instrumental delivery through performing physical activity (z = 3.48, < 0.001; RR = 0.84, 95% CI = 0.76, 0.93, I = 0%, P = 0.63). A significant decrease in the 15 RCTs' ( = 4797) duration of first stage labor was found in physically active pregnant women (z = 2.09, = 0.04; MD = -62.26, 95% CI = -120.66, -3.85, I = 93%, P < 0.001) compared to those not active. Prenatal physical activity could decrease the risk of cesarean section and instrumental delivery and the duration of first stage labor.

摘要

剖宫产可能会增加麻醉的需求,从而对母婴健康造成潜在风险。本文旨在研究孕期体育活动对分娩方式、产程以及硬膜外麻醉使用的影响(注册号:CRD42022370646)。此外,纳入的57项随机对照试验(n = 15301)表明,体育活动可降低剖宫产风险(z = 3.22,P = 0.001;RR = 0.87,95%CI = 0.79,0.95,I² = 37%,P = 0.004),32项随机对照试验(n = 9468)显示,通过进行体育活动器械助产显著减少(z = 3.48,P < 0.001;RR = 0.84,95%CI = 0.76,0.93,I² = 0%,P = 0.63)。与不运动的孕妇相比,15项随机对照试验(n = 4797)发现运动的孕妇第一产程时间显著缩短(z = 2.09,P = 0.04;MD = -62.26,95%CI = -120.66,-3.85,I² = 93%,P < 0.001)。产前体育活动可降低剖宫产和器械助产的风险以及第一产程的时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8db2/10419719/de5a54d22937/jcm-12-05139-g001.jpg

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