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运动干预对超重或肥胖孕妇并发症和妊娠结局的影响:系统评价和荟萃分析。

The effects of exercise intervention on complications and pregnancy outcomes in pregnant women with overweight or obesity: A systematic review and meta-analysis.

机构信息

Department of Obstetrics and Gynecology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, Hubei, China.

出版信息

Medicine (Baltimore). 2023 Oct 6;102(40):e34804. doi: 10.1097/MD.0000000000034804.

Abstract

BACKGROUND

Being overweight or obese is closely related to adverse pregnancy outcomes and harms both pregnant women and neonates, increasing complications during pregnancy and leading to adverse pregnancy outcomes. Consequently, a meta-analysis was done to investigate exercise therapy impact on the complications and outcomes of pregnant women who are obese or overweight.

MATERIALS AND METHODS

The computer system searched PubMed, Cochrane Library, Wanfang, EMBASE, and CNKI databases. The search duration extended from the database establishment until October 2022. A thorough search was carried out for pertinent studies investigating exercise therapy impact on pregnancy complications and outcomes in obese or overweight pregnant women. The heterogeneity test was carried out using Cochrane Q and Chi-square tests. The combined findings from the meta-analysis were examined for reliability and robustness using sensitivity and publication bias analyses. All statistics used RevMan 5.3 software.

RESULTS

This meta-analysis included data from 8026 patients from 22 randomized controlled trials. The results demonstrated that exercise therapy might successfully decrease the incidence of gestational diabetes mellitus (GDM) (odds ratio [OR] = 0.85, 95% confidence interval [CI]: 0.74-0.96, P = .01) and macrosomia (OR = 0.78, 95% CI: 0.68-0.89, P < .001), and control weight gain during pregnancy (SMD = -0.2, 95% CI: -0.31 to -0.08, P < .001).

CONCLUSIONS

Exercise therapy can control weight gain during pregnancy, lower the incidence of GDM and the macrosomia rate, and improve adverse pregnancy outcomes.

摘要

背景

超重或肥胖与不良妊娠结局密切相关,对孕妇和新生儿都有危害,增加了妊娠期间的并发症,并导致不良妊娠结局。因此,进行了一项荟萃分析,以研究运动疗法对肥胖或超重孕妇并发症和结局的影响。

材料和方法

计算机系统检索了 PubMed、Cochrane 图书馆、万方、EMBASE 和中国知网数据库。检索时间从数据库建立到 2022 年 10 月。全面检索了有关运动疗法对肥胖或超重孕妇妊娠并发症和结局影响的研究。使用 Cochrane Q 和卡方检验进行异质性检验。使用敏感性和发表偏倚分析对荟萃分析的综合结果进行可靠性和稳健性检验。所有统计均使用 RevMan 5.3 软件进行。

结果

这项荟萃分析纳入了 22 项随机对照试验中 8026 名患者的数据。结果表明,运动疗法可能成功降低妊娠期糖尿病(GDM)的发生率(比值比[OR] = 0.85,95%置信区间[CI]:0.74-0.96,P = 0.01)和巨大儿的发生率(OR = 0.78,95%CI:0.68-0.89,P < 0.001),并控制妊娠期间的体重增加(SMD = -0.2,95%CI:-0.31 至-0.08,P < 0.001)。

结论

运动疗法可以控制妊娠期间的体重增加,降低 GDM 和巨大儿的发生率,并改善不良妊娠结局。

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