产后身体活动对心脏代谢健康、母乳喂养、损伤及婴儿生长发育的影响：一项系统综述和荟萃分析

Impact of postpartum physical activity on cardiometabolic health, breastfeeding, injury and infant growth and development: a systematic review and meta-analysis.

作者信息

Jones Paris A T, Moolyk Amy, Ruchat Stephanie-May, Ali Muhammad Usman, Fleming Karen, Meyer Sarah, Sjwed Talia Noel, Wowdzia Jenna B, Maier Lauren, Mottola Michelle, Sivak Allison, Davenport Margie H

机构信息

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, Universite du Quebec a Trois-Rivieres, Trois-Rivieres, Quebec, Canada.

出版信息

Br J Sports Med. 2025 Mar 31;59(8):539-549. doi: 10.1136/bjsports-2024-108483.

DOI:10.1136/bjsports-2024-108483

PMID:39375006

Abstract

OBJECTIVE

To examine the relationship between postpartum physical activity and maternal postnatal cardiometabolic health, breastfeeding, injury, and infant growth and development.

DESIGN

Systematic review with random-effects meta-analysis and meta-regression.

DATA SOURCES

Eight online databases were searched up until 12 January 2024.

ELIGIBILITY CRITERIA

Studies of all designs in all languages were eligible (except case studies and reviews) if they contained information on the population (postpartum people), intervention (frequency, intensity, duration, volume, or type of exercise, alone ('exercise-only') or in combination with other intervention components (eg, dietary; 'exercise+co-intervention'), comparator (no or low volumes of physical activity), and outcomes: hypertension, diabetes, cardiometabolic risk factors (systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, high density lipoproteins, low density lipoproteins, and triglycerides, glycated hemoglobin (HbA1C), glucose and insulin concentration), breastfeeding (breast milk quality and volume), infant growth (length and weight) and development, or postpartum injury.

RESULTS

46 unique studies (n=8766 participants) from 20 countries were included. Moderate certainty of evidence showed exercise+co-interventions reduced the odds of developing diabetes by 28% (7 randomised controlled trials (RCTs), n=2496; OR 0.72 95% CI 0.54, 0.98, I 12%), reduced SBP (10 RCTs, n=2753; mean difference (MD) -2.15 95% CI -3.89 to -0.40, I 73%) and DBP (9 RCTs, n=2575; MD -1.38 95% CI -2.60 to -0.15, I 66%) compared with controls. Infant growth and development, breast milk quality and quantity, and risk of injury were not different between exercise and control groups.

CONCLUSIONS

Physical activity improves cardiometabolic health without adversely impacting breast milk supply or quality, infant growth or maternal injury.

摘要

目的

探讨产后身体活动与产妇产后心脏代谢健康、母乳喂养、损伤以及婴儿生长发育之间的关系。

设计

采用随机效应荟萃分析和荟萃回归的系统评价。

数据来源

检索了8个在线数据库，截至2024年1月12日。

纳入标准

所有语言的所有设计的研究均符合条件（病例研究和综述除外），如果它们包含有关人群（产后人群）、干预措施（运动的频率、强度、持续时间、量或类型，单独进行（“仅运动”）或与其他干预成分联合进行（如饮食；“运动+联合干预”））、对照（无身体活动或低运动量身体活动）以及结局指标的信息：高血压、糖尿病、心脏代谢危险因素（收缩压（SBP）、舒张压（DBP）、总胆固醇、高密度脂蛋白、低密度脂蛋白、甘油三酯、糖化血红蛋白（HbA1C）、血糖和胰岛素浓度）、母乳喂养（母乳质量和量）、婴儿生长（身长和体重）与发育，或产后损伤。

结果

纳入了来自20个国家的46项独特研究（n=8766名参与者）。中等证据确定性表明，与对照组相比，运动+联合干预使患糖尿病的几率降低了28%（7项随机对照试验（RCT），n=2496；OR 0.72，95%CI 0.54，0.98，I²=12%），收缩压降低（10项RCT，n=2753；平均差值（MD）-2.15，95%CI -3.89至-0.40，I²=73%）以及舒张压降低（9项RCT，n=2575；MD -1.38，95%CI -2.60至-0.15，I²=66%）。运动组和对照组在婴儿生长发育、母乳质量和量以及损伤风险方面没有差异。