Effects of Supervised Exercise on the Development of Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis.
Effects of Supervised Exercise on the Development of Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis.
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DOI：
10.3390/jcm11030793
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发表时间：
2022-02-01
影响因子：
3.9
通讯作者：
Tan BK
中科院分区：
文献类型：
--
作者：
Danielli M;Gillies C;Thomas RC;Melford SE;Baker PN;Yates T;Khunti K;Tan BK
妊娠期高血压疾病（HDP）是妊娠期最常见的医学并发症，影响全球约10-15%的妊娠。HDP是孕产妇和围产期发病率和死亡率的主要原因，每年全世界约有70，000名母亲和500，000名婴儿死于HDP。目前缺乏最新的高质量的系统评价，量化运动的作用和发展HDP的风险。体育锻炼被认为是安全和有益的孕妇。在一般人群中，以及在肥胖和糖尿病妇女的怀孕期间，有监督的运动已被证明是安全的，并且比无监督的运动更有益。因此，我们进行了一项系统性综述和荟萃分析，以调查妇女在怀孕期间进行监督运动与对照组（标准产前护理或无监督运动）相比对HDP发展的影响。我们检索了Medline、Embase、CINHAL和科克伦图书馆，检索时间从开始到2021年12月。我们只纳入了随机对照试验（RCT），调查HDP的发展与对照组（标准产前护理或无监督运动）进行监督运动的孕妇相比。两名独立的评审员选择了符合条件的试验进行荟萃分析。数据收集和分析由两名独立的评审员进行。PROSPERO注册号为CRD 42020176814。在检索到的6332篇文章中，16项RCT符合合格标准，共比较了5939名孕妇（干预组2904名孕妇和对照组3035名孕妇）。与对照组相比，干预组孕妇发生HDP的风险显著降低，估计干预组发生HDP的累积发生率为3%（95% CI：3 - 4），对照组为5%（95%CI：5至6），并且将干预与对照进行比较的合并比值比（OR）为0.54（95%CI：0.40至0.72，p < 0.001）。有氧运动和无氧运动相结合，或仅瑜伽，与仅进行有氧运动相比，具有更大的有益效果（混合OR = 0.50，95% CI：0.33至0.75，p = 0.001;瑜伽OR = 0.28，95% CI：0.13至0.58，p = 0.001;仅有氧运动OR = 0.87，95% CI：0.55至1.37，p = 0.539）。怀孕是医疗保健提供者促进积极健康活动的机会，从而优化孕妇的健康，对母亲和儿童都有潜在的短期和长期利益。这项系统性综述和荟萃分析支持结构化运动（有氧、力量和柔韧性锻炼的组合）或瑜伽预防HDP发作的有益效果。瑜伽被认为是一种低影响的体力活动，对于怀孕的妇女来说，在降低患HDP的风险方面可能更容易接受和更安全。
Hypertensive disorders of pregnancy (HDP) are the most common medical complication in pregnancy, affecting approximately 10–15% of pregnancies worldwide. HDP are a major cause of maternal and perinatal morbidity and mortality, and each year, worldwide, around 70,000 mothers and 500,000 babies die because of HDP. Up-to-date high-quality systematic reviews quantifying the role of exercise and the risks of developing HDP are currently lacking. Physical exercise is considered to be safe and beneficial to pregnant women. Supervised exercise has been shown to be safe and to be more beneficial than unsupervised exercise in the general population, as well as during pregnancy in women with obesity and diabetes. Therefore, we undertook a systematic review and meta-analysis to investigate the effects of women performing supervised exercise during pregnancy compared to a control group (standard antenatal care or unsupervised exercise) on the development of HDP. We searched Medline, Embase, CINHAL, and the Cochrane Library, which were searched from inception to December 2021. We included only randomized controlled trials (RCTs) investigating the development of HDP compared to a control group (standard antenatal care or unsupervised exercise) in pregnant women performing supervised exercise. Two independent reviewers selected eligible trials for meta-analysis. Data collection and analyses were performed by two independent reviewers. The PROSPERO registration number is CRD42020176814. Of 6332 articles retrieved, 16 RCTs met the eligibility criteria, comparing a total of 5939 pregnant women (2904 pregnant women in the intervention group and 3035 controls). The risk for pregnant women to develop HDP was significantly reduced in the intervention compared to the control groups, with an estimated pooled cumulative incidence of developing HDP of 3% in the intervention groups (95% CI: 3 to 4) and of 5% in the control groups (95% CI: 5 to 6), and a pooled odds ratio (OR) comparing intervention to control of 0.54 (95% CI:0.40 to 0.72, p < 0.001). A combination of aerobic and anaerobic exercise, or yoga alone, had a greater beneficial effect compared to performing aerobic exercise only (mixed-OR = 0.50, 95% CI:0.33 to 0.75, p = 0.001; yoga-OR = 0.28, 95% CI:0.13 to 0.58, p = 0.001); aerobic exercise only-OR = 0.87, 95% CI:0.55 to 1.37, p = 0.539). Pregnancy is an opportunity for healthcare providers to promote positive health activities, thus optimizing the health of pregnant women with potential short- and long-term benefits for both mother and child. This systematic review and meta-analysis support a beneficial effect of either structured exercise (combination of aerobic, strength, and flexibility workouts) or yoga for preventing the onset of HDP. Yoga, considered a low-impact physical activity, could be more acceptable and safer for women in pregnancy in reducing the risk of developing HDP.
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DOI：
10.1186/s12966-017-0632-6
发表时间：
2017-12-22
期刊：
The international journal of behavioral nutrition and physical activity
影响因子：
--
作者：
da Silva SG;Hallal PC;Domingues MR;Bertoldi AD;Silveira MFD;Bassani D;da Silva ICM;da Silva BGC;Coll CVN;Evenson K
通讯作者：
Evenson K
影响因子：
7.2
作者：
de Oliveria Melo, Adriana S.;Silva, Joao Luiz P.;Amorim, Melania M. R.
通讯作者：
Amorim, Melania M. R.
影响因子：
1.9
作者：
Evenson KR;Barakat R;Brown WJ;Dargent-Molina P;Haruna M;Mikkelsen EM;Mottola MF;Owe KM;Rousham EK;Yeo S
通讯作者：
Yeo S
影响因子：
1.9
作者：
Arena, B;Maffulli, N
通讯作者：
Maffulli, N
影响因子：
2
作者：
Higgins, JPT;Thompson, SG
通讯作者：
Thompson, SG