运动疗法对超重或肥胖孕妇孕期并发症和妊娠结局影响的Meta分析  

Effects of Exercise Therapy on Complications and Pregnancy Outcomes in Overweight or Obese Pregnant Women: A Meta-analysis

作　　者：张莉[1,2] 章江琳[1,2] 虎洁婷[1,2] 张彩云 张志刚 魏丽[3] 孙文丽[3] 田金徽[4] ZHANG Li;ZHANG Jiang-lin;HU Jie-ting;ZHANG Cai-yun;ZHANG Zhi-gang;WEI Li;SUN Wen-li;TIAN Jin-hui(The First Hospital of Lanzhou University,Lanzhou 730000,China;School of Nursing,Lanzhou University,Lanzhou 730000,China;Evidence Based Medicine Center, Lanzhou University,Lanzhou 730000,China;The Second Hospital of Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一医院,甘肃兰州730000 [2]兰州大学护理学院,甘肃兰州730000 [3]兰州大学第二医院,甘肃兰州730000 [4]兰州大学循证医学中心,甘肃兰州730000

出　　处：《护理学报》2018年第11期44-50,共7页Journal of Nursing（China）

摘　　要：目的探讨运动疗法对超重或肥胖孕妇孕期并发症和妊娠结局的影响。方法计算机检索Pub Med、Cochrane Library、Embase、Web of Science、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库。全面检索运动疗法对超重或肥胖孕妇孕期并发症和妊娠结局影响的相关研究。采用Cochrane系统评价方法 ,对纳入文献进行质量评价,并使用Rev Man 5.3软件对资料进行Meta分析。结果共纳入9篇随机对照试验,1 444例患者。Meta分析结果显示:运动疗法可降低妊娠期糖尿病的发生率(RR=0.52,95%CI:0.39~0.68,P<0.001)、妊娠期高血压疾病的发生率(RR=0.62,95%CI:0.45~0.84,P=0.002)、剖宫产发生率(RR=0.83,95%CI:0.70~0.98,P=0.030)、早产发生率(RR=0.55,95%CI:0.31~0.98,P=0.040),产后出血发生率(RR=0.28,95%CI:0.15~0.52,P<0.001)、巨大儿发生率(RR=0.15,95%CI:0.08~0.27,P<0.001)、新生儿窒息发生率(RR=0.33,95%CI:0.18~0.60,P<0.001)。结论运动疗法可降低超重或肥胖孕妇孕期并发症的发生,改善不良妊娠结局。Objective To evaluate the effect of exercise therapy on complications and pregnancy outcomes in overweight or obese pregnant women.Methods The electronic database of PubMed,Cochrane Library,Embase,Web of science,CBM,CNKI and Wanfang Database were searched for studies on effects of exercise therapy on the complications of pregnancy and pregnancy in overweight or obese pregnant women.Cochrane systematic review was used to evaluate the quality of the included studies and to extract the data,and the data were analyzed using RevMan 5.3 software to meta-analysis.Results Nine randomized controlled trials involving 1,444 patients were included.Meta-analysis showed that exercise therapy reduced the incidence of gestational diabetes(RR=0.52,95%CI:0.39~0.68,P<0.001),pregnancy-induced hypertension(RR=0.62,95%CI:0.45~0.84,P=0.002),cesarean section(RR=0.83,95%CI:0.70~0.98,P=0.030),preterm birth(RR=0.55,95%CI:0.31~0.98,P=0.040),postpartum hemorrhage(RR=0.28,95%CI:0.15~0.52,P<0.001),giant children(RR=0.15,95%CI:0.08~0.27,P<0.001),and neonatal asphyxia(RR=0.33,95%CI:0.18~0.60,P<0.001).Conclusion Exercise therapy can reduce the complications and improve the outcome of adverse pregnancy in overweight or obese pregnant women.

关 键 词：孕妇 超重 肥胖 运动疗法 妊娠结局 META分析 

分 类 号：R473.71[医药卫生—护理学]