摘要
目的对孕期运动预防妊娠期糖尿病相关的系统评价进行再评价。方法计算机检索Cochrane Library,Joanna Briggs Institute Library,PubMed,Web of Science,EMBASE,CINAHL以及中国生物医学文献摘要数据库、中国知网、万方数据库、维普中文科技期刊数据库,检索孕期运动预防妊娠期糖尿病相关的系统评价/Meta分析,2位研究者独立进行文献筛选和资料提取,分别采用AMSTAR量表和GRADE系统对纳入文献进行方法学质量和证据质量评价。结果最终共纳入14篇系统评价/Meta分析。采用AMSTAR 2工具进行方法学质量评价的结果为1篇高水平、1篇中水平、3篇低水平、9篇极低水平。采用GRADE进行证据质量评价的结果显示,14个结局指标中大部分证据质量等级为低或极低。孕期运动在降低妊娠期糖尿病发生率、控制孕期体质量增长值、降低部分不良妊娠结局的发生风险(包括早产、剖宫产、妊娠期高血压疾病、巨大儿)等方面存在一定效果。结论目前孕期运动预防妊娠期糖尿病相关的系统评价的方法学质量总体中等,但是证据质量等级不高,仍需要更多的大样本、高质量的原始研究进行进一步的探讨。孕期运动可作为控制妊娠期糖尿病发生风险的干预措施之一,在孕早期可鼓励无运动禁忌症的孕妇开始运动锻炼,由专业人员制定适宜的运动方案以保证预期的运动效果并保障母儿的安全。
Objective To overview the systematic reviews/meta-analysis(SRs/MAs) of effectiveness of exercise during pregnancy for preventing gestational diabetes mellitus(GDM).Methods Cochrane Library, Joanna Briggs Institute Library, PubMed, Web of Science, EMBASE, CINAHL, CBM, CNKI, Wan Fang Data and VIP were searched through computer to collect systematic reviews or meta-analysis of effectiveness of exercise during pregnancy for preventing gestational diabetes mellitus. Two researchers independently conducted literature search and data extraction. The methodological quality and evidence quality of included researches were relatively evaluated using AMSTAR 2 scale and GRADE system.Results A total of 14 SRs/MAs were included. The results of AMSTAR 2 evaluation showed that 1 of included researches was of high quality, 1 was of middle quality, 3 were of low quality, and rest were of very low level. The results of GRADE evaluation showed that most of 14 outcomes were of low or very low quality.According to the results of this study, exercise during pregnancy may be effective on reducing the incidence of GDM, controlling gestational weight gain, reducing several adverse pregnancy outcomes(including preterm, caesarean section, pregnancy-induced hypertension, and macrosomia).Conclusion The methodological quality of include SRs/MAs was among the middle level, while the evidence quality was among the poor level and more large-sample and high qualify researches regarding exercise during pregnancy are needed. Exercise during pregnancy can be regarded as an intervention to control the incidence of GDM, and pregnant women can be encouraged to begin exercising at the early stage of pregnancy; meanwhile, professionals are needed to make suitable exercise plans for pregnant women to ensure the effectiveness and safety of exercising.
引文
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