适度运动减少妊娠糖尿病风险


  【24drs.com】根据在线发表于6月3日英国妇产科期刊的一篇随机控制试验统合分析,怀孕期间适度运动可以降低妊娠糖尿病风险达31%,且可减少孕妇的体重增加。
  
  第一作者、西班牙Cuenca Virgen de la Luz医院的Gema Sanabria-Martinez在期刊新闻稿中表示,怀孕期间不用害怕运动,这些研究中所使用的适当运动对于健康有显著的正面影响,且对孕妇与胎儿都安全。
  
  妊娠糖尿病是怀孕期间常见的并发症,与许多严重问题有关,例如:先兆子痫、高血压、早产、剖腹产、以及产妇后来患有第二型糖尿病的比率较高;妊娠糖尿病孕妇产下的孩童,后来发生第二型糖尿病与肥胖的风险也比较高。
  
  怀孕期间体重增加过多也会有类似的健康风险,体重增加过多也使产后减重的困难增加,因而使肥胖风险上升。
  
  传统上认为妇女在怀孕期间要减少活动、或完全停止运动,不过,最近的研究认为,怀孕期间运动可以改善孕妇与胎儿的结果。美国妇产科协会最近建议,孕妇每周尽量能每天适度运动至少30分钟。不过,作者们写道,对于怀孕期间运动是否可减少妊娠糖尿病与改善孕妇的体重增加,有些研究结果有所不同。
  
  为了进行统合分析,作者们查找了六个随机控制试验科学资料库,于1990年1月至2014年5月间以英文或西班牙文发表的研究。纳入的试验评估了健康孕妇的运动计画,这些孕妇在研究开始时属于久坐或运动程度低。这些运动计画在类型、每周频率、整体时间都各有差异;有些计画是在第二孕期开始,有一些是涵盖整个孕期。
  
  这篇分析包括了13篇随机控制试验、2,873名孕妇,结果显示,有进行运动计画的妇女,妊娠糖尿病风险降低31% (相对风险[RR]为0.69;95%信赖区间[CI]为0.52 - 0.91;P = .009)。整个孕期皆运动的妇女结果更好,妊娠糖尿病风险降低达36% (RR,0.64;95% CI,0.36 - 0.98;P = .038)。
  
  进行综合运动如调理、强化、灵活度与有氧运动,妊娠糖尿病风险降低31% (RR,0.69;95% CI,0.48 - 0.99;P = .043)。
  
  另外,怀孕期间运动的妇女,体重增加比没有运动者少约1公斤(体重平均差异[WMD]为 -1.14公斤;95% CI,-1.50 至 -0.78;P < .001)。在降低体重增加方面,整个孕期运动以及从第二孕期开始运动这两组之间没有显著差异(分别是WMD,-1.16公斤 [95% CI,-1.47 至 -0.85;P < .001];WMD,-1.03公斤[95% CI,-1.48至-0.59;P < .001])。
  
  怀孕期间运动的妇女并没有发生任何与运动有关的不良事件。
  
  作者们结论表示,我们的研究有重要的临床与公卫意义,因为它支持我们建议孕妇以有效且安全的方法从事运动,借以经历更健康的孕期。她们得以降低妊娠糖尿病风险、可避免体重增加过多,因此,还可以提高其子代的健康状况。
  
  资料来源:http://www.24drs.com/
  
  Native link:Moderate Exercise Reduces Risk for Gestational Diabetes

Moderate Exercise Reduces Risk for Gestational Diabetes

By Veronica Hackethal, MD
Medscape Medical News

Moderate exercise during pregnancy can decrease the risk for gestational diabetes by 31% and also can reduce maternal weight gain, according to a meta-analysis of randomized controlled trials published online June 3 in the British Journal of Obstetrics and Gynecology.

"Exercise is not something to be feared during pregnancy — the moderate levels of exercise used in these studies had significantly positive effects on health and were found to be safe for both mother and baby," lead author Gema Sanabria-Martinez, MSc, from Virgen de la Luz Hospital in Cuenca, Spain, said in a journal news release.

Gestational diabetes, a common complication during pregnancy, is linked to more serious problems, such as preeclampsia, hypertension, premature birth, higher rates of caesarean delivery, and later type 2 diabetes in the mother. Children born to women with gestational diabetes also have a higher risk of developing type 2 diabetes and obesity later in life.

Excessive weight gain during pregnancy poses similar health risks. Women with excessive weight gain may also have difficulty losing the weight after pregnancy, increasing their risk for obesity.

Traditional wisdom has held that women should reduce their physical activity, or stop exercising altogether, during pregnancy. Recent research, however, has suggested that exercise during pregnancy could improve outcomes in the mother and child. The American College of Obstetricians and Gynecologists currently recommends that pregnant women engage in moderate exercise at least 30 minutes per day on most days of the week. Studies have conflicted, though, on whether exercise during pregnancy can decrease gestational diabetes and improve maternal weight gain, the authors write.

For the meta-analysis, the authors searched six scientific databases for randomized controlled trials published in English or Spanish between January 1990 and May 2014. Included trials evaluated exercise programs for healthy pregnant women who were sedentary or had low exercise levels at the start of the studies. The exercise programs varied widely in type, frequency during a week, and overall duration; some programs started in the second trimester, whereas others spanned the entire pregnancy.

The analysis included 13 randomized controlled trials, covering 2873 pregnant women. Results showed that pregnant women who engaged in exercise programs decreased their risk for gestational diabetes by 31% (relative risk [RR], 0.69; 95% confidence interval [CI], 0.52 - 0.91; P = .009). Women who exercised during their entire pregnancy did even better, with a 36% decreased risk for gestational diabetes (RR, 0.64; 95% CI, 0.36 - 0.98; P = .038). Engaging in combined exercises such as toning, strengthening, flexibility, and aerobic exercises lowered the risk for gestational diabetes by 31% (RR, 0.69; 95% CI, 0.48 - 0.99; P = .043).

In addition, women who exercised during pregnancy gained about 1 kg less than those who did not (weight mean differences [WMD], ?1.14 kg; 95% CI, ?1.50 to ?0.78; P < .001). There was no substantial difference in terms of reduced weight gain between exercising throughout pregnancy versus from the second trimester on (WMD, ?1.16 kg [95% CI, ?1.47 to ?0.85; P < .001]; WMD, ?1.03 kg [95% CI, ?1.48 to ?0.59; P < .001], respectively).

Women who exercised during pregnancy did not experience any adverse effects related to exercise.

"[O]ur study has important clinical and public health implications, because it provides support for the recommendation to advise mothers to engage in [physical activity] programmes as an effective and safe strategy to experience healthier pregnancies," the authors conclude. "[T]hey will have less risk of [gestational diabetes] and they will avoid excessive weight gain and, as a consequence, improve the health status of their offspring."

The authors have disclosed no relevant financial relationships.

BJOG. Published online June 3, 2015.

    
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