摘要
目的:采用meta分析的方法研究运动和饮食干预对超重及肥胖妇女妊娠期糖尿病(GDM)及妊娠结局的影响。方法:检索The Cochrane Library、PubMed、EMbase、CNKI、万方数据库从建库至2019年5月发表的有关运动和饮食干预对超重及肥胖妇女GDM及妊娠结局影响的随机对照试验,两名研究者对文献的质量进行严格评价并进行资料提取,对符合标准的随机对照研究采用Revman 5.3软件进行meta分析。结果:最终纳入10篇文章,包括5436名研究对象,与常规干预相比较,运动饮食干预不会减少超重及肥胖妇女GDM发生率(RR=0.98,95%CI 0.87~1.11)与剖宫产率(RR=0.94,95%CI 0.87~1.02),但会降低巨大儿的发生率(RR=0.83,95%CI 0.73~0.94)和妊娠期体重增加(MD=-0.69,95%CI-1.29~-0.09)。结论:由于干预时间较短或者孕妇依从性较差等原因,妊娠后开始的运动和饮食干预并不能有效预防超重或肥胖妇女GDM的发生或者降低其剖宫产率。针对超重或肥胖的育龄期女性,临床工作人员应在其孕前给予健康咨询,以有效改善其妊娠结局。
Objective:To study the effects of exercise and dietary intervention on gestational diabetes in overweight or obese women by Meta-analysis.Methods:The Cochrane Library,PubMed,EMbase,CNKI and Wanfang database were retrieved from the establishment of the library to May 2019 on exercise and dietary interventions for gestational diabetes in overweight and obese women.Two investigators rigorously evaluated the quality of the literature、extracted the data and used the Revman 5.3 software for Meta-analysis of randomized controlled trials that met the criteria.Results:Ten articles were included,including 5436 subjects.Compared with routine care,exercise and dietary intervention did not reduce the incidence of gestational diabetes(RR=0.98,95%CI=0.87-1.11,p=0.77)and the incidence of cesarean section(RR=0.94,95%CI=0.87-1.02,p=0.12)in overweight and obese women,but reduced the incidence of giant children(RR=0.83,95%CI=0.73-0.94,p=0.004)and the weight gain during pregnancy(MD=-0.69,95%CI=(-1.29--0.09),P=0.02).Conclusions:Because of the intervention duration or the poor compliance of pregnant women,the exercise and diet intervention started after pregnancy could not prevent the occurrence of gestational diabetes or reduce the rate of cesarean section in overweight or obese women.For overweight or obese child-bearing women,clinical staff should give them pre-pregnancy health counseling to effectively improve their pregnancy outcome.
作者
任丽杰
李琦
周静
白雪
杨艳
Ren Lijie;Li Qi;Zhou Jing;Bai Xue;Yang Yan(Shengjing Hospital Affiliated to China Medical University,shengyang,Province,110004)
出处
《中国计划生育学杂志》
2021年第2期216-220,236,共6页
Chinese Journal of Family Planning
