適度運動減少妊娠糖尿病風險


  【24drs.com】根據線上發表於6月3日英國婦產科期刊的一篇隨機控制試驗統合分析,懷孕期間適度運動可以降低妊娠糖尿病風險達31%,且可減少孕婦的體重增加。
  
  第一作者、西班牙Cuenca Virgen de la Luz醫院的Gema Sanabria-Martinez在期刊新聞稿中表示,懷孕期間不用害怕運動,這些研究中所使用的適當運動對於健康有顯著的正面影響,且對孕婦與胎兒都安全。
  
  妊娠糖尿病是懷孕期間常見的併發症,與許多嚴重問題有關,例如:先兆子癇、高血壓、早產、剖腹產、以及產婦後來患有第二型糖尿病的比率較高;妊娠糖尿病孕婦產下的孩童,後來發生第二型糖尿病與肥胖的風險也比較高。
  
  懷孕期間體重增加過多也會有類似的健康風險,體重增加過多也使產後減重的困難增加,因而使肥胖風險上升。
  
  傳統上認為婦女在懷孕期間要減少活動、或完全停止運動,不過,最近的研究認為,懷孕期間運動可以改善孕婦與胎兒的結果。美國婦產科協會最近建議,孕婦每週盡量能每天適度運動至少30分鐘。不過,作者們寫道,對於懷孕期間運動是否可減少妊娠糖尿病與改善孕婦的體重增加,有些研究結果有所不同。
  
  為了進行統合分析,作者們搜尋了六個隨機控制試驗科學資料庫,於1990年1月至2014年5月間以英文或西班牙文發表的研究。納入的試驗評估了健康孕婦的運動計畫,這些孕婦在研究開始時屬於久坐或運動程度低。這些運動計畫在類型、每週頻率、整體時間都各有差異;有些計畫是在第二孕期開始,有一些是涵蓋整個孕期。
  
  這篇分析包括了13篇隨機控制試驗、2,873名孕婦,結果顯示,有進行運動計畫的婦女,妊娠糖尿病風險降低31% (相對風險[RR]為0.69;95%信賴區間[CI]為0.52 - 0.91;P = .009)。整個孕期皆運動的婦女結果更好,妊娠糖尿病風險降低達36% (RR,0.64;95% CI,0.36 - 0.98;P = .038)。
  
  進行綜合運動如調理、強化、靈活度與有氧運動,妊娠糖尿病風險降低31% (RR,0.69;95% CI,0.48 - 0.99;P = .043)。
  
  另外,懷孕期間運動的婦女,體重增加比沒有運動者少約1公斤(體重平均差異[WMD]為 -1.14公斤;95% CI,-1.50 至 -0.78;P < .001)。在降低體重增加方面,整個孕期運動以及從第二孕期開始運動這兩組之間沒有顯著差異(分別是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])。
  
  懷孕期間運動的婦女並沒有發生任何與運動有關的不良事件。
  
  作者們結論表示,我們的研究有重要的臨床與公衛意義,因為它支持我們建議孕婦以有效且安全的方法從事運動,藉以經歷更健康的孕期。她們得以降低妊娠糖尿病風險、可避免體重增加過多,因此,還可以提高其子代的健康狀況。
  
  資料來源: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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