Exercise for diabetic pregnant women

 

Abstract

Background

Diabetes in pregnancy may result in unfavourable maternal and neonatal outcomes. Exercise was proposed as an additional strategy to improve glycaemic control. The effect of exercise during pregnancies complicated by diabetes needs to be assessed.

Objectives

To evaluate the effect of exercise programs, alone or in conjunction with other therapies, compared to no specific program or to other therapies, in pregnant women with diabetes on perinatal and maternal morbidity and on the frequency of prescription of insulin to control glycaemia. To compare the effectiveness of different types of exercise programs on perinatal and maternal morbidity.

Search methods

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2005). We updated this search on 1 October 2009 and added the results to the awaiting classification section.

Selection criteria

All known randomised controlled trials evaluating the effect of exercise in diabetic pregnant women on perinatal outcome and maternal morbidity.

Data collection and analysis

We evaluated relevant studies for meeting the inclusion criteria and methodological quality. Three review authors abstracted the data. For all data analyses, we entered data based on the principle of intention to treat. We calculated relative risks and 95% confidence intervals for dichotomous data.

Main results

Four trials, involving 114 pregnant women with gestational diabetes, were included in the review. None included pregnant women with type 1 or type 2 diabetes. Women were recruited during the third trimester and the intervention was performed for about six weeks. The programs generally consisted in exercising three times a week for 20 to 45 minutes. We found no significant difference between exercise and the other regimen in all the outcomes evaluated.

Authors' conclusions

There is insufficient evidence to recommend, or advise against, diabetic pregnant women to enrol in exercise programs. Further trials, with larger sample size, involving women with gestational diabetes, and possibly type 1 and 2 diabetes, are needed to evaluate this intervention.

[Note: The six citations in the awaiting classification section of the review may alter the conclusions of the review once assessed.]

 

Plain language summary

Exercise for diabetic pregnant women

Insufficient information available to recommend or advise against diabetic pregnant women enrolling on exercise programs.

Exercise was proposed to improve glycaemic control in pregnant women with diabetes. Four small trials involving 114 pregnant women evaluated this intervention. None included pregnant women with type 1 or type 2 diabetes. There is insufficient evidence to recommend, or advise against, diabetic pregnant women enrolling in exercise programs. Further trials, with larger sample size, are needed.

 

摘要

背景

糖尿病孕婦之運動

糖尿病在懷孕時可能會導致不好的母親和新生兒結果。運動有被提議來改善血糖控制。但是懷孕期間運動對於糖尿病的效果相當複雜而有待評估。

目標

評估糖尿病孕婦僅用運動計畫或併用其他治療，和沒有特定計畫或和其他療法做比較，針對週產期母親發病率、需使用胰島素控制血糖的頻率等，比較不同類型運動計畫對於週產期和母親罹病率的效果。

搜尋策略

我們搜尋Cochrane Pregnancy和Childbirth Group's Trials Register (2005年12月31日)。

選擇標準

所有已知隨機控制試驗(randomised controlled trials)內容有評估運動對於糖尿病孕婦的週產期結果和母親發病率的效果。

資料收集與分析

我們評估符合納入規範和方法學品質的研究。3位回顧作者來摘錄這些資料。在資料分析方面，我們根據治療意向(intention to treat)原則輸入資料。計算二分法資料的相對風險和95% 信賴區間。

主要結論

有4篇試驗、共114名妊娠糖尿病孕婦納入這篇回顧。這些孕婦都不是第1或第2型糖尿病患，在第3孕期時納入該研究，介入治療進行約6週。運動計畫大多是每週3次、每次20 – 45分鐘。我們發現，運動和其他治療在各項評估結果之間沒有顯著差異。

作者結論

沒有足夠證據來建議或反對糖尿病孕婦進行運動計畫。因此未來的研究需要更大的樣本規模，納入妊娠糖尿病、或者第1或第2型糖尿病的孕婦，以評估此介入方式。

翻譯人

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

糖尿病孕婦之運動。 資料不足以建議或反對糖尿病孕婦進行運動計畫。運動有被提議來改善糖尿病孕婦之血糖控制。共有4篇試驗、114名婦女來評估此介入治療方式，這些孕婦都不是第1或第2型糖尿病患。沒有足夠證據來建議或反對糖尿病孕婦進行運動計畫。未來需要更多樣本的大型試驗。