Physical Activity and the Risk of Preeclampsia A Systematic Review and Meta-Analysis

被引:177
作者
Aune, Dagfinn [1 ,2 ,3 ]
Saugstad, Ola Didrik [4 ]
Henriksen, Tore [5 ]
Tonstad, Serena [1 ,6 ]
机构
[1] Univ Oslo, Ulleval Hosp, Dept Prevent Cardiol, Oslo, Norway
[2] Norwegian Univ Sci & Technol, Fac Med, Dept Publ Hlth & Gen Practice, N-7034 Trondheim, Norway
[3] Univ London Imperial Coll Sci Technol & Med, Dept Epidemiol & Biostat, London W2 1PG, England
[4] Univ Oslo, Rikshosp, Oslo Univ Hosp, Dept Pediat Res, N-0027 Oslo, Norway
[5] Oslo Univ Hosp, Rikshosp, Div Obstet & Gynaecol, Sect Obstet, Oslo, Norway
[6] Loma Linda Univ, Dept Hlth Promot & Educ, Loma Linda, CA 92350 USA
关键词
DOSE-RESPONSE DATA; LEISURE-TIME; WEIGHT-GAIN; HYPERTENSIVE DISORDERS; PROSPECTIVE COHORT; LIFE-STYLE; PREGNANCY; EXERCISE; METAANALYSIS; ASSOCIATION;
D O I
10.1097/EDE.0000000000000036
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Physical activity has been hypothesized to reduce the risk of preeclampsia, but epidemiologic studies have not shown consistent results. Therefore, we conducted a systematic review and dose-response meta-analysis of epidemiologic studies. Methods: PubMed, Embase, and Ovid databases were searched for case-control and cohort studies of physical activity and preeclampsia up to 2 November 2012. We estimated summary relative risks (RRs) using a random effects model. Results: Fifteen studies were included. The summary RR for high versus low prepregnancy physical activity was 0.65 (95% confidence interval [CI] = 0.47-0.89, I-2 = 0%; n = 5). In the dose-response analysis, the summary RR was 0.72 (0.53-0.99; I-2 = 0%; n = 3) per 1 hour per day and 0.78 (0.63-0.96; I-2 = 0%; n = 2) per 20 metabolic equivalent task (MET)-hours per week. The summary RR for high versus low physical activity in early pregnancy was 0.79 (0.70-0.91; I-2 = 0%; n = 11). In the dose-response analysis, the summary RR per 1 hour per day was 0.83 (0.72-0.95; I-2 = 21%; n = 7) and 0.85 (0.68-1.07; I-2 = 69%; n = 3) per 20 MET-hours per week. A nonlinear association was observed for physical activity before pregnancy and risk of preeclampsia (test for nonlinearity, P = 0.03), but not for physical activity in early pregnancy (test for nonlinearity, P = 0.37), with a flattening of the curve at higher levels of activity. Both walking and greater intensity of physical activity were inversely associated with preeclampsia. Conclusions: Our analysis suggests a reduced risk of preeclampsia with increasing levels of physical activity before pregnancy and during early pregnancy.
引用
收藏
页码:331 / 343
页数:13
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