体育锻炼对孕期抑郁治疗效果的Meta分析

目的 抑郁已经成为威胁心理健康的重要疾病，孕期抑郁会对孕妇、胎儿及新生儿产生不良影响，适宜的锻炼干预是改善孕期抑郁的重要手段，而明确更加合理的锻炼干预方案，对治疗孕期抑郁具有重要作用。采用Meta分析法，探讨锻炼干预对孕期抑郁的影响，并进一步分析可能产生较大干预效应的锻炼方案，以期为今后该领域的锻炼干预研究及临床护理提供参考。方法 通过 PubMed、EMBase、The Cochrane Library、Web of Science、中国知网（CNKI）、中国生物医学文献数据库（CBM）等数据库，检索有关孕期锻炼对抑郁影响的相关文献，采用Cochrane偏倚风险评估工具对纳入的研究进行方法学质量评估并采用改良Jadad进行评分，采用Review Manager 5.4软件对文献数据进行统计学分析。结果 共纳入13篇文献，总样本量为1256例。Meta分析结果显示:锻炼对孕期抑郁呈大效应量干预效果〔SMD=-0.37，95%CI（-0.49，-0.26）,P＜0.00001〕,具有统计学意义。亚组分析结果显示，孕期锻炼开始节点13~27周的干预效果优于孕期28~40、＜12周；≥3次/周的干预效果优于＜3次/周；30~60min/次的干预效果优于＞60min、30min/次；中等强度锻炼的干预效果优于低强度锻炼；8~12周锻炼周期的干预效果优于＞12周、＜8周；锻炼内容对孕期抑郁治疗的干预效果为有氧结合抗阻、瑜伽等。结论 孕期体育锻炼对孕期抑郁治疗有效，不同锻炼内容、强度、频率、周期、开始干预时间节点、单次锻炼时长的锻炼方案干预均有效，且孕期第13~27周开始进行≥3次/周、30~60min/次、8~12周中等强度的体育锻炼方案对孕期抑郁治疗效果更好。

Meta-analysis of the therapeutic effect of physical exercise on depression during pregnancy

Objective To explore the influence of exercise intervention on depression during pregnancy and further analyze the exercise programs that may have a greater intervention effect by Meta-analysis, and to provide references for future exercise intervention research and clinical practice in this field. Methods Through PubMed, EMBase, the Cochrane Library, Web of Science, China Knowledge Network (CNKI), China Biomedical Literature Database (CBM) and other databases, relevant literature on the influence of pregnancy exercise on depression was searched, and Cochrane’s risk of bias assessment tool was used to evaluate the inclusion. The methodological quality of the research was evaluated, and the improved Jadad was used for scoring, and the literature data was statistically analyzed using Review Manager 5.4 software. Results A total of 13 articles were included, with a total sample size of 1 256 cases. The results of Meta-analysis showed that exercise had a large intervention effect on depression during pregnancy ［SMD=-0.37, 95%CI (-0.49, -0.26), P<0.00001］. The results of subgroup analysis showed that the intervention effect of 13-27 weeks at the beginning of exercise during pregnancy was better than that of 28-40 and <12 weeks during pregnancy. The intervention effect of ≥3 times/week was better than that of <3 times/week. The intervention effect of 30-60 min/time was better than that of >60min and 30min/time. The intervention effect of moderate intensity exercise was better than that of low intensity exercise. The intervention effect of exercise cycle of 8-12 weeks was better than that of >12 weeks and <8 weeks. Aerobic combined with resistance, yoga and so on had intervention effect on the treatment of depression during pregnancy. Conclusion The results show that physical exercise during pregnancy has a therapeutic effect on depression during pregnancy. The exercise intervention plans of different content, intensity, frequency, cycle, start time, and single time are effective. Starting from 13-27 weeks of pregnancy, ≥3 times/week, 30-60 min/time, 8-12 weeks of moderate-intensity physical exercise has a better effect on the depression during pregnancy.