孕期身体活动对产妇泌乳启动延迟影响的范围综述

A Scoping Review of the Effects of Physical Activity during Pregnancy on Delayed Lactation Initiation in New Mothers

摘要: 目的：对孕期身体活动(physical activity, PA)在孕妇促进产后泌乳中的应用研究进行范围综述，旨在阐明并总结孕期PA改善产妇泌乳启动延迟的关键作用，重点剖析该时期PA与促进产妇泌乳之间的潜在调控机制，为临床医护人员开展孕期PA相关研究提供参考依据。方法：基于Arksey和O’Malley的范围综述报告框架，检索PubMed、Cochrane Library、Web of Science、Embase、知网、万方、维普、CBM 8个数据库，检索时限为建库至2025年11月30日，对纳入文献进行筛选、汇总并分析。结果：共收纳11篇文献，来自7个国家，7篇为随机对照试验，5篇为类实验研究。孕期PA可通过三大核心路径显著提升产妇产后泌乳率：一是缓解焦虑、抑郁等负性情绪，增强哺乳信心；二是支持健康的孕期体重管理，减少孕期体重过度增长，因超重/肥胖导致的泌乳障碍；三是改善妊娠期糖代谢，降低妊娠期糖尿病发生率，优化泌乳生理基础。结论：孕期是实施母婴健康干预的关键窗口期，推广以身体活动为核心的健康生活方式，可进一步改善产妇泌乳启动延迟的发生。

Abstract: Objective: To conduct a scoping review of applied research on the role of physical activity (PA) during pregnancy in promoting postpartum lactation. The aim is to elucidate and summarize the key role of physical activity during pregnancy in improving delayed lactation onset, with a focus on analyzing the potential regulatory mechanisms linking physical activity during this period to the promotion of postpartum lactation, thereby providing a reference for clinical healthcare professionals conducting research on physical activity during pregnancy. Methods: Based on the scoping review framework proposed by Arksey and O’Malley, we searched eight databases—including PubMed, the Cochrane Library, Web of Science, Embase, CNKI, Wanfang, VIP, and CBM—from the date of each database’s establishment through November 30, 2025. The included literature was screened, synthesized, and analyzed. Results: A total of 11 studies from 7 countries were included, comprising 7 randomized controlled trials and 5 quasi-experimental studies. Physical activity during pregnancy significantly improves postpartum lactation rates through three key mechanisms: first, by alleviating negative emotions such as anxiety and depression, thereby enhancing confidence in breastfeeding; second, by supporting healthy weight management during pregnancy, reducing excessive weight gain, and preventing lactation disorders caused by overweight or obesity; third, by improving glucose metabolism during pregnancy, reducing the incidence of gestational diabetes, and optimizing the physiological foundation for lactation. Conclusion: Pregnancy is a critical window for implementing maternal and infant health interventions. Promoting a healthy lifestyle centered on physical activity can further reduce the incidence of delayed lactation initiation among mothers.