Ask an answerable question (PICO)：
In today's society, pregnant women are encouraged to exercise moderately during pregnancy. In 2020, the American College of Obstetricians and Gynecologists proposed at least 150 minutes of moderate intensity aerobic exercise per week during pregnancy and postpartum to avoid excessive weight gain, reduce gestational hypertension, relieve negative emotions such as depression and anxiety, relieve lower back pain and pelvic pain, and shorten the period of the first stage of labor. In Taiwan, even healthy pregnant women are being asked to reduce or suspend physical activity to avoid preterm births that cause neonatal deaths or serious complications. Therefore, the risk and symptoms of preterm birth can cause considerable stress and anxiety in pregnant women. Therefore, most pregnant women in Taiwan reduce or avoid exercise during pregnancy, which is contrary to the concept promoted by the American Academy of Obstetrics and Gynecology. Therefore, the author wants to use an empirical search method to understand pregnancy. Does exercise increase the incidence of preterm birth in healthy pregnant women?
The Method and Analysis of Literature Review：
The keywords "Pregnant woman", "Exercise*", "Preterm birth" and their agreement words are established by PICO and MeSH term. There are total 189 articles searched according to Boolean logic and searching databases including PubMed, Cochrane and Medline. Therefore, two systematic reviews and one randomized controlled trial of the literature are included in the final review.
Critical Appraisal：
The Systematic Review Appraisal Sheet (2019) and the Cochrane Risk of Bias Tool were accorded to appraise the quality of study in systematicreview and randomized controlled trial respectively. The OCEBM Levels of Evidence table (2011) was used to rank the level of evidence body of study.
The two SR is rigorous and complete, so the level of evidence is Level 1. The RCT is complete except for the loss of data that has not been analyzed, so the level of evidence is Level 2. , after the review, it is confirmed that the quality of the literature and the evidence are excellent, and it can be effectively used in clinical reference.
Results, Conclusions and Recommendations：
Combining three empirical literatures, the results show that there is no significant difference in the incidence of preterm birth between healthy pregnant women who exercise during pregnancy and the control group, which means that exercise during pregnancy does not increase the incidence of preterm birth.
Exercise is a low-cost, easy-to-implement and diversified activity. It is recommended that obstetric clinics can refer to the recommendations of the American College of Obstetricians and Gynecologists to promote healthy pregnant women to perform at least 150 minutes of moderate-intensity aerobic exercise per week during pregnancy and postpartum to change deep-rooted mistakes. Thinking, improve health literacy.
