The objectives were to assess (i) the quality of theory implementation, (ii) the application of behavior change techniques, and (iii) the effectiveness of theory-based interventions in promoting physical activity in pregnant women and improving maternal and neonatal outcomes. A systematic search was conducted across 8 databases (Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, EMBASE, MEDLINE, APA PsycINFO, PubMed, SPORTDiscus, and Web of Science) to identify randomized controlled trials published from database inception to 8 July 2023. The Cochrane risk-of-bias 2.0 tool was used to evaluate the quality of the included studies. The theory coding scheme was used to measure the quality of theory implementation, and behavior change techniques were coded according to behavior change taxonomy (version 1). The meta-analysis was performed using RevMan 5.3. The Grading of Recommendations, Assessment, Development, and Evaluation Approach was used to assess the certainty of evidence. Eleven studies met the study criteria. Nine studies were based on one theory, while two studies were based on a combination of two theories. The quality of theory implementation was generally moderate. A total of 24 unique behavior change techniques were extracted. The most commonly used types of behavior change techniques were ‘instruction on how to perform the behavior’ (n = 9), ‘goal setting’ (behavior) (n = 8), ‘action planning’ (n = 7), and ‘information about health consequences’ (n = 7). Theory-based interventions significantly improved moderate-to-vigorous physical activity (standardized mean difference (SMD) = 0.17, 95 % confidence interval (CI) [0.04, 0.30], = 0.01; moderate certainty of evidence), reduced the average gestational weight gain per week (mean difference (MD) = −0.06, 95 % CI [−0.11, −0.01], = 0.02; moderate certainty of evidence), and decreased the incidence of gestational diabetes mellitus (risk ratio (RR) = 0.64, 95 % CI [0.46, 0.89], = 0.008; high certainty of evidence). However, the effects of theory-based interventions on total physical activity, total gestational weight gain and the incidence of gestational hypertension and preterm delivery were unclear ( > 0.05). (i) Most of the studies exhibited a moderate level of theory implementation quality. (ii) The use of theories varies, but common behavior change techniques were found across studies. (iii) Theory-based interventions can improve physical activity and maternal and neonatal outcomes and appear to be safe. Appropriate health behavior theories and behavior change techniques should be fully utilized in future interventions. PROSPERO: CRD42023440886. Theory-based interventions can improve physical activity and maternal and neonatal outcomes and appear to be safe. Appropriate health behavior theories and behavior change techniques should be fully utilized in the development of future interventions.

中文翻译：

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旨在促进孕妇身体活动的基于理论的干预措施：随机对照试验的系统回顾和荟萃分析

目标是评估（i）理论实施的质量，（ii）行为改变技术的应用，以及（iii）基于理论的干预措施在促进孕妇身体活动和改善孕产妇和新生儿结局方面的有效性。对 8 个数据库（护理和联合健康文献累积索引、Cochrane 图书馆、EMBASE、MEDLINE、APA PsycINFO、PubMed、SPORTDiscus 和 Web of Science）进行了系统检索，以确定从数据库建立到 7 月 8 日期间发表的随机对照试验2023.使用Cochrane偏倚风险2.0工具评估纳入研究的质量。理论编码方案用于衡量理论实施的质量，行为改变技术根据行为改变分类法（版本1）进行编码。使用 RevMan 5.3 进行荟萃分析。建议、评估、制定和评估方法的分级用于评估证据的确定性。十一项研究符合研究标准。九项研究基于一种理论，两项研究基于两种理论的结合。理论实施的质量总体上是中等的。总共提取了 24 种独特的行为改变技术。最常用的行为改变技术类型是“如何执行行为的指导”（n = 9）、“目标设定”（行为）（n = 8）、“行动计划”（n = 7）和“有关健康后果的信息”（n = 7）。基于理论的干预措施显着改善了中度至剧烈的体力活动（标准化平均差 (SMD) = 0.17，95% 置信区间 (CI) [0.04, 0.30], = 0.01；证据质量中等），降低了平均妊娠体重每周体重增加（平均差（MD）= -0.06，95 % CI [-0.11，-0.01]，= 0.02；证据质量中等），并降低妊娠期糖尿病的发生率（风险比（RR）= 0.64， 95% CI [0.46, 0.89], = 0.008；证据质量高）。然而，基于理论的干预措施对总体力活动、总妊娠体重增加以及妊娠期高血压和早产发生率的影响尚不清楚（> 0.05）。 (i) 大多数研究表现出中等水平的理论实施质量。 (ii) 理论的使用各不相同，但各项研究发现了共同的行为改变技术。 (iii) 基于理论的干预措施可以改善身体活动以及孕产妇和新生儿的结局，并且似乎是安全的。在未来的干预措施中应充分利用适当的健康行为理论和行为改变技术。普洛斯彼罗：CRD42023440886。基于理论的干预措施可以改善体力活动以及孕产妇和新生儿的结局，而且似乎是安全的。在未来干预措施的制定中应充分利用适当的健康行为理论和行为改变技术。