Objective To synthesise the existing literature relating to barriers and enablers encountered by elite athletes during preconception and pregnancy for the purpose of identifying key recommendations and actionable steps to inform the development of pregnancy guidelines to support preconception and pregnancy in national sporting organisations. Design Mixed-methods systematic review with thematic analysis. Data sources Four databases (Medline, SPORTDiscus, PsycINFO and CINAHL) were systematically searched to identify relevant studies, along with reference lists of included studies until 3 April 2023. Eligibility criteria Peer-reviewed primary studies from any date, language and location which identify at least one barrier and/or enabler encountered by elite female athletes during preconception and/or pregnancy were included. Grey literature, books, conference papers and other reviews were excluded. Results A total of 29 studies met the eligibility criteria for inclusion. The most common barriers identified were attitudes, perceptions and beliefs of the athlete and society, lack of support provided by sports organisations and lack of evidence-based information available. The most common enablers were specific strategies used by athletes (eg, modified training) to manage the demands of preconception and pregnancy, attitudes, perceptions and beliefs of the athlete, and support of family. Conclusion Key recommendations developed from the results are for sporting organisations to (1) develop clear, transparent and multifaceted policies to support preconception and pregnancy; (2) foster supportive environments which offer flexible training, social support and positive promotion of pregnant athletes and (3) provide clear, evidence-based education and information about preconception and pregnancy to athletes, coaches, support staff and organisational staff. All data relevant to the study are included in the article or uploaded as online supplemental information.

中文翻译：

---

精英运动员在孕前和怀孕期间遇到的障碍和促成因素：混合方法系统评价


目的 综合有关精英运动员在孕前和怀孕期间遇到的障碍和促成因素的现有文献，以确定关键建议和可行步骤，为制定怀孕指南提供信息，以支持国家体育组织的孕前和怀孕。设计混合方法系统评价与主题分析。数据来源 系统检索了四个数据库（Medline、SPORTDiscus、PsycINFO 和 CINAHL），以识别相关研究，以及截至 2023 年 4 月 3 日纳入研究的参考文献列表。 资格标准 任何日期、语言和地点的经过同行评审的初步研究，这些研究在其中包括精英女运动员在孕前和/或怀孕期间遇到的至少一个障碍和/或促成因素。灰色文献、书籍、会议论文和其他评论被排除在外。结果 共有 29 项研究符合纳入资格标准。最常见的障碍是运动员和社会的态度、看法和信仰、缺乏体育组织提供的支持以及缺乏可用的循证信息。最常见的促成因素是运动员使用的具体策略（例如，修改训练）来管理孕前和怀孕的需求、运动员的态度、看法和信仰以及家庭的支持。 结论 根据研究结果提出的主要建议是，体育组织应 (1) 制定明确、透明和多方面的政策来支持孕前和怀孕； (2) 营造支持性环境，为怀孕运动员提供灵活的训练、社会支持和积极宣传；(3) 向运动员、教练、后勤人员和组织工作人员提供有关孕前和怀孕的明确、循证教育和信息。与研究相关的所有数据都包含在文章中或作为在线补充信息上传。