PurposeTo systematically review lifestyle interventions for women with prior Gestational Diabetes Mellitus (GDM) to report study characteristics, intervention design and study quality and explore changes in 1) diet, physical activity and sedentary behaviour; 2) anthropometric outcomes and; 3) glycaemic control and diabetes risk.MethodsDatabases (Web of Science, CCRCT, EMBASE and Science DIRECT) were searched (1980 to April 2014) using keywords for controlled or pre–post design trials of lifestyle intervention targeting women with previous GDM reporting at least one behavioural, anthropometric or diabetes outcome. Selected studies were narratively synthesized with anthropometric and glycaemic outcomes synthesized using meta-analysis.ResultsThree of 13 included studies were rated as low bias risk. Recruitment rates were poor but study retention good. Six of 11 studies reporting on physical activity reported favourable intervention effects. All six studies reporting on diet reported favourable intervention effects. In meta-analysis, significant weight-loss was attributable to one Chinese population study (WMD = − 1.06 kg (95% CI = − 1.68, − 0.44)). Lifestyle interventions did not change fasting blood glucose (WMD = − 0.05 mmol/L, 95% CI = − 0.21, 0.11) or type 2 diabetes risk.ConclusionsLack of methodologically robust trials gives limited evidence for the success of lifestyle interventions in women with prior GDM. Recruitment into trials is challenging.

This systematic review and meta-analysis reports the efficacy of post-natal physical activity change interventions with content coding of behaviour change techniques (BCTs). Electronic databases (MEDLINE, CINAHL and PsychINFO) were searched for interventions published from January 1980 to July 2013. Inclusion criteria were: (i) interventions including ≥1 BCT designed to change physical activity behaviour, (ii) studies reporting ≥1 physical activity outcome, (iii) interventions commencing later than four weeks after childbirth and (iv) studies including participants who had given birth within the last year. Controlled trials were included in the meta-analysis. Interventions were coded using the 40-item Coventry, Aberdeen & London - Refined (CALO-RE) taxonomy of BCTs and study quality assessment was conducted using Cochrane criteria. Twenty studies were included in the review (meta-analysis: n = 14). Seven were interventions conducted with healthy inactive post-natal women. Nine were post-natal weight management studies. Two studies included women with post-natal depression. Two studies focused on improving general well-being. Studies in healthy populations but not for weight management successfully changed physical activity. Interventions increased frequency but not volume of physical activity or walking behaviour. Efficacious interventions always included the BCTs 'goal setting (behaviour)' and 'prompt self-monitoring of behaviour'.

Despite the importance of reducing prenatal exposure to alcohol, a recent Cochrane review found limited evidence from randomised controlled trials (RCTs) regarding effectiveness of interventions to reduce drinking during pregnancy. The aim of this systematic review was to consider additional evidence by including RCTs and non-RCTs to determine whether pregnant women reduced alcohol consumption during pregnancy following interventions delivered during antenatal care. Five electronic databases were searched using keywords: e.g. pregnancy, maternal, alcohol, consumption, drinking, cognitive-behavioural therapy, motivational interviewing (MI), brief intervention, health education, social support and self-efficacy. Papers were excluded through a consecutive method using the title, abstract and full text paper. Two authors assessed the full text papers, including quality assessment. Eight trials were included in the review, including six RCTs and two non-RCTs. Interventions included brief interventions, MI, a self-help manual, supportive counselling, high feedback ultrasound and basic educational interventions. In general, methodological quality in all but two studies was poor, limiting the conclusions that could be drawn from this review. However, there was some evidence from a small number of studies that single-session face-to-face brief interventions resulted in positive effects on the maintenance of alcohol abstinence during pregnancy. Women choosing abstinence as their drinking goals and heavier drinking women who participated with a partner were more likely to be abstinent at follow-up. However, more intensive interventions may be required to encourage women who continue to drink during pregnancy to reduce their consumption. Implications for practice and future research directions are discussed