The Effect of a Lifestyle-Based Training Package on Weight Gain and Frequency of Gestational Diabetes in Obese and Overweight Pregnant Females

Eslami, Elham; Mohammad‐Alizadeh‐Charandabi, Sakineh; Khalili, Azizeh Farshbaf; Jafarabadi, Mohammad Asghari; Mirghafourvand, Mojgan

doi:10.5812/ircmj.62576

Cited by 9 publications

(15 citation statements)

References 43 publications

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“…After reviewing titles and abstracts, 236 studies progressed to full manuscript review. Of these, 213 full-texts were excluded and the remaining 23 individual studies involving 8877 participants were finally included [5,8,[13][14][15][16][17][18][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] (Figure 1). the different interventions and the control condition of usual care, and lines connecting the nodes represented the direct head-to-head comparisons between interventions.…”

Section: Basic Characteristics Of Included Studiesmentioning

confidence: 99%

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Prevention of Gestational Diabetes Mellitus and Gestational Weight Gain Restriction in Overweight/Obese Pregnant Women: A Systematic Review and Network Meta-Analysis

Jin

et al. 2022

Nutrients

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Background: Overweight/obesity is associated with pregnancy-related disorders, such as gestational diabetes mellitus (GDM) and excessive gestational weight gain (GWG). Although multiple interventions have been proposed to prevent GDM and restrict GWG, our knowledge of their comparative efficacy is limited. Objective: To evaluate the effectiveness and identify the optimal intervention strategy to prevent GDM and restrict GWG among overweight/obese pregnant women. Methods: Randomized controlled trials that recruited overweight/obese pregnant women at <20 gestational week were obtained. Predictive and confidence interval plot and surface under the cumulative ranking (SUCRA) were performed using Stata statistical software to determine and compare the efficacy of interventions (diet, physical activity (PA), diet + PA intervention and medication). Results: 23 studies with a total of 8877 participants were eligible for analysis. Our results indicated that although neither PA, diet + PA, diet nor medication intervention could significantly protect overweight/obese women from the development of GDM, there was a trend that PA and diet + PA intervention were preventive factors of GDM. Of these, PA intervention (SUCRA, 82.8%) ranked as the superior strategy, and diet intervention (SUCRA, 19.7%) was the least efficacious regimen. Furthermore, interventions of diet, PA and diet + PA were significantly beneficial for GWG restriction, whereas medication intervention could not restrict GWG. In detail, diet intervention (SUCRA, 19.7%) ranked as the optimal regimen, whilst PA intervention (SUCRA, 62.3%) ranked as the least efficacious regimen. Conclusion: Although none of the interventions could offer remarkable benefit for GDM prevention, interventions of diet, PA and diet + PA were significant factors to restrict GWG. In aggregate, diet + PA intervention seemed the superior choice for the prevention of both GDM and excessive GWG. Registration: PROSPERO CRD42022313542.

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Section: Basic Characteristics Of Included Studiesmentioning

confidence: 99%

“…Network forest plot of direct pairwise comparisons of regimens (A), and of both direct and indirect comparisons of regimens (B) on the incidence of GDM. Abbreviations: physical activity, PA; control, Con; medication, Med[5,8,[13][14][15][16][17][18][21][22][23][24][25][26][29][30][31][32][33][34][35][36].…”

mentioning

confidence: 99%

Prevention of Gestational Diabetes Mellitus and Gestational Weight Gain Restriction in Overweight/Obese Pregnant Women: A Systematic Review and Network Meta-Analysis

Jin

et al. 2022

Nutrients

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“…The 102 research reports (31-67, 69-132) yielded 198 GDM prevalence studies. Iran (32.3%) (41,(69)(70)(71)(72)(73)(74)(75)(76)(77) and Saudi Arabia (24.2%) contributed to most of the prevalence studies, followed by Qatar (9.7%). In these prevalence studies, a total of 279,202 pregnant women were tested for GDM between 2000 and 2019, and the crude GDM prevalence was estimated to be about 11.0%.…”

Section: Crude Gdm Prevalencementioning

confidence: 99%

Prevalence of Gestational Diabetes Mellitus in the Middle East and North Africa, 2000–2019: A Systematic Review, Meta-Analysis, and Meta-Regression

et al. 2021

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Women in the Middle East and North Africa (MENA) region are burdened with several risk factors related to gestational diabetes mellitus (GDM) including overweight and high parity. We systematically reviewed the literature and quantified the weighted prevalence of GDM in MENA at the regional, subregional, and national levels. Studies published from 2000 to 2019 reporting the prevalence of GDM in the MENA region were retrieved and were assessed for their eligibility. Overall and subgroup pooled prevalence of GDM was quantified by random-effects meta-analysis. Sources of heterogeneity were investigated by meta-regression. The risk of bias (RoB) was assessed by the National Heart, Lung, and Blood Institute’s tool. One hundred and two research articles with 279,202 tested pregnant women for GDM from 16 MENA countries were included. Most of the research reports sourced from Iran (36.3%) and Saudi Arabia (21.6%), with an overall low RoB. In the 16 countries, the pooled prevalence of GDM was 13.0% (95% confidence interval [CI], 11.5–14.6%, I2, 99.3%). Nationally, GDM was highest in Qatar (20.7%, 95% CI, 15.2–26.7% I2, 99.0%), whereas subregionally, GDM was highest in Gulf Cooperation Council (GCC) countries (14.7%, 95% CI, 13.0–16.5%, I2, 99.0%). The prevalence of GDM was high in pregnant women aged ≥30 years (21.9%, 95% CI, 18.5–25.5%, I2, 97.1%), in their third trimester (20.0%, 95% CI, 13.1–27.9%, I2, 98.8%), and who were obese (17.2%, 95% CI, 12.8–22.0%, I2, 93.8%). The prevalence of GDM was 10.6% (95% CI, 8.1–13.4%, I2, 98.9%) in studies conducted before 2009, whereas it was 14.0% (95% CI, 12.1–16.0%, I2, 99.3%) in studies conducted in or after 2010. Pregnant women in the MENA region are burdened with a substantial prevalence of GDM, particularly in GCC and North African countries. Findings have implications for maternal health in the MENA region and call for advocacy to unify GDM diagnostic criteria.Systematic Review RegistrationPROSPERO CRD42018100629

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“…The authors of the trials defined exercise as simple counselling [54,55], aerobic training [30], a mix of aerobic and strength training [29,31,32,33], an individualized program [34], or did not provide a further specification [28]. Dietary interventions included counselling [35,36,37,38,54], a Mediterranean diet [40], and a low-glycemic index diet supported by a mobile phone application [47]. Participants of combined interventions were "only" counselled [41,42,43,46,47,54], given a brochure [53], or offered a supervised program [44,45,48,55].…”

Section: General Characteristics Of the Studiesmentioning

confidence: 99%

“…Trials that met the inclusion criteria and were published between January 2008 and January 2021 (n = 28; ▶ Table 1) consisted of seven trials investigating physical activity [28] [29,30,31,32,33,34], six trials with diet [35,36,37,38,39,40], and 12 trials with combined interventions [41,42,43,44,45,46,47,48,49,50,51,52]. Out of those, four study groups had additionally implied behavioral therapy [49,50,51,52].…”

Section: General Characteristics Of the Studiesmentioning

confidence: 99%

Lifestyle Interventions to Improve Pregnancy Outcomes: a Systematic Review and Specified Meta-Analyses

Behnam

Timmesfeld

Arabin

2022

Geburtshilfe Frauenheilkd

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To compare the impact of lifestyle interventions for overweight and obese pregnant women a systematic review and meta-analysis was conducted using pre-registration and audit of the interventions as selection criteria. PubMed, Web of Science and CENTRAL were searched for randomized controlled trials examining diet, exercise, combined interventions or associated behavioral therapy. Trials were selected if they reported one of the primary outcomes (gestational diabetes, hypertensive disorders, perinatal mortality, admission to neonatal intensive care unit). Results were established from the total group and separately from pre-registered or clinically audited studies. Out of 1304 titles, 28 randomized controlled trials were included. Among the primary outcomes only hypertensive disorders were significantly reduced by exercise in the total group: odds ratio 0.52 (95% confidence interval 0.28 to 0.96, four trials, 1324 participants). When behavioral therapy supported combined interventions, maternal weight gain, (Standardized Mean Difference −0.16 kilogram; 95% confidence interval −0.28 to −0.04, four trials, 2132 participants) and neonatal birthweight, (Standardized Mean Difference −0.4 gram; 95% confidence interval −0.62 to −0.18, five trials, 1058 participants), were significantly reduced within the total group and both specified meta-analyses. Higher frequencies of physical activity improved the results. Risk of bias, assessed with the Cochrane Tool, was low to moderate. Elements of behavioral therapy might better prevent adverse effects of maternal obesity when combined with lifestyle interventions. Unfortunately, high heterogeneity due to different intervention and population characteristics was a limiting factor. Future studies should also focus on increased intensities of physical activity.

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The Effect of a Lifestyle-Based Training Package on Weight Gain and Frequency of Gestational Diabetes in Obese and Overweight Pregnant Females

Cited by 9 publications

References 43 publications

Prevention of Gestational Diabetes Mellitus and Gestational Weight Gain Restriction in Overweight/Obese Pregnant Women: A Systematic Review and Network Meta-Analysis

Prevention of Gestational Diabetes Mellitus and Gestational Weight Gain Restriction in Overweight/Obese Pregnant Women: A Systematic Review and Network Meta-Analysis

Prevalence of Gestational Diabetes Mellitus in the Middle East and North Africa, 2000–2019: A Systematic Review, Meta-Analysis, and Meta-Regression

Lifestyle Interventions to Improve Pregnancy Outcomes: a Systematic Review and Specified Meta-Analyses

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