The effect of exercise on the prevention of gestational diabetes in obese and overweight pregnant women: a systematic review and meta-analysis

Abstract

Background Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and its prevalence worldwide is increasing along with enhancing type two of diabetes. Contrary results have been found in some review articles that examine the effect of exercise activities on preventing GDM, regardless of obesity. Therefore, the aim of this study was to systematically review the articles on the effect of exercise activities on the prevention of GDM in obese and overweight pregnant women. Main text Literature was retrieved by formally searching PubMed, Embase, Cochrane library, Web of Science, Scopus, Proquest and by hand searching of reference lists of related articles. Finally, a total of eight literatures included, and Review manager 5.3 and STATA 14.0 statistical software were utilized for processing. In order to investigate the effect of sports activities on the incidence of GDM, the risk ratio (RR), and for quantitative indices, the standardized mean difference (SMD) with 95% confidence interval (CI) for each study was calculated. Out of 5107 papers identified, eight papers with 1441 participants included in meta-analysis (intervention group 727, control group 714). In the intervention group, 143 (19.66%, 95% CI 76.83 to 22.74) and in the control group, 196 (27.45%, 95% CI 20.24 to 30.88%), pregnant women had diabetes. The RR of gestational diabetes was 0.76 (95% CI 0.56 to 1.03, I 2 = 50%, P = 0.05). In studies that the time for the intervention was three times a week or less, effect of intervention was significant in reducing the incidence of diabetes (RR: 0.59, 95% CI 0.46 to 0.76, I 2 = 0%, P = 0.47). However, in studies with repeat of intervention was more than three times a week, the effect of intervention between two intervention and control groups was not different (RR: 1.03, 95% CI 0.78 to 1.35, I 2 = 0%, P = 0.46). Conclusions The exercise activities, alone, in obese or overweight pregnant women did not have a significant effect on the overall incidence of GDM, but considering the effect measure, the incidence of GDM was 24% lower in the intervention group than control group. This difference is considerable in the two groups. As the systematic review literatures both represent the information gap on the research subject and pave the way for further studies so it seems that there is a need for more randomized controlled trials so that we can make a complete conclusion on the type, intensity and duration of exercise in preventing GDM.

Gestational diabetes and long-term risk for dyslipidemia: a population-based historical cohort study

“…Although data on weight measurements in the index pregnancy were available for the majority of research cohorts, increased intake of rapidly absorbable carbohydrates that is positively associated with GDM28 may have explained some of the associations observed in our study. According to a recently published meta-analysis,29 exercise has no significant effect on the overall risk of GDM. Therefore, it is unlikely that our analysis was confounded by lack of information on physical activity 30…”

Association Between Recommended Preconception Health Behaviors and Screenings and Improvements in Cardiometabolic Outcomes of Pregnancy

“…GDM and HDP are associated with increased risk of maternal illness and death ( 9 , 10 ) and increased risk of cardiovascular disease ( 11 – 13 ). Evidence for the effectiveness of preconception behavior changes for preventing GDM or HDP is sparse ( 14 , 15 ). The only behavior with strong evidence of effectiveness is control of preexisting diabetes to reduce risk of HDP, which applies only to the small number of women with chronic diabetes ( 16 , 17 ).…”

“…The only behavior with strong evidence of effectiveness is control of preexisting diabetes to reduce risk of HDP, which applies only to the small number of women with chronic diabetes ( 16 , 17 ). Although preconception obesity is associated with increased risk of both GDM and HDP ( 18 , 19 ), no evidence indicates that weight loss interventions in the year before pregnancy (eg, diet, exercise) reduce risk of either HDP or GDM ( 14 , 15 , 20 ).…”

Introduction for the special issue on “exercise during pregnancy”

“…There are currently specific guidelines being created for women with gestational diabetes (Padayachee, 2015), one of the most common complications of pregnancy that continues to increase in prevalence worldwide. However, establishing the guidelines will require more studies of pregnant women to determine the “type, intensity, and duration of exercise in preventing” gestational diabetes mellitus which is known to negatively impact the health of the pregnant mother and her child (Nasiri‐Amiri, Sepidarkish, Shirvani, Habibipour, & Tabari, 2019).…”