A systematic review and meta-analysis of exercise-based intervention to prevent gestational diabetes in women with overweight or obesity
Abstract Background There is evidence that exercise may reduce the risk of gestational diabetes mellitus (GDM) and improve other obstetric outcomes in overweight or obese pregnant women. However, the available evidence is of low quality and inconclusive. The purpose of this study is to assess the ef...
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2025-01-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | https://doi.org/10.1186/s12884-024-07021-w |
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| author | Teresa E. Santa Cruz Cristina Sarasqueta Juan Carlos Muruzábal Eukene Ansuategui Olga Sanz |
| author_facet | Teresa E. Santa Cruz Cristina Sarasqueta Juan Carlos Muruzábal Eukene Ansuategui Olga Sanz |
| author_sort | Teresa E. Santa Cruz |
| collection | DOAJ |
| description | Abstract Background There is evidence that exercise may reduce the risk of gestational diabetes mellitus (GDM) and improve other obstetric outcomes in overweight or obese pregnant women. However, the available evidence is of low quality and inconclusive. The purpose of this study is to assess the effects of exercise, compared with usual care, in reducing GDM and other obstetric risks, in overweight and obese pregnant women. Methods We searched MEDLINE, Embase, and the Cochrane Library from their inception dates up to August 2022. Randomised studies comparing physical exercise versus routine obstetric care in pregnant women with overweight or obesity (BMI ≥ 25.0). Each abstract and full-text article was independently reviewed by the same two authors. The primary outcome was the incidence of GDM, and the secondary outcomes were excessive weight gain, preterm delivery, and foetal macrosomia. Summary risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. Main Results. Seven studies covering 1162 patients were identified. Exercise did not reduce the risk of GDM: RR, 0.82 [95% CI, (0.58–1.17)] but subgroup analysis shows a significant benefit among patients adhering to the programs: RR, 0.56 [95% CI, (0.40–0.78)] and no effect among non-adherents: RR, 1.11 [95% CI, (0.82–1.50)]. We did not find a significant effect on excessive weight gain: RR, 0.92 [95% CI, (0.76–1.11)] but there was a reduction in the risk of foetal macrosomia: RR, 0.5 [95% CI, (0.32–0.79)]. Exercise has not been associated with an increased risk of preterm birth: RR, 0.79 [95% CI, (0.44–1.39)]. Conclusions The present study does not allow us to conclude that structured exercise programs for pregnant women with overweight or obesity leads to a reduction in the risk of gestational diabetes. When exercise program adherence is high, a significant reduction of GDM is observed. These findings will need to be confirmed with large primary trials. A reduction in the incidence of foetal macrosomia has also been observed. Trial registration This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO; identifier: CRD42023399004). |
| format | Article |
| id | doaj-art-17efec099fdb4ab1b80d38e50074eb2a |
| institution | DOAJ |
| issn | 1471-2393 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Pregnancy and Childbirth |
| spelling | doaj-art-17efec099fdb4ab1b80d38e50074eb2a2025-08-20T02:46:00ZengBMCBMC Pregnancy and Childbirth1471-23932025-01-0125111110.1186/s12884-024-07021-wA systematic review and meta-analysis of exercise-based intervention to prevent gestational diabetes in women with overweight or obesityTeresa E. Santa Cruz0Cristina Sarasqueta1Juan Carlos Muruzábal2Eukene Ansuategui3Olga Sanz4Department of Gynecology and Obstetrics, Navarra University HospitalDepartment of Clinical Epidemiology, Donostia University HospitalDepartment of Gynecology and Obstetrics, Navarra University HospitalBiogipuzkoa Health Research InstituteDepartment of Gynecology and Obstetrics, Reina Sofía HospitalAbstract Background There is evidence that exercise may reduce the risk of gestational diabetes mellitus (GDM) and improve other obstetric outcomes in overweight or obese pregnant women. However, the available evidence is of low quality and inconclusive. The purpose of this study is to assess the effects of exercise, compared with usual care, in reducing GDM and other obstetric risks, in overweight and obese pregnant women. Methods We searched MEDLINE, Embase, and the Cochrane Library from their inception dates up to August 2022. Randomised studies comparing physical exercise versus routine obstetric care in pregnant women with overweight or obesity (BMI ≥ 25.0). Each abstract and full-text article was independently reviewed by the same two authors. The primary outcome was the incidence of GDM, and the secondary outcomes were excessive weight gain, preterm delivery, and foetal macrosomia. Summary risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. Main Results. Seven studies covering 1162 patients were identified. Exercise did not reduce the risk of GDM: RR, 0.82 [95% CI, (0.58–1.17)] but subgroup analysis shows a significant benefit among patients adhering to the programs: RR, 0.56 [95% CI, (0.40–0.78)] and no effect among non-adherents: RR, 1.11 [95% CI, (0.82–1.50)]. We did not find a significant effect on excessive weight gain: RR, 0.92 [95% CI, (0.76–1.11)] but there was a reduction in the risk of foetal macrosomia: RR, 0.5 [95% CI, (0.32–0.79)]. Exercise has not been associated with an increased risk of preterm birth: RR, 0.79 [95% CI, (0.44–1.39)]. Conclusions The present study does not allow us to conclude that structured exercise programs for pregnant women with overweight or obesity leads to a reduction in the risk of gestational diabetes. When exercise program adherence is high, a significant reduction of GDM is observed. These findings will need to be confirmed with large primary trials. A reduction in the incidence of foetal macrosomia has also been observed. Trial registration This study was registered in the International Prospective Register of Systematic Reviews (PROSPERO; identifier: CRD42023399004).https://doi.org/10.1186/s12884-024-07021-wGestational diabetesExerciseAdherenceObesityOverweightPregnant women |
| spellingShingle | Teresa E. Santa Cruz Cristina Sarasqueta Juan Carlos Muruzábal Eukene Ansuategui Olga Sanz A systematic review and meta-analysis of exercise-based intervention to prevent gestational diabetes in women with overweight or obesity BMC Pregnancy and Childbirth Gestational diabetes Exercise Adherence Obesity Overweight Pregnant women |
| title | A systematic review and meta-analysis of exercise-based intervention to prevent gestational diabetes in women with overweight or obesity |
| title_full | A systematic review and meta-analysis of exercise-based intervention to prevent gestational diabetes in women with overweight or obesity |
| title_fullStr | A systematic review and meta-analysis of exercise-based intervention to prevent gestational diabetes in women with overweight or obesity |
| title_full_unstemmed | A systematic review and meta-analysis of exercise-based intervention to prevent gestational diabetes in women with overweight or obesity |
| title_short | A systematic review and meta-analysis of exercise-based intervention to prevent gestational diabetes in women with overweight or obesity |
| title_sort | systematic review and meta analysis of exercise based intervention to prevent gestational diabetes in women with overweight or obesity |
| topic | Gestational diabetes Exercise Adherence Obesity Overweight Pregnant women |
| url | https://doi.org/10.1186/s12884-024-07021-w |
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