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Influence of exercise intervention on gestational diabetes mellitus: a systematic review and meta-analysis

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Abstract

Aims

Exercise intervention might be a promising approach to prevent gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the effect of exercise intervention on gestational diabetes mellitus.

Methods

PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of exercise intervention on gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was the incidence of gestational diabetes mellitus, preterm birth, and gestational age at birth. Meta-analysis was performed using random-effect model.

Results

Five RCTs involving 1872 patients were included in the meta-analysis. Overall, compared with control intervention, exercise intervention was found to significantly reduce the risk of gestational diabetes mellitus (std. mean difference 0.62; 95% CI 0.43–0.89; P = 0.01), but demonstrated no influence on preterm birth (OR 0.93; 95% CI 0.44–1.99; P = 0.86), gestational age at birth (std. mean difference −0.03; 95% CI −0.12 to 0.07; P = 0.60), glucose 2-h post-OGTT (std. mean difference −1.02; 95% CI −2.75 to 0.71; P = 0.25), birth weight (std. mean difference −0.10; 95% CI −0.25 to 0.04; P = 0.16), Apgar score less than 7 (OR 0.78; 95% CI 0.21–2.91; P = 0.71), and preeclampsia (OR 1.05; 95% CI 0.53–2.07; P = 0.88).

Conclusions

Compared to control intervention, exercise intervention was found to significantly reduce the incidence of gestational diabetes mellitus, but had no significant influence on preterm birth, gestational age at birth, glucose 2-h post-OGTT, birth weight, Apgar score less than 7, and preeclampsia.

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References

  1. Weinert LS (2010) International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy: comment to the International Association of Diabetes and Pregnancy Study Groups Consensus Panel. Diabetes Care 33:e97 (author reply e8)

    Article  PubMed  Google Scholar 

  2. Nobles C, Marcus BH, Stanek EJ 3rd, Braun B, Whitcomb BW, Solomon CG et al (2015) Effect of an exercise intervention on gestational diabetes mellitus: a randomized controlled trial. Obstet Gynecol 125:1195–1204

    Article  PubMed  PubMed Central  Google Scholar 

  3. Xiang AH, Black MH, Li BH, Martinez MP, Sacks DA, Lawrence JM et al (2015) Racial and ethnic disparities in extremes of fetal growth after gestational diabetes mellitus. Diabetologia 58:272–281

    Article  PubMed  Google Scholar 

  4. Group HSCR, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U et al (2008) Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 358:1991–2002

    Article  Google Scholar 

  5. Buchanan TA, Xiang AH, Page KA (2012) Gestational diabetes mellitus: risks and management during and after pregnancy. Nat Rev Endocrinol 8:639–649

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Gunderson EP, Hurston SR, Ning X, Lo JC, Crites Y, Walton D et al (2015) Lactation and progression to type 2 diabetes mellitus after gestational diabetes mellitus: a prospective cohort study. Ann Intern Med 163:889–898

    Article  PubMed  PubMed Central  Google Scholar 

  7. Jaskolka D, Retnakaran R, Zinman B, Kramer CK (2015) Sex of the baby and risk of gestational diabetes mellitus in the mother: a systematic review and meta-analysis. Diabetologia 58:2469–2475

    Article  PubMed  Google Scholar 

  8. Cosson E, Bihan H, Vittaz L, Khiter C, Carbillon L, Faghfouri F et al (2015) Improving postpartum glucose screening after gestational diabetes mellitus: a cohort study to evaluate the multicentre IMPACT initiative. Diabet Med 32:189–197

    Article  CAS  PubMed  Google Scholar 

  9. Liu B, Xu Y, Zhang Y, Cai J, Deng L, Yang J et al (2016) Early Diagnosis of Gestational Diabetes Mellitus (EDoGDM) study: a protocol for a prospective, longitudinal cohort study. BMJ Open 6:e012315

    Article  PubMed  PubMed Central  Google Scholar 

  10. Perez-Ferre N, Del Valle L, Torrejon MJ, Barca I, Calvo MI, Matia P et al (2015) Diabetes mellitus and abnormal glucose tolerance development after gestational diabetes: a three-year, prospective, randomized, clinical-based, Mediterranean lifestyle interventional study with parallel groups. Clin Nutr 34:579–585

    Article  CAS  PubMed  Google Scholar 

  11. Wang C, Wei Y, Zhang X, Zhang Y, Xu Q, Su S et al (2016) Effect of regular exercise commenced in early pregnancy on the incidence of gestational diabetes mellitus in overweight and obese pregnant women: a randomized controlled trial. Diabetes Care 39:e163–e164

    Article  PubMed  Google Scholar 

  12. Dempsey JC, Sorensen TK, Williams MA, Lee IM, Miller RS, Dashow EE et al (2004) Prospective study of gestational diabetes mellitus risk in relation to maternal recreational physical activity before and during pregnancy. Am J Epidemiol 159:663–670

    Article  PubMed  Google Scholar 

  13. Bao W, Yeung E, Tobias DK, Hu FB, Vaag AA, Chavarro JE et al (2015) Long-term risk of type 2 diabetes mellitus in relation to BMI and weight change among women with a history of gestational diabetes mellitus: a prospective cohort study. Diabetologia 58:1212–1219

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Guelfi KJ, Ong MJ, Crisp NA, Fournier PA, Wallman KE, Grove JR et al (2016) Regular exercise to prevent the recurrence of gestational diabetes mellitus: a randomized controlled trial. Obstet Gynecol 128:819–827

    Article  PubMed  Google Scholar 

  15. Barakat R, Pelaez M, Lopez C, Lucia A, Ruiz JR (2013) Exercise during pregnancy and gestational diabetes-related adverse effects: a randomised controlled trial. Br J Sports Med 47:630–636

    Article  PubMed  Google Scholar 

  16. Stafne SN, Salvesen KA, Romundstad PR, Eggebo TM, Carlsen SM, Morkved S (2012) Regular exercise during pregnancy to prevent gestational diabetes: a randomized controlled trial. Obstet Gynecol 119:29–36

    Article  PubMed  Google Scholar 

  17. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535

    Article  PubMed  PubMed Central  Google Scholar 

  18. Higgins JPT GS (2011) Cochrane handbook for systematic reviews of interventions version 5.1.0 [updated March 2011]. The Cochrane Collaboration. http://www.cochrane-handbook.org

  19. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJM, Gavaghan DJ et al (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12

    Article  CAS  PubMed  Google Scholar 

  20. Kjaergard LL, Villumsen J, Gluud C (2001) Reported methodologic quality and discrepancies between large and small randomized trials in meta-analyses. Ann Intern Med 135:982–989

    Article  CAS  PubMed  Google Scholar 

  21. Triunfo S, Lanzone A (2014) Impact of overweight and obesity on obstetric outcomes. J Endocrinol Invest 37:323–329

    Article  CAS  PubMed  Google Scholar 

  22. Alptekin H, Çizmecioğlu A, Işık H, Cengiz T, Yildiz M, Iyisoy MS (2016) Predicting gestational diabetes mellitus during the first trimester using anthropometric measurements and HOMA-IR. J Endocrinol Invest 39:577–583

    Article  PubMed  Google Scholar 

  23. Yin YN, Li XL, Tao TJ, Luo BR, Liao SJ (2014) Physical activity during pregnancy and the risk of gestational diabetes mellitus: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med 48:290–295

    Article  PubMed  Google Scholar 

  24. Cordero Y, Mottola MF, Vargas J, Blanco M, Barakat RO (2015) Exercise is associated with a reduction in gestational diabetes mellitus. Med Sci Sports Exerc 47(7):1328–1333

    Article  PubMed  Google Scholar 

  25. Tobias DK, Zhang C, van Dam RM, Bowers K, Hu FB (2011) Physical activity before and during pregnancy and risk of gestational diabetes mellitus. A meta-analysis. Diabetes Care 34:223–229

    Article  PubMed  Google Scholar 

  26. Zavorsky GS, Longo LD (2011) Exercise guidelines in pregnancy: new perspectives. Sports Med 41:345–360

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Endocrinology, Chongqing People’s Hospital, Chongqing, China

    J. Zheng & H. Wang

  2. Digestive Department, Chongqing People’s Hospital, Chongqing, China

    M. Ren

Authors
  1. J. Zheng
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  2. H. Wang
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  3. M. Ren
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Correspondence to M. Ren.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Zheng, J., Wang, H. & Ren, M. Influence of exercise intervention on gestational diabetes mellitus: a systematic review and meta-analysis. J Endocrinol Invest 40, 1027–1033 (2017). https://doi.org/10.1007/s40618-017-0673-3

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  • DOI: https://doi.org/10.1007/s40618-017-0673-3

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