Exercise for pregnant women for preventing gestational diabetes mellitus

Han, Shanshan; Middleton, Philippa; Crowther, Caroline A

doi:10.1002/14651858.cd009021.pub2

Cited by 99 publications

(94 citation statements)

References 75 publications

(18 reference statements)

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“…10 Furthermore, recent metaanalyses have not evaluated the effect of maternal exercise across differing study populations (eg, obesity, GDM) or strictly evaluated the influence of intervention type (ie, aerobic, resistance, or both types of exercise). [10][11][12][13][14] Thus, we conducted a systematic review and meta-analysis of newborn outcomes from randomized controlled trials of structured prenatal exercise. Secondarily, we examined associations among fetal growth, study population, and the characteristics of the exercise intervention.…”

Section: Tabulation Integration and Resultsmentioning

confidence: 99%

The Effect of Supervised Prenatal Exercise on Fetal Growth

Wiebe

Boulé

Chari

et al. 2015

Obstetrics &Amp; Gynecology

138

117

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Section: Tabulation Integration and Resultsmentioning

confidence: 99%

The Effect of Supervised Prenatal Exercise on Fetal Growth

Wiebe

Boulé

Chari

et al. 2015

Obstetrics &Amp; Gynecology

138

117

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“…Meta-analyses of these RCTs have reported conflicting evidence, with some studies finding significant beneficial effects of physical activity on reducing maternal GWG 105 but others reporting minimal effects. 106 A recent systematic review found that diet or exercise or both interventions reduced the risk of excessive GWG by 20% (average risk ratio 0.8, 0.73 to 0.87; n=7096 over 24 studies).…”

Section: Long Term Effects Of Maternal Obesity On the Mother And Offsmentioning

confidence: 99%

Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child

Catalano

Shankar

2017

BMJ

805

726

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Obesity is the most common medical condition in women of reproductive age. Obesity during pregnancy has short term and long term adverse consequences for both mother and child. Obesity causes problems with infertility, and in early gestation it causes spontaneous pregnancy loss and congenital anomalies. Metabolically, obese women have increased insulin resistance in early pregnancy, which becomes manifest clinically in late gestation as glucose intolerance and fetal overgrowth. At term, the risk of cesarean delivery and wound complications is increased. Postpartum, obese women have an increased risk of venous thromboembolism, depression, and difficulty with breast feeding. Because 50-60% of overweight or obese women gain more than recommended by Institute of Medicine gestational weight guidelines, postpartum weight retention increases future cardiometabolic risks and prepregnancy obesity in subsequent pregnancies. Neonates of obese women have increased body fat at birth, which increases the risk of childhood obesity. Although there is no unifying mechanism responsible for the adverse perinatal outcomes associated with maternal obesity, on the basis of the available data, increased prepregnancy maternal insulin resistance and accompanying hyperinsulinemia, inflammation, and oxidative stress seem to contribute to early placental and fetal dysfunction. We will review the pathophysiology underlying these data and try to shed light on the specific underlying mechanisms.

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“…32,35–38 A Cochrane Review concluded that results from three randomized controlled trials suggested no significant difference in GDM incidence between women receiving exercise intervention vs routine care. 39 …”

Section: Lifestyle Interventions During Pregnancy: Are They Successful?mentioning

confidence: 99%

Maternal obesity and metabolic risk to the offspring: why lifestyle interventions may have not achieved the desired outcomes

2015

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Obesity during pregnancy is associated with an increased risk of short- and long-term metabolic dysfunction in the mother and her offspring. Both higher maternal pregravid body mass index (kg m−2) and excessive gestational weight gain (GWG) have been associated with adverse pregnancy outcomes such as gestational diabetes, preeclampsia and fetal adiposity. Multiple lifestyle intervention trials consisting of weight management using various diets, increased physical activity and behavioral modification techniques have been employed to avoid excessive GWG and improve perinatal outcomes. These randomized controlled trials (RCTs) have achieved modest success in decreasing excessive GWG, although the decrease in GWG was often not within the current Institute of Medicine guidelines. RCTs have generally not had any success with decreasing the risk of maternal gestational diabetes (GDM), preeclampsia or excessive fetal growth often referred to as macrosomia. Although the lack of success for these trials has been attributed to lack of statistical power and poor compliance with study protocols, our own research suggests that maternal pregravid and early pregnancy metabolic condition programs early placenta function and gene expression. These alterations in maternal/placental function occur in the first trimester of pregnancy prior to when most intervention trials are initiated. For example, maternal accrural of adipose tissue relies on prior activation of genes controlling lipogenesis and low-grade inflammation in early pregnancy. These metabolic alterations occur prior to any changes in maternal phenotype. Therefore, trials of lifestyle interventions before pregnancy are needed to demonstrate the safety and efficacy for both the mother and her offspring.

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Exercise for pregnant women for preventing gestational diabetes mellitus

Cited by 99 publications

References 75 publications

The Effect of Supervised Prenatal Exercise on Fetal Growth

The Effect of Supervised Prenatal Exercise on Fetal Growth

Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child

Maternal obesity and metabolic risk to the offspring: why lifestyle interventions may have not achieved the desired outcomes

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