Skip to main content
Erschienen in: Journal of Endocrinological Investigation 10/2017

01.10.2017 | Review

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

verfasst von: J. Zheng, H. Wang, M. Ren

Erschienen in: Journal of Endocrinological Investigation | Ausgabe 10/2017

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat 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) CrossRefPubMed 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) CrossRefPubMed
2.
Zurück zum Zitat 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 125:1195–1204CrossRefPubMedPubMedCentral 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 125:1195–1204CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat 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 58:272–281CrossRefPubMed 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 58:272–281CrossRefPubMed
4.
Zurück zum Zitat Group HSCR, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U et al (2008) Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 358:1991–2002CrossRef Group HSCR, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U et al (2008) Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 358:1991–2002CrossRef
5.
Zurück zum Zitat Buchanan TA, Xiang AH, Page KA (2012) Gestational diabetes mellitus: risks and management during and after pregnancy. Nat Rev Endocrinol 8:639–649CrossRefPubMedPubMedCentral Buchanan TA, Xiang AH, Page KA (2012) Gestational diabetes mellitus: risks and management during and after pregnancy. Nat Rev Endocrinol 8:639–649CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat 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 163:889–898CrossRefPubMedPubMedCentral 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 163:889–898CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat 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 58:2469–2475CrossRefPubMed 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 58:2469–2475CrossRefPubMed
8.
Zurück zum Zitat 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 32:189–197CrossRefPubMed 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 32:189–197CrossRefPubMed
9.
Zurück zum Zitat 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:e012315CrossRefPubMedPubMedCentral 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:e012315CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat 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 34:579–585CrossRefPubMed 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 34:579–585CrossRefPubMed
11.
Zurück zum Zitat 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–e164CrossRefPubMed 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–e164CrossRefPubMed
12.
Zurück zum Zitat 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 159:663–670CrossRefPubMed 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 159:663–670CrossRefPubMed
13.
Zurück zum Zitat 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 58:1212–1219CrossRefPubMedPubMedCentral 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 58:1212–1219CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat 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 128:819–827CrossRefPubMed 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 128:819–827CrossRefPubMed
15.
Zurück zum Zitat 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 47:630–636CrossRefPubMed 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 47:630–636CrossRefPubMed
16.
Zurück zum Zitat 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 119:29–36CrossRefPubMed 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 119:29–36CrossRefPubMed
17.
Zurück zum Zitat 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:b2535CrossRefPubMedPubMedCentral 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:b2535CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat 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 17:1–12CrossRefPubMed 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 17:1–12CrossRefPubMed
20.
Zurück zum Zitat Kjaergard LL, Villumsen J, Gluud C (2001) Reported methodologic quality and discrepancies between large and small randomized trials in meta-analyses. Ann Intern Med 135:982–989CrossRefPubMed Kjaergard LL, Villumsen J, Gluud C (2001) Reported methodologic quality and discrepancies between large and small randomized trials in meta-analyses. Ann Intern Med 135:982–989CrossRefPubMed
21.
Zurück zum Zitat Triunfo S, Lanzone A (2014) Impact of overweight and obesity on obstetric outcomes. J Endocrinol Invest 37:323–329CrossRefPubMed Triunfo S, Lanzone A (2014) Impact of overweight and obesity on obstetric outcomes. J Endocrinol Invest 37:323–329CrossRefPubMed
22.
Zurück zum Zitat 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 39:577–583CrossRefPubMed 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 39:577–583CrossRefPubMed
23.
Zurück zum Zitat 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 48:290–295CrossRefPubMed 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 48:290–295CrossRefPubMed
24.
Zurück zum Zitat 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):1328–1333CrossRefPubMed 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):1328–1333CrossRefPubMed
25.
Zurück zum Zitat 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 34:223–229CrossRefPubMed 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 34:223–229CrossRefPubMed
26.
Zurück zum Zitat Zavorsky GS, Longo LD (2011) Exercise guidelines in pregnancy: new perspectives. Sports Med 41:345–360CrossRefPubMed Zavorsky GS, Longo LD (2011) Exercise guidelines in pregnancy: new perspectives. Sports Med 41:345–360CrossRefPubMed
Metadaten
Titel
Influence of exercise intervention on gestational diabetes mellitus: a systematic review and meta-analysis
verfasst von
J. Zheng
H. Wang
M. Ren
Publikationsdatum
01.10.2017
Verlag
Springer International Publishing
Erschienen in
Journal of Endocrinological Investigation / Ausgabe 10/2017
Elektronische ISSN: 1720-8386
DOI
https://doi.org/10.1007/s40618-017-0673-3

Weitere Artikel der Ausgabe 10/2017

Journal of Endocrinological Investigation 10/2017 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Semaglutid bei Herzinsuffizienz: Wie erklärt sich die Wirksamkeit?

17.05.2024 Herzinsuffizienz Nachrichten

Bei adipösen Patienten mit Herzinsuffizienz des HFpEF-Phänotyps ist Semaglutid von symptomatischem Nutzen. Resultiert dieser Benefit allein aus der Gewichtsreduktion oder auch aus spezifischen Effekten auf die Herzinsuffizienz-Pathogenese? Eine neue Analyse gibt Aufschluss.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.