Jury Still Out on Benefits of Exercise for Prevention of Gestational Diabetes

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Data are limited and evidence inconclusive on whether exercise prevents glucose intolerance in pregnant women.

Data are limited and evidence inconclusive on whether exercise prevents glucose intolerance in pregnant women. So say the results of a Cochrane Collaboration analysis of outcomes from the 5 existing randomized trials in this area, representing experience in more than 1,000 women.

Randomized and cluster-randomized trials assessing the effects of exercise for preventing pregnancy glucose intolerance or gestational diabetes mellitus (GDM) were identified based on a search of the Cochrane Pregnancy and Childbirth Group's Trials Register, http://ClinicalTrials.gov/, and the WOMBAT Perinatal Trials Registry. Risk of bias was moderate in all 5 trials selected, 4 of which had small sample sizes and 1 of which recruited 855 women and babies.

The analysis found no significant difference in GDM incidence (three trials, 826 women, RR 1.10, 95% CI 0.66 to 1.84), cesarean section (two trials, 934 women, RR 1.33, 95% CI 0.97 to 1.84), or operative vaginal birth (two trials, 934 women, RR 0.83, 95% CI 0.58 to 1.17) between women who received additional exercise interventions and those who received routine antenatal care. No significant differences in insulin sensitivity were found in any of the trials. In the single large trial, no significant difference was seen in incidence of developing pregnancy hyperglycemia not meeting GDM diagnostic criteria, preeclampsia, or admission to the neonatal ward.

Han S, Middleton P, Crowther CA. Exercise for pregnant women for preventing gestational diabetes mellitus. Cochrane Database Syst Rev. 2012 Jul 11;7:CD009021.

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raanan meyer, md
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