Author:
Davenport Margie H,Ruchat Stephanie-May,Poitras Veronica J,Jaramillo Garcia Alejandra,Gray Casey E,Barrowman Nick,Skow Rachel J,Meah Victoria L,Riske Laurel,Sobierajski Frances,James Marina,Kathol Amariah J,Nuspl Megan,Marchand Andree-Anne,Nagpal Taniya S,Slater Linda G,Weeks Ashley,Adamo Kristi B,Davies Gregory A,Barakat Ruben,Mottola Michelle F
Abstract
ObjectiveGestational diabetes mellitus (GDM), gestational hypertension (GH) and pre-eclampsia (PE) are associated with short and long-term health issues for mother and child; prevention of these complications is critically important. This study aimed to perform a systematic review and meta-analysis of the relationships between prenatal exercise and GDM, GH and PE.DesignSystematic review with random effects meta-analysis and meta-regression.Data sourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were included (except case studies) if published in English, Spanish or French, and contained information on the Population (pregnant women without contraindication to exercise), Intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone [“exercise-only”] or in combination with other intervention components [e.g., dietary; “exercise + co-intervention”]), Comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and Outcomes (GDM, GH, PE).ResultsA total of 106 studies (n=273 182) were included. ‘Moderate’ to ‘high’-quality evidence from randomised controlled trials revealed that exercise-only interventions, but not exercise+cointerventions, reduced odds of GDM (n=6934; OR 0.62, 95% CI 0.52 to 0.75), GH (n=5316; OR 0.61, 95% CI 0.43 to 0.85) and PE (n=3322; OR 0.59, 95% CI 0.37 to 0.9) compared with no exercise. To achieve at least a 25% reduction in the odds of developing GDM, PE and GH, pregnant women need to accumulate at least 600 MET-min/week of moderate-intensity exercise (eg, 140 min of brisk walking, water aerobics, stationary cycling or resistance training).Summary/conclusionsIn conclusion, exercise-only interventions were effective at lowering the odds of developing GDM, GH and PE.
Funder
Canadian Institute of Health Research Knowledge Synthesis Grant
Fonds de Recherche en Santé du Québec Doctoral Research Award
Canadian Institutes for Health Research Doctoral Research Award
Advancing Women’s Heart Health Initiative New Investigator Award supported by Health Canada and the Heart and Stroke Foundation of Canada
Subject
Physical Therapy, Sports Therapy and Rehabilitation,Orthopedics and Sports Medicine,General Medicine