371: Insufficient evidence for exercise preventing gestational diabetes mellitus

November 25, 2012

Pearls 371, September, 2012, written by Brian R McAvoy

Clinical question: How effective is physical exercise for pregnant women for prevent.ing glucose intolerance or gestational diabetes mellitus (GDM)?

Bottom line: Compared with routine antenatal care, exercise programmes, including individualised exercise with regular advice, weekly supervised group exercise sessions or home-based stationary cycling, either supervised or unsupervised, had no clear effect on preventing GDM or improving insulin sensitivity.

Caveat: None of the trials reported large-for-gestational age babies, peri.natal mortality or long-term outcomes for women or their babies. No information was available on health service costs. All trials were conducted in high-income countries.

Context: GDM affects a significant number of women each year. GDM is associated with a wide range of adverse outcomes for women (type 2 diabetes mellitus) and their babies (birthweight >4kg and birth trauma). Recent observational studies have found physical activity during normal pregnancy decreases insulin resistance and therefore might help to decrease the risk of developing GDM.

Cochrane Systematic Review: Han S, Middleton P and Crowther CA. Exercise for pregnant women for preventing gestational diabetes mellitus. Cochrane Reviews, 2012, Issue 7. Article No. CD009021. DOI: 10.1002/ 14651858.CD009021.pub2. This review contains 5 studies involving 1115 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.