Interventions designed to reduce excessive gestational weight gain can reduce the incidence of gestational diabetes mellitus

A systematic review and meta-analysis of randomised controlled trials

Christie Jane Bennett, Ruth Elizabeth Walker, Michelle Louise Blumfield, Stella May Gwini, Jianhua Ma, Fenglei Wang, Yi Wan, Hayley Dickinson, Helen Truby

Research output: Contribution to journalReview ArticleResearchpeer-review

Abstract

Aims: To (i) evaluate the global impact of interventions designed to prevent excessive gestational weight gain (eGWG) on the incidence of gestational diabetes (GDM), and (ii) examine whether the effects differ by pre-conception body mass index (BMI) or ethnicity. Methods: A systematic search of randomised controlled trials (RCTs) with a primary or secondary aim to reduce eGWG was conducted in seven international and three Chinese databases without date limits. Meta-analysis data are reported as relative risk (RR) for GDM incidence for interventions including: diet, physical activity (PA), and lifestyle (diet and PA). Results: Forty-five studies were included, 37 in the meta-analyses. Diet and PA interventions reduced GDM risk by 44% (RR: 0.56, 95% CI: 0.36–0.87) and 38% (RR: 0.62, 95% CI: 0.50–0.78), respectively. Lifestyle interventions and BMI didn't significantly alter GDM risk. PA interventions from Southern-Europe reduced GDM risk by 37% (RR: 0.63, 95% CI: 0.50–0.80). Whereas, diet and lifestyle interventions conducted in Asia reduced GDM risk by 62% (RR: 0.38, 95% CI: 0.24–0.59) and 32% (RR: 0.68, 95% CI: 0.54–0.86), respectively. Conclusion: Diet and PA interventions designed to reduce GWG are more effective than standard care in reducing the incidence of GDM, although the effect varies by region and BMI. The ‘one size fits all’ approach is not supported.

Original languageEnglish
Pages (from-to)69-79
Number of pages11
JournalDiabetes Research and Clinical Practice
Volume141
DOIs
Publication statusPublished - 1 Jul 2018

Keywords

  • Diet
  • Exercise
  • Gestational diabetes mellitus
  • Gestational weight gain
  • Lifestyle
  • Pregnancy
  • Pregnancy-associated diabetes

Cite this

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title = "Interventions designed to reduce excessive gestational weight gain can reduce the incidence of gestational diabetes mellitus: A systematic review and meta-analysis of randomised controlled trials",
abstract = "Aims: To (i) evaluate the global impact of interventions designed to prevent excessive gestational weight gain (eGWG) on the incidence of gestational diabetes (GDM), and (ii) examine whether the effects differ by pre-conception body mass index (BMI) or ethnicity. Methods: A systematic search of randomised controlled trials (RCTs) with a primary or secondary aim to reduce eGWG was conducted in seven international and three Chinese databases without date limits. Meta-analysis data are reported as relative risk (RR) for GDM incidence for interventions including: diet, physical activity (PA), and lifestyle (diet and PA). Results: Forty-five studies were included, 37 in the meta-analyses. Diet and PA interventions reduced GDM risk by 44{\%} (RR: 0.56, 95{\%} CI: 0.36–0.87) and 38{\%} (RR: 0.62, 95{\%} CI: 0.50–0.78), respectively. Lifestyle interventions and BMI didn't significantly alter GDM risk. PA interventions from Southern-Europe reduced GDM risk by 37{\%} (RR: 0.63, 95{\%} CI: 0.50–0.80). Whereas, diet and lifestyle interventions conducted in Asia reduced GDM risk by 62{\%} (RR: 0.38, 95{\%} CI: 0.24–0.59) and 32{\%} (RR: 0.68, 95{\%} CI: 0.54–0.86), respectively. Conclusion: Diet and PA interventions designed to reduce GWG are more effective than standard care in reducing the incidence of GDM, although the effect varies by region and BMI. The ‘one size fits all’ approach is not supported.",
keywords = "Diet, Exercise, Gestational diabetes mellitus, Gestational weight gain, Lifestyle, Pregnancy, Pregnancy-associated diabetes",
author = "Bennett, {Christie Jane} and Walker, {Ruth Elizabeth} and Blumfield, {Michelle Louise} and Gwini, {Stella May} and Jianhua Ma and Fenglei Wang and Yi Wan and Hayley Dickinson and Helen Truby",
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Interventions designed to reduce excessive gestational weight gain can reduce the incidence of gestational diabetes mellitus : A systematic review and meta-analysis of randomised controlled trials. / Bennett, Christie Jane; Walker, Ruth Elizabeth; Blumfield, Michelle Louise; Gwini, Stella May; Ma, Jianhua; Wang, Fenglei; Wan, Yi; Dickinson, Hayley; Truby, Helen.

In: Diabetes Research and Clinical Practice, Vol. 141, 01.07.2018, p. 69-79.

Research output: Contribution to journalReview ArticleResearchpeer-review

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AU - Walker, Ruth Elizabeth

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AU - Gwini, Stella May

AU - Ma, Jianhua

AU - Wang, Fenglei

AU - Wan, Yi

AU - Dickinson, Hayley

AU - Truby, Helen

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N2 - Aims: To (i) evaluate the global impact of interventions designed to prevent excessive gestational weight gain (eGWG) on the incidence of gestational diabetes (GDM), and (ii) examine whether the effects differ by pre-conception body mass index (BMI) or ethnicity. Methods: A systematic search of randomised controlled trials (RCTs) with a primary or secondary aim to reduce eGWG was conducted in seven international and three Chinese databases without date limits. Meta-analysis data are reported as relative risk (RR) for GDM incidence for interventions including: diet, physical activity (PA), and lifestyle (diet and PA). Results: Forty-five studies were included, 37 in the meta-analyses. Diet and PA interventions reduced GDM risk by 44% (RR: 0.56, 95% CI: 0.36–0.87) and 38% (RR: 0.62, 95% CI: 0.50–0.78), respectively. Lifestyle interventions and BMI didn't significantly alter GDM risk. PA interventions from Southern-Europe reduced GDM risk by 37% (RR: 0.63, 95% CI: 0.50–0.80). Whereas, diet and lifestyle interventions conducted in Asia reduced GDM risk by 62% (RR: 0.38, 95% CI: 0.24–0.59) and 32% (RR: 0.68, 95% CI: 0.54–0.86), respectively. Conclusion: Diet and PA interventions designed to reduce GWG are more effective than standard care in reducing the incidence of GDM, although the effect varies by region and BMI. The ‘one size fits all’ approach is not supported.

AB - Aims: To (i) evaluate the global impact of interventions designed to prevent excessive gestational weight gain (eGWG) on the incidence of gestational diabetes (GDM), and (ii) examine whether the effects differ by pre-conception body mass index (BMI) or ethnicity. Methods: A systematic search of randomised controlled trials (RCTs) with a primary or secondary aim to reduce eGWG was conducted in seven international and three Chinese databases without date limits. Meta-analysis data are reported as relative risk (RR) for GDM incidence for interventions including: diet, physical activity (PA), and lifestyle (diet and PA). Results: Forty-five studies were included, 37 in the meta-analyses. Diet and PA interventions reduced GDM risk by 44% (RR: 0.56, 95% CI: 0.36–0.87) and 38% (RR: 0.62, 95% CI: 0.50–0.78), respectively. Lifestyle interventions and BMI didn't significantly alter GDM risk. PA interventions from Southern-Europe reduced GDM risk by 37% (RR: 0.63, 95% CI: 0.50–0.80). Whereas, diet and lifestyle interventions conducted in Asia reduced GDM risk by 62% (RR: 0.38, 95% CI: 0.24–0.59) and 32% (RR: 0.68, 95% CI: 0.54–0.86), respectively. Conclusion: Diet and PA interventions designed to reduce GWG are more effective than standard care in reducing the incidence of GDM, although the effect varies by region and BMI. The ‘one size fits all’ approach is not supported.

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