TY - JOUR
T1 - Interventions designed to reduce excessive gestational weight gain can reduce the incidence of gestational diabetes mellitus
T2 - A systematic review and meta-analysis of randomised controlled trials
AU - Bennett, Christie Jane
AU - Walker, Ruth Elizabeth
AU - Blumfield, Michelle Louise
AU - Gwini, Stella May
AU - Ma, Jianhua
AU - Wang, Fenglei
AU - Wan, Yi
AU - Dickinson, Hayley
AU - Truby, Helen
PY - 2018/7/1
Y1 - 2018/7/1
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.
KW - Diet
KW - Exercise
KW - Gestational diabetes mellitus
KW - Gestational weight gain
KW - Lifestyle
KW - Pregnancy
KW - Pregnancy-associated diabetes
UR - http://www.scopus.com/inward/record.url?scp=85046678233&partnerID=8YFLogxK
U2 - 10.1016/j.diabres.2018.04.010
DO - 10.1016/j.diabres.2018.04.010
M3 - Review Article
C2 - 29698713
AN - SCOPUS:85046678233
VL - 141
SP - 69
EP - 79
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
SN - 0168-8227
ER -