Diet and exercise interventions for preventing gestational diabetes mellitus

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Preventive Medicine

Background:

• Gestational diabetes mellitus (GDM) poses significant short- and long-term health risks to mothers and infants.
• Increasing GDM prevalence worldwide necessitates evaluating prevention strategies like diet and exercise interventions.

Purpose of the Study:

• To evaluate the effectiveness of combined diet and exercise interventions in preventing GDM.
• To assess the impact of these interventions on adverse maternal and infant health outcomes.

Main Methods:

• Systematic review of 13 randomized controlled trials (RCTs) involving 4983 women.
• Data extraction and risk of bias assessment conducted independently by two reviewers.
• Interventions included combined diet and exercise compared to standard care.

Main Results:

• No clear difference in GDM incidence (RR 0.92, 95% CI 0.68 to 1.23) between intervention and control groups.
• Combined interventions showed a reduced risk of preterm birth (RR 0.71, 95% CI 0.55 to 0.93).
• A trend towards reduced maternal weight gain during pregnancy was observed (MD -0.76 kg).

Conclusions:

• Current evidence from moderate-quality RCTs suggests no clear benefit of combined diet and exercise for GDM prevention.
• Limitations include trial heterogeneity and outcome definition variations, hindering firm conclusions.
• Further large, well-designed RCTs are needed to clarify effects on GDM and other critical pregnancy outcomes.