Different exercises for pregnant women with gestational diabetes: a meta-analysis of randomized controlled trials

There is evidence that maternal and child outcomes in patients with gestational diabetes mellitus (GDM) are associated with different exercise patterns. However, the evidence on which forms of exercise are beneficial for pregnant women with GDM is unclear.

PubMed, EMBASE, the Cochrane Library and the Web of Science were systematically searched for eligible studies until Feb.24, 2019. A randomized controlled trial (RCT) was used as the study method. The literature quality was evaluated and the data extracted by two researchers, and statistical analysis was carried out using Review Manage 5.2 software.

A total of nine RCTs were included. The research results show that compared with the conventional treatment group, aerobic exercise reduced the fasting blood glucose (WMD=-0.35, 95% CI: -0.62 to -0.08, I2=87%), postprandial blood glucose (WMD=-0.62, 95% CI:-0.95 to -0.29, I2=84%) and glycosylated hemoglobin levels (WMD=-0.35, 95% CI:-0.49 to -0.20, I2=71%) in patients with GDM. Compared with the conventional treatment group, the dosage of insulin (WMD=0.97, 95% CI: 0.42-2.26, I2=0%) in patients with GDM in the resistance exercise group was reduced, and the effect of combined treatment was statistically significant. Compared with the conventional treatment group, the combination of aerobic exercise plus resistance exercise training reduced postprandial blood glucose in patients with GDM (WMD=-0.64, 95% CI:-0.94 to -0.34), and the combined treatment effect was statistically significant.

Different types of exercise have different intervention effects on the outcome of patients with gestational diabetes. However, we do not have enough data to determine whether infants benefit from this exercise, and it is still necessary to conduct large-scale, high-quality and long-term intervention studies for verification.