Physical activity recommendations for pregnant women with gestational diabetes mellitus: A best evidence synthesis

A gap persists between recommendations and actual implementation of physical activity management for gestational diabetes mellitus (GDM), largely due to the limitations in the existing evidence. The objective of this study was to systematically identify and synthesize the available evidence regarding physical activity management for pregnant women with GDM.

A best-evidence synthesis was performed. Structured literature searches were conducted using the 6S model across selected evidence-based healthcare databases. Evidence extraction and synthesis followed the Joanna Briggs Institute's (JBI) development process. The JBI Levels of Evidence (2014 edition) was applied to classify evidence levels, and the JBI Grades of Recommendation (2014 edition) was used to assign recommendation levels to each included piece of evidence.

A total of 31,527 articles were identified, of which 7,936 were duplicates. After screening 23,591 titles and abstracts, 288 full-text articles were retrieved for eligibility assessment. Ninety-seven studies underwent quality assessment. Ultimately, 26 guidelines, 6 experts' consensus, 19 systematic reviews, and 16 original studies were included for evidence extraction. Forty-seven distinct pieces of evidence were summarized across eight key aspects: assessment,exercise prescription, exercise timing, blood glucose management during exercise, sedentary and daily activities, health education, exercise promotion strategies, training, and effect evaluation.

Updating the limited evidence on the strategies to reduce sedentary behavior and the benefits and risks of different exercise methods would improve a better physical activity management in pregnant women with GDM.

This study summarized the evidence on physical activity management in pregnant women with GDM.