Abstract
Being overweight is associated with pregnancy-related disorders such as gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), and excessive maternal weight gain (MWG). Exercise and metformin reduce the risk of these disorders. This network meta-analysis (NMA) aims to compare the effect of metformin and different types of exercise (aerobic, resistance and combined) on the risk of GDM, HDP, and MWG among overweight/obese pregnant women. Medline, EMBASE, Web of Science and Cochrane Library were searched from inception to June 2021. Meta-analyses and NMAs were performed. Sixteen randomized controlled trials were included. In the NMA, aerobic exercise showed an effect on GDM (RR = 0.51, 95% CI = 0.26, 0.97), and metformin a reduction in MWG (MWG = −2.93 kg, 95% CI = −4.98, −0.87). No intervention showed any effect on the reduction of HDP. Our study suggests that aerobic exercise may have the greatest effect in reducing the risk of GDM, and perhaps, the MWG. Strategies should be developed to increase adherence to this type of intervention among overweight women without contraindications. Although metformin could reduce MWG, medicalization of pregnancy in healthy women is not justified with the present results. More research is needed on the effect of the intensity and frequency of exercise sessions and the length of interventions.
Highlights
Overweight and obesity are a major public health problem [1]
Considering that the aforementioned network meta-analysis (NMA) analyzed exercise as a single prescription, and that the results reported by the NMA were inconclusive but promising, we conducted this systematic review and NMA to comparatively synthesize data on the effect of metformin and different types of exercise interventions on gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP) and maternal weight gain (MWG) among overweight/obese pregnant women
A total of 2903 pregnant women were included in the Randomized controlled trials (RCTs) (412 in aerobic exercise, 925 in combined exercise, 40 in resistance exercise, and 1526 in metformin interventions)
Summary
Overweight and obesity are a major public health problem [1]. Obesity increases the risk of developing pregnancy complications, such as gestational diabetes mellitus (GDM), preeclampsia, or gestational hypertension [2]. GDM increases the risk of induced and caesarean deliveries and type 2 diabetes in women, as well as neonatal hypoglycemia, macrosomia, type 2 diabetes, obesity, and cardiovascular diseases in offspring [6,7,8,9,10]. The effect of resistance exercise interventions on the health of pregnant women remains unclear [16]. The exercise recommendation for overweight/obese pregnant women remains a debatable issue [17]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
