Physical activity pre- and during pregnancy and gestational diabetes onset across multi-ethnic pregnant populations: a systematic review and meta-analysis of epidemiological studies

Abstract

Background: Gestational diabetes mellitus (GDM) is a common complication during pregnancy and is associated with adverse pregnancy outcomes and maternal and neonatal risks. Lifestyle intervention through physical activity is generally similar to dietary management in that it helps reduce weight and improve metabolism. However, it functions more on the preventive side of the spectrum in managing risk rather than actual treatment and management of the condition. This review aims to present an updated systematic review to determine the relationship between physical activity and onset of GDM across multi-ethnic pregnant populations. Methods: A systematic review and meta-analysis of epidemiological studies was conducted. We identified papers published from 2010 onwards using CINAHL, MEDLINE, EMBASE, Cochrane, ASSIA, PsycInfo, PubMed and Web of Science databases. Studies were limited to English language only, pregnant populations by ethnicity and reported physical activity pre- and during pregnancy. Results: Our research identified one pre-pregnancy and seven during-pregnancy studies. These studies were six prospective cohort studies, two case-control studies and one cross-sectional study. Physical activity was assessed pre-pregnancy in four studies, giving a pooled odds ratio (OR) of 0.68 (95% CI 0.53, 0.86). Physical activity in early and mid-pregnancy was assessed in five studies, giving a pooled OR of 0.77 (95% CI 0.66, 0.90) and 0.70 (95% CI 0.35, 1.40), respectively. Conclusion: Findings suggest that high total physical activity pre- and during pregnancy has a significant protective effect against GDM.