Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2012 Jul 11;2012(7):CD009021.
doi: 10.1002/14651858.CD009021.pub2.

Exercise for pregnant women for preventing gestational diabetes mellitus

Shanshan Han  1 , Philippa Middleton, Caroline A Crowther
Affiliations
Meta-Analysis

Exercise for pregnant women for preventing gestational diabetes mellitus

Shanshan Han et al. Cochrane Database Syst Rev. .

Abstract

Background: Gestational diabetes mellitus (GDM) affects a significant number of women each year. GDM is associated with a wide range of adverse outcomes for women and their babies. Recent observational studies have found physical activity during normal pregnancy decreases insulin resistance and therefore might help to decrease the risk of developing GDM.

Objectives: To assess the effects of physical exercise for pregnant women for preventing glucose intolerance or GDM.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (2 April 2012), ClinicalTrials.gov (2 April 2012) and the WOMBAT Perinatal Trials Registry (2 April 2012).

Selection criteria: Randomised and cluster-randomised trials assessing the effects of exercise for preventing pregnancy glucose intolerance or GDM.

Data collection and analysis: Two review authors independently assessed study eligibility, extracted data and assessed the risk of bias of included studies.

Main results: We included five trials with a total of 1115 women and their babies (922 women and their babies contributed outcome data). Four of the five included trials had small sample sizes with one large trial that recruited 855 women and babies. All five included trials had a moderate risk of bias. When comparing women receiving additional exercise interventions with those having routine antenatal care, there was no significant difference in GDM incidence (three trials, 826 women, risk ratio (RR) 1.10, 95% confidence interval (CI) 0.66 to 1.84), caesarean section (two trials, 934 women, RR 1.33, 95% CI 0.97 to 1.84) or operative vaginal birth (two trials, 934 women, RR 0.83, 95% CI 0.58 to 1.17). No trial reported the infant primary outcomes prespecified in the review.None of the five included trials found significant differences in insulin sensitivity. Evidence from one single large trial suggested no significant difference in the incidence of developing pregnancy hyperglycaemia not meeting GDM diagnostic criteria, pre-eclampsia or admission to neonatal ward between the two study groups. Babies born to women receiving exercise interventions had a non-significant trend to a lower ponderal index (mean difference (MD) -0.08 gram x 100 m(3), 95% CI -0.18 to 0.02, one trial, 84 infants). No significant differences were seen between the two study groups for the outcomes of birthweight (two trials, 167 infants, MD -102.87 grams, 95% CI -235.34 to 29.60), macrosomia (two trials, 934 infants, RR 0.91, 95% CI 0.68 to 1.22), or small-for-gestational age (one trial, 84 infants, RR 1.05, 95% CI 0.25 to 4.40) or gestational age at birth (two trials, 167 infants, MD -0.04 weeks, 95% CI -0.37 to 0.29) or Apgar score less than seven at five minutes (two trials, 919 infants, RR 1.00, 95% CI 0.27 to 3.65). None of the trials reported long-term outcomes for women and their babies. No information was available on health services costs.

Authors' conclusions: There is limited randomised controlled trial evidence available on the effect of exercise during pregnancy for preventing pregnancy glucose intolerance or GDM. Results from three randomised trials with moderate risk of bias suggested no significant difference in GDM incidence between women receiving an additional exercise intervention and routine care.Based on the limited data currently available, conclusive evidence is not available to guide practice. Larger, well-designed randomised trials, with standardised behavioural interventions are needed to assess the effects of exercise on preventing GDM and other adverse pregnancy outcomes including large-for-gestational age and perinatal mortality. Longer-term health outcomes for both women and their babies and health service costs should be included. Several such trials are in progress. We identified another seven trials which are ongoing and we will consider these for inclusion in the next update of this review.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1
1
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
2
2
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Any exercise intervention versus routine care, Outcome 1 Gestational diabetes mellitus.
1.2
1.2. Analysis
Comparison 1 Any exercise intervention versus routine care, Outcome 2 Caesarean section.
1.3
1.3. Analysis
Comparison 1 Any exercise intervention versus routine care, Outcome 3 Operative vaginal birth.
1.4
1.4. Analysis
Comparison 1 Any exercise intervention versus routine care, Outcome 4 Pregnancy hyperglycaemia not meeting GDM diagnostic criteria.
1.5
1.5. Analysis
Comparison 1 Any exercise intervention versus routine care, Outcome 5 Weight change during pregnancy (kg).
1.6
1.6. Analysis
Comparison 1 Any exercise intervention versus routine care, Outcome 6 Maternal BMI at late pregnancy (third trimester) (kg/m2).
1.7
1.7. Analysis
Comparison 1 Any exercise intervention versus routine care, Outcome 7 Pre‐eclampsia.
1.8
1.8. Analysis
Comparison 1 Any exercise intervention versus routine care, Outcome 8 Birthweight.
1.9
1.9. Analysis
Comparison 1 Any exercise intervention versus routine care, Outcome 9 Macrosomia (birthweight > 4000 gram).
1.10
1.10. Analysis
Comparison 1 Any exercise intervention versus routine care, Outcome 10 Small‐for‐gestational age.
1.11
1.11. Analysis
Comparison 1 Any exercise intervention versus routine care, Outcome 11 Gestational age at birth (week).
1.12
1.12. Analysis
Comparison 1 Any exercise intervention versus routine care, Outcome 12 Ponderal index (gram x 100/m3).
1.13
1.13. Analysis
Comparison 1 Any exercise intervention versus routine care, Outcome 13 Apgar score less than seven at five minutes.
1.14
1.14. Analysis
Comparison 1 Any exercise intervention versus routine care, Outcome 14 Admission to neonatal ward.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD009021

References

References to studies included in this review

Barakat 2011 {published data only}
    1. Barakat R, Cordero Y, Coteron J, Luaces M, Montejo R. Exercise during pregnancy improves maternal glucose screen at 24‐28 weeks: a randomised controlled trial. British Journal of Sports Medicine 2011 Sep 26. [Epub ahead of print]. - PubMed
Callaway 2010 {published data only}
    1. Byrne NM, Groves AM, McIntyre HD, Callaway LK. Changes in resting and walking energy expenditure and walking speed during pregnancy in obese women. American Journal of Clinical Nutrition 2011;94(3):819‐30. - PubMed
    1. Callaway L. A randomized controlled trial using exercise to reduce gestational diabetes and other adverse maternal and neonatal outcomes in obese pregnant women ‐ the pilot study. Australian Clinical Trials Registry (www.actr.org.au) (accessed 21 June 2007).
    1. Callaway L, McIntyre D, Colditz P, Byrne N, Foxcroft K, O'Connor B. Exercise in obese pregnant women: a randomized study to assess feasibility. Hypertension in Pregnancy 2008;27(4):549.
    1. Callaway LK, Colditz PB, Byrne NM, Lingwood BE, Rowlands IJ, Foxcroft K, et al. Prevention of gestational diabetes. Feasibility issues for an exercise intervention in obese pregnant women. Diabetes Care 2010;33(7):1457‐9. - PMC - PubMed
Hopkins 2010 {published data only}
    1. Hofman P, Hopkins S. Randomised controlled study of the effects of exercise during pregnancy on maternal insulin sensitivity and neonatal outcomes. Australian Clinical Trials Register (http://www.actr.org/actr) (accessed 6 December 2005).
    1. Hopkins SA, Baldi JC, Cutfield WS, McCowan L, Hofman PL. Effects of exercise training on maternal hormonal changes in pregnancy. Clinical Endocrinology 2011;74(4):495‐500. - PubMed
    1. Hopkins SA, Baldi JC, Cutfield WS, McCowan L, Hofman PL. Exercise training in pregnancy reduces offspring size without changes in maternal insulin sensitivity. Journal of Clinical Endocrinology and Metabolism 2010;95(5):2080‐8. - PubMed
Ong 2009 {published data only}
    1. Ong MJ, Guelfi KJ, Hunter T, Wallman KE, Fournier PA, Newnham JP. Supervised home‐based exercise may attenuate the decline of glucose tolerance in obese pregnant women. Diabetes and Metabolism 2009;35(5):418‐21. - PubMed
Stafne 2012 {published data only}
    1. Morkved S. Effects of regular exercise during pregnancy. ClinicalTrials.gov (http://clinicaltrials.gov/) (accessed 20 February 2008).
    1. Stafne SN, Salvesen KA, Romundstad PR, Eggebo TM, Carlsen SM, Morkved S. Regular exercise during pregnancy to prevent gestational diabetes: a randomized controlled trial. Obstetrics and Gynecology 2012;119(1):29‐36. - PubMed

References to studies excluded from this review

Chen 1997 {published data only}
    1. Chen B, Steiner JL, Holcomb WL. Effects of a short‐term moderate exercise program on glucose tolerance in pregnancy. American Journal of Obstetrics and Gynecology 1997;176(1 Pt 2):S173.
Clapp 1997 {published data only}
    1. Clapp JF 3rd. Diet, exercise, and feto‐placental growth. Archives of Gynecology and Obstetrics 1997;260:101‐8.
Clapp 2002 {published data only}
    1. Clapp JF 3rd. Maternal carbohydrate intake and pregnancy outcome. Proceedings of the Nutrition Society 2002;61(1):45‐50. - PubMed
Clapp 2002a {published data only}
    1. Clapp JF 3rd, Kim H, Burciu B, Schmidt S, Petry K, Lopez B. Continuing regular exercise during pregnancy: effect of exercise volume on fetoplacental growth. American Journal of Obstetrics and Gynecology 2002;186(1):142‐7. - PubMed
Gaston 2009 {published data only}
    1. Gaston A, Prapavessis H. Maternal‐fetal disease information as a source of exercise motivation during pregnancy. Health Psychology 2009;28(6):726‐33. - PubMed
Haakstad 2011 {published data only}
    1. Haakstad L, Bo K. Effect of regular exercise on prevention of excessive weight gain in pregnancy: a randomised controlled trial. European Journal of Contraception and Reproductive Health Care 2011;16:116‐25. - PubMed
    1. Haakstad L, Bo K. Effect of supervised aerobic dance exercise in prevention of excessive weight gain in pregnancy: a single blind randomized controlled trial. International Journal of Gynaecology and Obstetrics 2009;107(Suppl 2):S198.
Hui 2006 {published data only}
    1. Hui AL, Ludwig SM, Gardiner P, Sevenhuysen G, Murray R, Morris M, et al. Community‐based exercise and dietary intervention during pregnancy: a pilot study. Canadian Journal of Diabetes 2006;30(2):169‐75.
Kim 2010a {published data only}
    1. Kim C. Walking exercise and nutrition to reduce diabetes risk for you (WENDY). ClinicalTrials.gov (http://clinicaltrials.gov/) (accessed 06 July 2011).
Luoto 2010 {published data only}
    1. Luoto R. Primary prevention of gestational diabetes among women at risk: a cluster‐randomized controlled trial. Current Controlled Trials (http://www.controlled‐trials.com/ISRCTN33885819) (accessed 2010).
    1. Luoto RM, Kinnunen TI, Aittasalo M, Ojala K, Mansikkamaki K, Poropainen E, et al. Prevention of gestational diabetes: design of a cluster‐randomized controlled trial and one‐year follow‐up. BMC Pregnancy and Childbirth 2010;10:39. - PMC - PubMed
Quinlivan 2007 {published data only}
    1. Quinlivan J. A randomised trial of a multidisciplinary team care approach involving obstetric, dietary and clinical psychological input in obese pregnant women to reduce the incidence of gestational diabetes. Australian Clinical Trials Register (www.actr.org.au) (accessed 6 December 2005).

References to ongoing studies

Chasan‐Taber 2009 {published data only}
    1. Chasan‐Taber L. B.A.B.Y. Study: an exercise intervention to prevent gestational diabetes. Annals of Behavioral Medicine 2011 2011;41(Suppl 1):S135.
    1. Chasan‐Taber L, Marcus BH, Stanek E 3rd, Ciccolo JT, Marquez DX, Solomon CG, et al. A randomized controlled trial of prenatal physical activity to prevent gestational diabetes: design and methods. Journal of Women's Health 2009;18(6):851‐9. - PMC - PubMed
    1. Chasan‐Taber L, Silveira M, Marcus BH, Braun B, Stanek E, Markenson G. Feasibility and efficacy of a physical activity intervention among pregnant women: the behaviours affecting baby and you (B.A.B.Y.) study. Journal of Physical Activity and Health 2011;8(Suppl 2):S228‐S238. - PubMed
Ko 2008 {published data only}
    1. Ko CW. Effect of physical activity on metabolic syndrome in pregnancy and fetal outcome. ClinicalTrials.gov (http://clinicaltrials.gov/) (accessed 9 April 2008).
Melo 2008 {published data only}
    1. Melo A. Exercise and pregnancy: randomised clinical trial. Current Controlled Trials (www.controlled‐trials.com/) (accessed 17 March 2010).
Newnham 2011 {published data only}
    1. Newnham J. Fournier P. Guelfi K. Grove R. Wallman K. Doherty D. Preventing gestational diabetes mellitus using a home‐based supervised exercise program during pregnancy. ClinicalTrials.gov (http://clinicaltrials.gov/), (accessed 25 July 2011). [NCT01283854]
Oostdam 2009 {published data only}
    1. Oostdam N, Poppel MN, Eekhoff EM, Wouters MG, Mechelen W. Design of FitFor2 study: the effects of an exercise program on insulin sensitivity and plasma glucose levels in pregnant women at high risk for gestational diabetes. BMC Pregnancy and Childbirth 2009;9:1. - PMC - PubMed
Ramirez‐Velez 2009 {published data only}
    1. Ramirez‐Velez R, Aguilar AC, Mosquera M, Garcia RG, Reyes LM, Lopez‐Jaramillo P. Clinical trial to assess the effect of physical exercise on endothelial function and insulin resistance in pregnant women. Trials 2009;10:104. - PMC - PubMed
Shen 2008 {published data only}
    1. Shen G. Impact of diet and exercise activity on pregnancy outcomes (IDEA). ClinicalTrials.gov (http://clinicaltrials.gov/) (accessed 20 February 2008).

Additional references

ACOG 2001
    1. American College of Obstetricians and Gynecologists Committee on Practice Bulletins‐‐Obstetrics. ACOG Practice Bulletin. Clinical management guidelines for obstetrician‐gynecologists. Number 30, September 2001 (replaces Technical Bulletin Number 200, December 1994). Gestational diabetes. Obstetrics & Gynecology 2001;98(3):525‐38. - PubMed
ADA 2003
    1. American Diabetes Association. Gestational diabetes mellitus. Diabetes Care 2003;26(Suppl 1):S103‐S105. - PubMed
Alwan 2009
    1. Alwan N, Tuffnell DJ, West J. Treatments for gestational diabetes. Cochrane Database of Systematic Reviews 2009, Issue 3. [DOI: 10.1002/14651858.CD003395.pub2] - DOI - PMC - PubMed
Amorim 2007
    1. Amorim Adegboye AR, Linne YM, Lourenco PMC. Diet or exercise, or both, for weight reduction in women after childbirth. Cochrane Database of Systematic Reviews 2007, Issue 3. [DOI: 10.1002/14651858.CD005627.pub2] - DOI - PubMed
Barker 1994
    1. Barker D. Mothers, babies and diseases in later life. London: BMJ Publishing Group, 1994.
Bellamy 2009
    1. Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta‐analysis. Lancet 2009;373(9677):1773‐9. - PubMed
Bottalico 2007
    1. Bottalico JN. Recurrent gestational diabetes: risk factors, diagnosis, management, and implications. Seminars in Perinatology 2007;31(3):176‐84. - PubMed
Ceysens 2006
    1. Ceysens G, Rouiller D, Boulvain M. Exercise for diabetic pregnant women. Cochrane Database of Systematic Reviews 2006, Issue 3. [DOI: 10.1002/14651858.CD004225.pub2] - DOI - PMC - PubMed
Chasan‐Taber 2008
    1. Chasan‐Taber L, Schmidt MD, Pekow P, Sternfeld B, Manson JE, Solomon CG, et al. Physical activity and gestational diabetes mellitus among Hispanic women. Journal of Women's Health 2008;17(6):999‐1008. - PubMed
Chodick 2010
    1. Chodick G, Elchalal U, Sella T, Heymann AD, Porath A, Kokia E, et al. The risk of overt diabetes mellitus among women with gestational diabetes: a population‐based study. Diabetic Medicine 2010;27(7):779‐85. - PubMed
Clapp 1991
    1. Clapp JF 3rd, Capeless EL. The changing glycaemic response to exercise during pregnancy. American Journal of Obstetrics and Gynecology 1991;165(6 Pt 1):1678‐83. - PubMed
Clapp 1998
    1. Clapp JF 3rd. Effect of dietary carbohydrate on the glucose and insulin response to mixed caloric intake and exercise in both nonpregnant and pregnant women. Diabetes Care 1998;21(Suppl 2):B107‐B112. - PubMed
Clapp 2000
    1. Clapp JF 3rd, Kiess W. Effects of pregnancy and exercise on concentrations of the metabolic markers tumor necrosis factor alpha and leptin. American Journal of Obstetrics & Gynecology 2000;182(2):300‐6. - PubMed
Clapp 2006
    1. Clapp JF. Effects of diet and exercise on insulin resistance during pregnancy. Metabolic Syndrome and Related Disorders 2006;4(2):84‐90. - PubMed
ClinicalTrials 2011
    1. ClinicalTrials.gov. ClinicalTrials.gov (http://clinicaltrials.gov/) (accessed 6 July 2011).
Coustan 2010
    1. Coustan DR, Lowe LP, Metzger BE, Dyer AR, International Association of Diabetes and Pregnancy Study Groups. The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study: paving the way for new diagnostic criteria for gestational diabetes mellitus. American Journal of Obstetrics & Gynecology 2010;202(6):654 e1‐6. - PMC - PubMed
Crowther 2005
    1. Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS, Australian Carbohydrate Intolerance Study in Pregnant Women (ACHOIS) Trial Group. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. New England Journal of Medicine 2005;352(24):2477‐86. - PubMed
Cypryk 2008
    1. Cypryk K, Szymczak W, Czupryniak L, Sobczak M, Lewinski A. Gestational diabetes mellitus ‐ an analysis of risk factors. Endokrynologia Polska 2008;59(5):393‐7. - PubMed
Dabelea 2005
    1. Dabelea D, Snell‐Bergeon JK, Hartsfield CL, Bischoff KJ, Hamman RF, McDuffie RS. Increasing prevalence of gestational diabetes mellitus (GDM) over time and by birth cohort: Kaiser Permanente of Colorado GDM Screening Program. Diabetes Care 2005;28(3):579‐84. - PubMed
Dempsey 2004a
    1. Dempsey JC, Sorensen TK, Williams MA, Lee IM, Miller RS, Dashow EE, et al. Prospective study of gestational diabetes mellitus risk in relation to maternal recreational physical activity before and during pregnancy. American Journal of Epidemiology 2004;159(7):663‐70. - PubMed
Dempsey 2004b
    1. Dempsey JC, Butler CL, Sorensen TK, Lee IM, Thompson ML, Miller RS, et al. A case‐control study of maternal recreational physical activity and risk of gestational diabetes mellitus. Diabetes Research and Clinical Practice 2004;66(2):203‐15. - PubMed
Dempsey 2005
    1. Dempsey JC, Butler CL, Williams MA. No need for a pregnant pause: physical activity may reduce the occurrence of gestational diabetes mellitus and preeclampsia. Exercise and Sport Sciences Reviews 2005;33(3):141‐9. - PubMed
Devlieger 2008
    1. Devlieger R, Casteels K, Assche FA. Reduced adaptation of the pancreatic B cells during pregnancy is the major causal factor for gestational diabetes: current knowledge and metabolic effects on the offspring. Acta Obstetricia et Gynecologica Scandinavica 2008;87(12):1266‐70. - PubMed
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. BMJ 1997;315(7109):629‐34. - PMC - PubMed
Guerrero‐Romero 2010
    1. Guerrero‐Romero F, Aradillas‐García C, Simental‐Mendia LE, Monreal‐Escalante E, Cruz Mendoza E, Rodríguez‐Moran M. Birth weight, family history of diabetes, and metabolic syndrome in children and adolescents. Journal of Pediatrics 2010;156(5):719‐23. - PubMed
HAPO Study Cooperative Research Group 2008
    1. HAPO Study Cooperative Research Group, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, Coustan DR, et al. Hyperglycemia and adverse pregnancy outcomes. New England Journal of Medicine 2008;358(19):1991‐2002. - PubMed
Harbord 2006
    1. Harbord RM, Egger M, Sterne JA. A modified test for small‐study effects in meta‐analyses of controlled trials with binary endpoints. Statistics in Medicine 2006;25(20):3443‐57. - PubMed
Harder 2009
    1. Harder T, Roepke K, Diller N, Stechling Y, Dudenhausen JW, Plagemann A. Birth weight, early weight gain, and subsequent risk of type 1 diabetes: systematic review and meta‐analysis. American Journal of Epidemiology 2009;169(12):1428‐36. - PubMed
Hedderson 2010
    1. Hedderson M, Gunderson E, Ferrara A. Gestational weight gain and risk of gestational diabetes mellitus. Obstetrics and Gynecology 2010;115(3):597‐604. - PMC - PubMed
Henriksen 2008
    1. Henriksen T. The macrosomic fetus: a challenge in current obstetrics. Acta Obstetricia et Gynecologica Scandinavica 2008;87(2):134‐45. - PubMed
Higgins 2011
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Hoffman 1998
    1. Hoffman L, Nolan C, Wilson JD, Oats JJ, Simmons D. Gestational diabetes mellitus‐‐management guidelines. The Australasian Diabetes in Pregnancy Society. Medical Journal of Australia 1998;169(2):93‐7. - PubMed
Jastrow 2010
    1. Jastrow N, Roberge S, Gauthier RJ, Laroche L, Duperron L, Brassard N, et al. Effect of birth weight on adverse obstetric outcomes in vaginal birth after cesarean delivery. Obstetrics & Gynecology 2010;115(2 Pt 1):338‐43. - PubMed
Ju 2008
    1. Ju H, Rumbold AR, Willson KJ, Crowther CA. Borderline gestational diabetes mellitus and pregnancy outcomes. BMC: Pregnancy and Childbirth 2008;8:31. - PMC - PubMed
Kim 2002
    1. Kim C, Newton KM, Knopp RH. Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care 2002;25(10):1862‐8. - PubMed
Kim 2010b
    1. Kim SY, England L, Wilson HG, Bish C, Satten GA, Dietz P. Percentage of gestational diabetes mellitus attributable to overweight and obesity. American Journal of Public Health 2010;100(6):1047‐52. - PMC - PubMed
Knowler 2002
    1. Knowler WC, Barrett‐Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine 2002;346(6):393‐403. - PMC - PubMed
Kramer 2006
    1. Kramer MS, McDonald SW. Aerobic exercise for women during pregnancy. Cochrane Database of Systematic Reviews 2006, Issue 3. [DOI: 10.1002/14651858.CD000180.pub2] - DOI - PMC - PubMed
Landon 2009
    1. Landon MB, Spong CY, Thom E, Carpenter MW, Ramin SM, Casey B, et al. A multicenter, randomized trial of treatment for mild gestational diabetes. New England Journal of Medicine 2009;361(14):1339‐48. - PMC - PubMed
Langer 2005
    1. Langer O, Yogev Y, Most O, Xenakis EM. Gestational diabetes: the consequences of not treating. American Journal of Obstetrics and Gynecology 2005;192(4):989‐97. - PubMed
Lo 2006
    1. Lo JC, Feigenbaum SL, Escobar GJ, Yang J, Crites YM, Ferrara A. Increased prevalence of gestational diabetes mellitus among women with diagnosed polycystic ovary syndrome: a population‐based study. Diabetes Care 2006;29(8):1915‐7. - PubMed
Melzer 2010
    1. Melzer K, Schutz Y, Boulvain M, Kayser B. Physical activity and pregnancy: cardiovascular adaptations, recommendations and pregnancy outcomes. Sports Medicine 2010;40(6):493‐507. - PubMed
Metzger 1998
    1. Metzger BE, Coustan DR. Summary and recommendations of the Fourth International Workshop‐Conference on Gestational Diabetes Mellitus. The Organizing Committee. Diabetes Care 1998;21(Suppl 2):B161‐B167. - PubMed
Metzger 2007
    1. Metzger BE, Buchanan TA, Coustan DR, Leiva A, Dunger DB, Hadden DR, et al. Summary and recommendations of the Fifth International Workshop‐Conference on Gestational Diabetes Mellitus. Diabetes Care 2007;30(Suppl 2):S251‐S260. - PubMed
Morisset 2010
    1. Morisset AS, St‐Yves A, Veillette J, Weisnagel SJ, Tchernof A, Robitaille J. Prevention of gestational diabetes mellitus: a review of studies on weight management. Diabetes Metabolism Research and Reviews 2010;26(1):17‐25. - PubMed
Morrison 2008
    1. Morrison JA, Friedman LA, Wang P, Glueck CJ. Metabolic syndrome in childhood predicts adult metabolic syndrome and type 2 diabetes mellitus 25 to 30 years later. Journal of Pediatrics 2008;152(2):201‐6. - PubMed
Mottola 2008
    1. Mottola MF. The role of exercise in the prevention and treatment of gestational diabetes mellitus. Current Diabetes Reports 2008;8(4):299‐304. - PubMed
Mulla 2010
    1. Mulla WR, Henry TQ, Homko CJ. Gestational diabetes screening after HAPO: has anything changed?. Current Diabetes Reports 2010;10(3):224‐8. - PubMed
NICE 2008
    1. National Institute for Health and Clinical Excellence. Diabetes in pregnancy: management of diabetes and its complications from pre‐conception to the postnatal period. London: National Institute for Health and Clinical Excellence, 2008.
Oken 2006
    1. Oken E, Ning Y, Rifas‐Shiman SL, Radesky JS, Rich‐Edwards JW, Gillman MW. Associations of physical activity and inactivity before and during pregnancy with glucose tolerance. Obstetrics and Gynecology 2006;108(5):1200‐7. - PMC - PubMed
Petitt 1985
    1. Petitt DJ, Bennett PH, Knowler WC, Baird HR, Aleck KA. Gestational diabetes mellitus and impaired glucose tolerance during pregnancy. Long‐term effects on obesity and glucose tolerance in the offspring. Diabetes 1985;34(Suppl 2):119‐22. - PubMed
Petry 2010
    1. Petry CJ. Gestational diabetes: risk factors and recent advances in its genetics and treatment. British Journal of Nutrition 2010;104(6):775‐87. - PubMed
Pivarnik 2006
    1. Pivarnik JM, Chambliss HO, Clapp JF, Dugan SA, Hatch MC, Lovelady CA, et al. Impact of physical activity during pregnancy and postpartum on chronic disease risk. Medicine and Science in Sports and Exercise 2006;38(5):989‐1006. - PubMed
Redden 2010
    1. Redden SL, Lamonte MJ, Freudenheim JL, Rudra CB. The association between gestational diabetes mellitus and recreational physical activity. Maternal and Child Health Journal 2010 Mar 6. [Epub ahead of print]. - PubMed
Reece 2009
    1. Reece EA, Leguizamón G, Wiznitzer A. Gestational diabetes: the need for a common ground. Lancet 2009;373(9677):1789‐97. - PubMed
RevMan 2011 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.1.2. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Rizzo 1997
    1. Rizzo TA, Metzger BE, Dooley SL, Cho NH. Early malnutrition and child neurobehavioral development: insights from the study of children of diabetic mothers. Child Development 1997;68(1):26‐38. - PubMed
Schlüssel 2008
    1. Schlüssel MM, Souza EB, Reichenheim ME, Kac G. Physical activity during pregnancy and maternal‐child health outcomes: a systematic literature review. Cadernos de Saude Publica 2008;24(Suppl 4):S531‐S544. - PubMed
Sedaghati 2007
    1. Sedaghati P, Ziaee V, Ardjmand A. The effect of an ergometric training program on pregnants weight gain and low back pain. Gazzetta Medica Italiana Archivio per le Scienze Mediche 2007;166:209‐13.
Silva 2010
    1. Silva JC, Pacheco C, Bizato J, Souza BV, Ribeiro TE, Bertini AM. Metformin compared with glyburide for the management of gestational diabetes. International Journal of Gynaecology and Obstetrics 2010;111(1):37‐40. - PubMed
Simmons 2004
    1. Simmons D, Walters BN, Rowan JA, McIntyre HD. Metformin therapy and diabetes in pregnancy. Medical Journal of Australia 2004;180(9):462‐4. - PubMed
Snapp 2008
    1. Snapp CA, Donaldson SK. Gestational diabetes mellitus: physical exercise and health outcomes. Biological Research for Nursing 2008;10(2):145‐55. - PubMed
Soler 1978
    1. Soler NG, Soler SM, Malins JM. Neonatal morbidity among infants of diabetic mothers. Diabetes Care 1978;1(6):340‐50. - PubMed
Solomon 1997
    1. Solomon CG, Willett WC, Carey VJ, Rich‐Edwards J, Hunter DJ, Colditz GA, et al. A prospective study of pregravid determinants of gestational diabetes mellitus. JAMA 1997;278(13):1078‐83. - PubMed
Streuling 2011
    1. Streuling I, Beyerlein A, Rosenfeld E, Hofmann H, Schulz T, Kries R. Physical activity and gestational weight gain: a meta‐analysis of intervention trials. British Journal of Obstetrics and Gynaecology 2011;118(3):278‐84. - PubMed
Whincup 2008
    1. Whincup PH, Kaye SJ, Owen CG, Huxley R, Cook DG, Anazawa S, et al. Birth weight and risk of type 2 diabetes: a systematic review. JAMA 2008;300(24):2886‐97. - PubMed
WOMBAT 2011
    1. Women and babies health and wellbeing: action through trials. http://www.wombatcollaboration.net/ (accessed 6 July 2011) 2011.
Yogev 2009
    1. Yogev Y, Visser GH. Obesity, gestational diabetes and pregnancy outcome. Seminars in Fetal and Neonatal Medicine 2009;14(2):77‐84. - PubMed
Zhang 2006
    1. Zhang C, Solomon CG, Manson JE, Hu FB. A prospective study of pregravid physical activity and sedentary behaviors in relation to the risk for gestational diabetes mellitus. Archives of Internal Medicine 2006;166(5):543‐8. - PubMed

Publication types