Pre-pregnancy diet and physical activity interventions for prevention of gestational diabetes mellitus: a systematic review and meta-analysis — ASN Events
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  2. Session 1: Antenatal and Technology
  3. Pre-pregnancy diet and physical activity interventions for prevention of gestational diabetes mellitus: a systematic review and meta-analysis

Pre-pregnancy diet and physical activity interventions for prevention of gestational diabetes mellitus: a systematic review and meta-analysis (#9)

Amanda J Poprzeczny 1 2 , Megan Mitchell 1 2 , Nahal Habibi 1 2 , Tin Oi Cheung 1 2 , Jessica A Grieger 1 2
  1. Women's and Children's Hospital, North Adelaide, SOUTH AUSTRALIA, Australia
  2. Robinson Research Institute, Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, South Australia, Australia

Importance

Gestational diabetes mellitus (GDM) is associated with short- and long-term adverse health outcomes for women and their infants. Antenatal diet and/or physical activity interventions have not been effective at preventing GDM.  Currently, it is not clear whether intervening similarly prior to pregnancy will be more beneficial.

Objectives

To evaluate the impact of pre-pregnancy diet and/or physical activity interventions on rates of GDM, and other maternal and infant health outcomes.

Data Sources

A systematic literature search of the online databases Embase, Pubmed, Cochrane Central Register of Controlled Trials, Ovid MEDLINE, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) was conducted from inception to 7 February, 2023.

Study selection

All randomized controlled trials comparing pre-pregnancy diet and/or physical activity interventions with standard care or control.

Data extraction and synthesis

Data were extracted by two reviewers independently and meta-analysis was performed using random-effects models to calculate summary effect estimates and 95% confidence intervals.

Main outcomes and measures

The primary outcome was GDM. Secondary maternal outcomes included mean weight change over the intervention, gestational weight gain, hypertensive disorders of pregnancy, preterm birth, cesarean birth, postpartum haemorrhage. Secondary infant outcomes were mean birthweight, large- and small-for gestational-age, and need for admission to the neonatal intensive care unit. Longer term maternal and child health outcomes included maternal type 2 diabetes mellitus and hypertension, and childhood obesity.

Results

A total of five randomized trials assessing pre-pregnancy diet and/or physical activity interventions (involving 1924 women) were included. Pre-pregnancy diet and/or physical activity interventions were not associated with a significant difference in rates of GDM (two studies; 214 women; RR 1.19, 95% CI 0.81, 1.75). There were no significant differences in any of the secondary maternal or infant outcomes reported. None of the included studies reported longer term maternal or child health outcomes. There was significant heterogeneity between studies with regards type, duration and intensity of the pre-pregnancy diet and/or physical activity interventions.

Conclusions and relevance

We found no evidence that pre-pregnancy diet and/or physical activity interventions reduced the risk for GDM, or any other adverse maternal and infant outcomes.

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