title: Does dose matter in reducing gestational weight gain in exercise interventions? A systematic review of literature.
abstract: OBJECTIVE
  The purpose of this review was to examine the relationship between exercise dose and reductions in weight gain during pregnancy in exercise interventions.
  
  
  METHODS
  Systematic literature review.
  
  
  METHODS
  Four electronic research databases (PubMed, Web of Science, CINAHL, and Academic Search Premiere) were used to identify exercise interventions conducted with pregnant women. Eligible articles must have satisfied the following criteria: inclusion of a control condition, exercise as a major intervention component, weight gain measured and reported for each experimental condition, description of exercise dose (frequency, intensity and duration), and utilized an adequate number of control conditions to assess independent effects of exercise on weight gain.
  
  
  RESULTS
  The literature search identified 4837 articles. Of these, 174 abstracts were screened and 21 intervention studies (18 exercise-only, 3 exercise/diet) were eligible for review. Only 38% of the interventions achieved statistically significant reductions in gestational weight gain. Successful interventions possessed higher adherence and lower attrition rates and were predominantly conducted among normal weight populations. No clear patterns or consistencies of exercise dose and reductions in weight gain were evident.
  
  
  CONCLUSIONS
  An exercise dose associated with reductions in weight gain was unquantifiable among these interventions. Adherence and retention rates were strong contributors to the success of exercise interventions on gestational weight gain. It is strongly suggested that future researchers investigate methods to increase adherence and compliance, especially among overweight and obese women, and utilize objective measurement tools to accurately evaluate exercise dose performed by the participants and the impact on body composition and weight gain.
authors.affiliation: Department of Exercise Science, Arnold School of Public Health, University of South Carolina, United States. Electronic address: mcdona84@email.sc.edu.
authors.forename: Samantha M
authors.initials: SM
authors.lastname: McDonald
authors.affiliation: Department of Epidemiology and Biostatistics, University of South Carolina, United States.
authors.forename: Jihong
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Exercise Science, Arnold School of Public Health, University of South Carolina, United States.
authors.forename: Sara
authors.initials: S
authors.lastname: Wilcox
authors.affiliation: Department of Exercise Science, Arnold School of Public Health, University of South Carolina, United States.
authors.forename: Erica Y
authors.initials: EY
authors.lastname: Lau
authors.affiliation: Office of Energetics, Nutrition Obesity Research Center, University of Alabama, United States.
authors.forename: Edward
authors.initials: E
authors.lastname: Archer
mesh_terms: D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D011247:Pregnancy / Q000502:physiology*; D016032:Randomized Controlled Trials as Topic; D015430:Weight Gain / Q000502:physiology*
keywords: Obesity; Physical activity; Pregnancy; Programs
references.citation: Ann Intern Med. 2009 Aug 18;151(4):264-9, W64
references.pmid: 19622511
references.citation: BMJ. 2012 May 16;344:e2088
references.pmid: 22596383
references.citation: Appl Physiol Nutr Metab. 2008 Jun;33(3):511-7
references.pmid: 18461104
references.citation: Metabolism. 1994 Jul;43(7):814-8
references.pmid: 8028502
references.citation: Hepatology. 2009 Oct;50(4):1105-12
references.pmid: 19637289
references.citation: Am J Obstet Gynecol. 1983 Mar 15;145(6):702-7
references.pmid: 6829657
references.citation: Am J Obstet Gynecol. 1998 Feb;178(2):280-6
references.pmid: 9500487
references.citation: Am J Obstet Gynecol. 2000 Dec;183(6):1484-8
references.pmid: 11120515
references.citation: BJOG. 2012 Aug;119(9):1098-107
references.pmid: 22616913
references.citation: Acta Diabetol. 2010 Mar;47(1):15-22
references.pmid: 19495557
references.citation: Am J Prev Med. 2008 Jun;34(6):523-8
references.pmid: 18471590
references.citation: PLoS One. 2013;8(2):e56620
references.pmid: 23437187
references.citation: BJOG. 2011 Feb;118(3):278-84
references.pmid: 21134106
references.citation: Int J Obes (Lond). 2009 Sep;33(9):1048-57
references.pmid: 19636320
references.citation: Diabetes. 1991 Dec;40 Suppl 2:182-5
references.pmid: 1748256
references.citation: J Am Coll Nutr. 1997 Feb;16(1):68-73
references.pmid: 9013436
references.citation: Med Sci Sports Exerc. 2012 Aug;44(8):1419-26
references.pmid: 22453250
references.citation: Obstet Gynecol. 2005 Aug;106(2):243-9
references.pmid: 16055571
references.citation: Int J Gynaecol Obstet. 2005 Mar;88(3):271-5
references.pmid: 15733880
references.citation: Med Sci Sports Exerc. 2012 Dec;44(12):2263-9
references.pmid: 22843114
references.citation: Clin Obstet Gynecol. 2003 Jun;46(2):488-95
references.pmid: 12808398
references.citation: Med Sci Sports Exerc. 2008 Nov;40(11):1863-72
references.pmid: 18845966
references.citation: Am J Clin Nutr. 2010 Oct;92(4):678-87
references.pmid: 20668049
references.citation: Res Nurs Health. 2009 Aug;32(4):379-90
references.pmid: 19415672
references.citation: Reprod Health. 2009 Jan 06;6:1
references.pmid: 19126239
references.citation: BJOG. 2011 Nov;118(12):1455-63
references.pmid: 21895947
references.citation: Mayo Clin Proc. 2013 Dec;88(12):1398-407
references.pmid: 24290113
references.citation: Paediatr Perinat Epidemiol. 2012 Mar;26(2):109-16
references.pmid: 22324496
references.citation: Diabetes Metab. 2009 Nov;35(5):418-21
references.pmid: 19747869
references.citation: Sports Med. 2007;37(9):737-63
references.pmid: 17722947
references.citation: Mayo Clin Proc. 2013 Dec;88(12):1388-97
references.pmid: 24290112
references.citation: J Reprod Med. 2000 Apr;45(4):293-8
references.pmid: 10804484
references.citation: Am J Health Promot. 2014 Sep-Oct;29(1):2-8
references.pmid: 24200335
references.citation: Obes Rev. 2000 Oct;1(2):95-111
references.pmid: 12119991
references.citation: Public Health Rep. 1985 Mar-Apr;100(2):126-31
references.pmid: 3920711
references.citation: Am J Obstet Gynecol. 1979 Sep 1;135(1):3-9
references.pmid: 474659
references.citation: Br J Sports Med. 2003 Feb;37(1):6-12; discussion 12
references.pmid: 12547738
references.citation: Eur J Appl Physiol. 2008 Aug;103(6):707-17
references.pmid: 18496708
references.citation: Int J Gynaecol Obstet. 2010 Apr;109(1):41-4
references.pmid: 20018282
references.citation: Pediatrics. 2003 May;111(5 Pt 2):1181-5
references.pmid: 12728135
references.citation: Acta Obstet Gynecol Scand. 2008;87(4):423-9
references.pmid: 18382868
references.citation: Am J Obstet Gynecol. 2006 May;194(5):e32-4
references.pmid: 16647894
references.citation: Eur J Contracept Reprod Health Care. 2011 Apr;16(2):116-25
references.pmid: 21417561
references.citation: J Clin Endocrinol Metab. 2010 May;95(5):2080-8
references.pmid: 20335449
references.citation: Am J Obstet Gynecol. 2002 Jan;186(1):142-7
references.pmid: 11810100
references.citation: Prog Cardiovasc Dis. 2011 May-Jun;53(6):412-8
references.pmid: 21545927
references.citation: Am J Obstet Gynecol. 1992 Nov;167(5):1344-52
references.pmid: 1442988
references.citation: Obes Rev. 2011 Jul;12(7):e602-20
references.pmid: 21521451
references.citation: J Appl Physiol (1985). 2011 Oct;111(4):1201-10
references.pmid: 21836047
references.citation: Reproduction. 2010 Sep;140(3):387-98
references.pmid: 20562299
references.citation: Obstet Gynecol. 2010 Mar;115(3):597-604
references.pmid: 20177292
references.citation: N Engl J Med. 1995 Mar 9;332(10):621-8
references.pmid: 7632212
references.citation: Cochrane Database Syst Rev. 2002;(2):CD000180
references.pmid: 12076383
references.citation: Obstet Gynecol. 2002 Aug;100(2):245-52
references.pmid: 12151145
references.citation: Prev Med. 2013 Jun;56(6):351-64
references.pmid: 23480971
references.citation: Med Sci Sports Exerc. 2000 Jan;32(1):58-62
references.pmid: 10647530
references.citation: Mayo Clin Proc. 2013 Dec;88(12):1368-77
references.pmid: 24290110