title: Lifestyle intervention can reduce the risk of gestational diabetes: a meta-analysis of randomized controlled trials.
abstract: This study aimed to examine the effect of lifestyle intervention on the risk of gestational diabetes mellitus (GDM). We searched PubMed, Springer and other databases to retrieve articles published in English and Chinese up to 30 September 2015. The inclusion criteria were randomized controlled trials evaluating the effects of lifestyle intervention on risk of GDM. Exclusion criteria were studies with prepregnancy diabetes mellitus or interventions with nutrient supplements. Random-effect and fixed-effect model analyses were used to obtain pooled relative risks and 95% confidence intervals (CIs) of diet and physical activity on the risk of GDM. Subgroup analyses were performed to check the consistency of effect sizes across groups where appropriate. We identified 29 randomized controlled trials with 11,487 pregnant women, addressing the effect of lifestyle intervention on the risk of GDM. In the pooled analysis, either diet or physical activity resulted in an 18% (95%CI 5-30%) reduction in the risk of GDM (P = 0.0091). Subgroup analysis showed that such intervention was effective among women with intervention before the 15th gestational week (relative risk: 0.80, 95%CI 0.66-0.97), but not among women receiving the intervention afterwards. We conclude that lifestyle modification during pregnancy, especially before the 15th gestational week, can reduce the risk of GDM. © 2016 World Obesity.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.|Center for Disease Control and Prevention of Tianjin Economic-Technological Development Area, TEDA, Tianjin, China.
authors.forename: C
authors.initials: C
authors.lastname: Song
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.|Tianjin Women and Children's Health Centre, Tianjin, China.
authors.forename: J
authors.initials: J
authors.lastname: Leng
authors.affiliation: Department of Medicine and Therapeutics, Prince of Wales Hospital, and the Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: R C
authors.initials: RC
authors.lastname: Ma
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China. yangxilin@tmu.edu.cn, yxl@hotmail.com.
authors.forename: X
authors.identifier: 0000-0002-9462-7992
authors.initials: X
authors.lastname: Yang
mesh_terms: D016640:Diabetes, Gestational / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D004032:Diet; D015444:Exercise; D005260:Female; D006266:Health Education; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000628:therapy; D010349:Patient Compliance; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods; D011322:Primary Prevention / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D040242:Risk Reduction Behavior
keywords: gestational diabetes; lifestyle intervention; obesity; overweight