title: Influence of exercise intervention on gestational diabetes mellitus: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Exercise intervention might be a promising approach to prevent gestational diabetes mellitus. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the effect of exercise intervention on gestational diabetes mellitus.
  
  
  METHODS
  PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of exercise intervention on gestational diabetes mellitus were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was the incidence of gestational diabetes mellitus, preterm birth, and gestational age at birth. Meta-analysis was performed using random-effect model.
  
  
  RESULTS
  Five RCTs involving 1872 patients were included in the meta-analysis. Overall, compared with control intervention, exercise intervention was found to significantly reduce the risk of gestational diabetes mellitus (std. mean difference 0.62; 95% CI 0.43-0.89; P = 0.01), but demonstrated no influence on preterm birth (OR 0.93; 95% CI 0.44-1.99; P = 0.86), gestational age at birth (std. mean difference -0.03; 95% CI -0.12 to 0.07; P = 0.60), glucose 2-h post-OGTT (std. mean difference -1.02; 95% CI -2.75 to 0.71; P = 0.25), birth weight (std. mean difference -0.10; 95% CI -0.25 to 0.04; P = 0.16), Apgar score less than 7 (OR 0.78; 95% CI 0.21-2.91; P = 0.71), and preeclampsia (OR 1.05; 95% CI 0.53-2.07; P = 0.88).
  
  
  CONCLUSIONS
  Compared to control intervention, exercise intervention was found to significantly reduce the incidence of gestational diabetes mellitus, but had no significant influence on preterm birth, gestational age at birth, glucose 2-h post-OGTT, birth weight, Apgar score less than 7, and preeclampsia.
authors.affiliation: Department of Endocrinology, Chongqing People's Hospital, Chongqing, China.
authors.forename: J
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Department of Endocrinology, Chongqing People's Hospital, Chongqing, China.
authors.forename: H
authors.initials: H
authors.lastname: Wang
authors.affiliation: Digestive Department, Chongqing People's Hospital, Chongqing, China. renmengjun6@163.com.
authors.forename: M
authors.initials: M
authors.lastname: Ren
mesh_terms: D016640:Diabetes, Gestational / Q000453:epidemiology / Q000517:prevention & control*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D011247:Pregnancy
keywords: Exercise intervention; Gestational diabetes mellitus; Meta-analysis; Randomized controlled trials (RCTs); Systematic review