A systematic review and meta-analysis, soon to be published, has confirmed the positive effects of prenatal exercise in reducing neonatal complications for women diagnosed with gestational diabetes mellitus (GDM). This comprehensive analysis, which combined results from 17 studies, aimed to assess how exercise during pregnancy influences adverse neonatal outcomes, including premature birth, macrosomia, cesarean deliveries, fetal growth restriction, and birth trauma.
The research team conducted an extensive search across multiple databases, including PubMed, EMBASE, the Cochrane Library, Web of Science, and Scopus, spanning from the databases’ inception to September 2023. After eliminating duplicates and screening abstracts, the team selected 107 studies for full-text evaluation, ultimately including 17 articles—four of which were sourced through manual searches. The final data included variables such as study design, geographic location, sample size, and specific intervention details, alongside the relevant outcomes.
The pooled results from the meta-analysis, utilizing random-effects models, revealed that prenatal exercise notably lowered the risk of several adverse neonatal outcomes in women with GDM. Specifically, the risk for cesarean delivery was reduced by 9% (OR = 0.91, 95% CI: 0.88-0.94), while the likelihood of premature birth was halved (OR = 0.49, 95% CI: 0.27-0.90). Additionally, the incidence of macrosomia was 42% lower (OR = 0.58, 95% CI: 0.40-0.83), fetal growth restriction was reduced by 79% (OR = 0.21, 95% CI: 0.08-0.52), and the risk of birth trauma dropped by 74% (OR = 0.26, 95% CI: 0.13-0.54).
Subgroup analyses suggested that single-component exercise programs were slightly more effective than multi-component programs in reducing macrosomia risk, though the difference was not statistically significant (P = 0.06).
The findings underscore the crucial role of prenatal exercise in improving fetal health and mitigating complications associated with GDM. As such, the study advocates for the incorporation of exercise as a routine component of prenatal care for women with GDM. The meta-analysis is registered with PROSPERO.
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