Effectiveness Of Exercise Program On Glucose Control And Pregnancy Outcomes Of Gestational Diabetes Mellitus Women:a Meta Analysis

Objective:To evaluate the effectiveness of exercise program in improving glucose control and pregnancy outcomes for gestational diabetes mellitus women.Method:We searched the Cochrane Database of Systematic Reviews (2011)、JBI Database of Systematic Reviews、MEDLINE (1980～2011). EMbase (1980-2011)、 CINAHL (Cumulative Index to Nursing and Allied Health literature). CBMdisc (1980～2011)、CNKI (1980～2011) to collect randomized controlled trials (RCTs). The quality of RCTs was critically appraised and data were extracted by2reviewers independently. Meta-analyses were conducted for the eligible RCTs.Results:Four trials were included in the review. women were recruited during the third trimester and the intervention was performed for about six weeks. The programs generally consisted in exercising three times a week for20to45minutes. Four RCTS indicate that exercise could reduce the number of women who need insulin, however, when we made sensitive analysis by changing fix model to random model, there was no difference between exercise and other regimen in insulin use, which indicated that there existed clinical heterogeneity between these RCTS. We found significant difference between exercise and other regimen in Postprandial blood glucose but no difference in fasting blood glucose and gestational outcomes including incidence of macrosomia, incidence of cesarean section and neonatal weight. three RCTs discovered that there was no side effect during exercises, regardless of aerobic or resistance training.Conclusion:These RCTS had good quality, most of which were randomized grouped and with Allocation concealment, Intentional analysis. three of them were graded as B, one graded as A.Exercise has some effect on special GDM population:most of the population in all RCTS were in America and the Middle East, aged between15-45years old at24-34week of gestation and has no obstetrical complications and exercise contraindication. For these population, evidence indicating that exercise could reduce their Postprandial blood glucose, however, there was no sufficient evidence to recommend or advise against, GDM women enrolling in exercise programs reducing the insulin usage, fasting blood glucose, the incidence of macrosomia and cesarean section and neonatal body weight.Exercise intervention on GDM women in our country is insufficient, currently, good quality trials about exercise on GDM women are few, further randomized controlled trials, with with larger sample size, are needed.