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Preventive effects of exercise on the occurence of gestational diabetes mellitus

Gestational diabetes mellitus (GDM) refers to impaired glucose tolerance of various degrees first manifested during pregnancy, is related to an increased risk of complications during pregnancy, during and after birth, and has longterm health consequences for mother and child. The principal goals of treatment are to optimize glycaemic control and improve pregnancy outcomes. The article provides an overview of findings on the preventive effects of exercise before and after pregnancy on the occurrence of GDM. In May 2012 Pubmed, OvidSP and ClinicalTrials.gov databases were searched for trials on the protective effects of exercise and physical activity on the occurrence of GDM. The effects of exercise before and during pregnancy on the prevention of GDM, and the parameters of glycaemic control, are described mainly in cohort studies and a small number of randomized controlled trials, with discrepant and contradictory results. Cohort studies relate higher levels of physical activity before and during early pregnancy to lower risk of developing GDM. Published randomized controlled trials have not succeeded in confirming the preventive effects of structured exercise programmes on the occurrence of GDM and insulin resistance decrease, partly due to small samples and methodological issues. Regular exercise before and during early pregnancy may have a more important role in the prevention of GDM than exercise during the second half of pregnancy, but producing more specific results calls for additional randomized controlled trials, especially for the high-risk population, as well as defining the optimal exercise intensity, type, duration and frequency.

pregnancy ; gestational diabetes mellitus ; exercise ; physical activity

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