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Moderate exercise, dieting may reduce risk of C-section, gestational diabetes

Pearl Toh
28 Jul 2017

A healthy diet and regular exercise during pregnancy can limit gestational weight gain without adverse effects on offspring outcomes, along with reduced risks of caesarean section and gestational diabetes, according to a systematic review and meta-analysis by the i-WIP* Collaborative Group.

“Our findings are important because it is often thought that pregnant women shouldn’t exercise because it may harm the baby. But we show that the babies are not affected by physical activity or dieting,” said senior author Professor Shakila Thangaratinam from Barts Research Centre for Women’s Health at Queen Mary University of London, UK.

Pregnant women who received diet- and physical activity-based interventions gained an average of 0.7 kg less weight than those who did not undergo intervention (control group), and the difference between groups was significant after adjustment for baseline weight and clustering. [BMJ 2017;358:j3119]    

Women in the intervention group were also significantly less likely to undergo caesarean section compared with control (odds ratio [OR], 0.91, 95 percent confidence interval [CI], 0.83–0.99).

Evidence of benefit in terms of reduction in gestational diabetes risk was significant in particular among interventions based mainly on physical activity (OR, 0.67, 95 percent CI, 0.44–0.99), although the difference between groups was not statistically significant in the overall individual participant data meta-analysis comparing diet and exercise based interventions with routine care.

The results remained across subgroup analyses based on maternal baseline characteristics such as body mass index (BMI), age, parity, ethnicity, and medical comorbidities.

Also, no significant effect was observed with interventions during pregnancy on offspring outcomes, including stillbirth, small/large for gestational age foetus, and admission to a neonatal intensive care unit.

“Mothers should be reassured about the safety of the interventions, particularly on physical activity and structured exercise in pregnancy, by highlighting the benefits and lack of harm. This may improve engagement and compliance with the intervention,” advised Thangaratinam and co-authors. 

“This should be part of routine advice in pregnancy, given by practitioners as well as midwives. Now that we’re able to link the advice to why it’s beneficial for mothers-to-be, we hope mothers are more likely to adopt these lifestyle changes,” Thangaratinam added.

The meta-analysis included 36 trials comprising individual participant data of 12,526 pregnant women who were randomized to interventions based on diet and/or physical activity of moderate intensity or routine care.

“Often with interventions like these, certain groups benefit more than others, but we’ve shown that diet and physical activity have a beneficial effect across all groups, irrespective of your BMI, age or ethnicity; so these interventions have the potential to benefit a huge number of people,” said Thangaratinam. 

The long-term benefits of these interventions on mother and child need to be confirmed in large randomized trials to enable detailed recommendations to be made, according to the researchers. 

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Most Read Articles
6 days ago
Intravenous (IV) iron is less toxic and more effective compared to oral iron, making it a potential frontline therapy for neonatal iron deficiency anaemia, suggests a recent study.
Shilpa Kolhe, MBBS, MD, MRCOG; Shilpa Deb, MBBS, DGO, MRCOG, 01 Aug 2012

Dysmenorrhoea is a medical condition characterized by severe uterine pain during menstruation manifesting as cyclical lower abdominal or pelvic pain, which may also radiate to the back and thighs. The term dysmenorrhoea is derived from the Greek words ‘dys’ meaning difficult, painful or abnormal, ‘meno’ meaning month, and ‘rrhea’ meaning flow. It is commonly divided into primary dysmenorrhoea, where there is no coexistent pathology, and secondary dysmenorrhoea where there is an identifiable pathological condition known to contribute to painful menstruation. Symptoms of primary dysmenorrhoea begin a few hours before the start of menstruation and are often relieved during the first few days of bleeding. The initial onset of primary dysmenorrhoea is usually shortly after menarche (6–12 months), when ovulatory cycles are established. Secondary dysmenorrhoea can also occur at any time after menarche but is most commonly observed in women in their third and fourth decade of life in association with an existing condition.

02 Dec 2014
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