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Effectiveness of exercise interventions in the prevention of excessive gestational weight gain and postpartum weight retention: a systematic review and meta-analysis
  1. Stephanie-May Ruchat1,
  2. Michelle F Mottola2,
  3. Rachel J Skow3,
  4. Taniya S Nagpal,
  5. Victoria L Meah4,
  6. Marina James3,
  7. Laurel Riske3,
  8. Frances Sobierajski3,
  9. Amariah J Kathol3,
  10. Andree-Anne Marchand5,
  11. Megan Nuspl6,
  12. Ashley Weeks7,
  13. Casey E Gray8,
  14. Veronica J Poitras9,
  15. Alejandra Jaramillo Garcia9,
  16. Nick Barrowman10,
  17. Linda G Slater11,
  18. Kristi B Adamo12,
  19. Gregory A Davies13,
  20. Ruben Barakat14,
  21. Margie H Davenport3
  1. 1 Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
  2. 2 R Samuel McLaughlin Foundation - Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Children’s Health Research Institute, The University of Western Ontario, London, Ontario, Canada
  3. 3 Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport, and Recreation, Women and Children’s Health Research Institute, Alberta Diabetes InstituteUniversity of Alberta, Edmonton, Alberta, Canada
  4. 4 Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
  5. 5 Department of Anatomy, Universite du Quebec a Trois-Rivieres, Trois-Rivieres, Quebec, Canada
  6. 6 Alberta Research Centre for Health Evidence, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
  7. 7 School of Interdisciplinary Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
  8. 8 Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
  9. 9 Independent Researcher, Ottawa, Ontario, Canada
  10. 10 Clinical Research Unit, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
  11. 11 John W Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada
  12. 12 School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
  13. 13 Department of Obstetrics and Gynecology, Queen’s University, Kingston, Ontario, Canada
  14. 14 Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
  1. Correspondence to Dr Margie H Davenport, Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport, and Recreation, Women and Children’s Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada; mdavenpo{at}ualberta.ca

Abstract

Objective Gestational weight gain (GWG) has been identified as a critical modifier of maternal and fetal health. This systematic review and meta-analysis aimed to examine the relationship between prenatal exercise, GWG and postpartum weight retention (PPWR).

Design Systematic review with random effects meta-analysis and meta-regression. Online databases were searched up to 6 January 2017.

Study eligibility criteria Studies of all designs in English, Spanish or French were eligible (except case studies and reviews) if they contained information on the population (pregnant women without contraindication to exercise), intervention (frequency, intensity, duration, volume or type of exercise, alone [“exercise-only”] or in combination with other intervention components [eg, dietary; “exercise + co-intervention”]), comparator (no exercise or different frequency, intensity, duration, volume or type of exercise) and outcomes (GWG, excessive GWG (EGWG), inadequate GWG (IGWG) or PPWR).

Results Eighty-four unique studies (n=21 530) were included. ‘Low’ to ‘moderate’ quality evidence from randomised controlled trials (RCTs) showed that exercise-only interventions decreased total GWG (n=5819; −0.9 kg, 95% CI −1.23 to –0.57 kg, I2=52%) and PPWR (n=420; −0.92 kg, 95% CI −1.84 to 0.00 kg, I2=0%) and reduced the odds of EGWG (n=3519; OR 0.68, 95% CI 0.57 to 0.80, I2=12%) compared with no exercise. ‘High’ quality evidence indicated higher odds of IGWG with prenatal exercise-only (n=1628; OR 1.32, 95% CI 1.04 to 1.67, I2=0%) compared with no exercise.

Conclusions Prenatal exercise reduced the odds of EGWG and PPWR but increased the risk of IGWG. However, the latter result should be interpreted with caution because it was based on a limited number of studies (five RCTs).

  • pregnancy
  • body weight regulation
  • exercise

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Footnotes

  • Contributors MHD, S-MR, MFM, GAD, KBA contributed to the conception of the study. MHD, S-MR, MFM, GAD, KBA, AJG, NB, VJP, CEG, LGS, RB contributed to the design of the study and development of the search strategy. LGS conducted the systematic search. FS, MJ, VM, RS, LR, MN, TSN, AW, AJK, AAM completed the acquisition of data. MHD, NB, MN performed the data analysis. All authors assisted with the interpretation. S-MR and MHD were the principal writers of the manuscript. All authors contributed to the drafting and revision of the final article. All authors approved the final submitted version of the manuscript.

  • Funding This project was funded by a Canadian Institute of Health Research Knowledge Synthesis Grant. MHD is funded by an Advancing Women’s Heart Health Initiative New Investigator Award supported by Health Canada and the Heart and Stroke Foundation of Canada. A-AM is funded by a Fonds de Recherche du Québec–Santé Doctoral Research Award. RS is funded by a Canadian Institutes for Health Research Doctoral Research Award.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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