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Glucose responses to acute and chronic exercise during pregnancy: a systematic review and meta-analysis
  1. Margie H Davenport1,
  2. Frances Sobierajski1,
  3. Michelle F Mottola2,
  4. Rachel J Skow1,
  5. Victoria L Meah3,
  6. Veronica J Poitras4,
  7. Casey E Gray5,
  8. Alejandra Jaramillo Garcia4,
  9. Nick Barrowman6,
  10. Laurel Riske1,
  11. Marina James1,
  12. Taniya S Nagpal2,
  13. Andree-Anne Marchand7,
  14. Linda G Slater8,
  15. Kristi B Adamo9,
  16. Gregory A Davies10,
  17. Ruben Barakat11,
  18. Stephanie-May Ruchat12
  1. 1 Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children’s Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, 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 Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
  4. 4 Independent Researcher, Ottawa, Ontario, Canada
  5. 5 Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
  6. 6 Clinical Research Unit, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
  7. 7 Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
  8. 8 John W Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada
  9. 9 Faculty of Health Science, University of Ottawa, Ottawa, Ontario, Canada
  10. 10 Department of Obstetrics and Gynecology, Queen’s University, Kingston, Ontario, Canada
  11. 11 Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
  12. 12 Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
  1. Correspondence to Dr Margie H Davenport, Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta T6G 2E1, Canada; mdavenpo{at}ualberta.ca

Abstract

Objective To perform a systematic review and meta-analysis to explore the relationship between prenatal exercise and glycaemic control.

Design Systematic review with random-effects meta-analysis and meta-regression.

Data sources Online databases were searched up to 6 January 2017.

Study eligibility criteria Studies of all designs were included (except case studies and reviews) if they were published in English, Spanish or French, and contained information on the population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of acute or chronic exercise, alone (‘exercise-only’) or in combination with other intervention components (eg, dietary; ‘exercise+cointervention’) at any stage of pregnancy), comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and outcome (glycaemic control).

Results A total of 58 studies (n=8699) were included. There was ‘very low’ quality evidence showing that an acute bout of exercise was associated with a decrease in maternal blood glucose from before to during exercise (6 studies, n=123; mean difference (MD) −0.94 mmol/L, 95% CI −1.18 to −0.70, I2=41%) and following exercise (n=333; MD −0.57 mmol/L, 95% CI −0.72 to −0.41, I2=72%). Subgroup analysis showed that there were larger decreases in blood glucose following acute exercise in women with diabetes (n=26; MD −1.42, 95% CI −1.69 to −1.16, I2=8%) compared with those without diabetes (n=285; MD −0.46, 95% CI −0.60 to −0.32, I2=62%). Finally, chronic exercise-only interventions reduced fasting blood glucose compared with no exercise postintervention in women with diabetes (2 studies, n=70; MD −2.76, 95% CI −3.18 to −2.34, I2=52%; ‘low’ quality of evidence), but not in those without diabetes (9 studies, n=2174; MD −0.05, 95% CI −0.16 to 0.05, I2=79%).

Conclusion Acute and chronic prenatal exercise reduced maternal circulating blood glucose concentrations, with a larger effect in women with diabetes.

  • exercise
  • pregnancy
  • glucose

https://doi.org/10.1136/bjsports-2018-099829

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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, RJS, VLM, LR, MJ, TSN, A-AM completed the acquisition of data. FS, MHD, NB performed the data analysis. All authors assisted with the interpretation. FS, 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 The study is funded by a Canadian Institutes of Health Research Knowledge Synthesis Grant (140995). 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 (0033140). RJS is funded by a Canadian Institutes of Health Research Doctoral Research Award (146252). A-AM is funded by a Fonds de Recherche du Québec - Santé Doctoral Research Award (34399).

    • Competing interests None declared.

    • Patient consent Not required.

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