Lifestyle interventions in pregnancy reduce gestational diabetes risk

Researchers at the University of Liverpool have led a study that has established that lifestyle interventions provide significant benefits in reducing the risk of gestational diabetes (GDM). The study, the largest to date, showed that physical activity-based interventions are the most effective.

Characterised by glucose intolerance first diagnosed in pregnancy, GDM poses substantial risks to mother and baby, including an increased risk of stillbirths, preterm births and preeclampsia. In the long term, it predisposes the mother and her offspring to obesity, type 2 diabetes and cardiovascular complications.

Robust evidence to guide recommendations on the preferred type of lifestyle intervention to prevent GDM has been lacking, despite its rising incidence worldwide. A team of global collaborators set out to address this.

A meta-analysis of 104 randomised trials on the effects of lifestyle interventions (physical activity, diet or mixed) in pregnancy, involving nearly 36,000 women, was conducted. It assessed whether such interventions prevent GDM, for whom they work best and which components provide the greatest benefit.

The study concluded that:

• Lifestyle interventions in pregnancy are likely to prevent GDM.
• Physical activity-based interventions, such as walking, aerobic and strength training, and swimming, were most effective.
• Interventions delivered in group formats and by newly trained providers enhanced effectiveness.

The effects did not vary across maternal characteristics like BMI, age and ethnicity, but varied by educational levels, where women from lower education backgrounds benefited less. The authors suggest that future interventions should focus on ways to prevent GDM in this high-risk group, and that tailored approaches are needed to address inequities in access and engagement.

The full study, published in The BMJ, can be read here.