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Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Meta-Analysis

Impact of Physical Activity on Gestational Weight Gain in Overweight and Obese Pregnant Women: A Meta-Analysis

Author(s): Vandana Rani*, Sivachidambaram Kulandaivelan, Rekha Chaturvedi and Ravinder Yadav

Volume 18, Issue 2, 2022

Published on: 10 March, 2021

Article ID: e241221192202 Pages: 14

DOI: 10.2174/1573404817666210310163107

Price: $65

Abstract

Background: Regular physical activity and exercises play an important role in a healthy pregnancy in overweight and obese women.

Objective: To investigate the effect of exercise parameters (frequency, duration and intensity) and Physical Activity (PA) on maternal Gestational Weight Gain (GWG) in overweight and obese pregnant women.

Methods: PubMed and Cochrane database were used to locate the literature; randomized controlled trials comparing PA with standard care on combined overweight and obese pregnant women, published in English language from January 2011 to March 2020 were selected. PA interventions, including walking, aerobic and resistance exercise either alone or in combination compared with standard care during pregnancy in overweight and obese pregnant women were screened. Mean Difference (MD) with 95% Confidence Interval (CI) between the intervention and standard care for GWG was calculated.

Results: Twelve studies with 1667 pregnant women were included. The result showed a statistically significant reduction of GWG in the PA group as compared to the standard care (MD=0.99 kg, P<0.00001 & I2 =25%). Overweight and obese pregnant women who performed exercises for the duration of 45-60 minutes/session (MD=1.01 kg, P=0.0008 and I2 =61%), a frequency of 3 times/week (MD=1.19 kg, P=0.0002 and I2 =58%) and light to moderate intensity (MD=1.37 kg, P<0.0001 & I2 =62%), reported good weight control during pregnancy as compared with standard care group.

Conclusion: There was a statistically significant reduction in GWG in overweight and obese pregnant women. Owing to the promising results shown by exercise intervention and PA in maternal weight control, these interventions should be used as a tool for managing weight gain during pregnancy as routine care.

Keywords: GWG, walking, pedometer, aerobics, resistance training, exercises.

Graphical Abstract
[1]
Hui A, Back L, Ludwig S, et al. Lifestyle intervention on diet and exercise reduced excessive gestational weight gain in pregnant women under a randomised controlled trial. BJOG 2012; 119(1): 70-7.
[http://dx.doi.org/10.1111/j.1471-0528.2011.03184.x] [PMID: 22017967]
[2]
Ravussin E, Valencia ME, Esparza J, Bennett PH, Schulz LO. Effects of a traditional lifestyle on obesity in Pima Indians. Diabetes Care 1994; 17(9): 1067-74.
[http://dx.doi.org/10.2337/diacare.17.9.1067] [PMID: 7988310]
[3]
Dodd JM, Cramp C, Sui Z, et al. The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on maternal diet and physical activity: the LIMIT randomised trial. BMC Med 2014; 12: 161.
[http://dx.doi.org/10.1186/s12916-014-0161-y] [PMID: 25315237]
[4]
Petrella E, Malavolti M, Bertarini V, et al. Gestational weight gain in overweight and obese women enrolled in a healthy lifestyle and eating habits program. J Matern Fetal Neonatal Med 2014; 27(13): 1348-52.
[http://dx.doi.org/10.3109/14767058.2013.858318] [PMID: 24175912]
[5]
Eddouks M, Hebi M, Ajebli M. Medicinal plants and gyneco-obstetric disorders among women in the south east of Morocco. Curr Womens Health Rev 2020; 16(1): 2-17.
[http://dx.doi.org/10.2174/1573404815666191206112518]
[6]
Harrison CL, Thompson RG, Teede HJ, Lombard CB. Measuring physical activity during pregnancy. Int J Behav Nutr Phys Act 2011; 8: 19.
[http://dx.doi.org/10.1186/1479-5868-8-19] [PMID: 21418609]
[7]
Solomon CG, Willett WC, Carey VJ, et al. A prospective study of pregravid determinants of gestational diabetes mellitus. JAMA 1997; 278(13): 1078-83.
[http://dx.doi.org/10.1001/jama.1997.03550130052036] [PMID: 9315766]
[8]
Dempsey JC, Butler CL, Sorensen TK, et al. A case-control study of maternal recreational physical activity and risk of gestational diabetes mellitus. Diabetes Res Clin Pract 2004; 66(2): 203-15.
[http://dx.doi.org/10.1016/j.diabres.2004.03.010] [PMID: 15533588]
[9]
Dempsey JC, Sorensen TK, Williams MA, et al. Prospective study of gestational diabetes mellitus risk in relation to maternal recreational physical activity before and during pregnancy. Am J Epidemiol 2004; 159(7): 663-70.
[http://dx.doi.org/10.1093/aje/kwh091] [PMID: 15033644]
[10]
Clapp JF III, Little KD. Effect of recreational exercise on pregnancy weight gain and subcutaneous fat deposition. Med Sci Sports Exerc 1995; 27(2): 170-7.
[http://dx.doi.org/10.1249/00005768-199502000-00004] [PMID: 7723638]
[11]
Kong KL, Campbell CG, Foster RC, Peterson AD, Lanningham- Foster L. A pilot walking program promotes moderate-intensity physical activity during pregnancy. Med Sci Sports Exerc 2014; 46(3): 462-71.
[http://dx.doi.org/10.1249/MSS.0000000000000141] [PMID: 24002348]
[12]
Gradmark A, Pomeroy J, Renström F, et al. Physical activity, sedentary behaviors, and estimated insulin sensitivity and secretion in pregnant and non-pregnant women. BMC Pregnancy Childbirth 2011; 11: 44.
[http://dx.doi.org/10.1186/1471-2393-11-44] [PMID: 21679399]
[13]
Artal R. Exercise in Pregnancy: Guidelines. Clin Obstet Gynecol 2016; 59(3): 639-44.
[http://dx.doi.org/10.1097/GRF.0000000000000223] [PMID: 27398880]
[14]
Bacchi E, Bonin C, Zanolin ME, et al. Physical activity patterns in normal-weight and overweight/obese pregnant women. PLoS One 2016; 11(11): e0166254.
[http://dx.doi.org/10.1371/journal.pone.0166254] [PMID: 27829017]
[15]
Walsh JM, McGowan C, Byrne J, McAuliffe FM. Prevalence of physical activity among healthy pregnant women in Ireland. Int J Gynaecol Obstet 2011; 114(2): 154-5.
[http://dx.doi.org/10.1016/j.ijgo.2011.02.016] [PMID: 21683951]
[16]
Evenson KR, Wen F. National trends in self-reported physical activity and sedentary behaviors among pregnant women: NHANES 1999-2006. Prev Med 2010; 50(3): 123-8.
[http://dx.doi.org/10.1016/j.ypmed.2009.12.015] [PMID: 20053370]
[17]
Olson CM, Strawderman MS. Modifiable behavioral factors in a biopsychosocial model predict inadequate and excessive gestational weight gain. J Am Diet Assoc 2003; 103(1): 48-54.
[http://dx.doi.org/10.1053/jada.2003.50001] [PMID: 12525793]
[18]
Haakstad LAH, Voldner N, Henriksen T, Bø K. Physical activity level and weight gain in a cohort of pregnant Norwegian women. Acta Obstet Gynecol Scand 2007; 86(5): 559-64.
[http://dx.doi.org/10.1080/00016340601185301] [PMID: 17464584]
[19]
Stuebe AM, Oken E, Gillman MW. Associations of diet and physical activity during pregnancy with risk for excessive gestational weight gain. Am J Obstet Gynecol 2009; 201(1): 58.e1-8.
[http://dx.doi.org/10.1016/j.ajog.2009.02.025] [PMID: 19467640]
[20]
Evenson KR, Barakat R, Brown WJ, et al. Guidelines for physical activity during pregnancy: comparisons from around the world. Am J Lifestyle Med 2014; 8(2): 102-21.
[http://dx.doi.org/10.1177/1559827613498204] [PMID: 25346651]
[21]
U.S. Department of Health and Human Services. Physical activity guidelines advisory committee report, 2008. To the secretary of health and human services. Part A: Executive summary. Nutr Rev 2009; 67(2): 114-20.
[PMID: 19178654]
[22]
Dekker Nitert M, Barrett HL, Denny KJ, McIntyre HD, Callaway LK. Exercise in pregnancy does not alter gestational weight gain, MCP-1 or leptin in obese women. Aust N Z J Obstet Gynaecol 2015; 55(1): 27-33.
[http://dx.doi.org/10.1111/ajo.12300] [PMID: 25688817]
[23]
Garnæs KK, Mørkved S, Salvesen Ø, Moholdt T. Exercise training and weight gain in obese pregnant women: A randomized controlled trial (ETIP Trial). PLoS Med 2016; 13(7): e1002079.
[http://dx.doi.org/10.1371/journal.pmed.1002079] [PMID: 27459375]
[24]
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 2009; 151(4): 264-269, W64.
[http://dx.doi.org/10.7326/0003-4819-151-4-200908180-00135] [PMID: 19622511]
[25]
Garvey WT, Mechanick JI, Brett EM, et al. American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesity. Endocr Pract 2016; 22(Suppl. 3): 1-203.
[http://dx.doi.org/10.4158/EP161365.GL] [PMID: 27219496]
[26]
World Health Organization; Report of a WHO Consultation on Obesity. Obesity: Preventing and managing the global epidemic 1998.
[27]
Maher CG, Sherrington C, Herbert RD, Moseley AM, Elkins M. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther 2003; 83(8): 713-21.
[http://dx.doi.org/10.1093/ptj/83.8.713] [PMID: 12882612]
[28]
Higgins JPT, Altman DG, Sterne JAC. Assessing risk of bias in included studies. Cochrane Handbook for Systematic Reviews of Interventions version 520 2017. Available from: www.training.cochrane.org/handbook
[29]
Higgins JPT, Thomas J, Chandler J, et al. Cochrane handbook for systematic reviews of interventions version 61 2020. Available from: www.training.cochrane.org/handbook
[30]
Simmons D, Devlieger R, van Assche A, et al. Effect of physical activity and/or healthy eating on GDM risk: the DALI lifestyle study. J Clin Endocrinol Metab 2017; 102(3): 903-13.
[PMID: 27935767]
[31]
Bisson M, Alméras N, Dufresne SS, et al. A 12-week exercise program for pregnant women with obesity to improve physical activity levels: an open randomised preliminary study. PLoS One 2015; 10(9): e0137742.
[http://dx.doi.org/10.1371/journal.pone.0137742] [PMID: 26375471]
[32]
Daly N, Farren M, McKeating A, OʼKelly R, Stapleton M, Turner MJ. A medically supervised pregnancy exercise intervention in obese women: a randomized controlled trial. Obstet Gynecol 2017; 130(5): 1001-10.
[http://dx.doi.org/10.1097/AOG.0000000000002267] [PMID: 29016485]
[33]
Nascimento SL, Surita FG, Parpinelli MA, Siani S, Pinto e Silva JL. The effect of an antenatal physical exercise programme on maternal/perinatal outcomes and quality of life in overweight and obese pregnant women: a randomised clinical trial. BJOG 2011; 118(12): 1455-63.
[http://dx.doi.org/10.1111/j.1471-0528.2011.03084.x] [PMID: 21895947]
[34]
Oostdam N, van Poppel MN, Wouters MG, et al. No effect of the FitFor2 exercise programme on blood glucose, insulin sensitivity, and birthweight in pregnant women who were overweight and at risk for gestational diabetes: results of a randomised controlled trial. BJOG 2012; 119(9): 1098-107.
[http://dx.doi.org/10.1111/j.1471-0528.2012.03366.x] [PMID: 22616913]
[35]
Seneviratne SN, Jiang Y, Derraik J, et al. Effects of antenatal exercise in overweight and obese pregnant women on maternal and perinatal outcomes: a randomised controlled trial. BJOG 2016; 123(4): 588-97.
[http://dx.doi.org/10.1111/1471-0528.13738] [PMID: 26542419]
[36]
Renault KM, Nørgaard K, Nilas L, et al. The Treatment of Obese Pregnant Women (TOP) study: a randomized controlled trial of the effect of physical activity intervention assessed by pedometer with or without dietary intervention in obese pregnant women. Am J Obstet Gynecol 2014; 210(2): 134.e1-9.
[http://dx.doi.org/10.1016/j.ajog.2013.09.029] [PMID: 24060449]
[37]
Ruiz JR, Perales M, Pelaez M, Lopez C, Lucia A, Barakat R. Supervised exercise-based intervention to prevent excessive gestational weight gain: a randomized controlled trial. Mayo Clin Proc 2013; 88(12): 1388-97.
[http://dx.doi.org/10.1016/j.mayocp.2013.07.020] [PMID: 24290112]
[38]
Wang C, Wei Y, Zhang X, et al. A randomized clinical trial of exercise during pregnancy to prevent gestational diabetes mellitus and improve pregnancy outcome in overweight and obese pregnant women. Am J Obstet Gynecol 2017; 216(4): 340-51.
[http://dx.doi.org/10.1016/j.ajog.2017.01.037] [PMID: 28161306]
[39]
Du M-C, Ouyang Y-Q, Nie X-F, Huang Y, Redding SR. Effects of physical exercise during pregnancy on maternal and infant outcomes in overweight and obese pregnant women: A meta-analysis. Birth 2019; 46(2): 211-21.
[http://dx.doi.org/10.1111/birt.12396] [PMID: 30240042]
[40]
Sui Z, Grivell RM, Dodd JM. Antenatal exercise to improve outcomes in overweight or obese women: A systematic review. Acta Obstet Gynecol Scand 2012; 91(5): 538-45.
[http://dx.doi.org/10.1111/j.1600-0412.2012.01357.x] [PMID: 22229625]
[41]
Streuling I, Beyerlein A, Rosenfeld E, Hofmann H, Schulz T, von Kries R. Physical activity and gestational weight gain: a meta-analysis of intervention trials. BJOG 2011; 118(3): 278-84.
[http://dx.doi.org/10.1111/j.1471-0528.2010.02801.x] [PMID: 21134106]
[42]
Choi J, Fukuoka Y, Lee JH. The effects of physical activity and physical activity plus diet interventions on body weight in overweight or obese women who are pregnant or in postpartum: a systematic review and meta-analysis of randomized controlled trials. Prev Med 2013; 56(6): 351-64.
[http://dx.doi.org/10.1016/j.ypmed.2013.02.021] [PMID: 23480971]
[43]
Wang J, Wen D, Liu X, Liu Y. Impact of exercise on maternal gestational weight gain: An updated meta-analysis of randomized controlled trials. Medicine (Baltimore) 2019; 98(27): e16199.
[http://dx.doi.org/10.1097/MD.0000000000016199] [PMID: 31277127]
[44]
Barakat R, Refoyo I, Coteron J, Franco E. Exercise during pregnancy has a preventative effect on excessive maternal weight gain and gestational diabetes. A randomized controlled trial. Braz J Phys Ther 2019; 23(2): 148-55.
[http://dx.doi.org/10.1016/j.bjpt.2018.11.005] [PMID: 30470666]
[45]
Sagedal LR, Øverby NC, Bere E, et al. Lifestyle intervention to limit gestational weight gain: the Norwegian Fit for Delivery randomised controlled trial. BJOG 2017; 124(1): 97-109.
[http://dx.doi.org/10.1111/1471-0528.13862] [PMID: 26768233]
[46]
Nobles C, Marcus BH, Stanek EJ III, et al. The effect of an exercise intervention on gestational weight gain: the behaviors affecting baby and you (B.A.B.Y) study: A randomized controlled trial. Am J Health Promot 2018; 32(3): 736-44.
[http://dx.doi.org/10.1177/0890117117732409] [PMID: 28950725]
[47]
Herring SJ, Cruice JF, Bennett GG, Rose MZ, Davey A, Foster GD. Preventing excessive gestational weight gain among African American women: A randomized clinical trial. Obesity (Silver Spring) 2016; 24(1): 30-6.
[http://dx.doi.org/10.1002/oby.21240] [PMID: 26592857]
[48]
Flannery C, Fredrix M, Olander EK, McAuliffe FM, Byrne M, Kearney PM. Effectiveness of physical activity interventions for overweight and obesity during pregnancy: a systematic review of the content of behaviour change interventions. Int J Behav Nutr Phys Act 2019; 16(1): 97.
[http://dx.doi.org/10.1186/s12966-019-0859-5] [PMID: 31675954]
[49]
Currie S, Sinclair M, Murphy MH, Madden E, Dunwoody L, Liddle D. Reducing the decline in physical activity during pregnancy: a systematic review of behaviour change interventions. PLoS One 2013; 8(6): e66385.
[http://dx.doi.org/10.1371/journal.pone.0066385] [PMID: 23799096]
[50]
Bravata DM, Smith-Spangler C, Sundaram V, et al. Using pedometers to increase physical activity and improve health: a systematic review. JAMA 2007; 298(19): 2296-304.
[http://dx.doi.org/10.1001/jama.298.19.2296] [PMID: 18029834]
[51]
Renault K, Nørgaard K, Andreasen KR, Secher NJ, Nilas L. Physical activity during pregnancy in obese and normal-weight women as assessed by pedometer. Acta Obstet Gynecol Scand 2010; 89(7): 956-61.
[http://dx.doi.org/10.3109/00016341003792459] [PMID: 20583938]

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