Exercise for diabetic pregnant women

ArticleinCochrane database of systematic reviews (Online) 3(3):CD004225 · February 2006with10 Reads
DOI: 10.1002/14651858.CD004225.pub2 · Source: PubMed
Diabetes in pregnancy may result in unfavourable maternal and neonatal outcomes. Exercise was proposed as an additional strategy to improve glycaemic control. The effect of exercise during pregnancies complicated by diabetes needs to be assessed. To evaluate the effect of exercise programs, alone or in conjunction with other therapies, compared to no specific program or to other therapies, in pregnant women with diabetes on perinatal and maternal morbidity and on the frequency of prescription of insulin to control glycaemia. To compare the effectiveness of different types of exercise programs on perinatal and maternal morbidity. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 December 2005). All known randomised controlled trials evaluating the effect of exercise in diabetic pregnant women on perinatal outcome and maternal morbidity. We evaluated relevant studies for meeting the inclusion criteria and methodological quality. Three review authors abstracted the data. For all data analyses, we entered data based on the principle of intention to treat. We calculated relative risks and 95% confidence intervals for dichotomous data. Four trials, involving 114 pregnant women with gestational diabetes, were included in the review. None included pregnant women with type 1 or type 2 diabetes. Women were recruited during the third trimester and the intervention was performed for about six weeks. The programs generally consisted in exercising three times a week for 20 to 45 minutes. We found no significant difference between exercise and the other regimen in all the outcomes evaluated. There is insufficient evidence to recommend, or advise against, diabetic pregnant women to enrol in exercise programs. Further trials, with larger sample size, involving women with gestational diabetes, and possibly type 1 and 2 diabetes, are needed to evaluate this intervention.
    • "Dependent variables All <150 PA min a ≥150 PA min a Crude OR (95% CI) Adjusted b OR (95% CI) n (%) n (%) n (%) between women who did and women who did not reach the recommended levels of LTPA. A Cochrane review has concluded that the evidence is insufficient regarding the impact of physical activity on the risk of GDM [10]. Our study was primarily dimensioned for investigating the associations between specified maternal characteristics and pre-pregnancy and early pregnancy physical activities. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Physical activity during pregnancy is generally considered safe and beneficial for both the pregnant woman and her fetus. The overall aim was to investigate pregnant women's pre-pregnancy and early pregnancy physical activity and its associations with maternal characteristics and pregnancy outcomes. Methods: This cross-sectional study combined data from the Maternal Health Care Register in Västerbotten (MHCR-VB) and the Salut Programme Register (Salut-R). Data were collected from 3,868 pregnant women living in northern Sweden between 2011 and 2012. Results: Almost half of the participants (47.1%) achieved the recommended level of physical activity. Compared to the women who did not achieve the recommended level of exercise, these women had lower BMI, very good or good self-rated health, and a higher educational level. No significant associations could be established between physical activity levels and GDM, birth weight, or mode of delivery. Conclusions: Positively, a considerably high proportion of Swedish pregnant women achieved the recommended level of physical activity. Factors associated with recommended physical activity level were BMI ≤30 kg/m2, very good or good self-rated health, and higher educational level. Our findings emphasize the need for health care professionals to early detect and promote fertile and pregnant women towards health-enhancing physical activity, especially those with low levels of physical activity and overweight/obesity, to improve overall health in this population.
    Full-text · Article · May 2016
    • "Mais a ` ce jour, aucune e ´ tude n'a exploré cette possibilité chez 269 les femmes enceintes [22]. Concernant le diabè te de type 2 et le 270 diabè te gestationnel, les donné es restent encore insuffisantes pour 271 aboutir a ` des conclusions fiables [22]. 272 Spé cifiquement pour la pré -eclampsie, une mé ta-analyse [38] 273 indique que les preuves des bé né fices de l'AP comme moyen de 274 pré vention restent insuffisantes pour aboutir a ` des recommanda- 275 tions pré cises. "
    [Show abstract] [Hide abstract] ABSTRACT: Les bénéfices de l’activité physique (AP) sur la santé physique et mentale ont conduit à la mise en place de recommandations internationales spécifiques pour les femmes enceintes. Durant la grossesse, il est recommandé de pratiquer de l’activité physique aérobie (marche, vélo) à raison de 30 minutes 3 fois par semaine à une intensité de 60 à 90 % de la fréquence cardiaque maximale, ainsi que du renforcement musculaire 1 à 2 fois par semaine. Les programmes d’AP durant la grossesse ont montré des effets bénéfiques en termes de prévention et de traitement des complications telles que le diabète gestationnel ou le surpoids. Les bienfaits de l’AP durant la grossesse ainsi que les risques liés à la sédentarité restent encore mal connus par les femmes enceintes et devraient être diffusés par le personnel médical spécialiste de la périnatalité.
    Full-text · Article · Oct 2014
    • "Furthermore, aquatic exercise during pregnancy may decrease maternal stress, discomfort and improve health-promoting behaviors [14,15]. However, there is insufficient evidence on aquatic exercise due to poor methodological and reporting quality and heterogeneity of non-randomized clinical trials [10,16]. Specifically in relation to GDM, there are no clinical trials testing aquatic exercise as an adjunctive treatment. "
    [Show abstract] [Hide abstract] ABSTRACT: Gestational diabetes mellitus (GDM) is increasing worldwide and has been associated with adverse perinatal outcomes and high risk for chronic disease both for the mother and for the child. Physical exercise is feasible for diabetic pregnant women and contributes to better glycemic control and to a decrease in adverse perinatal outcomes. However, there are no randomized controlled trials (RCT) assessing the effects of aquatic physical exercise on GDM control and adverse maternal and fetal outcomes.Methods/design: An RCT will be conducted at Instituto de Medicina Integral Prof Fernando Figueira (IMIP), Brazil. A total of 72 pregnant women will be studied; 36 gestational diabetics will undergo an aquatic physical exercise program in a thermal pool, 3 times per week over 2 months. The primary endpoint will be glucose level control and use of insulin; secondary endpoints will be the following maternal and fetal outcomes: weight gain during pregnancy, blood pressure, pre-eclampsia diagnosis, intrauterus growth restriction, preterm birth, Cesarean section, macrosomia and maternal or neonatal intensive care admission. Endpoints between intervention and control group will analyzed by t test for unpaired data and chi2 test, and the level of significance will set at <0.05. The physical proprieties of water make aquatic exercises ideal for pregnant women. An aquatic physical exercise program developed for GDM women will be trialed in a thermal pool and under the supervision of physiotherapist to ensure compliance. It is expected that this study will provide evidence as to the effect of aquatic physical exercise on GDM control.Trial registration: NCT01940003.
    Full-text · Article · Nov 2013
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