Gestational diabetes: The effects of lifestyle interventions for mother and baby

This study analyzed the results of 15 separate studies to examine the effects of lifestyle interventions for gestational diabetes mellitus (GDM). Authors reported on a number of benefits for the mother and the baby following lifestyle interventions.

When a woman without diabetes develops high blood glucose levels during pregnancy this is known as gestational diabetes mellitus (GDM). GDM is generally associated with few symptoms and often normalizes after pregnancy. However, it does greatly increase the risk of a number of complications, such as preeclampsia (high blood pressure during pregnancy), abnormally high birth weight, and the need for a cesarean section. The mother is also at increased risk of developing diabetes later in life. The main way to treat GDM is through lifestyle interventions, such as diet, exercise, and checking blood sugar levels.

This study examined the effects of lifestyle interventions for GDM.

The results of 15 separate studies were analyzed, involving a total of 4,501 pregnant women with GDM. None of the women included had diabetes before pregnancy. All studies randomly assigned women to undergo a lifestyle intervention or to a control group. Lifestyle interventions included education, diet, exercise, and self-monitoring of blood glucose. Control groups included usual prenatal care or diet alone.

Based on the results of 4 studies, lifestyle interventions did not significantly improve the risk of preeclampsia. The risk of a cesarian section was also found to be comparable between lifestyle intervention groups and control groups (across 10 studies). 2 studies with a maximum follow-up of 10 years reported no significant differences between groups in the risk of the mother later developing type 2 diabetes. The evidence from these studies was considered low quality.

One study examined the rates of trauma during labor (such as vaginal tearing) and 4 studies examined the rates of induction of labor. Both categories were found to be unaffected by lifestyle interventions. The evidence from these studies was considered moderate to high quality.

Women in the lifestyle intervention group were 75% more likely to meet their post-pregnancy weight goal compared to the control group (based on 1 study). The risk of postnatal depression was reduced by 51% among women undergoing lifestyle interventions (based on 1 study). The evidence from these studies was considered low quality.

The results from 6 studies showed that the risk of the infant being born large was reduced by 40% among women in the lifestyle intervention group. This included lower birthweight and fewer incidences of macrosomia (newborns who are significantly larger than average). The evidence from these studies was considered moderate quality. 1 low-quality study further reported significantly reduced body fat among infants born to mothers who underwent lifestyle interventions. However, in childhood there were no differences in body weight categories across groups. This finding was based on 3 studies with a maximum follow-up of 10 years, considered moderate quality.

The risk of the child dying during labor was not significantly different between the lifestyle intervention or control group. Only 5 events were reported in total in the control group and there were no events in the lifestyle group. This finding was based on 2 trials involving 1,988 infants. The trials were considered low quality. There was also no clear evidence of a difference between groups for other serious infant outcomes, including the newborn’s low blood sugar levels. This was based on 8 studies that were considered very low to moderate quality.

Authors concluded that lifestyle interventions are a suitable primary treatment strategy for GDM.