How Can Maternal Lifestyle Interventions Modify the Effects of Gestational Diabetes in the Neonate and the Offspring? A Systematic Review of Meta-Analyses

Delphine Mitanchez (1, 2) , Cécile Ciangura (3, 4) , Sophie Jacqueminet (3, 4)

1 Hôpital Bretonneau
2 CRSA - Centre de Recherche Saint-Antoine
3 CHU Pitié-Salpêtrière [AP-HP]
4 ICAN - Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases

Gestational diabetes (GDM) has deleterious effects on the offspring. Maternal obesity and excessive gestational weight gain (GWG), often associated with diabetes, also contribute to these adverse outcomes. OBJECTIVES: To assess the benefit for the offspring of maternal lifestyle interventions, including diets and physical activity, to prevent or to improve GDM and to limit excessive GWG. METHOD: Systematic review of meta-analyses published in English between December 2014 and November 2019. RESULTS: Lifestyle interventions to reduce the risk of GDM reported a decreased risk of 15% to 40%, with a greater effect of exercise compared to diet. Combined lifestyle interventions specifically designed to limit GWG reduced GWG by 1.6 kg in overweight and obese women, and on average by 0.7 to 1 kg in all pregnant women. In these trials, adverse neonatal outcomes were poorly studied. Combined lifestyle interventions in women with GDM significantly reduced fetal growth. Altogether, lifestyle interventions reduced the risk of preterm birth and shoulder dystocia, but individually, diets or exercise alone had no effect on neonatal adverse outcomes. CONCLUSION: Specific maternal, neonatal and offspring benefits of lifestyle interventions during pregnancy to prevent or improve GDM control or to limit GWG still require clarification.

Mots clés: adiposity; diabetes; diet; exercise; gestational weight gain; macrosomia; neonate; obesity

Domaines: Sciences du Vivant [q-bio]; Médecine humaine et pathologie

Delphine Mitanchez, Cécile Ciangura, Sophie Jacqueminet. How Can Maternal Lifestyle Interventions Modify the Effects of Gestational Diabetes in the Neonate and the Offspring? A Systematic Review of Meta-Analyses. Nutrients, 2020, 12 (2), pp.353. ⟨10.3390/nu12020353⟩. ⟨hal-02553755⟩