Preventive effects of different types of exercises during pregnancy on gestational diabetes: a systematic review and network meta-analysis.

BACKGROUND

Exercise is known to reduce the risk of gestational diabetes mellitus (GDM). However, the effectiveness of various exercise regimens in preventing GDM remains unclear, and the optimal approach has yet to be identified. This study aims to perform a systematic review and network meta-analysis to evaluate the preventive effects of different exercise interventions on GDM and to identify the most effective exercise strategy for its prevention.

METHODS

A comprehensive search of seven databases was conducted for studies published before March 2025 that examined the relationship between exercise during pregnancy and the risk of GDM. All literature underwent a rigorous screening process based on pre-defined inclusion and exclusion criteria. The quality of evidence was assessed using the Cochrane Risk of Bias (RoB) tool. Data analysis, heterogeneity testing, publication bias assessment, and sensitivity analysis were performed using the Stata 17.0 software.

RESULTS

(1) Meta-analysis revealed that the risk of GDM was significantly lower in the exercise intervention group compared to the conventional care group (OR 0.56, 95% CI = 0.44-0.71). (2) Subgroup analysis indicated that aerobic exercise (OR 0.40, 95% CI = 0.25-0.64), yoga (OR 0.19, 95% CI = 0.05-0.69), and diet and exercise guidance (OR 0.53, 95% CI = 0.37-0.76) significantly reduced the risk of GDM compared to the control group. Exercise intervention during pregnancy effectively reduced the risk of GDM in healthy individuals (OR 0.63, 95% CI = 0.43-0.93), overweight and/or obese individuals (OR 0.53, 95% CI = 0.36-0.79), and pregnant women at risk of GDM (OR 0.53, 95% CI = 0.34-0.82). Additionally, exercise intervention initiated in early pregnancy significantly prevented the development of GDM (OR 0.51, 95% CI = 0.39-0.68). (3) Network meta-analysis results demonstrated that yoga had the lowest surface under the cumulative ranking curve (SUCRA = 6.8%), suggesting that yoga was the most effective intervention in reducing the risk of GDM.

CONCLUSION

Various types of exercise, including yoga, aerobic exercise, and diet and exercise guidance, are effective in preventing GDM during pregnancy. Among these, yoga appears to be particularly promising and could be considered for inclusion in preventive care strategies for pregnant women.

TRIAL REGISTRATION

The study was registered on the International Prospective Registry of Systematic Reviews (PROSPERO) database (CRD42024552641) on 10 June 2024.

© 2025. The Author(s).