Exercise versus Metformin to Improve Pregnancy Outcomes among Overweight Pregnant Women: A Systematic Review and Network Meta-Analysis
Being overweight is associated with pregnancy-related disorders such as gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), and excessive maternal weight gain (MWG). Exercise and metformin reduce the risk of these disorders. This network meta-analysis (NMA) aims to compar...
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doaj-7ce541f6df884e2ebc7f91ff7eaedc402021-08-26T13:55:02ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-01103490349010.3390/jcm10163490Exercise versus Metformin to Improve Pregnancy Outcomes among Overweight Pregnant Women: A Systematic Review and Network Meta-AnalysisCarlos Pascual-Morena0Iván Cavero-Redondo1Celia Álvarez-Bueno2Maribel Lucerón-Lucas-Torres3Gema Sanabria-Martínez4Raquel Poyatos-León5Beatriz Rodríguez-Martín6Vicente Martínez-Vizcaíno7Health and Social Research Center, Universidad de Castilla—La Mancha, 16071 Cuenca, SpainHealth and Social Research Center, Universidad de Castilla—La Mancha, 16071 Cuenca, SpainHealth and Social Research Center, Universidad de Castilla—La Mancha, 16071 Cuenca, SpainHealth and Social Research Center, Universidad de Castilla—La Mancha, 16071 Cuenca, SpainHealth and Social Research Center, Universidad de Castilla—La Mancha, 16071 Cuenca, SpainHealth and Social Research Center, Universidad de Castilla—La Mancha, 16071 Cuenca, SpainHealth and Social Research Center, Universidad de Castilla—La Mancha, 16071 Cuenca, SpainHealth and Social Research Center, Universidad de Castilla—La Mancha, 16071 Cuenca, SpainBeing overweight is associated with pregnancy-related disorders such as gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), and excessive maternal weight gain (MWG). Exercise and metformin reduce the risk of these disorders. This network meta-analysis (NMA) aims to compare the effect of metformin and different types of exercise (aerobic, resistance and combined) on the risk of GDM, HDP, and MWG among overweight/obese pregnant women. Medline, EMBASE, Web of Science and Cochrane Library were searched from inception to June 2021. Meta-analyses and NMAs were performed. Sixteen randomized controlled trials were included. In the NMA, aerobic exercise showed an effect on GDM (RR = 0.51, 95% CI = 0.26, 0.97), and metformin a reduction in MWG (MWG = −2.93 kg, 95% CI = −4.98, −0.87). No intervention showed any effect on the reduction of HDP. Our study suggests that aerobic exercise may have the greatest effect in reducing the risk of GDM, and perhaps, the MWG. Strategies should be developed to increase adherence to this type of intervention among overweight women without contraindications. Although metformin could reduce MWG, medicalization of pregnancy in healthy women is not justified with the present results. More research is needed on the effect of the intensity and frequency of exercise sessions and the length of interventions.https://www.mdpi.com/2077-0383/10/16/3490gestational diabetes mellitusexercisemetforminpregnancyoverweightobesity |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Carlos Pascual-Morena Iván Cavero-Redondo Celia Álvarez-Bueno Maribel Lucerón-Lucas-Torres Gema Sanabria-Martínez Raquel Poyatos-León Beatriz Rodríguez-Martín Vicente Martínez-Vizcaíno |
spellingShingle |
Carlos Pascual-Morena Iván Cavero-Redondo Celia Álvarez-Bueno Maribel Lucerón-Lucas-Torres Gema Sanabria-Martínez Raquel Poyatos-León Beatriz Rodríguez-Martín Vicente Martínez-Vizcaíno Exercise versus Metformin to Improve Pregnancy Outcomes among Overweight Pregnant Women: A Systematic Review and Network Meta-Analysis Journal of Clinical Medicine gestational diabetes mellitus exercise metformin pregnancy overweight obesity |
author_facet |
Carlos Pascual-Morena Iván Cavero-Redondo Celia Álvarez-Bueno Maribel Lucerón-Lucas-Torres Gema Sanabria-Martínez Raquel Poyatos-León Beatriz Rodríguez-Martín Vicente Martínez-Vizcaíno |
author_sort |
Carlos Pascual-Morena |
title |
Exercise versus Metformin to Improve Pregnancy Outcomes among Overweight Pregnant Women: A Systematic Review and Network Meta-Analysis |
title_short |
Exercise versus Metformin to Improve Pregnancy Outcomes among Overweight Pregnant Women: A Systematic Review and Network Meta-Analysis |
title_full |
Exercise versus Metformin to Improve Pregnancy Outcomes among Overweight Pregnant Women: A Systematic Review and Network Meta-Analysis |
title_fullStr |
Exercise versus Metformin to Improve Pregnancy Outcomes among Overweight Pregnant Women: A Systematic Review and Network Meta-Analysis |
title_full_unstemmed |
Exercise versus Metformin to Improve Pregnancy Outcomes among Overweight Pregnant Women: A Systematic Review and Network Meta-Analysis |
title_sort |
exercise versus metformin to improve pregnancy outcomes among overweight pregnant women: a systematic review and network meta-analysis |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-08-01 |
description |
Being overweight is associated with pregnancy-related disorders such as gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), and excessive maternal weight gain (MWG). Exercise and metformin reduce the risk of these disorders. This network meta-analysis (NMA) aims to compare the effect of metformin and different types of exercise (aerobic, resistance and combined) on the risk of GDM, HDP, and MWG among overweight/obese pregnant women. Medline, EMBASE, Web of Science and Cochrane Library were searched from inception to June 2021. Meta-analyses and NMAs were performed. Sixteen randomized controlled trials were included. In the NMA, aerobic exercise showed an effect on GDM (RR = 0.51, 95% CI = 0.26, 0.97), and metformin a reduction in MWG (MWG = −2.93 kg, 95% CI = −4.98, −0.87). No intervention showed any effect on the reduction of HDP. Our study suggests that aerobic exercise may have the greatest effect in reducing the risk of GDM, and perhaps, the MWG. Strategies should be developed to increase adherence to this type of intervention among overweight women without contraindications. Although metformin could reduce MWG, medicalization of pregnancy in healthy women is not justified with the present results. More research is needed on the effect of the intensity and frequency of exercise sessions and the length of interventions. |
topic |
gestational diabetes mellitus exercise metformin pregnancy overweight obesity |
url |
https://www.mdpi.com/2077-0383/10/16/3490 |
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