Background: It is commonly accepted that pregnancy‐related physiological changes (circulatory, respiratory, and locomotor) negatively influence the daily physical activity of pregnant women.Objectives: The aim of this study is to conduct a meta‐analysis of randomised controlled trials (RCTs) for assessing the effectiveness of physical exercise interventions during pregnancy to prevent gestational diabetes mellitus and excessive maternal weight gain.Search strategy: Keywords were used to conduct a computerised search in six databases: Cochrane Library Plus, Science Direct, EMBASE, PubMed, Web of Science, and ClinicalTrials.gov.Selection criteria: Healthy pregnant women who were sedentary or had low levels of physical activity were selected for RCTs that included an exercise programme.Data collection and analysis: Two independent reviewers extracted data and assessed the quality of the included studies. Of 4225 articles retrieved, 13 RCTs (2873 pregnant women) met the inclusion criteria. Pooled relative risk (RR) or weighted mean differences (WMDs) (depending on the outcome measure) were calculated using a random‐effects model.Main results: Overall, physical exercise programmes during pregnancy decreased the risk of gestational diabetes mellitus (RR = 0.69; P = 0.009), particularly when the exercise programme was performed throughout pregnancy (RR = 0.64; P = 0.038). Furthermore, decreases were also observed in maternal weight (WMD = −1.14 kg; 95% CI −1.50 to −0.78; P < 0.001). No serious adverse effects were reported.Conclusion: Structured moderate physical exercise programmes during pregnancy decrease the risk of gestational diabetes mellitus and diminish maternal weight gain, and seem to be safe for the mother and the neonate; however, further studies are needed to establish recommendations.Tweetable Exercise programmes decreased the risk of gestational diabetes mellitus and excessive weight gain.

Introduction: We conducted a systematic review and meta‐analysis to examine the influence of physical exercise interventions on the mode of delivery of healthy pregnant women with low to moderate levels of physical activity.Material and Methods: Key words were used to conduct a computerized search for articles on the topic in six databases: Cochrane Library Plus, Science Direct, EMBASE, PubMed, Web of Science and ClinicalTrials.gov. Ten randomized controlled trials were identified and included in the meta‐analysis. Main outcome measures were mode of delivery (normal, instrumental vaginal, or cesarean delivery) and physical activity.Results: Relative risk reductions and their 95% confidence interval were calculated for each study, and the heterogeneity of the studies was estimated using Cochran's Q statistic. The evidence suggests that physical exercise during pregnancy may increase the likelihood of normal delivery (relative risk = 1.12, 95% confidence interval 1.01–1.24; p = 0.041), in particular when exercise takes place during the second and third trimesters (relative risk = 1.14, 95% confidence interval 1.01–1.32; p = 0.048), even reducing the risk of cesarean delivery (relative risk = 0.66, 95% confidence interval 0.46–0.96; p = 0.028).Conclusions: Regular exercise during pregnancy appears to modestly increase the chance for normal delivery among healthy pregnant women. This applies to women with low to moderate levels of physical activity, but studies are needed to understand better the effect of physical exercise of moderate to vigorous intensity in the different trimesters.

Objective: This study aimed to provide, through an umbrella review, an overview of the effect of single exercise interventions during pregnancy on gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP). Also, to update the current evidence through an updated meta‐analysis.Design: Umbrella review.Setting: PubMed, EMBASE, Web of Science, Cochrane database of systematic reviews, Epistemonikos, SPORTDiscus, Clinicaltrials.gov, and PROSPERO register were searched from the database inception until August 2021.Population: Peer‐reviewed systematic reviews and meta‐analyses of randomised controlled trials (RCTs) and RCTs samples.Methods: Random‐effects model was used to calculate relative risk with 95% confidence interval in the updated meta‐analysis. The reference category was the groups that received usual prenatal care. AMSTAR 2 and the Cochrane Collaboration tool were used to assess the quality and GRADE approach was used to assess the overall certainly of evidence.Main outcome measures: GDM and HDP relative risk.Results: Twenty‐three systematic reviews and meta‐analyses; and 63 RCTs were included. Single exercise interventions reduced the incidence of GDM and HDP in most systematic reviews and meta‐analyses. Moreover, exercise interventions during pregnancy decrease the incidence of developing GDM and GH, particularly when they are supervised, have a low to moderate intensity level, and are initiated during the first trimester of pregnancy.Conclusion: Based on the findings, obstetric and physical exercise professionals could recommend exercise interventions during pregnancy as an effective strategy to improve maternal outcomes.

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.