Effects of supervised exercise during pregnancy on gestational diabetes mellitus and other pregnancy outcomes: a systematic review and meta-analysis
In brief
Supervised exercise during pregnancy cuts gestational diabetes risk by about a quarter
In a meta-analysis of 19 trials involving 6,213 pregnant women, supervised exercise lowered the chance of gestational diabetes by 26% and also reduced gestational hypertension, excessive weight gain and large-for-gestational-age babies. Benefits were strongest when training began early, lasted at least 20 weeks, included both aerobic and resistance work, and averaged 150 minutes per week. Further research should define the optimal dose and how to sustain high adherence.
- Journal
- British journal of sports medicine (Q1)
- Published
- 15 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Lingxia Li, Jialin He, Chun Wang, Ludi Liu, Bingqi Ye, Shanshan Zhu, et al.
- PMID
- 42457535
- DOI
- 10.1136/bjsports-2026-111586
Why clinicians should know about it
- Picked for Endocrinology, Diabetes and Metabolism (top studies of the week, 19 July 2026).
- Picked for Orthopedics and Sports Medicine (top studies of the week, 19 July 2026).
Abstract
OBJECTIVE: To evaluate the effects of supervised exercise on gestational diabetes mellitus (GDM) and other pregnancy outcomes and examine dose-response relationships. DESIGN: Systematic review with random-effects meta-analysis and meta-regression. DATA SOURCES: Four databases were searched up to November 2025. ELIGIBILITY CRITERIA: Randomised controlled trials in pregnant women comparing supervised exercise with usual care were included if they reported GDM. GDM was prespecified as the primary outcome, while other outcomes were extracted where available, including gestational hypertension (GH), pre-eclampsia, excessive gestational weight gain (EGWG), macrosomia, caesarean delivery, preterm birth and low birth weight. RESULTS: Nineteen studies (n=6213; 48.6% in intervention groups) were included, with moderate certainty of evidence. Supervised exercise reduced the risk of GDM (risk ratio (RR) 0.74, 95% CI 0.57 to 0.96; I2=47%), GH (RR 0.55, 95% CI 0.40 to 0.77; I2=1%), EGWG (RR 0.75, 95% CI 0.61 to 0.92; I2=70%) and macrosomia (RR 0.61, 95% CI 0.46 to 0.81; I2=27%). Subgroup analyses for these outcomes suggested greater effects with earlier intervention (initiated in early pregnancy or duration >20 weeks), higher adherence (≥80%), combined aerobic and resistance training, and weekly exercise duration ≥150 min/week. Significant subgroup differences in GDM risk were observed for intervention initiation timing (p=0.009) and intervention duration (p=0.010). Dose-response analysis showed a peak effect at approximately 500-550 metabolic equivalent task-minutes per week for EGWG, with a plateau at higher doses. CONCLUSION: Supervised exercise during pregnancy reduces adverse pregnancy outcomes when initiated early, with high adherence, at moderate doses, and with combined aerobic and resistance training.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.