| Title: |
Effects of lifestyle interventions in pregnancy on gestational diabetes: individual participant data and network meta-analysis |
| Authors: |
Allotey, John; Coomar, Dyuti; Ensor, Joie; Ruiz-Calvo, Gabriel; Boath, Anna; Ogwulu, Chidubem Okeke; Monahan, Mark; Kabeya, Valencia; Zheng, Min; McNeill, Rachel; Meacham, Hollie; Mahmoud, Ghadir; Simpson, Sharon Anne; Hitman, Graham A; Nirantharakumar, Krish; Heslehurst, Nicola; Pelaez, Mireia; Tonstad, Serena; Yeo, SeonAe; Cecatti, Jose G; Facchinetti, Fabio; Motahari-Tabari, Narges Sadat; Renault, Kristina M; Guelfi, Kym J; Jensen, Dorte Møller; Harrison, Cheryce; Khomami, Mahnaz Bahri; Calle-Pascual, Alfonso L; McAuliffe, Fionnuala M; Hauner, Hans; Barakat, Ruben; Geiker, Nina Rica Wium; Vinter, Christina Anne; Phelan, Suzanne; Kinnunen, Tarja I; Kothari, Alka; Teede, Helena; Poston, Lucilla; Betrán, Ana Pilar; Moss, Ngawai; Iliodromiti, Stamatina; Austin, Frances; Roberts, Tracy; Zamora, Javier; Riley, Richard D; Thangaratinam, Shakila; i-WIP Collaborative Group |
| Source: |
BMJ, 392 |
| Publisher Information: |
BMJ |
| Publication Year: |
2026 |
| Collection: |
Carolina Digital Repository (UNC - University of North Carolina) |
| Subject Terms: |
confidence; odds ratio; group formation; parity; intervention effects; data; subgroups; strategies; benefits; gestation; risk reduction estimates; body mass index; participant data; IPD; network meta-analysis; NICE criteria; ethnicity; pregnancy; maternal characteristics; age; formation; stage; estimation; odds; characteristics; intervention characteristics; gestational diabetes; randomised trials; aggregate data; provider training |
| Description: |
OBJECTIVES: To assess the effects of lifestyle interventions on gestational diabetes, determine whether the effects vary by maternal body mass index, age, parity, ethnicity, education level, or intervention, and rank interventions by effectiveness. DESIGN: Individual participant data (IPD) and network meta-analysis. DATA SOURCES: Major electronic databases (January 1990 to April 2025). METHODS: This meta-analysis included randomised trials on the effects of lifestyle interventions (physical activity based, diet based, or mixed) in pregnancy on gestational diabetes. Main outcomes were gestational diabetes defined by any criteria and by UK NICE (National Institute for Health and Care Excellence) criteria; other outcomes included IADPSG (International Association of Diabetes in Pregnancy Study Group) and modified IADPSG defined gestational diabetes. A two stage IPD meta-analysis estimated summary odds ratios and 95% confidence intervals and interactions (subgroup effects), along with absolute risk reduction estimates. Aggregate data from non-IPD trials were added to the meta-analysis when possible. Intervention effects were ranked using network meta-analysis. RESULTS: 104 randomised trials (35 993 women) were included, with IPD for 68% of participants (24 391 women; 54 studies). Lifestyle interventions reduced gestational diabetes defined by any criteria by 10% in IPD trials (odds ratio 0.90, 95% confidence interval (CI) 0.80 to 1.02; absolute risk reduction 1.3%, 95% CI -0.3% to 2.6%), and by 20% when combining IPD and non-IPD trials (odds ratio 0.80, 95% CI 0.73 to 0.88; absolute risk reduction 2.6%, 95% CI 1.6% to 3.6%), and no reduction was observed using NICE criteria (odds ratio 0.98, 95% CI 0.84to 1.13). Lifestyle interventions reduced gestational diabetes defined using IADPSG criteria by 14% in IPD trials (odds ratio 0.86, 95% CI 0.75 to 0.97; absolute risk reduction 2.7%, 95% CI 0.6% to 5.0%) and by 18% when combining IPD and non-IPD trials (odds ratio 0.82, 95% CI 0.72 to 0.93; absolute risk reduction ... |
| Document Type: |
article in journal/newspaper |
| Language: |
unknown |
| Relation: |
https://cdr.lib.unc.edu/downloads/jm215555m?file=thumbnail; https://cdr.lib.unc.edu/downloads/jm215555m |
| DOI: |
10.17615/04ps-rh47 |
| Availability: |
https://doi.org/10.17615/04ps-rh47; https://cdr.lib.unc.edu/downloads/jm215555m?file=thumbnail; https://cdr.lib.unc.edu/downloads/jm215555m |
| Rights: |
http://rightsstatements.org/vocab/InC/1.0/ ; http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.B78F1752 |
| Database: |
BASE |