Meta-Analysis: The Effect of Physical Activity in Reducing Excessive Gestational Weight Gain and Gestational Diabetes Mellitus among Overweight and Obese Pregnant Women


  • Hapsari Cahyaningrum Master's Program in Public Health, Universitas Sebelas Maret
  • Didik Tamtomo Faculty of Medicine, Universitas Sebelas Maret
  • Bhisma Murti Master's Program in Public Health, Universitas Sebelas Maret



Background: The prevalence of overweight and obesity among women continues to increase every year. Overweight and obesity can lead to complications in pregnancy such as Excessive gesta­tional weight gain (EGWG) and Gestational diabetes mellitus (GDM). Physical activity inter­vention is an option to prevent EGWG and GDM. The study aims to analyze the effects of physical activity interventions in reducing EGWG and GDM.

Subjects and Method: The study used a meta-analysis study design by following PRISMA guidelines. The research question was formulated in PICO.  The population was pregnant women with a Body Mass Index (BMI) of > 25 kg/m2. The intervention used was measured physical acti­vity. The comparison was without measured physical activity. The outcomes were EGWG and GDM. Article search was carried out through the databases such as PubMed, Cochrane Library, Scopus Database, and PEDro which was published from 2011 to 2020. The article search used the following keywords: "pregnancy" OR "pregnant woman" AND "obese" OR "overweight" AND "excessive gestational weight gain" OR "gestational weight gain" OR "weight gain" AND "gestatio­nal diabetes mellitus" OR "gestational diabetes" AND "exercise " OR "antenatal exercise" OR "physical activity". Articles that met the criteria were full-text articles with a Randomized Control Trial (RCT) study design. The assessment of the quality of the study was conducted with Cochrane Collaboration's Tool for Assessing Risk of Bias and the articles were subsequently analyzed using the Review Manager 5.4 application.

Results: A total of 10 articles analyzed in this study came from Asian, European, Australian, and American countries with a total sample of 2,086. The results of the meta-analysis showed that overweight and obese pregnant women who performed measured physical activity did not experience weight changes compared to those who did not engage in physical activity (SMD= 0.03; 95% CI= 0.17 to 0.73; p=0.770).  However, overweight and obese pregnant women who do measured physical activity experience changes in fasting sugar levels compared to those who did not do measured physical activity (SMD= 0. 20; CI95%= 0.30 to 0.10; p=0.001).

Conclusion: The results of this study state that physical activity interventions are effective in reducing GDM but not for EGWG in overweight and obese pregnant women.

Keywords: physical activity, excessive gestational weight gain, gestational diabetes mellitus, overweight and obese pregnant women, meta-analysis.

Correspondence: Hapsari Cahyaningrum. Master’s Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: Mobile: 081328932469.


ACOG (2015). ACOG Committee Opinion No. 650: Physical activity and exercise during pregnancy and the postpartum Period. Obstetrics and Gynecology, 126(6): e135–e142. DOI: 10.1097/AOG.0000000000001214.

Agha M, Agha RA, Sandell J (2014). Interventions to reduce and prevent obesity in pre-conceptual and pregnant women: a systematic review and meta-analysis. PloS one, 9(5): 95-132. DOI: 10.1371/journal.pone.0095132.

Agustina R, Meilianawati F, Atmarita, Suparmi, Susiloretni KA, Lestari W, Pritasari K, et al. (2021). Psychosocial, eating behavior, and lifestyle factors influencing overweight and obesity in adolescents. Food Nutr Bull. 42(1): S72–S91. DOI: 10.1177/0379572121992750.

Bain E, Crane M, Tieu J, Han S, Crowther CA, Middleton P (2015). Diet and exercise interventions for preventing gestational diabetes mellitus. Cochrane Database Sys Rev. 12(4). DOI: 10.1002/14651858.CD010443.pub2.

Bider-Canfield Z, Martinez MP, Wang X, Yu W, Bautista MP, Brookey J, Page KA, et al. (2017). Maternal obesity, gestational diabetes, breastfeeding and childhood overweight at age 2 years. Int J Pediatr Obes. 12(2): 171–178. DOI: 10.1111/ijpo.12125.

Boutari C, Mantzoros CS (2022). A 2022 update on the epidemiology of obesity and a call to action: as its twin COVID-19 pandemic appears to be receding, the obesity and dysmetabolism pandemic continues to rage on. Metab. Clin. Exp. 133(8): 155-217. DOI: 10.1016/j.metabol.2022.155217.

Catalano PM, Shankar K (2017). Obesity and pregnancy: mechanisms of short term and long term adverse consequences for mother and child. Br. Med. J. (Clin. Res. Ed.). (8): 356, j1. DOI: 10.1136/bmj.j1

Chang YH, Yang HY, Shun SC (2021). Effect of exercise intervention dosage on reducing visceral adipose tissue: a systematic review and network meta-analysis of randomized controlled trials. Int J Obes, 45(5): 82–97. DOI: 10.1038/s41366021007679.

Chen Y, Ma G, Hu Y, Yang Q, Deavila JM, Zhu MJ, Du M (2021). Effects of maternal exercise during pregnancy on perinatal growth and childhood obesity outcomes: a meta-analysis and meta-regression. Sports Med. 51(11): 2329–2347. DOI: 10.1007/s40279021014996

Chopra M, Kaur N, Singh KD, Maria JC, Divakar H, Babu GR, Hong P, (2020). Population estimates, consequences, and risk factors of obesity among pregnant and postpartum women in India: results from a national survey and policy recommendations. Int. J. Gynecol. Obstets. 151(S1), 57–67. DOI: 10.1002/ijgo.13319.

Daly N, Farren M, McKeating A, OʼKelly R, Stapleton M, Turner MJ (2017). A medically supervised pregnancy exercise intervention in obese women: a randomized controlled trial. Obstet Gynecol, 130(5): 1–10. DOI: 10.1097/AOG.0000000000002267.

Davenport MH, Ruchat SM, Poitras VJ, Jaramillo-Garcia, A, Gray CE, Barrowman N, Skow RJ, Meah VL, et al. (2018). Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysis. Br J Sports Med, 52(21): 67–75. DOI: 10.1136/bjsports2018099355.

Du MC, Ouyang YQ, Nie XF, Huang Y, Redding SR (2019). Effects of physical exercise during pregnancy on maternal and infant outcomes in overweight and obese pregnant women: A meta-analysis. Birth (Berkeley, Calif.), 46 (2): 211–221. DOI: 10.1111/birt.12396.

Ehrlich SF, Ferrara A, Hedderson MM, Feng J, Neugebauer R (2021). Exercise during the first trimester of pregnancy and the risks of abnormal screening and gestational diabetes mellitus. Diabetes Care, 44(2): 25–32. DOI: 10.2337/dc201475.

Embaby H, Elsayed E, Fawzy M (2016). Insulin sensitivity and plasma glucose response to aerobic exercise in pregnant women at risk for gestational diabetes mellitus. Ethiop J Health Sci, 26(5): 409–414. DOI: 10.4314/ejhs.v26i5.2.

Garnæs KK, Mørkved S, Salvesen Ø, Moholdt T (2016). Exercise training and weight gain in obese pregnant women: a randomized controlled trial (ETIP Trial). PLoS Med, 13(7): DOI: 10.1371/journal.pmed.1002079.

Gonzalez-Gil AM, Elizondo-Montemayor L (2020). The Role of exercise in the interplay between myokines, heaptokines, osteokines, adipokines, and modulation of inflammation for energy substrate redistribution and fat mass loss: A Review. Nutrients, 12(6): 1899. DOI: 10.3390/nu12061899.

Han S, Middleton P, Crowther CA (2012). Exercise for pregnant women for preventing gestational diabetes mellitus. Cochrane Database Sys Rev, 11(7): DOI: 10.1002/14651858.CD009021.pub2.

Kautzky-Willer A, Harreiter J, Winhofer-Stöckl Y, Bancher-Todesca D, Berger A, Repa A, Lechleitner M, et al. (2019). Gestational diabetes mellitus (update 2019). Wien. Klin. Wochenschr, 131(1): 91–102. DOI: 10.1007/s0050801814198.

Kong KL, Campbell CG, Foster RC, Peterson AD, Lanningham-Foster L (2014). A pilot walking program promotes moderate-intensity physical activity during pregnancy. Med Sci Sports Exerc, 46(3): 62–71. DOI: 10.1249/MSS.0000000000000141.

Magro-Malosso ER, Saccone G, di Tommaso M, Roman A, Berghella V (2017). Exercise during pregnancy and risk of gestational hypertensive disorders: a systematic review and meta-analysis. Acta Obstet. Gynecol. Scand. 96(8): 921–931. DOI: 10.1111/aogs.13151.

Magro-Malosso ER, Saccone G, di Mascio D, di Tommaso M, Berghella V (2017). Exercise during pregnancy and risk of preterm birth in overweight and obese women: a systematic review and meta-analysis of randomized controlled trials. Acta Obstet. Gynecol. Scand. 96(3): 263–273. DOI: 10.1111/aogs.13087.

Mathew H, Castracane V D, Mantzoros C (2018). Adipose tissue and reproductive health. Metab. Clin. Exp. 86: 18–32. DOI: 10.1016/j.metabol.2017.11.006.

McDowell M, Cain MA, Brumley J (2019). Excessive Gestational Weight Gain. J Midwifery Women’s Health. 64(1): 46–54. DOI: 10.1111/jmwh.12927.

Muktabhant B, Lawrie TA, Lumbiganon P, Laopaiboon M (2015). Diet or exercise, or both, for preventing excessive weight gain in pregnancy. Cochrane Database Syst. Rev. 6(15): CD007145. DOI: 10.1002/14651858.CD007145.pub3.

Nasiri-Amiri F, Sepidarkish M, Shirvani MA, Habibipour P, Tabari NSM (2019). The effect of exercise on the prevention of gestational diabetes in obese and overweight pregnant women: a systematic review and meta-analysis. Diabetol Metab Syndr, 11(72): DOI: 10.1186/s1309801904706.

Oostdam N, van Poppel MNM, Wouters MGAJ, Eekhoff EMW, Bekedam DJ, Kuchenbecker WKH, Quartero HWP, Heres MHB, et al. (2012). No effect of the fit for2 exercise programme on blood glucose, insulin sensitivity, and birthweight in pregnant women who were overweight and at risk for gestational diabetes: results of a randomised controlled trial. BJOG. 119(9): 1098–1107. DOI:10.1111/j.14710528.2012.03366.x.

Rahman MM, Abe SK, Kanda M, Narita S, Rahman MS, Bilano V, Ota E, (2015). Maternal body mass index and risk of birth and maternal health outcomes in low- and middle-income countries: a systematic review and meta-analysis. Obes Rev.16(9): 758–770. DOI: 10.1111/obr.12293.

Renault KM, Nørgaard K, Nilas L, Carlsen EM, Cortes D, Pryds O, Secher NJ (2014). The treatment of obese pregnant women (TOP) study: a randomized controlled trial of the effect of physical activity intervention assessed by pedometer with or without dietary intervention in obese pregnant women. Am J Obstet Gynecol, 210(2): 1-9. DOI: 10.1016/j.ajog.2013.09.029.

Ruchat SM, Davenport MH, Giroux I, Hillier M, Batada A, Sopper MM, Mc-Manus, et al. (2012). Effect of exercise intensity and duration on capillary glucose responses in pregnant women at low and high risk for gestational diabetes. Diabetes Metab Res Rev, 28(8): 669–678. DOI: 10.1002/dmrr.2324.

Sanabria-Martínez G, Garcia-Hermoso A, Leon-Poatos R, Alvares-Bueno C, Lopez-Sancez M, Martinez-Vizcaino V (2015). Effectiveness of physical activity interventions on preventing gestational diabetes mellitus and excessive maternal weight gain: a meta-analysis. BJOG, 122(9): 1167–1174. DOI: 10.1111/14710528.13429.

Thompson PD, Arena R, Riebe D, Pescatello LS (2013). ACSM’s new preparticipation health screening recommendations from ACSM’s guidelines for exercise testing and prescription, ninth edition. Curr Sports Med. Rep. 12(4): 215–217. DOI: 10.1249/JSR.0b013e31829a68cf.

Vinter CA, Jensen DM, Ovesen P, Beck-Nielsen H, Jørgensen JS (2011). The LiP (Lifestyle in Pregnancy) study: a randomized controlled trial of lifestyle intervention in 360 obese pregnant women. Diabetes Care, 34(12): 2–7.

Wang C, Wei Y, Zhang X, Zhang Y, Xu Q, Su S, Zhang L, et al. (2016). Effect of regular exercise commenced in early pregnancy on the incidence of gestational diabetes mellitus in overweight and obese pregnant women: a randomized controlled trial. Diabetes care 39(10): 3-4. DOI: 10.2337/dc161320

Wewege M, van den Berg R, Ward RE, Keech A (2017). The effects of high-intensity interval training vs. moderate-intensity continuous training on body composition in overweight and obese adults: a systematic review and meta-analysis. Obes Revi, 18(6): 35–46. DOI: 10.1111/obr.12532.




How to Cite

Cahyaningrum, H., Tamtomo, D., & Murti, B. (2023). Meta-Analysis: The Effect of Physical Activity in Reducing Excessive Gestational Weight Gain and Gestational Diabetes Mellitus among Overweight and Obese Pregnant Women. Journal of Maternal and Child Health, 8(1), 78–90.