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 The review incorporates dozens of new studies to update a previous
review that did not find enough evidence to support the use of diet
and exercise during pregnancy.
After including the new studies, the new review found "high-quality
evidence" to show diet, exercise or both can reduce the risk of
excessive weight gain during pregnancy, write the researchers in The
Cochrane Library.
Other benefits may include a lower risk of cesarean delivery,
excessive birth weight, and respiratory
problems in the newborn, "particularly for high-risk women receiving
combined diet and exercise interventions," add the researchers, led
by Benja Muktabhant of Khon Kaen University in Thailand.
The U.S. Institute of Medicine says the amount of weight women
should gain during pregnancy varies depending on their non-pregnancy
weight.
For example, a normal-weight woman should gain between 25 and 35
pounds, while an overweight woman should gain between 15 and 25
pounds. Obese women should gain even less.
Gaining too much weight is tied to an increased risk of
complications for both mother and child, according to the
researchers, who completed the review for The Cochrane
Collaboration, an international organization that evaluates medical
research.
For the new review, the researchers examined data from 65 randomized
controlled trials, which are considered the "gold standard" of
medical research. They were able to combine data from 49 trials
involving a total of 11,444 pregnant women.
The women were randomly assigned to a diet, exercise, a combination
of the two or standard care. The diets and exercise programs varied,
but could include low-glycemic diets and unsupervised exercise.
Women who took part in diet, exercise or combination programs were
about 20 percent less likely than women in standard-care groups to
gain too much weight while pregnant, the researchers report.
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The women who took part in diet, exercise and combination programs
were also less likely to develop high blood pressure during
pregnancy, compared to those in the standard care group.
There was no clear benefit among the women in the diet and exercise
groups when the researchers looked at other complications, such as
cesarean delivery, but it did look like there may be some benefit,
they write.
While the new study generally did not show fewer complications in
the diet and exercise group, Dr. Loralei Thornburg told Reuters
Health that it's good that there was no increase in complications.
"This was very reassuring that there wasn’t an increased risk of
preterm birth with moderate exercise," said Thornburg, a high-risk
pregnancy expert at the University of Rochester Medical Center in
New York.
"Most people gain more weight than they probably should during
pregnancy," Thornburg, who was not involved with the review, told
Reuters Health.
She said women who gain too much weight may not be able to lose it
after the baby is born. Then, during the next pregnancy the woman is
already heavier and that may increase the risk of complications.
"In the next pregnancy, if you don’t get it off, you may go from
obese to very obese," Thornburg said.
She cautioned, however, that women should check with their doctors
before starting a diet and exercise program during pregnancy.
SOURCE: http://bit.ly/1C3lYDc The Cochrane Library, online June 11,
2015.
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