Gestational diabetes-high blood sugar during pregnancy-affects mothers and babies with immediate dangers like stillbirth, preterm birth, and pre-eclampsia, plus lifelong risks of obesity, type 2 diabetes, and heart disease. Global rates are climbing rapidly, yet evidence guiding prevention has been patchy. Funded by the UK's National Institute for Health and Care Research, this represents the largest-ever collection of individual participant data from pregnancy trials worldwide.
The team pooled detailed records from diverse interventions—comparing diet advice, physical activity programs, combined approaches, delivery formats (individual vs. group), and facilitator expertise. They used advanced statistical modeling to isolate effects on gestational diabetes rates, tracking outcomes across demographics, health status, and intervention specifics. Physical activity emerged as the clear winner: walking, aerobic exercise, strength training, and swimming showed strongest protection. Group-based programs delivered by newly trained facilitators outperformed others.
Overall, lifestyle interventions meaningfully lowered gestational diabetes risk with no adverse effects. Women should discuss safe exercise with midwives or doctors. However, a troubling gap appeared: women from lower educational backgrounds benefited less, suggesting barriers in access, engagement, or program design. Most data came from high-income countries, highlighting needs for culturally adapted approaches and technology-enabled delivery in diverse global settings.
These findings demand immediate policy shifts. Physical activity-based programs should become routine antenatal care, with tailored outreach to underserved communities. As gestational diabetes surges worldwide, evidence now exists to make prevention standard practice for all pregnancies.
REFERENCE: Allotey, J., et al. (2026). Effects of lifestyle interventions in pregnancy on gestational diabetes: individual participant data and network meta-analysis. BMJ. doi: 10.1136/bmj-2025-084159. https://www.bmj.com/content/392/bmj-2025-084159
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