{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T11:11:47Z","timestamp":1781521907828,"version":"3.54.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Clin. Diabetes Healthc."],"abstract":"<jats:p>This meta-analysis aimed to evaluate the benefits of prenatal exercise on neonatal outcomes in women with gestational diabetes mellitus (GDM). Systematic searches were conducted in PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus from their inception to September 9, 2023. ClinicalTrials.gov was also searched to ensure comprehensive coverage. We included studies that investigated the association between prenatal exercise and at least one adverse neonatal outcome of interest. A total of 4,268 publications were retrieved, and 3,060 records remained after removing duplicates. After screening abstracts, 107 studies were selected for full-text assessment, and ultimately, 17 articles (including 4 identified through manual searching) were included for data extraction. Extracted information included the first author, publication year, study design, geographical location, sample size, participants\u2019 demographic characteristics, intervention characteristics, and relevant outcome variables.Pooled results from random-effects models showed that prenatal exercise significantly reduced the risk of adverse neonatal outcomes, including: Cesarean delivery (OR = 0.91, 95% CI: 0.88\u20130.94), Premature birth (OR = 0.49, 95% CI: 0.27\u20130.90), Macrosomia (OR = 0.58, 95% CI: 0.40\u20130.83), Fetal growth restriction (OR = 0.21, 95% CI: 0.08\u20130.52), and Birth trauma (OR = 0.26, 95% CI: 0.13\u20130.54). Subgroup analyses indicated that single-component exercise programs were more effective than multi-component programs in reducing the risk of macrosomia (P = 0.06). In conclusion, prenatal exercise substantially reduces the risk of multiple adverse neonatal outcomes in women with GDM, including macrosomia, preterm birth, cesarean delivery, fetal growth restriction, and birth trauma. These findings highlight the outstanding benefits of antenatal exercise for fetal health, supporting its inclusion as a key component of prenatal care for women with GDM. This meta-analysis is registered with PROSPERO (Registration Number: CRD42023485375).<\/jats:p>","DOI":"10.3389\/fcdhc.2025.1566577","type":"journal-article","created":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T09:35:42Z","timestamp":1743500142000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["The effect of exercise on the adverse neonatal outcomes related to women with gestational diabetes mellitus: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"6","author":[{"given":"Hangyu","family":"Cui","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingzi","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,4,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1016\/j.rec.2021.07.010","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ (Clin Res. Ed)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ (Clin Res. Ed)"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1006\/bioe.2002.0137","article-title":"The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses","author":"George","year":"","journal-title":"Symposium on Systematic Reviews: Beyond the Basics"},{"key":"B4","article-title":"Integrated approach of yoga therapy on maternal and fetal outcome in gestational diabetes mellitus","volume":"7","author":"Abirami","year":"2015","journal-title":"Int. J. Pharm. Clin. Res"},{"key":"B5","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1139\/H07-024","article-title":"A lifestyle intervention of weight-gain restriction: diet and exercise in obese women with gestational diabetes mellitus","volume":"32","author":"Artal","year":"2007","journal-title":"Appl. Physiol. Nutr. Metab"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(97)84256-1","article-title":"Effects of a partially home-based exercise program for women with gestational diabetes","volume":"89","author":"Avery","year":"1997","journal-title":"Obstet Gynecol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5114\/pq.2019.84270","article-title":"Effect of antenatal exercise on mode of delivery in gestational diabetic females: A single-blind randomized controlled trial","volume":"27","author":"Awad","year":"2019","journal-title":"Physiother Q"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.5455\/njppp.2017.7.0306713032017","article-title":"Physiological effects of yoga asanas and pranayama on metabolic parameters, maternal, and fetal outcome in gestational diabetes","volume":"7","author":"Balaji","year":"2017","journal-title":"NJPPP"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2012-091788","article-title":"Exercise during pregnancy and gestational diabetes-related adverse effects: a randomised controlled trial","volume":"47","author":"Barakat","year":"2013","journal-title":"Br. J. Sports Med"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1111\/dom.12289","article-title":"Simple lifestyle recommendations and the outcomes of gestational diabetes. A 2 \u00d7 2 factorial randomized trial","volume":"16","author":"Bo","year":"2014","journal-title":"Diabetes Obes. Metab"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.07.015","article-title":"Resistance exercise and glycemic control in women with gestational diabetes mellitus","volume":"203","author":"de Barros","year":"2010","journal-title":"Am. J. Obstet Gynecol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"104271","DOI":"10.1016\/j.ijnurstu.2022.104271","article-title":"Effects of the original Gymnastics for Pregnant Women program on glycaemic control and delivery outcomes in women with gestational diabetes mellitus: A randomized controlled trial","volume":"132","author":"Jin","year":"2022","journal-title":"Int. J. Nurs. Stud"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.wombi.2017.10.004","article-title":"Combination of a structured aerobic and resistance exercise improves glycaemic control in pregnant women diagnosed with gestational diabetes mellitus. A randomised controlled trial","volume":"31","author":"Kokic","year":"2018","journal-title":"Women Birth"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdiacomp.2022.108186","article-title":"Effects of exercise on blood glucose level, weight gain and pregnancy outcome in patients with gestational diabetes mellitus","volume":"15","author":"Kumar","year":"2023","journal-title":"Int. J. Pharm. Clin. Res"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000738","article-title":"Effect of an exercise intervention on gestational diabetes mellitus","volume":"125","author":"Nobles","year":"2015","journal-title":"Obstetrics Gynecology"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2021.1874340","article-title":"Application of diversified and quantitative management model of exercise intervention in patients with gestational diabetes mellitus","volume":"35","author":"Wu","year":"2022","journal-title":"J. Matern-Fetal Neonatal Med"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-021-01135-6","article-title":"Effects of moderate-intensity aerobic exercise on blood glucose levels and pregnancy outcomes in patients with gestational diabetes mellitus: A randomized controlled trial","volume":"12","author":"Xie","year":"2021","journal-title":"Diabetes Ther"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1016\/j.jdiacomp.2022.108186","article-title":"Effects of moderate-intensity resistance exercise on blood glucose and pregnancy outcome in patients with gestational diabetes mellitus: A randomized controlled trial","volume":"36","author":"Zhao","year":"2022","journal-title":"J. Diabetes Complications"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1177\/1099800408323728","article-title":"Gestational diabetes mellitus: Physical exercise and health outcomes","volume":"10","author":"Snapp","year":"2008","journal-title":"Biol. Res. Nurs"},{"key":"B20","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1186\/s12884-015-0682-1","article-title":"Exercise intervention during pregnancy can be used to manage weight gain and improve pregnancy outcomes in women with gestational diabetes mellitus","volume":"15","author":"Wang","year":"2015","journal-title":"BMC Pregnancy Childbirth"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1210\/endrev\/bnac003","article-title":"A clinical update on gestational diabetes mellitus","volume":"43","author":"Sweeting","year":"2022","journal-title":"Endocr. Rev"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-1295","article-title":"Maternal lipid profile during early pregnancy and pregnancy complications and outcomes: the ABCD study","volume":"97","author":"Vrijkotte","year":"2012","journal-title":"J. Clin. Endocrinol. Metab"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2021-002622","article-title":"Effects of resistance exercise on blood glucose level and pregnancy outcome in patients with gestational diabetes mellitus: a randomized controlled trial","volume":"10","author":"Xie","year":"2022","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"B24","doi-asserted-by":"publisher","first-page":"9517","DOI":"10.3390\/ijerph17249517","article-title":"Prevalence, prevention, and lifestyle intervention of gestational diabetes mellitus in China","volume":"17","author":"Juan","year":"2020","journal-title":"Int. J. Environ. Res"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9378(03)00951-7","article-title":"Resistance exercise decreases the need for insulin in overweight women with gestational diabetes mellitus","volume":"190","author":"Brankston","year":"2004","journal-title":"Am. J. Obstet Gynecol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1111\/bjo.2019.126.issue-4","article-title":"Associations between maternal physical activity in early and late pregnancy and offspring birth size: remote federated individual level meta-analysis from eight cohort studies","volume":"126","author":"Pastorino","year":"2019","journal-title":"BJOG"},{"key":"B27","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1017\/S2040174418000879","article-title":"Attenuation of maternal weight gain impacts infant birthweight: systematic review and meta-analysis","volume":"10","author":"Bennett","year":"2019","journal-title":"J. Dev. Orig Health Dis"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2022\/9287737","article-title":"Exercise intervention improves blood glucose levels and adverse pregnancy outcomes in GDM patients: A meta-analysis","volume":"2022","author":"Li","year":"2022","journal-title":"Comput. Math Method Med"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2017.01.037","article-title":"A randomized clinical trial of exercise during pregnancy to prevent gestational diabetes mellitus and improve pregnancy outcome in overweight and obese pregnant women","volume":"216","author":"Wang","year":"2017","journal-title":"Am. J. Obstet Gynecol"},{"key":"B30","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.jsams.2016.06.007","article-title":"Perceived barriers to leisure-time physical activity during pregnancy: A literature review of quantitative and qualitative evidence","volume":"20","author":"Coll","year":"2017","journal-title":"J. Sci. Med. Sport"}],"container-title":["Frontiers in Clinical Diabetes and Healthcare"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcdhc.2025.1566577\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T09:35:45Z","timestamp":1743500145000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcdhc.2025.1566577\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,1]]},"references-count":30,"alternative-id":["10.3389\/fcdhc.2025.1566577"],"URL":"https:\/\/doi.org\/10.3389\/fcdhc.2025.1566577","relation":{},"ISSN":["2673-6616"],"issn-type":[{"value":"2673-6616","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,1]]},"article-number":"1566577"}}