eprintid: 27155 rev_number: 8 eprint_status: archive userid: 2 dir: disk0/00/02/71/55 datestamp: 2026-02-04 23:30:16 lastmod: 2026-02-04 23:30:18 status_changed: 2026-02-04 23:30:16 type: article metadata_visibility: show creators_name: Allotey, John creators_name: Coomar, Dyuti creators_name: Ensor, Joie creators_name: Ruiz-Calvo, Gabriel creators_name: Boath, Anna creators_name: Ogwulu, Chidubem Okeke creators_name: Monahan, Mark creators_name: Kabeya, Valencia creators_name: Zheng, Min creators_name: McNeill, Rachel creators_name: Meacham, Hollie creators_name: Mahmoud, Ghadir creators_name: Simpson, Sharon Anne creators_name: Hitman, Graham A creators_name: Nirantharakumar, Krish creators_name: Heslehurst, Nicola creators_name: Peláez, Mireia creators_name: Tonstad, Serena creators_name: Yeo, SeonAe creators_name: Cecatti, Jose G creators_name: Facchinetti, Fabio creators_name: Motahari-Tabari, Narges Sadat creators_name: Renault, Kristina M creators_name: Guelfi, Kym J creators_name: Jensen, Dorte Møller creators_name: Harrison, Cheryce creators_name: Khomami, Mahnaz Bahri creators_name: Calle-Pascual, Alfonso L creators_name: McAuliffe, Fionnuala M creators_name: Hauner, Hans creators_name: Barakat, Ruben creators_name: Geiker, Nina Rica Wium creators_name: Vinter, Christina Anne creators_name: Phelan, Suzanne creators_name: Kinnunen, Tarja I creators_name: Kothari, Alka creators_name: Teede, Helena creators_name: Poston, Lucilla creators_name: Betrán, Ana Pilar creators_name: Moss, Ngawai creators_name: Iliodromiti, Stamatina creators_name: Austin, Frances creators_name: Roberts, Tracy creators_name: Zamora, Javier creators_name: Riley, Richard D creators_name: Thangaratinam, Shakila creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: mireia.pelaez@uneatlantico.es creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: creators_id: title: Effects of lifestyle interventions in pregnancy on gestational diabetes: individual participant data and network meta-analysis ispublished: pub subjects: uneat_bm divisions: uneatlantico_produccion_cientifica full_text_status: public abstract: 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 3.5%, 95% CI 1.3% to 5.7%). Effects did not vary by maternal characteristics, except for education. Although women of all educational levels benefited from the intervention, the benefit was less in those with low education (low v middle interaction: odds ratio 0.68, 95% CI 0.51 to 0.90; low v high interaction: odds ratio 0.71, 95% CI 0.54 to 0.93). Benefits did not vary by intervention characteristics, except for greater effectiveness with group format (odds ratio 0.81, 95% CI 0.68 to 0.97; absolute risk reduction 2.5%, 95% CI 0.4% to 4.3%) and newly trained facilitators (odds ratio 0.82, 95% CI 0.69 to 0.96; absolute risk reduction 2.4%, 95% CI 0.5% to 4.2%). Physical activity based interventions ranked highest (mean rank 1.1, 95% CI 1 to 2) in preventing gestational diabetes. Conclusions Lifestyle interventions in pregnancy are likely to prevent gestational diabetes, with effects varying according to diagnostic criteria. Implementation strategies should address inequalities by maternal education, and consider group formats, provider training, and physical activity based interventions to prevent gestational diabetes. date: 2026-01 publication: BMJ volume: 392 pagerange: e084159 id_number: doi:10.1136/bmj-2025-084159 refereed: TRUE issn: 1756-1833 official_url: http://doi.org/10.1136/bmj-2025-084159 access: open language: en citation: Artículo Materias > Biomedicina Universidad Europea del Atlántico > Investigación > Artículos y libros Abierto Inglés 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 3.5%, 95% CI 1.3% to 5.7%). Effects did not vary by maternal characteristics, except for education. Although women of all educational levels benefited from the intervention, the benefit was less in those with low education (low v middle interaction: odds ratio 0.68, 95% CI 0.51 to 0.90; low v high interaction: odds ratio 0.71, 95% CI 0.54 to 0.93). Benefits did not vary by intervention characteristics, except for greater effectiveness with group format (odds ratio 0.81, 95% CI 0.68 to 0.97; absolute risk reduction 2.5%, 95% CI 0.4% to 4.3%) and newly trained facilitators (odds ratio 0.82, 95% CI 0.69 to 0.96; absolute risk reduction 2.4%, 95% CI 0.5% to 4.2%). Physical activity based interventions ranked highest (mean rank 1.1, 95% CI 1 to 2) in preventing gestational diabetes. Conclusions Lifestyle interventions in pregnancy are likely to prevent gestational diabetes, with effects varying according to diagnostic criteria. Implementation strategies should address inequalities by maternal education, and consider group formats, provider training, and physical activity based interventions to prevent gestational diabetes. metadata 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; Peláez, 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 y Thangaratinam, Shakila mail SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, mireia.pelaez@uneatlantico.es, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR, SIN ESPECIFICAR (2026) Effects of lifestyle interventions in pregnancy on gestational diabetes: individual participant data and network meta-analysis. BMJ, 392. e084159. ISSN 1756-1833 document_url: http://repositorio.uneatlantico.es/id/eprint/27155/1/bmj-2025-084159.full.pdf