Clinical practice guidelines on physical activity and exercise for pregnant women with gestational diabetes mellitus: A systematic review.

Aim: This review aimed to appraise clinical guidelines about exercise for women with gestational diabetes mellitus and summarize consensus and inconsistent recommendations. Background: Exercise is an effective non‐pharmacological therapeutic for gestational diabetes mellitus, but the variety of relevant clinical practice guidelines is confusing for healthcare professionals. Design: This is a systematic review of clinical practice guidelines. Data Sources: Websites of guideline development institutions, eight literature databases and organizations of obstetricians, gynaecologists, midwives, and medical sports associations were searched for guidelines published from January 2011 to October 2021. Review Methods: Two reviewers independently extracted recommendations. Four reviewers assessed guideline quality using the AGREE II instrument independently. Results: Fifteen guidelines were included. All women with diabetes are recommended to exercise during pregnancy. The consistent recommendations were for pre‐exercise screening, for 30 min per exercise session on 5 days of the week or every day after meals, exercise at moderate intensity, using aerobic and resistance exercise, and walking. The main non‐consistent recommendations included warning signs for women on insulin during exercise, minimum duration per session, intensity assessment, duration and frequency of sessions for strengthening and flexibility exercise and detailed physical activity giving birth. Conclusions: Guidelines strongly support pregnant women with diabetes to exercise regularly. Research is needed to make non‐consistent recommendations clear. Summary statement: What is already known about this topic? Gestational diabetes mellitus is strongly associated with a higher risk of short‐ and long‐term adverse maternal and fetus outcomes.Physical activity is a safe and beneficial non‐pharmacological treatment for gestational diabetes mellitus.The methodological rigour and quality of the physical activity guidelines for pregnant women with gestational diabetes mellitus are unclear. What this paper adds? Methodological rigour and quality of the physical activity guidelines for pregnant women with gestational diabetes mellitus were identified by AGREE II instrument.Consensus and non‐consistent recommendations of the physical activity guidelines for pregnant women with gestational diabetes mellitus were summarized. The implications of this paper: The consensus recommendations make it clear that health professionals should offer physical activity guidance to pregnant women with gestational diabetes mellitus.Non‐consistent recommendations offer opportunities for further research directions. [ABSTRACT FROM AUTHOR]