Research on Pre-Exam Article Worksheet 2 – Exam 2 PC718

Pre-Exam Research Article Worksheet 2 – Exam 2 PC718
Systematic Review: Meta-analysis
Du, M. C., Ouyang, Y. Q., Nie, X. F., Huang, Y., & Redding, S. R. (2018). Effects of physical exercise during pregnancy
on maternal and infant outcomes in overweight and obese pregnant women: A meta‐analysis. Birth.
https://onlinelibrary.wiley.com/doi/abs/10.1111/birt.12396
1. What study design was used for this article?
Meta-analysis was used as a study design for this article (Du et al., 2019).
2. What was the purpose/aim of the study?
The main aim of the study was to evaluate the effect of physical exercise during pregnancy on maternal
outcomes of obese and overweight pregnancy women.
3. What databases were searched for studies?
Databases like Cochrane Library, Embase, PubMed, Web of Science, and ClinicalTrials.gov. were used to
search for studies.
4. What MeSH terms and keywords were for the search of articles?
The keywords used for searching articles included “Women, Pregnant” OR “Pregnant Women”, (“Obesity” OR
“Overweight” OR “Obese”) and Exercises” OR “Physical Activity” OR “Aerobic Exercise” OR “Exercise
Training” OR “Training, Resistance”. No MeSH terms were used
5. What were the publication date range of the studies included?
a. From year_2009_____ to year__2017____
6. If stated, what were the inclusion criteria for a study to be used in the meta-analysis? If stated, what
were the exclusion criteria?
The inclusion criteria for the study included randomized controlled trials published in English and those
which investigated about the effects of physical exercise without nutritional interventions in obese and
overweight pregnant women. The exclusion criteria was studies which were not published in English and
those which were not in full text format.
7. What were the characteristics of the samples included in the meta-analysis?
The key characteristics of the research sample included overweight and pregnant women having a single
pregnancy with no exercise contraindications.
8. What was the total sample size for the meta-analysis?
A total of 1439 samples were included in the meta-analysis.
9. How many studies were included in the final analysis? How many were excluded?
Final studies included in the final analysis included 13 papers. 1721 articles were excluded.
10. How was the data extracted?
Data were extracted by two authors and the Outcomes and characteristic data were extracted from each
papers. The main data for outcome included sample size, standard deviation, mean and incidence rate. the
details for the characteristics of studies such as author details, publication, country, intervention, sample
method and outcome were excluded too.

11. Does the article state if intention to treat or per protocol analysis was used for missing data? Yes...
Which one?...No
Yes, 10 studies reported compliance to missing date by intention to treat and these studies includes the
research by Dekker Nitert et al. (2015), Seneviratne et al. (2016), Garnæs et al. (2017), Callaway et al. (2010),
Renault et al. (2014), Bisson et al. (2015), Oostdam et al. (2012), Daly et al. (2017), Wang et al. 2017 and
Nascimento et al. (2011).
12. How was quality and/or bias assessed for each of the studies?
The quality assessment for each study was done by evaluating risk of bias using the Cochrane Collaboration’s
bias risk assessment tool and this mainly covered assessment in the area of random sequence generation,
allocation concealment, blinding of participants and personnel, blinding of outcome assessment, incomplete
outcome data, selective reporting, and other bias.
13. What dependent variables (outcomes) were similar across all of the included studies chosen for meta-
analysis?
The outcomes related to gestations weight gain and risk of gestational diabetes were similar across all the
studies
14. What independent variables (interventions) were similar across all of the included studies chosen
meta-analysis?
The intervention related to physical exercise was same for all the studies and it differed only in the types of
exercise
15. Were the results of each study combined in analysis (i.e., meta-analysis) Yes.... No....
Yes, secondary analysis was combined with original articles
16. If yes, do you think that it made sense to combine the results Yes.... No....
Yes, combining studies made sense as it helped to assess difference in outcomes for all studies and
identify similar findings for diverse type of studies (Gough, 2015).
17. If no, were there good reasons, such as different variable definitions and measurement tools used, so
that it was not appropriate to combine results Yes.... No....
18. What were the major findings/results in the meta-analysis? Which of these were statistically and not
statistically significant?
The key findings of the metal-analysis were that exercise intervention was found to reduce gestation weight
gain and no significant difference between birth weight of infants. However, for the gestational weight gain
intervention, the outcome was not statistically significant as the mean difference was only -1.14 kg.
19. How did the investigators interpret the results? (See Reading Research: A User-Friendly Guide for Health
Professionals for a description of sensitivity and specificity to help you with the Forest Plot interpretation).
The results were interpreted by the researcher after evaluating outcomes of research based on statistical
analysis and review of effect estimates. The forest plot was generated for each outcome which gave
idea about mean difference and confidence interval. The advantage of using forest plot for research
interpretation is that it helps to visually assess the heterogeneity of data and find out the validity and
statistical significances of the research outcome (Verhagen & Ferreira, 2014).