Despite the maternal and infant morbidity associated with gestational diabetes mellitus (GDM), few modifiable risk factors have been identified. We explored the relation between recreational physical activity performed during the year before and during the first 20 weeks of pregnancy and the risk of GDM. 155 GDM cases and 386 normotensive, non-diabetic pregnant controls provided information about the type, intensity, frequency, and duration of physical activity performed during these time periods. Women who participated in any recreational physical activity during the first 20 weeks of pregnancy, as compared with inactive women, experienced a 48% reduction in risk of GDM (odds ratio [OR] = 0.52; 95% confidence interval [CI] 0.33-0.80). The number of hours spent performing recreational activities and the energy expended were related to a decrease in GDM risk. No clear patterns related to distance walked and pace of walking emerged. Daily stair climbing, when compared with no stair climbing, was associated with a 49-78% reduction in GDM risk (P for trend <0.011). Recreational physical activity performed during the year before the index pregnancy was also associated with statistically significant reductions in GDM risk, but women who engaged in physical activity during both time periods experienced the greatest reduction in risk (OR = 0.40; 95% CI 0.23-0.68). These data suggest that recreational physical activity performed before and/or during pregnancy is associated with a reduced risk of GDM.
"Physical activity is a safe and effective way for healthy pregnant women to reduce the risk of pregnancy complications including gestational diabetes (Dempsey et al., 2004), preeclampsia (Sorensen et al., 2003), and preterm delivery (Evenson, Siega-Riz, Savitz, Leiferman, & Thorp, 2002), and to improve physical stamina and mood during pregnancy (Poudevigne & O'Connor, 2006). Physical activity after pregnancy also reduces the likelihood of postpartum depression (Koltyn & Schultes, 1997) and weight retention (O'Toole, Sawichi, & Artal, 2003). "
[Show abstract][Hide abstract] ABSTRACT: Physical and psychological changes that occur during pregnancy present a unique challenge for women's physical activity. Using a theory-based prospective design, this study examines the effects of pregnant women's (a) physical activity cognitions (self-efficacy, outcome expectancy, and safety beliefs) and (b) online self-regulation activities (goal-setting and self-monitoring) on subsequent changes in their physical activity intentions and behavior during pregnancy and immediately postpartum. The authors used data from three panel surveys administered to pregnant women enrolled in a web-based intervention to promote healthy pregnancy and postpartum weight, as well as log data on their use of self-regulatory features on the intervention website. Perceived self-efficacy and perceived safety of physical activity in pregnancy enhanced subsequent intentions to be physically active. Repeated goal-setting and monitoring of those goals helped to maintain positive intentions during pregnancy, but only repeated self-monitoring transferred positive intentions into actual behavior. Theoretically, this study offers a better understanding of the roles of self-regulation activities in the processes of goal-striving. The authors also discuss practical implications for encouraging physical activity among pregnant and early postpartum women.
Journal of Health Communication 07/2015; DOI:10.1080/10810730.2015.1018639 · 1.61 Impact Factor
"GDM, the most frequent medical complication of pregnancy, is associated with several adverse outcomes over the short- and long-term for both mother and offspring . First, the presence of GDM always accompanies an increased maternal risk for preeclampsia, cesarean section, and with an increased risk for developing type 2 diabetes (T2D) after pregnancy , . In addition, there is an increased risk for neonatal death, still birth and congenital defects  resulting from excessive mother-to-fetus glucose transfer , . "
[Show abstract][Hide abstract] ABSTRACT: Nowadays, there have been increasing studies comparing metformin with insulin. But the use of metformin in pregnant women is still controversial, therefore, we aim to examine the efficiency and safety of metformin by conducting a meta-analysis of randomized controlled trials (RCTs) comparing the effects of metformin with insulin on glycemic control, maternal and neonatal outcomes in gestational diabetes mellitus (GDM).
We used the key words "gestational diabetes" in combination with "metformin" and searched the databases including Pubmed, the Cochrane Library, Web of knowledge, and Clinical Trial Registries. A random-effects model was used to compute the summary risk estimates.
Meta-analysis of 5 RCTs involving 1270 participants detected that average weight gains after enrollment were much lower in the metformin group (n = 1006, P = 0.003, SMD = -0.47, 95%CI [-0.77 to -0.16]); average gestational ages at delivery were significantly lower in the metformin group (n = 1270, P = 0.02, SMD = -0.14, 95%CI [-0.25 to -0.03]); incidence of preterm birth was significantly more in metformin group (n = 1110, P = 0.01, OR = 1.74, 95%CI [1.13 to 2.68]); the incidence of pregnancy induced hypertension was significantly less in the metformin group (n = 1110, P = 0.02, OR = 0.52, 95%CI [0.30 to 0.90]). The fasting blood sugar levels of OGTT were significantly lower in the metformin only group than in the supplemental insulin group (n = 478, P = 0.0006, SMD = -0.83, 95%CI [-1.31 to -0.36]).
Metformin is comparable with insulin in glycemic control and neonatal outcomes. It might be more suitable for women with mild GDM. This meta-analysis also provides some significant benefits and risks of the use of metformin in GDM and help to inform further development of management guidelines.
PLoS ONE 05/2013; 8(5):e64585. DOI:10.1371/journal.pone.0064585 · 3.23 Impact Factor
"A sedentary lifestyle, on the other hand, may put the mother and fetus at risk for diseases through altered maternal pregnancy adaptations, such as excessive GWG, gestational diabetes, or gestational hypertension  . Observational studies showed that physical activity during pregnancy reduces the risk of glucose intolerance, gestational diabetes    , and excessive GWG  . Active promotion of physical activity for pregnant women is strongly recommended in the absence of either medical or obstetric contraindications by professional organizations   . "
[Show abstract][Hide abstract] ABSTRACT: . The period surrounding pregnancy has been identified as a risk period for overweight/obesity in both mother and child because of excessive gestational weight gain (GWG). The promotion of a healthy GWG is therefore of paramount importance in the context of the prevention of obesity in the current and next generations.
. To provide a comprehensive overview of the effect of prenatal physical activity interventions, alone or in combination with nutritional counselling, on GWG and to address whether preventing excessive GWG decreases the incidence of infant high birth weight and/or postpartum weight retention.
. A search of the PubMed database was conducted to identify all relevant studies. Nineteen studies were included in this review: 13 interventions combining physical activity, nutrition, and GWG counselling and 6 interventions including physical activity alone.
. Prenatal lifestyle interventions promoting healthy eating and physical activity habits appear to be the most effective approach to prevent excessive GWG. Achievement of appropriate GWG may also decrease the incidence of high infant birth weight and postpartum weight retention.
. Healthy eating habits during pregnancy, combined with an active lifestyle, may be important elements in the prevention of long-term risk of obesity for two generations.
Journal of pregnancy 12/2012; 2012(2):470247. DOI:10.1155/2012/470247
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