Background: Pregnancy is a period in the life of women that is often associated with decreased daily physical activity and/or exercise. However, maintaining adequate levels of daily physical activity during pregnancy is important for mother and child. Studies suggest that moderate daily physical activity and exercise during pregnancy are associated with reductions in the risk of gestational diabetes mellitus (GDM). However, at present, physical activity is not routinely advised to pregnant women at risk for gestational diabetes in the Netherlands. In FitFor2-study we aim to assess whether an exercise program can improve insulin sensitivity and fasting plasma glucose levels of women at high risk for gestational diabetes, assuming that this will lower their risk of gestational diabetes.
The results indicate that there may be some benefits of dietary counseling, an LGI diet advice, or an exercise program. However, better-designed studies are required to generate higher quality evidence. At the moment, no strong conclusions can be drawn with regard to the best intervention for prevention of GDM.
Objective. To evaluate the relationship of physical activity (PA) and sedentary behaviour with gestational weight gain (GWG) and birth weight. Design. Combined data from two prospective studies: (1) nulliparous pregnant women without BMI restrictions and (2) overweight and obese pregnant women at risk for gestational diabetes. Methods. Daily PA and sedentary behaviour were measured with an accelerometer around 15 and at 32–35 weeks of gestation. The association between time spent in moderate-to-vigorous PA (MVPA) and in sedentary activities with GWG and birth weight was determined. Main outcome measures were GWG between 15 and 32 weeks of gestation, average GWG per week, and birth weight. Results. We studied 111 women. Early in pregnancy, 32% of women spent ≥30 minutes/day in at least moderate PA versus 12% in late pregnancy. No significant associations were found between time spent in MVPA or sedentary behaviour with GWG or birth weight. Conclusions. We found no relation between MVPA and sedentary behaviour with GWG or birth weight. The small percentage of women meeting the recommended levels of PA indicates the need to inform and support pregnant women to maintain regular PA, as there seems to be no adverse effect on birth weight and maintaining PA increases overall health.
Introduction. We explored beliefs, perceived barriers, and preferences regarding lifestyle changes among overweight European pregnant women to help inform the development of future lifestyle interventions in the prevention of gestational diabetes mellitus. Methods. An explorative mixed methods, two-staged study was conducted to gather information from pregnant European women (BMI ≥ 25 kg/m2). In three European countries 21 interviews were conducted, followed by 71 questionnaires in six other European countries. Content analysis and descriptive and chi-square statistics were applied (p < 0.05). Results. Women preferred to obtain detailed information about their personal risk. The health of their baby was a major motivating factor. Perceived barriers for physical activity included pregnancy-specific issues such as tiredness and experiencing physical complaints. Insufficient time was a barrier more frequently reported by women with children. Abstaining from snacking was identified as a challenge for the majority of women, especially for those without children. Women preferred to obtain support from their partner, as well as health professionals and valued flexible lifestyle programs. Conclusions. Healthcare professionals need to inform overweight pregnant women about their personal risk, discuss lifestyle modification, and assist in weight management. Lifestyle programs should be tailored to the individual, taking into account barriers experienced by overweight first-time mothers and multipara women.
OBJECTIVEPreviously, we reported the positive association of moderate-to-vigorous physical activity (MVPA) with insulin sensitivity in overweight and obese pregnant women. We sought to assess whether these MVPA-induced changes in insulin sensitivity are mediated by changes in interleukin (IL)-6, IL-10, tumor necrosis factor (TNF)-a, and IL-1b.
RESEARCH DESIGN AND METHODSA prospective longitudinal study was conducted in 46 overweight and obese women at risk for gestational diabetes mellitus. Objective physical activity measurements and fasting blood samples were taken at 15, 24, and 32 weeks of pregnancy. At 24 and 32 weeks, a 100-g oral glucose test was performed in addition. Cytokines, C-reactive protein, and glucose and insulin levels were measured, and insulin sensitivity and first-phase insulin response were calculated. Relationships between the different parameters were assessed using linear regression models, adjusting for maternal age and BMI.
RESULTSAll cytokines were elevated in women with higher levels of MVPA at 15 weeks of gestation. Higher IL-6 was related to a lower first-phase insulin response (b 2810.5 [95% CI -1,524.5 to -96.5]; P = 0.03). TNF-a and IL-1b had different effects in women with low MVPA (with low IL-6 levels) compared with more active women. CRP was not related to MVPA.
CONCLUSIONSThe association of MVPA with insulin sensitivity and first-phase insulin response may be (partly) mediated by IL-6, since this cytokine was related to reduced firstphase insulin response. The possible positive effects of the elevated cytokine profile in active obese pregnant women warrant further study.
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