Movement Behavior during Pregnancy and Adverse Maternal–Fetal Outcomes in Women with Gestational Diabetes: A Pilot Case-Control Study

Abstract

Gestational diabetes mellitus (GDM) is a major complication in pregnancy. GDM is associated with a higher risk for adverse maternal–fetal outcomes. Associations between movement behavior, including physical activity (PA) and sedentary behavior (SB), and maternal–fetal outcomes are still unclear. The objective of this study was to investigate associations between movement behavior and adverse maternal–fetal outcomes in women with GDM. A total of 68 women with GDM (20–35 weeks, 32.1 ± 5.8 years) were included in this pilot case-control study. The cases were defined by the presence of an adverse composite maternal–fetal outcome (preterm birth, newborn large for gestational age, and neonatal hypoglycemia). Controls were defined as no adverse maternal–fetal outcome. PA intensities and domains, steps/day (pedometer), and SB were analyzed. A total of 35.3% of participants showed adverse maternal–fetal outcomes (n = 24). The controls showed a higher moderate-intensity PA level than the cases (7.5, 95%CI 3.6–22.9 vs. 3.1, 95%CI 0.4–10.3 MET-h/week; p = 0.04). The moderate-intensity PA level was associated with a lower risk for adverse maternal–fetal outcomes (OR 0.21, 95%CI 0.05–0.91). No significant associations were observed for other PA and SB measures (p > 0.05). In conclusion, moderate-intensity PA during pregnancy seems to have a protective role against adverse maternal–fetal outcomes in women with GDM.

Sedentary behaviors and gestational diabetes mellitus: A systematic review

“…Of the 18 included studies, most (13) had a low risk of bias, 16,17,27,28,30,[32][33][34][35][36][37][38][39] three had a moderate risk of bias, 26,29,31 and the remaining two had a high risk of bias (Table 2). 15,18 Most of the studies did not use an objective appraisal tool to identify SB and did not describe the reasons for loss to follow-up or take measures to deal with these issues.…”

“…In addition, two studies extrapolated the participants' diagnoses from their medical records, 27,28 one study was unclear, 18 and five studies did not report the diagnostic criteria used. 24,29,30,32,37 On the occurrence of SB, 14 studies focused on SB during pregnancy, [15][16][17][18]26,30,[32][33][34][35][36][37][38][39] four focused on SB before pregnancy, 18,27,29,31 and one was unclear. 28 Regarding SB assessment, three studies 26,37,38 utilized objective methods to assess SB (pedometer or accelerometer) and seven studies 15,30,[32][33][34][35][36] employed questionnaire measures.…”

“…24,29,30,32,37 On the occurrence of SB, 14 studies focused on SB during pregnancy, [15][16][17][18]26,30,[32][33][34][35][36][37][38][39] four focused on SB before pregnancy, 18,27,29,31 and one was unclear. 28 Regarding SB assessment, three studies 26,37,38 utilized objective methods to assess SB (pedometer or accelerometer) and seven studies 15,30,[32][33][34][35][36] employed questionnaire measures. In addition, eight studies assessed SB based on participants' self-reports.…”

“…15,33,39 One study assessed TV viewing time, reporting that it was 2.99 h/day. 15 This study also reported SB time in various domains; SB in the transport and general 32 12 1 0 0 92.31 Low Camargo et al 33 9 1 0 0 90.00 Low Mishra et al 34 8 2 0 0 80.00 Low Nasiri-Amiri et al 35 9 1 1 0 81.82 Low Yong et al 36 9 1 1 0 81.82 Low Nayak et al 37 7 1 0 0 87.50 Low Wagnild et al 38 8 0 0 0 100 Low Nguyen et al 39 8 1 2 0 72.73 Low Note: "Yes,", "No," "Not clear," and "Not applicable" indicate the reviewer ratings based on the JBI risk assessment tool. The risk of bias in each study was considered low, moderate, or high if 70%, 50-69%, or < 50%, respectively, of the reviewer ratings regarding the items were "Yes.…”

“…The associations of SB with maternal and infant outcomes were studied in three studies(Table 5). 15,28,33 The subjects included women with GDM 15,33 and women at risk of GDM (women with a history of GDM). 28 Of these, three on maternal outcomes, 15,28,33 and two on infant outcomes.…”