Physical Activity, Obesity, and Diabetes in Pregnancy

Abstract

Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy. Women with GDM are at elevated for numerous maternal health complications, and their infants are at elevated risk for death and morbidity. Management of GDM has traditionally been through diet and close monitoring of glucose levels, with initiation of insulin therapy when diet alone fails to maintain euglycemia. Recently, however, it has been suggested that alternative treatment modalities, such as exercise, may overcome a peripheral resistance to insulin, thus preventing GDM or controlling hyperglycemia in women with GDM. In this study, conducted from October 1995 to July 1996, the authors used a population-based birth registry to determine whether exercise has a preventive role in the development of GDM in women living in central New York State. They used contingency tables and chi-square statistics to examine bivariate differences among maternal and demographic variables and the occurrence of GDM. When stratified by prepregnancy body mass index category, exercise was associated with reduced rates of GDM only among women with a body mass index greater than 33 (odds ratio = 1.9, 95% confidence interval 1.2-3.1). The effect of exercise in obese women was further complicated by insurance status. When the data were stratified by insurance status, it appeared that women of higher socioeconomic status who were obese and did not exercise were at a significantly elevated risk of GDM compared with their counterparts of lower socioeconomic status. The results of this study suggest that for some women exercise may play a role in reducing the risk that they will develop GDM during pregnancy.

Dietary fat and gestational hyperglycaemia

“…It is possible that this association could be revealed to be significant using a more appropriate definition of physical activity. Exercise, in fact, seems associated with reduced rates of GDM particularly in obese women [9] in line with data of literature showing a protective effect of physical activity on the risk of Type II diabetes in women [38±39].…”

“…A lack of exercise seems to be an important risk factor for pregnant women who are obese only [9]. It has recently been shown that women with recurrent GDM had a higher overall intake of fat (as percentage of energy) than those without recurrences [10].…”

Non classical risk factors for gestational diabetes mellitus: a systematic review of the literature

“…This study found a non significant reduction of gestational diabetes mellitus risk for women who were vigorously physical active or did brisk walking before pregnancy. Dye et al 70 , also in 1997, found that inactive women presented OR: 1.9 (95%CI: 1.2-3.1) for gestational diabetes mellitus, compared to active women, only among those with BMI pre-pregnancy > 33. This study considered as physical activity those activities performed during leisure time.…”

Social Health Betterment via Optimizing Embryonic and Foetal Omics: An Obesity Perspective

“…Another example is obesity that has been a real threat to quality human life, which can be prevented at least in part via manipulating gestational characteristics of foetal cellular omics [4]. Regular, appropriate and adequately intensive physical activity during all phases of pregnancy can improve maternal intermediary metabolism by enhancing insulin sensitivity and minimizing gestational visceral adiposity and diabetes [1,[4][5][6][7]. This could basically enhance foetal genomic status in preventing obesity and dealing with glucose intolerance at certain unique times over the resulting individual lifespan.…”