The Association Between Physical Activity During Pregnancy and Gestational Diabetes Mellitus: A Case-Control Study

Abstract

BackgroundGestational diabetes mellitus is one of the most common complications of pregnancy. Physical activity is associated with a lower risk of type 2 diabetes mellitus. A recent meta-analysis study suggested that more research is needed to investigate the type, duration and intensity of physical activity that can help to reduce the risk of gestational diabetes mellitus.ObjectivesThe present study aimed to understand the association between physical activity and gestational diabetes mellitus through comparing the type and intensity of physical activity performed by pregnant females with gestational diabetes and healthy pregnant females in the first 20 weeks of their pregnancy.Patients and MethodsIn the current case-control study, 100 pregnant females with gestational diabetes mellitus as the case group and 100 pregnant females as the non-diabetic control group were recruited. The age range of the participants was 18 - 40 years with the gestation of 20 - 28 weeks. To diagnose gestational diabetes mellitus using the criteria introduced by carpenter and coustan females with abnormal glucose challenge test (> 140 mg/dL) were asked to perform the three-hour 100 g oral glucose tolerance test. The details of physical activity were collected by a modified version of the pregnancy physical activity questionnaire. Anthropometric and relevant data were recorded for all of the participants. Data were analyzed by SPSS version 21. Risk estimates were obtained by logistic regression and adjusted for confounders.ResultsFemales who had low total physical activity according to the pregnancy physical activity questionnaire during early pregnancy were at a significantly higher risk of developing gestational diabetes mellitus (OR = 4.12, 95% CI (2.28 - 7.43), P = 0.001) compared to the ones who reported higher levels of physical activity. Moreover, after adjusting for age, body mass index (BMI), gravidity and a family history of diabetes, females with low physical activity in the domain of transportation activity during 20 weeks of pregnancy were at a significantly higher risk of developing gestational diabetes mellitus. The statistical findings indicate that females with the low intensity of sedentary, light and moderate physical activity are at a higher risk of developing gestational diabetes mellitus (OR 2.32; 95% CI 1.21-4.43, P = 0.010, OR 6.26; 95% CI 2.95 - 13.30, P = 0.001 and OR 6.73; 95% CI 3.15 - 14.38, P = 0.001) compared to females with a higher intensity of sedentary, light and moderate physical activity.ConclusionsThe amount and intensity of physical activity during pregnancy is associated with a lower risk of gestational diabetes mellitus. As a result, the pregnant Iranian females have to be encouraged to do regular daily physical activity during pregnancy, if there is no specific contraindication to it.

Effect of physical activity during pregnancy on gestational diabetes mellitus

“…However, the case–control study of Nasiri-Amiri et al . [ 74 ] revealed significantly high risk but in transportation domain.…”

Physical activity level in women with gestational diabetes mellitus: Lifestyle INtervention for Diabetes prevention After pregnancy (LINDA‐Brasil) study

“…It is known that women with low levels of physical activity during pregnancy have a higher risk of developing GDM. 26,27 Approximately one-third of this sample of the LINDA-Brasil study was physically active; this is worrying considering the potential of this behavior to prevent development of T2D after delivery. In addition, physical activity improves glycemic control 8,10 and contributes to a reduction in weight gain in women diagnosed with GDM.…”

“…Charts were reviewed to collect data on prepregnancy weight, gestational weight, gestational age at recruitment, plasma glucose levels at diagnosis of GDM, treatment for GDM, and reproductive history. 21,23 For descriptive analyses, age was classified into three categories (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39), and ≥40 years). Self-declared skin color was categorized as white, black, brown, or other, according to the Brazilian census bureau.…”

High physical activity and high sedentary behavior increased the risk of gestational diabetes mellitus among women with excessive gestational weight gain: a prospective study

“…The benefits of PA and the disadvantages of physical inactivity among the general population are well recognized [22][23][24]. However, evidence on the effect of PA during pregnancy on GDM risk is inconsistent [25][26][27][28][29][30]. While several studies showed an inverse association [25,27,30], others did not find any association [26,28,29].…”

“…However, evidence on the effect of PA during pregnancy on GDM risk is inconsistent [25][26][27][28][29][30]. While several studies showed an inverse association [25,27,30], others did not find any association [26,28,29]. However, studies reporting an inverse association, have been limited by their cross-sectional examination of PA and GDM [25][26][27], making it difficult to ascertain the cause-effect relationship.…”