Maternal and Child Health Journal

, Volume 20, Issue 6, pp 1247–1257 | Cite as

Moderate and Vigorous Intensity Exercise During Pregnancy and Gestational Weight Gain in Women with Gestational Diabetes

  • Samantha F. Ehrlich
  • Barbara Sternfeld
  • Amy E. Krefman
  • Monique M. Hedderson
  • Susan D. Brown
  • Ashley Mevi
  • Lisa Chasan-Taber
  • Charles P. QuesenberryJr.
  • Assiamira Ferrara


Objectives To estimate the associations of moderate and vigorous intensity exercise during pregnancy with the rate of gestational weight gain (GWG) from gestational diabetes (GDM) diagnosis to delivery, overall and stratified by prepregnancy overweight/obesity. Methods Prospective cohort study with physical activity reported shortly after the GDM diagnosis and prepregnancy weight and post-diagnosis GWG obtained from electronic health records (n = 1055). Multinomial logistic regression models in the full cohort and stratified by prepregnancy overweight/obesity estimated associations of moderate and vigorous intensity exercise with GWG below and above the Institute of Medicine’s (IOM) prepregnancy BMI-specific recommended ranges for weekly rate of GWG in the second and third trimesters. Results In the full cohort, any participation in vigorous intensity exercise was associated with decreased odds of GWG above recommended ranges as compared to no participation [odds ratio (95 % confidence interval): 0.63 (0.40, 0.99)], with a significant trend for decreasing odds of excess GWG with increasing level of vigorous intensity exercise. Upon stratification by prepregnancy overweight/obesity, significant associations were only observed for BMI ≥ 25.0 kg/m2: any vigorous intensity exercise, as compared to none, was associated with 54 % decreased odds of excess GWG [0.46 (0.27, 0.79)] and significant trends were detected for decreasing odds of GWG both below and above the IOM’s recommended ranges with increasing level of vigorous exercise (both P ≤ 0.03). No associations were observed for moderate intensity exercise. Conclusions for Practice In women with GDM, particularly overweight and obese women, vigorous intensity exercise during pregnancy may reduce the odds of excess GWG.


Gestational diabetes mellitus Physical activity during pregnancy Moderate intensity exercise Vigorous intensity exercise Gestational weight gain 



Gestational weight gain


Gestational diabetes mellitus



This work was supported by Grant R01 HS019367 from the Agency for Healthcare Research and Quality to Dr. Ferrara, who was also supported by Grant P30 DK092924 from the National Institutes of Health. Data were presented at the American Diabetes Association’s 73rd Scientific Sessions. S.F.E. analyzed the data and drafted the manuscript; C.P.Q. and A.F. analyzed the data and revised the manuscript; B.S., A.E.K., M.M.H., S.D.B., A.M., and L.C.T. revised the manuscript.

Compliance with Ethical Standards

Conflict of interest

The authors have no relevant conflict of interest to disclose.


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Samantha F. Ehrlich
    • 1
    • 2
  • Barbara Sternfeld
    • 1
  • Amy E. Krefman
    • 1
  • Monique M. Hedderson
    • 1
  • Susan D. Brown
    • 1
  • Ashley Mevi
    • 1
  • Lisa Chasan-Taber
    • 3
  • Charles P. QuesenberryJr.
    • 1
  • Assiamira Ferrara
    • 1
  1. 1.Division of ResearchKaiser Permanente Northern CaliforniaOaklandUSA
  2. 2.Department of Public Health, College of Education, Health and Human SciencesUniversity of TennesseeKnoxvilleUSA
  3. 3.Division of Biostatistics and Epidemiology, School of Public Health and Health SciencesUniversity of MassachusettsAmherstUSA

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