Moderate and Vigorous Intensity Exercise During Pregnancy and Gestational Weight Gain in Women with Gestational Diabetes
- 976 Downloads
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.
KeywordsGestational 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.
- 8.Mamun, A. A., Kinarivala, M., O’Callaghan, M. J., Williams, G. M., Najman, J. M., & Callaway, L. K. (2010). Associations of excess weight gain during pregnancy with long-term maternal overweight and obesity: Evidence from 21 y postpartum follow-up. American Journal of Clinical Nutrition, 91(5), 1336–1341.CrossRefPubMedGoogle Scholar
- 11.IOM (Institutes of Medicine). (2009). Weight gain during pregnancy: Reexamining the guidelines. Washington, DC: The National Academic Press.Google Scholar
- 14.Sanabria-Martinez, G., Garcia-Hermoso, A., Poyatos-Leon, R., Alvarez-Bueno, C., Sanchez-Lopez, M., & Martinez-Vizcaino, V. (2015). Effectiveness of physical activity interventions on preventing gestational diabetes mellitus and excessive maternal weight gain: A meta-analysis. BJOG, 122, 1167–1174.CrossRefPubMedGoogle Scholar
- 16.American College of Obstetricians and Gynecologists. (2015). Physical activity and exercise during pregnancy and the postpartum period. Committee Opinion No. 650. Obstetrics and Gynecology, 126(6), e135–e142.Google Scholar
- 17.Physical Activity Guidelines Committee. (2008). Physical activity guidelines advisory committee report. Washington, DC: Department of Health and Human Services.Google Scholar
- 19.Gordon, N. (2007). Similarity of the adult Kaiser Permanente Membership in Northern California to the insured and general population in Northern California: Statistics from the 2007 California Health Interview Survey. Oakland, CA: Kaiser Permanente Northern California Division of Research.Google Scholar
- 20.Ferrara, A., Hedderson, M. M., Albright, C. L., Brown, S. D., Ehrlich, S. F., Caan, B. J., et al. (2014). A pragmatic cluster randomized clinical trial of diabetes prevention strategies for women with gestational diabetes: Design and rational of the Gestational Diabetes’ Effects on Moms (GEM) study. BMC Pregnancy Childbirth, 14(1), 21.CrossRefPubMedPubMedCentralGoogle Scholar
- 21.Committee opinion no. 504: Screening and diagnosis of gestational diabetes mellitus. Obstetrics and Gynecology, 118(3), 751–753 (2011).Google Scholar