The role of exercise in the prevention and treatment of gestational diabetes mellitus

The association between gestational diabetes mellitus and recreational physical activity

We aimed to investigate the association of recreational physical activity before pregnancy with gestational diabetes mellitus (GDM). A cross-sectional study was performed using self-reported data from the Pregnancy Risk Assessment and Monitoring System. The study population included 1,052 self-reported GDM cases and 10,351 non-GDM controls. Recreational physical activity in the 3 months before pregnancy was recalled in postpartum structured interviews. Compared to women exercising less than 1 day per week, women who exercised >5 days per week in the 3 months before pregnancy had a 31% lower odds of GDM (adjusted odds ratio [aOR]: 0.69; 95% confidence interval [CI]: 0.46, 1.03). Women who exercised 1-4 days per week had a 7% lower odds of GDM (aOR: 0.93; 95%CI: 0.72, 1.19). We did not observe statistically significant associations between pre-pregnancy physical activity and GDM risk. However, the magnitude and direction of association are consistent with previous observational studies. These studies collectively suggest a role of physical activity in GDM prevention.

Factors that influence physical activity for pregnant and postpartum women and implications for primary care

Many pregnant women and women of child-bearing age do not engage in the recommended levels of physical activity despite the well known benefits. Pregnancy and the postpartum period can be a time when inactivity actually increases. Women who experience gestational diabetes mellitus (GDM) during their pregnancy are often advised to become more active in order to ameliorate their increased risk of developing type 2 diabetes. Health professionals have an influential role in promoting physical activity, which would be enhanced with an understanding of the factors that positively and negatively influence women's participation in physical activity during pregnancy and in the postpartum period. This research sought to explore these factors with pregnant and postpartum women including those who had experienced GDM and the attention given to physical activity during pregnancy. A survey was developed after a critical review of factors identified from previous studies. Women were recruited from the antenatal clinic, community health centres and the local media. Results from 72 women are reported from a predominately well educated, Caucasian population. Overall, the results were confirmatory of factors previously identified. Lack of child care, time constraints, no time and feeling unwell during pregnancy hindered activity and factors that facilitated activity included family support, enjoyment of activity and to prevent later health problems. It was also found that non-GDM women are given minimal advice about exercise during pregnancy. A checklist has been developed for health professionals, in partnership with women, to direct attention to the factors that enable and hinder participation in physical activity during and after pregnancy.