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Diet, physical activity, mental health influence dysglycemia risk in pregnancy
Women with combined higher scores on diet, physical activity and mental health questionnaires were significantly less likely to experience dysglycemia during pregnancy vs. women who scored poorly, according to an analysis of the Healthy Start Study.
“When examined individually, physical activity levels were marginally associated with reduced risk [for dysglycemia], while diet quality and mental health status were not,” Katherine Ann Sauder, PhD, a nutrition fellow at the University of Colorado Denver Anschutz Medical Campus, and colleagues wrote. “However, when examined collectively, the synergistic association of multiple modifiable factors with dysglycemia was pronounced.”
Sauder and colleagues analyzed data from 832 mother–offspring pairs participating in the Healthy Start Study, a pre-birth cohort recruited between 2010 and 2014. Women completed questionnaires in early and mid-pregnancy (median 17 and 27 weeks, respectively) to assess dietary intake (assessed 1-7 times before 27 weeks’ gestation), physical activity and depression. Women received one point for each modifiable factor for which they had optimum scores: diet quality (Health Eating Index score 64), physical activity level (estimated energy expenditure 170 metabolic equivalent task-hours per week) and mental health status (perceived stress scale < 6 and Edinburgh Postnatal Depression Scale score < 13).
Routine gestational diabetes screenings occurred during weeks 24 to 28 gestation; researchers classified women with prenatal dysglycemia if they had an abnormal glucose challenge, more than one abnormal value on the glucose tolerance test or a clinical diagnosis of gestational diabetes. Within the cohort, 713 had normal glucose tolerance (mean age, 28 years; mean prepregnancy BMI, 25.5 kg/m²; 57% white); 119 had dysglycemia (mean age, 29.5 years; mean prepregnancy BMI, 27.6 kg/m²; 46% white). Logistic regression models estimated odds ratios for dysglycemia as a function of each factor and the total score.
Researchers found that only physical activity was significantly associated with a reduced risk for dysglycemia in individual analysis (adjusted OR = 0.67; 95% CI, 0.44-1). Researchers observed a significant dose–response association between increasing numbers of optimal factors and odds of dysglycemia (adjusted P = .01). Compared with having no optimal modifiable factors, having all three was associated with a 73% reduced risk for dysglycemia (adjusted OR = 0.27; 95% CI, 0.08-0.95). Further adjustment for gestational weight gain up to 26 weeks did not substantially change the results, according to researchers.
“Our results were independent of prepregnancy BMI and not affected by further adjustment for gestational weight gain, suggesting that these modifiable factors in pregnancy may be related to glucose tolerance regardless of maternal weight and weight gain,” the researchers wrote. – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.