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Exercise training may reduce gestational diabetes incidence in obese pregnant women
Supervised exercise training for obese, pregnant women appeared to reduce the risk for gestational diabetes and lower systolic BP in late pregnancy, and may be beneficial as part of standard care, according to data published in PLOS Medicine.
However, supervised exercise did not result in a reduction in gestational weight gain among women who were obese and pregnant.
“Maternal obesity is a risk factor for adverse pregnancy outcomes, such as gestational diabetes mellitus, gestational hypertension, preeclampsia, need for cesarean delivery and large gestational age,” Kirsti Krohn Garnæs, a PhD candidate at the department of circulation and medical imaging, Norwegian University of Science and Technology, in Trondheim, and colleagues wrote. “Because the prevalence of overweight and obesity among reproductive-age women is increasing, effective preventive strategies are urgently needed.”
To determine whether regular, supervised exercise training in pregnancy could reduce gestational weight gain in women with prepregnancy obesity, and to examine the training’s effect on gestational diabetes incidence, BP and other outcomes, the researchers conducted a single-center study involving 91 women who were pregnant with a prepregnancy BMI of 28 kg/m2 or greater. Forty-six participants were randomly assigned to receive exercise training, while 45 were assigned to the control group and received standard maternity care.
The researchers assessed the participants at pregnancy week 12 to 18, during late pregnancy weeks 34 to 37, and again at delivery. Participants in the exercise group had the opportunity to take part in thrice-weekly supervised sessions of 35 minutes of moderate-intensity endurance training and 25 minutes of strength training. Seventeen participants were lost to follow-up, eight in the exercise group and nine in the control.
According to the researchers, the mean gestational weight gain from baseline to delivery was 10.5 kg in the exercise group and 9.2 kg in the control, with a mean difference of 0.92 kg (95% CI, –1.35 to 3.18; P = .43). Among participants in late pregnancy, the researchers noted an apparent reduction in the incidence of gestational diabetes in the exercise group, compared with the control (OR = 0.1; 95% CI, 0.02-0.95; P = .04). In addition, systolic BP was significantly lower among participants in the exercise group, with a mean of 120.4 mm Hg, compared with the control group, which reported a mean of 128.1 mm Hg), for a mean difference of –7.73 mm Hg (95% CI, –13.23 to –2.22; P = .006). No significant differences were recorded between the two groups regarding diastolic BP, blood measurements, skinfold thickness or body composition in late pregnancy.
“In this trial, we did not observe a reduction of [gestational weight gain] or an improvement in body composition among overweight/obese women who were offered supervised exercise training during pregnancy,” Garnæs and colleagues wrote. “However, exercise training seemed to reduce the incidence of [gestational diabetes] as well as systolic [BP] in late pregnancy. As exercise adherence is a major concern in this population, there is a special need to find methods to reduce participant attrition in future studies.” – by Jason Laday
Disclosure: The researchers report no relevant financial disclosures.