A randomized clinical trial of exercise during pregnancy to prevent gestational diabetes mellitus and improve pregnancy outcome in overweight and obese pregnant women

American Journal of Obstetrics and Gynecology

Volumn 216, Issue 4, 2017, Pages 340-351

  Wang, Chen ^a   Wei, Yumei ^a   Zhang, Xiaoming ^a   Zhang, Yue ^a   Xu, Qianqian ^a   Sun, Yiying ^a   Su, Shiping ^a   Zhang, Li ^a   Liu, Chunhong ^a   Feng, Yaru ^a   Shou, Chong ^b   Guelfi, Kym J ^c   Newnham, John P ^c   Yang, Huixia ^a  

^a PEKING UNIVERSITY FIRST HOSPITAL   (China)

^b Hallmark Health System   (United States)

^c UNIVERSITY OF WESTERN AUSTRALIA   (Australia)

Author keywords

adverse pregnancy outcome; exercise; gestational diabetes mellitus; obesity; overweight; pregnant women

Indexed keywords

CHOLESTEROL; GLUCOSE; HIGH DENSITY LIPOPROTEIN CHOLESTEROL; LOW DENSITY LIPOPROTEIN CHOLESTEROL; TRIACYLGLYCEROL;

ADULT; APGAR SCORE; ARTICLE; BIRTH WEIGHT; BLOOD GLUCOSE MONITORING; BODY MASS; CERVICAL LENGTH MEASUREMENT; CESAREAN SECTION; CHOLESTEROL BLOOD LEVEL; CONTROLLED STUDY; CYCLING; ENERGY EXPENDITURE; EXERCISE; FEMALE; FOLLOW UP; GESTATIONAL AGE; GESTATIONAL WEIGHT GAIN; GLUCOSE BLOOD LEVEL; HUMAN; INSULIN RESISTANCE; INTERNATIONAL PHYSICAL ACTIVITY QUESTIONNAIRE; LARGE FOR GESTATIONAL AGE; MACROSOMIA; MAJOR CLINICAL STUDY; MATERNAL CARE; MATERNAL HYPERTENSION; MATERNAL MORBIDITY; MATERNAL OBESITY; ORAL GLUCOSE TOLERANCE TEST; PHYSICAL ACTIVITY; PREECLAMPSIA; PREGNANCY; PREGNANCY DIABETES MELLITUS; PREGNANCY OUTCOME; PREGNANT WOMAN; PREMATURE LABOR; PRIORITY JOURNAL; PROSPECTIVE STUDY; RANDOMIZED CONTROLLED TRIAL; RISK FACTOR; TRIACYLGLYCEROL BLOOD LEVEL; CHINA; DIABETES, GESTATIONAL; FETAL MACROSOMIA; HYPERTENSION, PREGNANCY-INDUCED; NEWBORN; OBESITY; OVERWEIGHT; PREMATURE BIRTH; STATISTICS AND NUMERICAL DATA; WEIGHT GAIN;

ADULT; CESAREAN SECTION; CHINA; DIABETES, GESTATIONAL; EXERCISE; FEMALE; FETAL MACROSOMIA; GESTATIONAL AGE; HUMANS; HYPERTENSION, PREGNANCY-INDUCED; INFANT, NEWBORN; INSULIN RESISTANCE; OBESITY; OVERWEIGHT; PREGNANCY; PREMATURE BIRTH; PROSPECTIVE STUDIES; WEIGHT GAIN;

EID: 85016261737     PISSN: 00029378     EISSN: 10976868     Source Type: Journal    
DOI: 10.1016/j.ajog.2017.01.037     Document Type: Article

References (61)

1. 1 Ng, M., Fleming, T., Robinson, M., et al. Global, regional and national prevalence of overweight and obesity in children and adults 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 384 (2014), 766–781.
2. 2 Poston, L., Caleyachetty, R., Cnattingius, S., et al. Preconceptional and maternal obesity: epidemiology and health consequences. Lancet Diabetes Endocrinol 4 (2016), 1025–1036.
3. 3 Silva, J.C., Amaral, A.R., Ferreira, B.D., Petry, J.F., Silva, M.R., Krelling, P.C., Obesity during pregnancy: gestational complications and birth outcomes. Rev Bras Ginecol Obstet 36 (2014), 509–513.
4. 4 Wei, Y.M., Yang, H.X., Zhu, W.W., et al. Risk of adverse pregnancy outcomes stratified for pre-pregnancy body mass index. J Matern Fetal Neonatal Med 29 (2016), 2205–2209.
5. 5 Hermann, M., Le Ray, C., Blondel, B., Goffinet, F., Zeitlin, J., The risk of prelabor and intrapartum cesarean delivery among overweight and obese women: possible preventive actions. Am J Obstet Gynecol 212 (2015), 241.e1–241.e9.
6. 6 Faucett, A.M., Metz, T.D., DeWitt, P.E., Gibbs, R.S., Effect of obesity on neonatal outcomes in pregnancies with preterm premature rupture of membranes. Am J Obstet Gynecol 214 (2016), 287.e1–287.e5.
7. 7 Smid, M.C., Kearney, M.S., Stamilio, D.M., Extreme obesity and postcesarean wound complications in the maternal-fetal medicine unit cesarean registry. Am J Perinatol 32 (2015), 1336–1341.
8. 8 Srichumchit, S., Luewan, S., Tongsong, T., Outcomes of pregnancy with gestational diabetes mellitus. Int J Gynaecol Obstet 131 (2015), 251–254.
9. 9 Catalano, P.M., McIntyre, H.D., Cruickshank, J.K., et al. The hyperglycemia and adverse pregnancy outcome study: associations of GDM and obesity with pregnancy outcomes. Diabetes Care 35 (2012), 780–786.
10. 10 Nehring, I., Chmitorz, A., Reulen, H., von Kries, R., Ensenauer, R., Gestational diabetes predicts the risk of childhood overweight and abdominal circumference independent of maternal obesity. Diabet Med 30 (2013), 1449–1456.
11. 11 Kelstrup, L., Damm, P., Mathiesen, E.R., et al. Insulin resistance and impaired pancreatic β-cell function in adult offspring of women with diabetes in pregnancy. J Clin Endocrinol Metab 98 (2013), 3793–3801.
12. 12 Valizadeh, M., Alavi, N., Mazloomzadeh, S., Piri, Z., Amirmoghadami, H., The risk factors and incidence of type 2 diabetes mellitus and metabolic syndrome in women with previous gestational diabetes. Int J Endocrinol Metab, 13, 2015, e21696.
13. 13 Barengo, N.C., Antikainen, R., Borodulin, K., Harald, K., Jousilahti, P., Leisure-time physical activity reduces total and cardiovascular mortality and cardiovascular disease incidence in older adults. J Am Geriatr Soc, 2016 [Epub ahead of print].
14. 14 La Vecchia, C., Gallus, S., Garattini, S., Effects of physical inactivity on non-communicable diseases. Lancet, 380, 2012, 1553.
15. 15 Cordero, Y., Mottola, M.F., Vargas, J., Blanco, M., Barakat, R., Exercise is associated with a reduction in gestational diabetes mellitus. Med Sci Sports Exerc 47 (2015), 1328–1333.
16. 16 Poston, L., Bell, R., Croker, H., et al. Effect of a behavioral intervention in obese pregnant women (the UPBEAT study): a multicenter, randomized controlled trial. Lancet Diabetes Endocrinol 3 (2015), 767–777.
17. 17 Barakat, R., Pelaez, M., Lopez, C., Lucia, A., Ruiz, J.R., Exercise during pregnancy and gestational diabetes-related adverse effects: a randomized controlled trial. Br J Sports Med 47 (2013), 630–636.
18. 18 Simmons, D., Devlieger, R., van Assche, A., et al. Effect of physical activity and/or healthy eating on GDM risk: the DALI lifestyle study. J Clin Endocrinol Metab, 2016 [Epub ahead of print].
19. 19 Dodd, J.M., Turnbull, D., McPhee, A.J., et al. Antenatal lifestyle advice for women who are overweight or obese: LIMIT randomized trial. BMJ, 348, 2014, g1285.
20. 20 Stafne, S.N., Salvesen, K.Å., Romundstad, P.R., Eggebø, T.M., Carlsen, S.M., Mørkved, S., Regular exercise during pregnancy to prevent gestational diabetes: a randomized controlled trial. Obstet Gynecol 119 (2012), 29–36.
21. 21 Price, B.B., Amini, S.B., Kappeler, K., Exercise in pregnancy: effect on fitness and obstetric outcomes–a randomized trial. Med Sci Sports Exerc 44 (2012), 2263–2269.
22. 22 Song, C., Li, J., Leng, J., Ma, R.C., Yang, X., Lifestyle intervention can reduce the risk of gestational diabetes: a meta-analysis of randomized controlled trials. Obes Rev 17 (2016), 960–969.
23. 23 Sun, Y., Zhao, H., The effectiveness of lifestyle intervention in early pregnancy to prevent gestational diabetes mellitus in Chinese overweight and obese women: a quasi-experimental study. Appl Nurs Res 30 (2016), 125–130.
24. 24 Zhou, B., Cooperative Meta-Analysis Group of China Obesity Task Force. Predictive values of body mass index and waist circumference to risk factors of related diseases in Chinese adult population. Zhonghua Liu Xing Bing Xue Za Zhi 23 (2002), 5–10.
25. 25 Roman, A., Suhag, A., Berghella, V., Overview of cervical insufficiency: diagnosis, etiologies, and risk factors. Clin Obstet Gynecol 59 (2016), 237–240.
26. 26 Halse, R.E., Wallman, K.E., Newnham, J.P., Guelfi, K.J., Home-based exercise training improves capillary glucose profile in women with gestational diabetes. Med Sci Sports Exerc 46 (2014), 1702–1709.
27. 27 Borg, G.A., Psychophysical bases of perceived exertion. Med Sci Sports Exerc 14 (1982), 377–381.
28. 28 Guelfi, K.J., Ong, M.J., Crisp, N.A., et al. Regular exercise to prevent the recurrence of gestational diabetes mellitus: a randomized controlled trial. Obstet Gynecol 128 (2016), 819–827.
29. 29 Ong, M.J., Wallman, K.E., Fournier, P.A., Newnham, J.P., Guelfi, K.J., Enhancing energy expenditure and enjoyment of exercise during pregnancy through the addition of brief higher intensity intervals to traditional continuous moderate intensity cycling. BMC Pregnancy Childbirth, 16, 2016, 161.
30. 30 Gomez, R., Galasso, M., Romero, R., et al. Ultrasonographic examination of the uterine cervix is better than cervical digital examination as a predictor of the likelihood of premature delivery in patients with preterm labor and intact membranes. Am J Obstet Gynecol 171 (1994), 956–964.
31. 31 Muniyappa, R., Lee, S., Chen, H., Quon, M.J., Current approaches for assessing insulin sensitivity and resistance in vivo: advantages, limitations, and appropriate usage. Am J Physiol Endocrinol Metab 294 (2008), E15–E26.
32. 32 Craig, C.L., Marshall, A.L., Sjöström, M., et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35 (2003), 1381–1395.
33. 33 Harizopoulou, V.C., Kritikos, A., Papanikolaou, Z., et al. Maternal physical activity before and during early pregnancy as a risk factor for gestational diabetes mellitus. Acta Diabetol 47:Suppl 1 (2010), 83–89.
34. 34 Diagnostic criteria and classification of hyperglycemia first detected in pregnancy: a World Health Organization guideline. Diabetes Res Clin Pract 103 (2014), 341–363.
35. 35 Wang, C., Wei, Y., Zhang, X., et al. Effect of regular exercise commenced in early pregnancy on the incidence of gestational diabetes mellitus in overweight and obese pregnant women: a randomized controlled trial. Diabetes Care 39 (2016), e163–e164.
36. 36 American College of Obstetricians and Gynecologists, Task Force on Hypertension in Pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol 122 (2013), 1122–1131.
37. 37 Villar, J., Cheikh Ismail, L., Victora, C.G., et al. International standards for newborn weight, length, and head circumference by gestational age and sex: the newborn cross-sectional study of the INTERGROWTH-21st project. Lancet 384 (2014), 857–868.
38. 38 Dela, F., Prats, C., Helge, J.W., Exercise interventions to prevent and manage type 2 diabetes: physiological mechanisms. Med Sport Sci 60 (2014), 36–47.
39. 39 Russo, L.M., Nobles, C., Ertel, K.A., et al. Physical activity interventions in pregnancy and risk of gestational diabetes mellitus: a systematic review and meta-analysis. Obstet Gynecol 125 (2015), 576–582.
40. 40 Nobles, C., Marcus, B.H., Stanek, E.J. III, et al. Effect of an exercise intervention on gestational diabetes mellitus: a randomized controlled trial. Obstet Gynecol 125 (2015), 1195–1204.
41. 41 Singh, J., Huang, C.C., Driggers, R.W., et al. The impact of pre-pregnancy body mass index on the risk of gestational diabetes. J Matern Fetal Neonatal Med 25 (2012), 5–10.
42. 42 Xi, B., Liang, Y., He, T., et al. Secular trends in the prevalence of general and abdominal obesity among Chinese adults, 1993-2009. Obes Rev 13 (2012), 287–296.
43. 43 Wang, C., Zhu, W., Wei, Y., Feng, H., Su, R., Yang, H., Exercise intervention during pregnancy can be used to manage weight gain and improve pregnancy outcomes in women with gestational diabetes mellitus. BMC Pregnancy Childbirth, 15, 2015, 255.
44. 44 Tal, T., R, Taylor, H.S., Burney, R.O., Mooney, S.B., Giudice, L.C., Endocrinology of pregnancy. De Groot, L.J., Beck-Peccoz, P., Chrousos, G., et al. (eds.) Endotext, 2015, MDText.com Inc, Sourth Dartmouth (MA).
45. 45 Catalano, P., deMouzon, S.H., Maternal obesity and metabolic risk to the offspring: why lifestyle interventions may have not achieved the desired outcomes. Int J Obes 39 (2015), 642–649.
46. 46 Tobias, D.K., Zhang, C., van Dam, R.M., Bowers, K., Hu, F.B., Physical activity before and during pregnancy and risk of gestational diabetes mellitus: a meta-analysis. Diabetes Care 34 (2011), 223–229.
47. 47 Hedderson, M.M., Gunderson, E.P., Ferrara, A., Gestational weight gain and risk of gestational diabetes mellitus. Obstet Gynecol 115 (2010), 597–604.
48. 48 Liu, Z., Ao, D., Yang, H., Wang, Y., Gestational weight gain and risk of gestational diabetes mellitus among Chinese women. Chin Med J (Engl) 127 (2014), 1255–1260.
49. 49 Berggren, E.K., Groh-Wargo, S., Presley, L., Hauguel-de Mouzon S, Catalano PM. Maternal fat, but not lean, mass is increased among overweight/obese women with excess gestational weight gain. Am J Obstet Gynecol 214 (2016), 745.e1–745.e5.
50. 50 Hantoushzadeh, S., Sheikh, M., Bosaghzadeh, Z., et al. The impact of gestational weight gain in different trimesters of pregnancy on glucose challenge test and gestational diabetes. Postgrad Med J 92 (2016), 520–524.
51. 51 Koivusalo, S.B., Rönö, K., Klemetti, M.M., et al. Gestational diabetes mellitus can be prevented by lifestyle intervention: the Finnish gestational diabetes prevention study (RADIEL): a randomized controlled trial. Diabetes Care 39 (2016), 24–30.
52. 52 Davenport, M.H., Mottola, M.F., McManus, R., Gratton, R., A walking intervention improves capillary glucose control in women with gestational diabetes mellitus: a pilot study. Appl Physiol Nutr Metab 33 (2008), 511–517.
53. 53 Brankston, G.N., Mitchell, B.F., Ryan, E.A., Okun, N.B., Resistance exercise decreases the need for insulin in overweight women with gestational diabetes mellitus. Am J Obstet Gynecol 190 (2004), 188–193.
54. 54 Golbidi, S., Laher, I., Potential mechanisms of exercise in gestational diabetes. J Nutr Metab, 2013, 2013, 285948.
55. 55 Sanabria-Martínez, G., García-Hermoso, A., Poyatos-León, R., González-García, A., Sánchez-López, M., Martínez-Vizcaíno, V., Effects of exercise-based interventions on neonatal outcomes: a meta-analysis of randomized controlled trials. Am J Health Promot 30 (2016), 214–223.
56. 56 Barakat, R., Pelaez, M., Cordero, Y., et al. Exercise during pregnancy protects against hypertension and macrosomia: randomized clinical trial. Am J Obstet Gynecol 214 (2016), 649.e1–649.e8.
57. 57 Ezegwui, H.U., Ikeako, L.C., Egbuji, C., Fetal macrosomia: obstetric outcome of 311 cases in UNTH, Enugu, Nigeria. Niger J Clin Pract 14 (2011), 322–326.
58. 58 Qiao, Y., Ma, J., Wang, Y., et al. Birth weight and childhood obesity: a 12-country study. Int J Obes Suppl 5:Suppl (2015), S74–S79.
59. 59 Evenson, K.R., Wen, F., National trends in self-reported physical activity and sedentary behaviors among pregnant women: NHANES 1999-2006. Prev Med 50 (2010), 123–128.
60. 60 Guelfi, K.J., Wang, C., Dimmock, J.A., Jackson, B., Newnham, J.P., Yang, H., A comparison of beliefs about exercise during pregnancy between Chinese and Australian pregnant women. BMC Pregnancy Childbirth, 15, 2015, 345.
61. 61 Di Mascio, D., Magro-Malosso, E.R., Saccone, G., Marhefka, G.D., Berghella, V., Exercise during pregnancy in normal-weight women and risk of preterm birth: a systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol 215 (2016), 561–571.