Zhang Cuilin, Solomon Caren G, Manson Joann E, Hu Frank B
Department of Nutrition, Harvard School of Public Health, Boston, Massachsuetts 02115, USA.
Arch Intern Med. 2006 Mar 13;166(5):543-8. doi: 10.1001/archinte.166.5.543.
Although gestational diabetes mellitus (GDM) has been associated with substantial adverse health outcomes for both mothers and offspring, few modifiable risk factors for GDM have been identified.
We conducted a prospective cohort study among women in the Nurses' Health Study II to assess whether the amount, type, and intensity of pregravid physical activity and sedentary behaviors are associated with GDM risk. The analysis included 21,765 women who reported at least 1 singleton pregnancy between 1990 and 1998. Physical activity and sedentary behaviors were assessed through validated questionnaire.
We documented 1428 incident GDM cases. After controlling for body mass index, dietary factors, and other covariates, there was a significant inverse association between vigorous activity and the risk of GDM. The multivariate relative risk (RR) comparing the highest with the lowest quintile of vigorous activity was 0.77 (95% confidence interval [CI], 0.69-0.94) (P = .002 for trend). Among women who did not perform vigorous activity, brisk walking pace was associated with significantly lower GDM risk (RR, 0.66; 95% CI, 0.46-0.95) compared with an easy pace. Women who spent 20 h/wk or more watching television but did not perform vigorous activity had a significantly higher GDM risk than women who spent less than 2 h/wk watching television and were physically active (multivariate RR, 2.30; 95% CI, 1.06-4.97).
Our prospective study provides strong evidence that regular physical activity before pregnancy is associated with lower GDM risk.
尽管妊娠糖尿病（GDM）与母亲和后代的大量不良健康结局相关，但已确定的GDM可改变风险因素很少。
我们在护士健康研究II中的女性中进行了一项前瞻性队列研究，以评估孕前体力活动和久坐行为的量、类型和强度是否与GDM风险相关。分析包括21765名在1990年至1998年间报告至少1次单胎妊娠的女性。通过经过验证的问卷评估体力活动和久坐行为。
我们记录了1428例GDM新发病例。在控制体重指数、饮食因素和其他协变量后，剧烈活动与GDM风险之间存在显著的负相关。将剧烈活动最高五分位数与最低五分位数进行比较的多变量相对风险（RR）为0.77（95%置信区间[CI]，0.69 - 0.94）（趋势P = 0.002）。在不进行剧烈活动的女性中，快走速度与显著较低的GDM风险相关（RR，0.66；95% CI，0.46 - 0.95），而慢走速度则不然。每周看电视20小时或更长时间但不进行剧烈活动的女性，其GDM风险显著高于每周看电视少于2小时且进行体力活动的女性（多变量RR，2.30；95% CI，1.06 - 4.97）。
我们的前瞻性研究提供了有力证据，表明孕前定期进行体力活动与较低的GDM风险相关。
