Wang Chen, Zhu Weiwei, Wei Yumei, Feng Hui, Su Rina, Yang Huixia
Department of Obstetrics and Gynecology of Peking University First Hospital, Xianmen Street No. 1, Xicheng District, Beijing, 100034, China.
National Institute of Hospital Administration, Beijing, China.
BMC Pregnancy Childbirth. 2015 Oct 12;15:255. doi: 10.1186/s12884-015-0682-1.
The study aimed to evaluate whether exercise intervention can be applied to pregnant women with gestational diabetes mellitus (GDM) for controlling gestational weight gain (GWG) and combating GDM-related outcomes.
Retrospective six months analysis of 14,168 single pregnant women without diabetes from 15 hospitals in Beijing in 2013. Each participant's demographic data, interventions condition and medical information were collected individually by questionnaires and relying on medical records. The level of statistical significance was set equal to 0.05.
2750 (19.4%) pregnant women were diagnosed with GDM, 74.9% of them received exercise intervention during pregnancy, and the starting time was 25.8 ± 3.7 gestational weeks. Women with GDM with exercise intervention (GDM-E) had the lowest BMI increase during late and mid-pregnancy than women with GDM without exercise intervention (GDM-nE) (2.05 ± 1.32 kg/m(2) vs. 2.40 ± 1.30 kg/m(2), p < 0.01) and non-GDM women (2.05 ± 1.32 kg/m(2) vs. 2.77 ± 1.21 kg/m(2), p < 0.01). Moreover, GDM-E group experienced a significantly lower risk of preterm birth (5.58% vs. 7.98%, p < 0.001), low birth weight (1.03% vs. 2.06 %, p < 0.001) and macrosomia (9.51 % vs. 11.18%, p > 0.05) than GDM-nE group. After including dietary factors in the analysis, women with GDM without either dietary or exercise intervention (GDM-nDnE) had the highest risk of preterm birth(OR = 1.64, 95 % CI, 1.14-2.36), while women with GDM with dietary intervention only (GDM-DnE) had the highest risk of low birth weight (OR = 3.10, 95 % CI, 1.23-7.81). However, women with GDM with both dietary and exercise intervention had the lowest rate of macrosomia.
Exercise intervention is a suitable non-invasive therapeutic option that can be readily applied to manage weight gain and improve pregnancy outcomes in women with GDM.
本研究旨在评估运动干预是否可应用于妊娠期糖尿病(GDM)孕妇,以控制孕期体重增加(GWG)并对抗与GDM相关的不良结局。
对2013年北京15家医院的14168名单胎非糖尿病孕妇进行回顾性六个月分析。通过问卷调查并依据病历分别收集每位参与者的人口统计学数据、干预情况和医疗信息。统计学显著性水平设定为0.05。
2750名(19.4%)孕妇被诊断为GDM,其中74.9%在孕期接受了运动干预,开始时间为妊娠25.8±3.7周。与未进行运动干预的GDM孕妇(GDM-nE)相比,进行运动干预的GDM孕妇(GDM-E)在妊娠中晚期的BMI增加值最低(2.05±1.32kg/m² vs. 2.40±1.30kg/m²,p<0.01),与非GDM孕妇相比也是如此(2.05±1.32kg/m² vs. 2.77±1.21kg/m²,p<0.01)。此外,GDM-E组早产风险显著低于GDM-nE组(5.58% vs. 7.98%,p<0.001),低出生体重风险也显著更低(1.03% vs. 2.06%,p<0.001),巨大儿风险虽低于GDM-nE组但差异无统计学意义(9.51% vs. 11.18%,p>0.05)。在分析中纳入饮食因素后,未进行饮食或运动干预的GDM孕妇(GDM-nDnE)早产风险最高(OR=1.64,95%CI,1.14 - 2.36),而仅进行饮食干预的GDM孕妇(GDM-DnE)低出生体重风险最高(OR=3.10,95%CI,1.23 - 7.81)。然而,同时进行饮食和运动干预的GDM孕妇巨大儿发生率最低。
运动干预是一种合适的非侵入性治疗选择,可轻松应用于管理GDM孕妇的体重增加并改善妊娠结局。