Badon Sylvia E, Wartko Paige D, Qiu Chunfang, Sorensen Tanya K, Williams Michelle A, Enquobahrie Daniel A
1Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA; 2Center for Perinatal Studies, Swedish Medical Center, Seattle, WA; 3Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
Med Sci Sports Exerc. 2016 Jun;48(6):1044-52. doi: 10.1249/MSS.0000000000000866.
Findings of studies investigating associations of leisure time physical activity (LTPA) with gestational diabetes mellitus (GDM) risk have been inconsistent. We investigated associations of LTPA with GDM and whether these associations differ by prepregnancy overweight/obese status or gestational weight gain category.
Participants (N = 3209) of the Omega study, a pregnancy cohort study in Washington State (1996-2008), reported LTPA duration (h·wk) and energy expenditure (MET·h·wk) in the year before pregnancy and in early pregnancy. Diagnoses of GDM were abstracted from medical records. Poisson regression models were used to determine relative risks of GDM across tertiles of prepregnancy or early pregnancy LTPA duration and energy expenditure. Stratified analyses and interaction terms were used to assess effect modification by prepregnancy overweight/obese status (BMI ≥25 kg·m) or gestational weight gain category (adequate or excessive).
Each tertile increase in prepregnancy LTPA duration or energy expenditure was associated with 15% (95% CI = 0.72-1.00) and 19% (95% CI = 0.69-0.96) lower risk of GDM, respectively. Each tertile increase in early pregnancy LTPA duration or energy expenditure was associated with 16% (95% CI = 0.72-0.97) and 17% (95% CI = 0.72-0.95) lower risk of GDM, respectively. LTPA during both prepregnancy and early pregnancy was associated with a 46% reduced risk of GDM (95% CI = 0.32-0.89) compared with inactivity during both periods. LTPA-GDM associations were similar by prepregnancy BMI and gestational weight gain.
Our results support a role for the promotion of physical activity before and during pregnancy in the prevention of GDM.
关于休闲时间体力活动（LTPA）与妊娠期糖尿病（GDM）风险之间关联的研究结果并不一致。我们调查了LTPA与GDM的关联，以及这些关联在孕前超重/肥胖状态或孕期体重增加类别方面是否存在差异。
欧米伽研究的参与者（N = 3209），这是一项在华盛顿州进行的妊娠队列研究（1996 - 2008年），报告了孕前一年和孕早期的LTPA持续时间（小时·周）和能量消耗（代谢当量·小时·周）。GDM的诊断信息从医疗记录中提取。采用泊松回归模型来确定孕前或孕早期LTPA持续时间和能量消耗三分位数范围内GDM的相对风险。分层分析和交互项用于评估孕前超重/肥胖状态（BMI≥25 kg·m）或孕期体重增加类别（适当或过度）的效应修正。
孕前LTPA持续时间或能量消耗每增加一个三分位数，GDM风险分别降低15%（95%CI = 0.72 - 1.00）和19%（95%CI = 0.69 - 0.96）。孕早期LTPA持续时间或能量消耗每增加一个三分位数，GDM风险分别降低16%（95%CI = 0.72 - 0.97）和17%（95%CI = 0.72 - 0.95）。与两个时期均不活动相比，孕前和孕早期进行LTPA与GDM风险降低46%相关（95%CI = 0.32 - 0.89）。LTPA与GDM的关联在孕前BMI和孕期体重增加方面相似。
我们的结果支持在孕前和孕期促进体育活动对预防GDM的作用。
