Clinical Research & Innovation Transformation Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai 200443, China; Shanghai University of Traditional Medicine, Shanghai 201203, China.
Clinical Research Center, Shanghai Eye Disease Prevention and Treatment Center, Shanghai 200041, China.
J Sport Health Sci. 2022 Sep;11(5):586-595. doi: 10.1016/j.jshs.2022.03.005. Epub 2022 Mar 26.
Multiparous women are at a higher risk of gestational diabetes mellitus (GDM) than primiparas. Physical activity during pregnancy has been shown to be beneficial for GDM, but there is little evidence on the association between physical activity and glycemic control among women with GDM, whether primiparas or multiparas. Thus, the objective of the present study was to examine the association between physical activity and glycemic control in women with GDM and to determine what, if any, effects result from number of parous events.
A prospective cohort of 1162 women with GDM was recruited, with 604 multiparas (51.98%). The general linear model was used to calculate the risk difference and its 95% confidence interval (95%CI) to quantify the impact of parous events on glycemic control in pregnancy as well as the association between physical activity time and glycemic control.
Among 1162 women with GDM, the median daily activity time was 65 min (interquartile range (IQR): 45-90 min), and the abnormal plasma glucose (PG) percentage, calculated as number of abnormal PG tests divided by the total number of PG tests, was 40.00% (IQR: 22.22%-66.67%). The percentage of abnormal PG was stabilized and statistically lower with daily physical activity time exceeding 60 min among primiparas (IQR: 30.89%-44.43%) and exceeding 90 min among multiparas (ranged from 27.76% to 38.82%). After adjusting for potential confounders, primiparas tended to have a lower percentage of abnormal PG than do multiparas (rate difference = -0.39, 95%CI: -3.61 to 2.84). The same amount of physical activity time was significantly less effective for multiparas than for primiparas (trend p-value < 0.01).
In women with GDM, being multiparous is associated with less effective glycemic control through physical activity, such that multiparas need more physical activity to achieve glycemic control at a similar level to primiparas.
与初产妇相比，多产妇患妊娠糖尿病（GDM）的风险更高。有研究表明，孕期身体活动对 GDM 有益，但关于 GDM 女性（包括初产妇和多产妇）身体活动与血糖控制之间的关系，证据有限。因此，本研究旨在探讨 GDM 女性身体活动与血糖控制之间的关系，并确定多胎妊娠事件对血糖控制的影响。
招募了 1162 名 GDM 女性的前瞻性队列研究，其中 604 名是多产妇（51.98%）。使用一般线性模型计算风险差异及其 95%置信区间（95%CI），以量化多胎妊娠事件对妊娠期间血糖控制的影响，以及身体活动时间与血糖控制之间的关系。
在 1162 名 GDM 女性中，每日活动时间中位数为 65 分钟（四分位距（IQR）：45-90 分钟），异常血糖（PG）百分比定义为异常 PG 测试次数与总 PG 测试次数之比，为 40.00%（IQR：22.22%-66.67%）。在初产妇中，每日身体活动时间超过 60 分钟时，异常 PG 百分比趋于稳定且统计学上较低（IQR：30.89%-44.43%），而在多产妇中，每日身体活动时间超过 90 分钟时，异常 PG 百分比较低（范围为 27.76%-38.82%）。调整潜在混杂因素后，初产妇的异常 PG 百分比倾向于低于多产妇（差异率=-0.39，95%CI：-3.61 至 2.84）。相同的身体活动时间对多产妇的效果明显低于初产妇（趋势 p 值<0.01）。
在 GDM 女性中，多胎妊娠与通过身体活动实现血糖控制的效果较差相关，即多产妇需要更多的身体活动才能达到与初产妇相似的血糖控制水平。
