Number of parous events affects the association between physical exercise and glycemic control among women with gestational diabetes mellitus: A prospective cohort study

Ruiping Wang; Jun Chen; Fei Yao; Ting Sun; Yan Qiang; Huan Li; Yue Tang; Qing Yang; Bin Li; Roger Adams; Jia Han

doi:10.1016/j.jshs.2022.03.005

Number of parous events affects the association between physical exercise and glycemic control among women with gestational diabetes mellitus: A prospective cohort study

J Sport Health Sci. 2022 Sep;11(5):586-595. doi: 10.1016/j.jshs.2022.03.005. Epub 2022 Mar 26.

Authors

Ruiping Wang¹, Jun Chen², Fei Yao³, Ting Sun⁴, Yan Qiang⁵, Huan Li⁴, Yue Tang⁴, Qing Yang⁴, Bin Li⁶, Roger Adams⁷, Jia Han⁸

Affiliations

¹ Clinical Research & Innovation Transformation Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai 200443, China; Shanghai University of Traditional Medicine, Shanghai 201203, China. Electronic address: w19830901@126.com.
² Clinical Research Center, Shanghai Eye Disease Prevention and Treatment Center, Shanghai 200041, China.
³ Shanghai University of Traditional Medicine, Shanghai 201203, China.
⁴ Songjiang Maternal and Child Health-care Hospital, Shanghai 201620, China.
⁵ Office of Clinic management, Shanghai Skin Diseases Hospital, Tongji University, Shanghai 200443, China.
⁶ Clinical Research & Innovation Transformation Center, Shanghai Skin Diseases Hospital, Tongji University, Shanghai 200443, China.
⁷ Research Institute for Sport and Exercise, University of Canberra, Bruce, ACT 2617, Australia.
⁸ School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China. Electronic address: Jia.Han@canberra.edu.au.

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusion: 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.

Keywords: Gestational diabetes mellitus; Glycemic control; Parous events; Physical activity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Blood Glucose
Cohort Studies
Diabetes, Gestational*
Exercise
Female
Glycemic Control
Humans
Pregnancy
Prospective Studies

Substances

Blood Glucose