Dietary And Exercise Intervention In Pregnancy For Preventing Gestational Diabetes Mellitus In Overweight And Obese Women

Background:Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is associated with substantially elevated risk of adverse health outcomes for both mothers and offspring. Obesity is a significant risk factor for developing GDM and the prevalence of obesity is increasing globally. It has testified that dietary and exercise intervention can reduce prevalence of GDM among overweight and obese pregnant women in other countries, however, there is less related research in China. Thus, it is necessary to explore the effect of dietary and exercise intervention on them to prevent GDM.Objectives:To investigate the effects of dietary and exercise intervention on development of GDM, maternal weight gain, mode of delivery and newborns with macrosomia among overweight and obese pregnant women.Methods:A quasi-experimental study was used. A convenient sample of74women with a BMI≥24kg/m2from Peking Union Medical College Hospital was enrolled. They were divided into intervention group (N=37) or control group (N=37) according to the time sequence of seeing doctor. The intervention group was provided exercise, dietary and weight gain counseling and detailed plans at weeks8-12and every month in the second trimester at the hospital. In addition, each counseling session included a personalized feedback based on their5-day-records.Follow-up phone calls or emails were conducted every week between antenatal visits. The control group was just provided usual care, exercise, dietary and weight gain knowledge, at weeks8-12. Data were collected at12,24-28weeks, before and after delivery. Primary outcome measures were the incidence of GDM and maternal weight gain. Second outcome measures were mode of delivery and newborns with macrosomia.Results:66women completed data collection procedures,32women in intervention group and34women in control group. Socio-demographic features were similar between groups. The incidence of gestational diabetes in intervention group was significant lower than control group (P<0.05). Maternal weight gain at the end of second trimester was significant lower than control group (P<0.05). There were no statistically significant differences between the groups in terms of total maternal weight gain, weight gain above the2009Institute of Medicine (IOM) recommendations, mode of delivery and newborns with macrosomia (P>0.05)Conclusions:Dietary and exercise intervention can reduce the incidence of GDM and prevent excessive maternal weight gain end to the second trimester among overweight and obese pregnant women. It is not associated with a significant positive effect on mode of delivery and newborns with macrosomia.