Relationship Between Physical Activity And Pregnancy Complications In Pregnant Women At High Risk Of Gestational Diabetes

Objectives1 The latent class growth model was used to fit the change trajectory of physical activity in pregnant women at high risk of gestational diabetes mellitus and explore the change trajectory characteristics.2 To explore the relationship between different types and intensity of physical activity levels and gestational diabetes mellitus,hypertensive disorders in pregnancy and its subtypes.MethodsAccording to the inclusion and exclusion criteria,588 pregnant women at high risk of gestational diabetes mellitus who received antenatal check-up in a third-class A hospital in Qingdao from July 2021 to March 2022 were selected as subjects by objective sampling method,and data were collected when the subjects first visited the outpatient clinic using the physical activity data questionnaire of pregnant women.The subjects were followed up at 8,12,16,20,24,28 weeks of gestation and after delivery.The energy consumption and changes of total physical activity,different types of physical activity(housework,transportation,exercise,occupational activity)and different intensity of physical activity(sedentary activity,low intensity activity,medium-high intensity activity)of the study subjects were analyzed.The latent class growth model was used to fit the change trajectory of physical activity during8-28 weeks of pregnancy.The prospective associations of each trajectory with gestational diabetes mellitus,gestational hypertension and their subtypes were explored.ResultsDuring each pregnancy,the physical activity energy consumption of the study subjects were mainly occupational activities(42.06%-46.51%)and housework activities(37.86%-42.96%),followed by transportation activities(13.63%-15.85%),and exercise accounted for the least(1.07%-1.39%).In terms of the intensity of physical activity,low intensity activities(59.15%-61.97%)dominated,followed by sedentary activities(20.81-29.10%),and medium to high intensity physical activities(10.75%-20.04%)accounted for the smallest proportion.Overall,the energy consumption of total physical activity,traffic activity,occupational activity,lowintensity activity and medium-high intensity activity decreased gradually from early to late pregnancy(P<0.05).The energy consumption of housework activities increased gradually from the first trimester to the second trimester(P<0.05),and the energy consumption of exercise activities was the highest in the second trimester,and was significantly higher than that in the first and third trimester(P<0.05).Energy consumption of sitting activity was the lowest in the first trimester,and significantly increased in the second trimester and remained until the third trimester(P<0.05).The latent class growth model was used to fit the physical activity trajectories of 8 groups during 8-28 weeks of gestation.Logistic regression analysis showed that before and after adjusting for confounding factors,The risk of gestational diabetes mellitus increased in total physical activity "low level continuous decline group",housework "low level rapid rise group",exercise "low level slow decline group",low intensity activity "low level slow decline group",medium-high intensity activity "medium level slow decline group" and medium-high intensity activity "low level slow decline group"(P<0.05),the risk of hypertensive disorders in pregnancy was increased in the "low level continuous decline group" of total physical activity(P<0.05).Conclusions1 According to the type of activity,the energy consumption of gestational diabetes mellitus high-risk pregnant women during pregnancy was mainly occupational activities and housework activities,followed by transportation activities,and less exercise.Divided by activity intensity,the energy consumption was dominated by low-intensity activities,followed by sedentary activities,and the least was medium-high intensity activities.2 The trajectory of low level of total physical activity,low level of household care activity,low level of exercise activity,low level of low intensity activity,low level of medium-high intensity activity and medium level of medium-high intensity activity during 8-28 weeks of gestation were independent risk factors for the occurrence of gestational diabetes mellitus,while the trajectory of low level of total physical activity during 8-28 weeks of gestation was independent risk factor for the occurrence of hypertensive disorders in pregnancy.It is suggested that the latent classification trajectory of gestational physical activity is a new method for risk stratification of gestational diabetes mellitus and gestational hypertension...