Maternal weight gain and gestational diabetes: exercise during pregnancy
Excessive maternal weight gain and gestational diabetes mellitus are among a number of conditions that can occur during pregnancy. This article looks at a study analyzing the effects of exercise during prenatal care.
The human body undergoes significant changes during pregnancy and delivery, which can ultimately affect maternal health and fetal well-being. Healthcare professionals have linked excessive maternal weight gain with adverse conditions, such as gestational diabetes—a condition where blood sugar levels become too high and is diagnosed for the first time during pregnancy.
The study:
Barakat et al performed a randomized controlled study analyzing the effects of exercise during pregnancy. 456 participants were allocated into two groups:
Control group (CG): 222 participants received obstetric standard care from healthcare professionals.
Experimental group (EG): 234 participants participated in a supervised, moderate exercise program 3 times a week (50-55 min/session) from 8-10 weeks to 36-38 weeks gestation. This exercise program consisted of warm-up, aerobic exercise, mild resistance training, coordination and balance, stretching, pelvic floor strengthening, and relaxation.
Outcome measures included maternal weight gain, excessive gestational weight gain categorization (based on 2009 Institute of Medicine guidelines using pre-pregnancy BMI), oral glucose tolerance test (OGTT) and cases of gestational diabetes mellitus (GDM). Weight measures were obtained on the first prenatal consult and last clinical visit (~week 36-38), while OGTT and GDM were collected from hospital records during weeks 24-26.
The results:
Maternal weight gain was significantly lower in the EG versus CG (12.19 kg vs 13.33 kg, respectively).
Excessive weight gain was significantly higher in CG versus EG (30.2% vs 25.5%, respectively)
Significant differences were also noted in OGTT tests (EG = 116.56 vs CG = 121.63 mg/dL)
The ratio of women diagnosed with GDM was higher in the CG than the EG (6.8% vs 2.6%, respectively)
Limitations in the study: 1) lack of information regarding nutritional intake of participants, and 2) participants were chosen from two hospital locations in Spain, which may affect its external validity. The study’s main strength, however, was the number of participants who have completed the study from start to finish.
What this means:
The study suggests that exercise of at least three times a week can help lower excessive maternal weight gain and act as a preventative for secondary conditions such as gestational diabetes mellitus. Therefore, the results of the study were largely in favor of exercise and its positive effects on maternal health.
Most people ask whether it’s okay to exercise, particularly in the later stages of pregnancy. This study suggests yes, we do—but with supervision.
REFERENCES:
Barakat R, Refoyo I, Coteron J, Franco E. Exercise during pregnancy has a preventative effect on excessive maternal weight gain and gestational diabetes. A randomized controlled trial. Braz J Phys Ther. 2019 Mar-Apr;23(2):148-155. doi: 10.1016/j.bjpt.2018.11.005. Epub 2018 Nov 17. PMID: 30470666; PMCID: PMC6428908.