A3-4: Recreational Physical Activity and Gestational Weight Gain in Women with Gestational Diabetes

Background/AimsExcess gestational weight gain (GWG) is associated with several adverse perinatal outcomes, including increased infant size at birth and postpartum weight retention. These outcomes are particularly problematic for women with gestational diabetes (GDM), who are already at risk for delivering a large infant and developing type 2 diabetes later in life. Participation in recreational physical activity during pregnancy may mitigate excess GWG, but the association has not been previously examined in a large cohort of women with GDM.MethodsThis study utilized baseline data from a clustered randomized intervention trial (Gestational Diabetes Effects on Moms - the GEM study) conducted at Kaiser Permanente Northern California (KPNC) to estimate the association between participation in recreational physical activity and GWG among women with GDM. Women with multiple fetuses and those on bed rest were excluded, leaving a final analytic cohort of 790 women. Recreational physical activity (walking quickly for fun or exercise, jogging, exercise classes, swimming, dancing, yoga, pilates, weight lifting/resistance exercises and team sports) in the past 3 months was assessed using the Pregnancy Physical Activity Questionnaire (PPAQ). Data on gestational weight gain per week (kg) up until the time of the oral glucose tolerance test (OGTT) was abstracted from the electronic medical record.ResultsCompared to those who reported not participating in any recreational physical activity, women who reported participating in some recreational physical activity had a significantly reduced risk of GWG in the upper quartile [GWG >0.39 kg (0.85 lb.) per week]; this association was independent of age, prepregnancy body mass index (BMI), race-ethnicity, and parity [OR = 0.63 (95% CI 0.41-0.97)]. In sensitivity analyses limited to women who completed the PPAQ within 6 weeks (n = 448) and 4 weeks (n = 234) of the OGTT, the associations were more pronounced [OR = 0.42 (95% CI 0.24-0.72) and OR = 0.28 (95% CI 0.12-0.63), respectively]. No dose-response relationship was observed between high (>1.07 MET hours per day) and low ( less than or equal to 1.07 MET hours per day) recreational physical activity.ConclusionsParticipation in recreational physical activity during pregnancy may mitigate high GWG in women with GDM.