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Physical activity, sedentary behavior and development of preeclampsia in women with preexisting diabetes

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Abstract

Aims

To explore the association between physical activity in early pregnancy and development of preeclampsia in women with preexisting diabetes.

Methods

In a prospective cohort study of 189 women with preexisting diabetes (110 type 1 and 79 type 2 diabetes), physical activity during pregnancy including sedentary behavior was evaluated with the Pregnancy Physical Activity Questionnaire. Primary outcome was preeclampsia. Secondary outcomes were preterm delivery, large and small for gestational age infants.

Results

Women developing preeclampsia (n = 23) had higher diastolic blood pressure in early pregnancy (mean 82 ± 9 SD vs. 77 ± 8, p = 0.004) and were more often nulliparous (91 vs. 52%, p < 0.001) compared with the remaining women (n = 166). Total physical activity in early pregnancy was similar between the groups (median 148 metabolic equivalent of task hours per week (MET-h/week) (interquartile range 118–227) versus 153 (121–205), p = 0.97). In early pregnancy, women developing preeclampsia reported a higher level of sedentary behavior (15 MET-h/week (7–18) versus 7 (4–15); p = 0.04); however, when adjusting for parity, diastolic blood pressure and smoking, the association attenuated (p = 0.13). Total physical activity and sedentary behavior in early pregnancy were not associated with preterm delivery, large or small for gestational age infants.

Conclusions

Among women with diabetes, sedentary behavior was reported higher in early pregnancy in women developing preeclampsia compared with the remaining women, while total physical activity was similar. Sedentary behavior was a predictor of preeclampsia in the univariate analysis, but not in the multiple regression analysis, and larger studies are needed to evaluate this possible modifiable risk factor.

Trial registration The study was registered at ClinicalTrials.gov (ID: NCT02890836).

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Acknowledgements

The authors thank the staff at Center for Pregnant Women with Diabetes, Rigshospitalet, and Center for Diabetes and Pregnancy, Odense University Hospital, for help with recruitment and data collection. We kindly thank research-midwife Maria Anna Mikkelsen for help with collection and handling of data.

Funding

NCD, BÁ and ERM were funded by Novo Nordisk Foundation. MV was funded by Rigshospitalets Research Foundation. The project was also funded by the Research Foundation between OUH and Rigshospitalet and the Exchange Foundation between OUH and Rigshospitalet. The funding sources had no influence on the study design, handling of data or writing of the manuscript.

Author information

Authors and Affiliations

  1. Center for Pregnant Women with Diabetes 4002, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Nicoline Callesen Do, Marianne Vestgaard, Björg Ásbjörnsdóttir, Vibeke Ladefoged Nichum, Lene Ringholm, Peter Damm & Elisabeth Reinhardt Mathiesen

  2. Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark

    Nicoline Callesen Do, Marianne Vestgaard, Björg Ásbjörnsdóttir, Lene Ringholm & Elisabeth Reinhardt Mathiesen

  3. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

    Nicoline Callesen Do, Marianne Vestgaard, Björg Ásbjörnsdóttir, Peter Damm & Elisabeth Reinhardt Mathiesen

  4. Steno Diabetes Center Copenhagen, Gentofte, Denmark

    Lene Ringholm

  5. Department of Obstetrics, Odense University Hospital, Odense, Denmark

    Lise Lotte Torvin Andersen & Dorte Møller Jensen

  6. Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark

    Dorte Møller Jensen

  7. Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark

    Peter Damm

Authors
  1. Nicoline Callesen Do
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  2. Marianne Vestgaard
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  6. Lise Lotte Torvin Andersen
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  8. Peter Damm
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  9. Elisabeth Reinhardt Mathiesen
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Contributions

ERM, NCD and MV contributed to the idea. NCD, MV and BA collected the data. NCD analyzed the data and wrote the first draft of the manuscript. All authors were involved in the interpretation of data, contributed to the discussion, reviewed and edited the manuscript and approved the final version. ERM is the guarantor of this work and, as such, has full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Corresponding author

Correspondence to Nicoline Callesen Do.

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Conflict of interest

The authors declare that they have no conflict of interest in connection with this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee—The National Committee on Health Research Ethics (H-15019186) and The Danish Data Protection Agency (2012-58-0004, RH-2015-289, I-Suite: 04305) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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This article belongs to the topical collection Pregnancy and diabetes managed by Antonio Secchi.

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Do, N.C., Vestgaard, M., Ásbjörnsdóttir, B. et al. Physical activity, sedentary behavior and development of preeclampsia in women with preexisting diabetes. Acta Diabetol 57, 559–567 (2020). https://doi.org/10.1007/s00592-019-01459-7

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  • DOI: https://doi.org/10.1007/s00592-019-01459-7

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