Skip to main content

Advertisement

Log in

Physical activity during pregnancy is associated with a lower prevalence of gestational diabetes mellitus in Vietnam

  • Original Article
  • Published:
Acta Diabetologica Aims and scope Submit manuscript

Abstract

Aims

To assess the association between physical activity (PA) during pregnancy and the prevalence of gestational diabetes mellitus (GDM) accounting for sitting time.

Methods

The study used data from a cohort study of 2030 pregnant women in Vietnam. Women were recruited from six hospitals in Ha Noi, Hai Phong, and Ho Chi Minh City. Baseline measurements including PA and GDM were taken at 24–28 weeks of gestation. PA was assessed during the past 3 months before the interview using the interviewer-administered Pregnancy Physical Activity Questionnaire. GDM was diagnosed at 24–28 weeks of gestation using the 2013 World Health Organization criteria.

Results

1987 out of 2030 pregnant women were included in the final analysis, of which 432 had GDM (21.7%). Women undertaking the highest level (upper tertile) of PA during pregnancy appeared to have a lower risk of GDM [odds ratio (OR) 0.70, 95% confidence interval (CI) 0.53–0.94, Ptrend 0.017] when compared to those at the lowest tertile of PA. Similarly, women with increased levels of moderate-intensive activity and household/caregiving activity during pregnancy were associated with reduced risks of GDM (OR 0.66, 95% CI 0.50–0.86, Ptrend 0.002 and OR 0.72, 95% CI 0.55–0.95, Ptrend 0.020, respectively). These apparent inverse associations were not attenuated by their sitting time. There were no significant associations between sitting time, light-intensity activity, vigorous-intensity activity, occupation, sports/exercise, commuting, or meeting exercise guidelines and GDM risk.

Conclusions

High levels of PA, particularly moderate-intensity and household/caregiving activities during pregnancy were associated with a lower prevalence of GDM independent of sitting time.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Metzger BE et al (2007) Summary and recommendations of the fifth international workshop-conference on gestational diabetes mellitus. Diabetes Care 30(Suppl 2):S251–S260

    Article  PubMed  CAS  Google Scholar 

  2. Guariguata L et al (2014) Global estimates of the prevalence of hyperglycaemia in pregnancy. Diabetes Res Clin Pract 103(2):176–185

    Article  PubMed  CAS  Google Scholar 

  3. Koning SH et al (2016) Gestational diabetes mellitus: current knowledge and unmet needs. J Diabetes 8(6):770–781

    Article  PubMed  Google Scholar 

  4. Cho NH et al (2018) IDF diabetes atlas: global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract 138:271–281

    Article  PubMed  CAS  Google Scholar 

  5. Kolu P et al (2012) Health care costs associated with gestational diabetes mellitus among high-risk women—results from a randomised trial. BMC Pregnancy Childbirth 12:71

    Article  PubMed  PubMed Central  Google Scholar 

  6. Xu T et al (2017) The short-term health and economic burden of gestational diabetes mellitus in China: a modelling study. BMJ Open 7(12):e018893

    Article  PubMed  PubMed Central  Google Scholar 

  7. International Diabetes Federation (2017) IDF Diabetes Atlas. https://www.idf.org/elibrary/epidemiology-research/diabetes-atlas/134-idf-diabetes-atlas-8th-edition.html. Accessed 6 Jan 2018

  8. Nguyen CL et al (2018) Prevalence of gestational diabetes mellitus in eastern and south-eastern Asia: a systematic review and meta-analysis. J Diabetes Res

  9. Metzger BE et al (2008) Hyperglycemia and adverse pregnancy outcomes. N Engl J Med 358(19):1991–2002

    Article  PubMed  Google Scholar 

  10. Mitanchez D (2010) Foetal and neonatal complications in gestational diabetes: perinatal mortality, congenital malformations, macrosomia, shoulder dystocia, birth injuries, neonatal complications. Diabetes Metab 36(6 Pt 2):617–627

    Article  PubMed  CAS  Google Scholar 

  11. Wendland EM et al (2012) Gestational diabetes and pregnancy outcomes—a systematic review of the World Health Organization (WHO) and the International Association of Diabetes in Pregnancy Study Groups (IADPSG) diagnostic criteria. BMC Pregnancy Childbirth 12:23

    Article  PubMed  PubMed Central  Google Scholar 

  12. Sesmilo G et al (2017) Maternal fasting glycemia and adverse pregnancy outcomes in a Mediterranean population. Acta Diabetol 54(3):293–299

    Article  PubMed  CAS  Google Scholar 

  13. Kim C, Newton KM, Knopp RH (2002) Gestational diabetes and the incidence of type 2 diabetes: a systematic review. Diabetes Care 25(10):1862–1868

    Article  PubMed  Google Scholar 

  14. Kohler M, Ziegler AG, Beyerlein A (2016) Development of a simple tool to predict the risk of postpartum diabetes in women with gestational diabetes mellitus. Acta Diabetol 53(3):433–437

    Article  PubMed  CAS  Google Scholar 

  15. McKenzie-Sampson S et al (2018) Gestational diabetes and risk of cardiovascular disease up to 25 years after pregnancy: a retrospective cohort study. Acta Diabetol 55(4):315–322

    Article  PubMed  Google Scholar 

  16. Goueslard K et al (2017) Early screening for type 2 diabetes following gestational diabetes mellitus in France: hardly any impact of the 2010 guidelines. Acta Diabetol 54(7):645–651

    Article  PubMed  CAS  Google Scholar 

  17. Kruk J (2007) Physical activity in the prevention of the most frequent chronic diseases: an analysis of the recent evidence. Asian Pac J Cancer Prev 8(3):325–338

    PubMed  Google Scholar 

  18. Sigal RJ et al (2006) Physical activity/exercise and type 2 diabetes: a consensus statement from the American Diabetes Association. Diabetes Care 29(6):1433–1438

    Article  PubMed  Google Scholar 

  19. Tobias DK et al (2011) Physical activity before and during pregnancy and risk of gestational diabetes mellitus: a meta-analysis. Diabetes Care 34(1):223–229

    Article  PubMed  Google Scholar 

  20. Aune D et al (2016) Physical activity and the risk of gestational diabetes mellitus: a systematic review and dose–response meta-analysis of epidemiological studies. Eur J Epidemiol 31(10):967–997

    Article  PubMed  PubMed Central  Google Scholar 

  21. Dempsey JC et al (2004) Prospective study of gestational diabetes mellitus risk in relation to maternal recreational physical activity before and during pregnancy. Am J Epidemiol 159(7):663–670

    Article  PubMed  Google Scholar 

  22. Oken E et al (2006) Associations of physical activity and inactivity before and during pregnancy with glucose tolerance. Obstet Gynecol 108(5):1200–1207

    Article  PubMed  PubMed Central  Google Scholar 

  23. Harizopoulou VC et al (2010) Maternal physical activity before and during early pregnancy as a risk factor for gestational diabetes mellitus. Acta Diabetol 47(Suppl 1):83–89

    Article  PubMed  Google Scholar 

  24. Oostdam N et al (2012) No effect of the FitFor2 exercise programme on blood glucose, insulin sensitivity, and birthweight in pregnant women who were overweight and at risk for gestational diabetes: results of a randomised controlled trial. BJOG Int J Obstet Gynaecol 119(9):1098–1107

    Article  CAS  Google Scholar 

  25. Stafne SN et al (2012) Regular exercise during pregnancy to prevent gestational diabetes a randomized controlled trial. Obstet Gynecol 119(1):29–36

    Article  PubMed  Google Scholar 

  26. Barakat R et al (2013) Exercise during pregnancy and gestational diabetes-related adverse effects: a randomised controlled trial. Br J Sports Med 47(10):630–636

    Article  PubMed  Google Scholar 

  27. Chasan-Taber L et al (2014) Physical activity before and during pregnancy and risk of abnormal glucose tolerance among Hispanic women. Diabetes Metab 40(1):67–75

    Article  PubMed  CAS  Google Scholar 

  28. Callaway LK et al (2010) Prevention of gestational diabetes: feasibility issues for an exercise intervention in obese pregnant women. Diabetes Care 33(7):1457–1459

    Article  PubMed  PubMed Central  Google Scholar 

  29. Anjana RM et al (2016) Physical activity patterns and gestational diabetes outcomes—the wings project. Diabetes Res Clin Pract 116:253–262

    Article  PubMed  Google Scholar 

  30. Leng JH et al (2016) Physical activity, sedentary behaviors and risk of gestational diabetes mellitus: a population-based cross-sectional study in Tianjin, China. Eur J Endocrinol 174(6):763–773

    Article  PubMed  CAS  Google Scholar 

  31. Padmapriya N et al (2017) Associations of physical activity and sedentary behavior during pregnancy with gestational diabetes mellitus among Asian women in Singapore. BMC Pregnancy Childbirth 17(1):364

    Article  PubMed  PubMed Central  Google Scholar 

  32. Biswas A et al (2015) Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Ann Intern Med 162(2):123–132

    Article  PubMed  Google Scholar 

  33. Patterson R et al (2018) Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis. Eur J Epidemiol

  34. Nguyen CL et al (2017) Cohort profile: maternal lifestyle and diet in relation to pregnancy, postpartum and infant health outcomes in Vietnam: a multicentre prospective cohort study. BMJ Open 7(9):e016794

    Article  PubMed  PubMed Central  Google Scholar 

  35. Ota E et al (2008) Reliability and validity of the Vietnamese version of the Pregnancy Physical Activity Questionnaire (PPAQ). Southeast Asian J Trop Med Public Health 39(3):562–570

    PubMed  Google Scholar 

  36. Chasan-Taber L et al (2004) Development and validation of a Pregnancy Physical Activity Questionnaire. Med Sci Sports Exerc 36(10):1750–1760

    Article  PubMed  Google Scholar 

  37. Ainsworth BE et al (2000) Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 32(9 Suppl):S498-504

    PubMed  Google Scholar 

  38. Berntsen S et al (2014) Objectively recorded physical activity in early pregnancy: a multiethnic population-based study. Scand J Med Sci Sports 24(3):594–601

    Article  PubMed  CAS  Google Scholar 

  39. Practice ACO (2002) ACOG Committee opinion. Number 267, January 2002: exercise during pregnancy and the postpartum period. Obstet Gynecol 99(1):171–173

    Google Scholar 

  40. World Health Organization (2013) Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. http://apps.who.int/iris/bitstream/10665/85975/1/WHO_NMH_MND_13.2_eng.pdf. Accessed 8 Apr 2015

  41. World Health Organization (2008) WHO SETPS instrument (core and expanded). http://www.who.int/chp/steps/instrument/STEPS_Instrument_V3.1.pdf. Accessed 8 Apr 2015

  42. Currie LM et al (2014) The association between physical activity and maternal and neonatal outcomes: a prospective cohort. Matern Child Health J 18(8):1823–1830

    Article  PubMed  Google Scholar 

  43. Chasan-Taber L et al (2008) Physical activity and gestational diabetes mellitus among Hispanic women. J Womens Health (Larchmt) 17(6):999–1008

    Article  Google Scholar 

  44. Zhang Y et al (2014) Physical activity level of urban pregnant women in Tianjin, China: a cross-sectional study. PLoS One 9(10):e109624. https://doi.org/10.1371/journal.pone.0109624

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  45. Kuhl C (1998) Etiology and pathogenesis of gestational diabetes. Diabetes Care 21(Suppl 2):B19-26

    PubMed  Google Scholar 

  46. Davenport MH et al (2008) A walking intervention improves capillary glucose control in women with gestational diabetes mellitus: a pilot study. Appl Physiol Nutr Metab 33(3):511–517

    Article  PubMed  CAS  Google Scholar 

  47. de Barros MC et al (2010) Resistance exercise and glycemic control in women with gestational diabetes mellitus. Am J Obstet Gynecol 203(6):556 e1–556 e6

    Article  Google Scholar 

  48. Golbidi S, Laher I (2013) Potential mechanisms of exercise in gestational diabetes. J Nutr Metab 2013:285948

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  49. Cao H (2014) Adipocytokines in obesity and metabolic disease. J Endocrinol 220(2):T47–T59

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  50. Daniele G et al (2014) The inflammatory status score including IL-6, TNF-alpha, osteopontin, fractalkine, MCP-1 and adiponectin underlies whole-body insulin resistance and hyperglycemia in type 2 diabetes mellitus. Acta Diabetol 51(1):123–131

    Article  PubMed  CAS  Google Scholar 

  51. Hayashino Y et al (2014) Effects of exercise on C-reactive protein, inflammatory cytokine and adipokine in patients with type 2 diabetes: a meta-analysis of randomized controlled trials. Metabolism 63(3):431–440

    Article  PubMed  CAS  Google Scholar 

  52. Kobe H et al (2002) Effect of regular maternal exercise on lipid peroxidation levels and antioxidant enzymatic activities before and after delivery. J Nippon Med Sch 69(6):542–548

    Article  PubMed  CAS  Google Scholar 

  53. Grissa O et al (2007) Antioxidant status and circulating lipids are altered in human gestational diabetes and macrosomia. Transl Res 150(3):164–171

    Article  PubMed  CAS  Google Scholar 

  54. White E, Hunt JR, Casso D (1998) Exposure measurement in cohort studies: the challenges of prospective data collection. Epidemiol Rev 20(1):43–56

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

The authors are grateful to the women who participated in this study and also would like to thank the participating hospitals and data enumerators for their support in data collection.

Funding

This study was partly funded by the School of Public Health, Curtin University, Perth, Western Australia.

Author information

Authors and Affiliations

Authors

Contributions

CLN, TKC, PTHN, and AVVH designed the study and collected data. CLN drafted the manuscript. NMP assisted with data analysis. THD provided expert advice on the study design. DVD, NMP, AHL and CWB were the study supervisors and involved in all aspects of the study. All authors revised the article and approved the final version for publication.

Corresponding author

Correspondence to C. L. Nguyen.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interests.

Human and animal rights

The study was approved by the Curtin University Human Research Ethics Committee (approval number: HR32/2015) and the Hai Phong University of Medicine and Pharmacy Human Research Ethics Committee (approval number: 05/HPUMPRB/2015).

Informed consent

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

Additional information

Managed by Antonio Secchi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nguyen, C.L., Pham, N.M., Lee, A.H. et al. Physical activity during pregnancy is associated with a lower prevalence of gestational diabetes mellitus in Vietnam. Acta Diabetol 55, 955–962 (2018). https://doi.org/10.1007/s00592-018-1174-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00592-018-1174-3

Keywords

Navigation