Physical activity, sedentary behaviors and risk of gestational diabetes mellitus: a population-based cross-sectional study in Tianjin, China

Abstract

OBJECTIVE: Physical activity in a nonpregnant state or before pregnancy reduces the risk of type 2 diabetes and is also associated with reduced risk of gestational diabetes mellitus (GDM). However, it is uncertain whether physical activity during pregnancy reduces the risk of GDM. DESIGN AND METHODS: Using an established universal screening system in Tianjin, China, we prospectively recruited 11 450 pregnant women within the 12th gestational week from 2010 to 2012. These women underwent a 50-g 1-h glucose challenge test (GCT) at 24-28 weeks of gestation and a 75-g 2-h oral glucose tolerance test if GCT glucose ≥7.8mmol/L. GDM was defined according to the International Association of Diabetes and Pregnancy Study Group's criteria. Self-reported physical activity in the last month was collected at GCT time using a validated questionnaire. RESULTS: GDM developed in 7.3% (n=840) of the women. Women with GDM were less likely to be engaged in moderate-to-high physical activity during pregnancy than those without (79.8% vs 81.6%, P=0.191). Moderate-to-high physical activity during pregnancy was associated with decreased risk of GDM (multivariable odds ratio (OR): 0.81, 95% confidence interval (CI): 0.67-0.97). Sitting at home for 2-4h per day and >4h per day were associated with significantly increased risk of GDM (multivariable OR of sitting time for 2-4h vs <2h: 1.59, 95% CI: 1.18-2.15; OR of sitting time for >4h vs <2h: 1.73, 95% CI: 1.22-2.43). CONCLUSIONS: Increased physical activity during pregnancy was associated with reduced GDM risk, whereas sedentary lifestyle was associated with increased GDM risk among Chinese pregnant women.