Lifestyle intervention for gestational diabetes mellitus prevention: A cluster-randomized controlled study Feasibility of a lifestyle intervention in early pregnancy to prevent deterioration of glucose tolerance The effects of yoga in prevention of pregnancy complications in high-risk pregnancies: a randomized controlled trial. The relationship between large-for-gestational-age infants and glycemic control in women with gestational diabetes. Effect of an Exercise Intervention on Gestational Diabetes Mellitus: A Randomized Controlled Trial Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. Exercise during pregnancy improves maternal glucose screen at 24–28 weeks: a randomised controlled trial Body weight and subsequent diabetes mellitus. Supervised exercise-based intervention to prevent excessive gestational weight gain: a randomized controlled trial. Exercise during pregnancy and gestational diabetes-related adverse effects: a randomised controlled trial Physical activity, sedentary behaviors and risk of gestational diabetes mellitus: a population-based cross-sectional study in Tianjin, China. Regular Exercise During Pregnancy to Prevent Gestational Diabetes: A Randomized Controlled Trial A randomized comparative trial of the efficacy and safety of exercise during pregnancy: design and methods. Intervening to reduce weight gain in pregnancy and gestational diabetes mellitus in Cree communities: an evaluation. Exercise Is Associated with a Reduction in Gestational Diabetes Mellitus. A Program of Exercise Throughout Pregnancy. Is it Safe to Mother and Newborn? Exercise in pregnancy: effect on fitness and obstetric outcomes-a randomized trial. Exercise throughout pregnancy does not cause preterm delivery: a randomized, controlled trial. Effect of intensive counselling on physical activity in pregnant women at high risk for gestational diabetes mellitus. A clinical study in primary care.
Objective The study was to examine whether gestational diabetes mellitus ( GDM ) can be prevented by early trimester lifestyle counseling in a high-risk population . Methods From September 2012 to January 2013 , 1664 pregnancies in the Department of Obstetrics and Gynecology of First Hospital of Peking University were enrolled in the study during their first prenatal care visit before the 8 gestational weeks visit and asked to fill out a question naire on GDM risk evaluation . According to the question naire and medical records , those with at least one risk factor of GDM were included in the intervention study and r and omly allocated to two groups , intervention group and control group . Routine prenatal care was offered , while st and ardized two-step lifestyle intervention was provided to the intervention group during 6–8 gestational weeks , and at 12–13 gestational weeks , enforcement intervention based on maternal anthropometrics were offered . Both groups were followed until 75 g oral glucose tolerance test ( OGTT ) testing at 24–28 gestational weeks . The weight gain after intervention and the prevalence of GDM were used to evaluate the effect . Results ( 1 ) According to the International Association of Diabetes and Pregnancy Study Groups ( IADPSG ) criteria , the positive rate of GDM for the intervention group was 17.16 % ( 23/134 ) , lower than the control group which was 23.91 % ( 33/138 ) , P = 0.168 . ( 2 ) The weight gain during the first and second trimester for the intervention group was ( 1.38 ± 2.34 ) kg and ( 5.51 ± 2.18 ) kg , lower than in the control group which was ( 1.41 ± 2.58 ) kg and ( 5.66 ± 2.25 ) kg , ( P = 0.905 , P = 0.567 ) . ( 3 ) Positive rate of GDM for those fasting plasma glucose ( FPG ) ≥5.1 mmol/L during early pregnancy was 11/36 ( 30.55 % ) for the intervention group that was lower than 17/37 ( 45.95 % ) for the control group , but the statistical difference was not significant ( P = 0.076 ) . Conclusion The positive rate of GDM could be reduced by a certain amount lifestyle intervention from the beginning of pregnancy . More vali date d effective intervention should be explored in the high-risk pregnant women Background In conjunction with the growing prevalence of obesity and the older age of pregnant women gestational diabetes ( GDM ) is a major health problem . The aim of the study was to evaluate if a lifestyle intervention since early pregnancy is feasible in improving the glucose tolerance of women at a high-risk for GDM in Finl and . Methods A 75-g oral glucose tolerance test ( OGTT ) was performed in early pregnancy ( n = 102 ) . Women at high risk for GDM ( n = 54 ) were r and omized at weeks 8 - 12 from Apr 2005 to May 2006 to a lifestyle intervention group ( n = 27 ) or to a close follow-up group ( n = 27 ) . An OGTT was performed again at weeks 26 - 28 for the lifestyle intervention and close follow-up groups . Results The values of the OGTT during the second trimester did not differ between the lifestyle intervention and close follow-up groups . In the lifestyle intervention group three women had GDM in the second trimester and respectively one woman in the close follow up group . Insulin therapy was not required in both groups . The intervention result ed in somewhat lower weight gain 11.4 ± 6.0 kg vs. 13.9 ± 5.1 kg , p = 0.062 , adjusted by the prepregnancy weight . Conclusions Early intervention with an OGTT and simple lifestyle advice is feasible . A more intensive lifestyle intervention did not offer additional benefits with respect to glucose tolerance , although it tended to ameliorate the weight gain . Trial Registration Clinical Trials.gov : OBJECTIVE While previous studies have shown the potential effects of yoga in normal pregnancies , this r and omized controlled trial investigated the effects of yoga in prevention of pregnancy complications in high-risk pregnancies for the first time . METHODS 68 high-risk pregnant women were recruited from two maternity hospitals in Bengaluru , India and were r and omized into yoga and control groups . The yoga group ( n=30 ) received st and ard care plus one-hour yoga sessions , three times a week , from the 12th to the 28th week of gestation . The control group ( n=38 ) received st and ard care plus conventional antenatal exercises ( walking ) during the same period . RESULTS Significantly fewer pregnancy induced hypertension ( PIH ) , preeclampsia , gestational diabetes ( GDM ) and intrauterine growth restriction ( IUGR ) cases were observed in the yoga group ( p=0.018 , 0.042 , 0.049 , 0.05 respectively ) . Significantly fewer Small for Gestational Age ( SGA ) babies and newborns with low APGAR scores ( p=0.006 ) were born in the yoga group ( p=0.033 ) . CONCLUSION This first r and omized study of yoga in high-risk pregnancy has shown that yoga can potentially be an effective therapy in reducing hypertensive related complications of pregnancy and improving fetal outcomes . Additional data is needed to confirm these results and better explain the mechanism of action of yoga in this important area In this prospect i ve study 246 women with gestational diabetes were followed up to determine the characteristics of metabolic control associated with large-for-gestational-age infants . Memory-based reflectance meters were used for self-monitoring blood glucose . Ambulatory glucose profiles were produced to characterize glycemic control levels throughout pregnancy . With these novel approaches to the collection and representation of glucose data , the severity of glucose intolerance ( hyperglycemia ) was found to be associated with both maternal and neonatal morbidity in terms of infant size and cesarean section rate . By use of hierarchical cluster analysis to identify three groups on the basis of control levels ( low less than 87 mg/dl , mid 87 to 105 mg/dl , high greater than 105 mg/dl ) we were able to show a positive outcome in the low group with reduced rates of large-for-gestational-age ( 2 % ) and macrosomatic ( 0 % ) infants . Furthermore , we showed that as mean blood glucose levels and instability in glycemic control increased from group to group , incidence of large-for-gestational-age and macrosomatic infants increased . Whereas obesity increased the relative risk of adverse neonatal outcome , type of treatment ( insulin versus diet ) did not appear to be significant . Appropriately monitored toward stability within a narrow range to achieve tight metabolic control , ambulatory glycemia in pregnancy is associated with a decreased risk of maternal and fetal complications OBJECTIVE : To examine the effect of an individually tailored , motivationally matched prenatal exercise intervention on gestational diabetes mellitus ( GDM ) and other measures of glucose intolerance among ethnically diverse prenatal care patients at increased risk for GDM . METHODS : The Behaviors Affecting Baby and You study r and omized eligible women at a mean ( st and ard deviation ) of 18.2 ( 4.1 ) weeks of gestation to a 12-week individually tailored , motivationally matched exercise intervention or a comparison health and wellness intervention . The goal of the exercise intervention was to achieve the American College of Obstetricians and Gynecologists ' guidelines for physical activity during pregnancy . Diagnosis of GDM , impaired glucose tolerance , abnormal glucose screen , and screening glucose values ( mg/dL ) were abstract ed from medical records . A sample size of 352 women ( 176 per group ) was planned to have 80 % power to detect reductions in risk of 35 % or larger . RESULTS : From July 2007 to December 2012 , a total of 251 ( 86.5 % ) women completed the intervention ; n=124 and 127 in the exercise and comparison interventions , respectively . Based on an intention-to-treat analysis , no statistically significant differences between the intervention groups were observed ; the relative odds of GDM in the exercise group was 0.61 ( 95 % confidence interval [ CI ] 0.28–1.32 ) as compared with the health and wellness comparison group . Odds ratios for impaired glucose tolerance and abnormal glucose screen were 0.68 ( 95 % CI 0.35–1.34 ) and 0.86 ( 95 % CI 0.51–1.47 ) , respectively . The intervention had no effect on birth outcomes . CONCLUSION : In this r and omized trial among ethnically diverse pregnant women at increased risk for GDM , we found that a prenatal exercise intervention implemented in the second trimester did not result in a statistically significant reduction in relative odds for GDM , impaired glucose tolerance , or abnormal glucose screen . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT00728377 . LEVEL OF EVIDENCE : BACKGROUND We conducted a r and omized clinical trial to determine whether treatment of women with gestational diabetes mellitus reduced the risk of perinatal complications . METHODS We r and omly assigned women between 24 and 34 weeks ' gestation who had gestational diabetes to receive dietary advice , blood glucose monitoring , and insulin therapy as needed ( the intervention group ) or routine care . Primary outcomes included serious perinatal complications ( defined as death , shoulder dystocia , bone fracture , and nerve palsy ) , admission to the neonatal nursery , jaundice requiring phototherapy , induction of labor , cesarean birth , and maternal anxiety , depression , and health status . RESULTS The rate of serious perinatal complications was significantly lower among the infants of the 490 women in the intervention group than among the infants of the 510 women in the routine-care group ( 1 percent vs. 4 percent ; relative risk adjusted for maternal age , race or ethnic group , and parity , 0.33 ; 95 percent confidence interval , 0.14 to 0.75 ; P=0.01 ) . However , more infants of women in the intervention group were admitted to the neonatal nursery ( 71 percent vs. 61 percent ; adjusted relative risk , 1.13 ; 95 percent confidence interval , 1.03 to 1.23 ; P=0.01 ) . Women in the intervention group had a higher rate of induction of labor than the women in the routine-care group ( 39 percent vs. 29 percent ; adjusted relative risk , 1.36 ; 95 percent confidence interval , 1.15 to 1.62 ; P<0.001 ) , although the rates of cesarean delivery were similar ( 31 percent and 32 percent , respectively ; adjusted relative risk , 0.97 ; 95 percent confidence interval , 0.81 to 1.16 ; P=0.73 ) . At three months post partum , data on the women 's mood and quality of life , available for 573 women , revealed lower rates of depression and higher scores , consistent with improved health status , in the intervention group . CONCLUSIONS Treatment of gestational diabetes reduces serious perinatal morbidity and may also improve the woman 's health-related quality of life Objective The influence of an exercise programme performed by healthy pregnant women on maternal glucose tolerance was studied . Study design A physical activity ( PA , l and /aquatic activities ) programme during the entire pregnancy ( three sessions per week ) was conducted by a qualified instructor . 83 healthy pregnant women were r and omly assigned to either an exercise group ( EG , n=40 ) or a control ( CG , n=43 ) group . 50 g maternal glucose screen ( MGS ) , maternal weight gain and several pregnancy outcomes were recorded . Results Significant differences were found between study groups on the 50 g MGS . Values corresponding to the EG ( 103.8±20.4 mg/dl ) were better than those of the CG ( 126.9±29.5 mg/dl ) , p=0.000 . In addition , no differences in maternal weight gain and no cases of gestational diabetes in EG versus 3 in CG ( 7 % ) ( p>0.05 ) were found . Conclusion A moderate PA programme performed during pregnancy improves levels of maternal glucose tolerance The ten- to 16-year predictive value of body weight for diabetes mellitus was evaluated prospect ively in two groups of women with initially normal results of glucose tolerance tests . The incidence of diabetes in 602 high-risk ( previous transient gestational glucose intolerance ) participants was significantly higher for overweight subjects ( 46.7 % ) than for those of normal weight ( 25.6 % ) . In 328 concurrently selected negative control subjects ( without previous intolerance ) , the difference was not significant ( 4.5 % v 1.9 % ) . Another definition of diabetes , indicating further deterioration , gave similar results , although high-risk overweight women had disproportionately higher incidence rates . Being overweight had no substantial predictive value for diabetes mellitus during this period unless the additional evidence for a high-risk classification was present . Among such persons at high risk , excess weight also predicted the severity of the subsequent diabetic condition OBJECTIVE To study the effect on  maternal weight gain of a supervised light- to moderate-intensity exercise-based intervention performed from the ninth week of pregnancy . PARTICIPANTS AND METHODS A total of 962 healthy pregnant women were r and omly assigned to a st and ard care or exercise intervention group conducted between September 1 , 2007 , and January 31 , 2011 . The intervention included light- to moderate-intensity aerobic and resistance exercises performed 3 days a week ( 50 - 55 minutes per session ) . Excessive gestational weight gain was calculated on the basis of the 2009 Institute of Medicine ( IOM ) recommendations . Gestational body weight gain was calculated on the basis of the weight measured at the first prenatal visit ( fifth to sixth weeks of gestation ) and weight measured at the last visit to the clinic before delivery . Women were categorized into normal weight or overweight or obese . RESULTS Women in the intervention group gained less weight ( adjusted mean difference , 1.039 kg ; 95 % CI , 0.534 - 1.545 kg ; P<.001 ) and were less likely to gain weight above the IOM recommendations ( odds ratio , 0.625 ; 95 % CI , 0.461 - 0.847 ) compared with those in the st and ard care group . The main treatment effects according to body mass index category were that normal weight women in the intervention group gained less weight ( adjusted mean difference , 1.393 kg ; 95 % CI , 0.813 - 1.972 kg ; P<.001 ) and were less likely to gain weight above the IOM recommendations ( odds ratio , 0.508 ; 95 % CI , 0.334 - 0.774 ) than normal weight women who received st and ard care . No significant treatment effect was observed in overweight or obese women . CONCLUSION Supervised exercise of light to moderate intensity can be used to prevent excessive gestational weight gain , especially in normal weight women . TRIAL REGISTRATION clinical trials.gov Identifier : NCT01790347 Objective To examine the effect of regular moderate-intensity exercise ( three training sessions/week ) on the incidence of  gestational diabetes mellitus ( GDM  , primary outcome ) . We also examined if the exercise intervention modifies the association between GDM and birth weight and risk of macrosomia , gestational age , risk of caesarean delivery and maternal weight gain ( secondary outcomes ) . Methods We r and omly assigned 510 healthy gravida to either an exercise intervention or a usual care ( control ) group ( n=255 each ) . The exercise programme focused on moderate-intensity resistance and aerobic exercises ( three times/week , 50–55 min/session ) . GDM diabetes was diagnosed according to the WHO criteria and the International Association for Diabetes in Pregnancy Study Group ( IADPSG ) . Results The intervention did not reduce the risk of developing GDM ( OR 0.84 , 95 % CI 0.50 to 1.40 ) when using the WHO criteria . We observed that the intervention reduced by 58 % the GDM-related risk ( WHO criteria ) of having a newborn with macrosomia ( OR 1.76 , 95 % CI 0.04 to 78.90 vs 4.22 , 95 % CI 1.35 to 13.19 ) in exercise and control groups , respectively ) , and by 34 % the GDM-related risk of having acute and elective caesarean delivery ( OR 1.30 , 95 % CI 0.44 to 3.84 vs 1.99 , 95 % CI 0.98 to 4.06 in exercise and control groups , respectively ) . Gestational age was similar across the treatment groups ( control , exercise ) and GDM category ( GDM or non-GDM ) , and maternal weight gain was ∼12 % lower in the exercise group independent of whether women developed GDM . The results were similar when the IADPSG criteria were used instead . Conclusions Regular moderate-intensity exercise performed over the second-third trimesters of pregnancy can be used to attenuate important GDM-related adverse outcomes 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 prospect ively 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 vali date d question naire . 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 OBJECTIVE : To assess whether exercise during pregnancy can prevent gestational diabetes and improve insulin resistance . METHODS : A total of 855 women in gestational week 18–22 were r and omly assigned to receiving a 12-week st and ard exercise program ( intervention group ) or st and ard antenatal care ( control group ) . The exercise program followed st and ard recommendations and included moderate-intensity to high-intensity activity 3 or more days per week . Primary outcomes were gestational diabetes and insulin resistance estimated by the homeostasis model assessment method . For the power calculation , we assumed a gestational diabetes prevalence of 9 % in the control group and a prevalence of 4 % in the exercise group ( risk difference of 5 % ) . Under these assumptions , a two- sample comparison with a 5 % level of significance and power of 0.80 gave a study population of 381 patients in each group . RESULTS : At 32–36 weeks of gestation there were no differences between groups in prevalence of gestational diabetes : 25 of 375 ( 7 % ) in the intervention group compared with 18 of 327 ( 6 % ) in the control group ( P=.52 ) . There were no differences in insulin resistance between groups when adjusting for baseline values . Only 55 % of women in the intervention group managed to follow the recommended exercise protocol . No serious adverse events related to physical exercise were seen , and the outcomes of pregnancy were similar in the two groups . CONCLUSION : There was no evidence that offering women a 12-week st and ard exercise program during the second half of pregnancy prevents gestational diabetes or improves insulin resistance in healthy pregnant women with normal body mass indexes . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT00476567 . LEVEL OF EVIDENCE : Use of an exercise intervention for high-risk and vulnerable population s , such as pregnant women at risk for gestational hypertension or preeclampsia , requires special consideration . A comparative trial testing the effects of two types of physical exercises - stretching ( a comparator ) and walking ( a testing intervention ) - for sedentary pregnant women at risk for preeclampsia - is presented in this paper . The study was design ed to reduce post-r and omization bias and dropout rates from both groups , and closely to monitor safety of subjects . The strengths of the study design and methods include use of a run-in phase ; use of a stretching exercise as a comparator ; multiple ways to measure daily physical activities and the exercise intervention ; and tailored support to remove barriers to exercise for subjects . The intervention consists of 40 min of walking at moderate intensity ( i.e. , 55 - 69 % of maximum heart rate and rating of perceived exhaustion 12 - 13 ) five times a week from 18 weeks gestation until birth . The comparator exercise consists of 40 min of stretching exercise without increasing heart rate to more than 10 % of resting heart rate , five times a week from 18 weeks gestation until birth . The primary outcome is the incidence of preeclampsia . Secondary outcomes include the physiologic effects of the intervention and birth outcomes BACKGROUND A high prevalence of gestational diabetes mellitus and type 2 diabetes has been observed among the Cree of James Bay , Quebec . To address this problem , a diet and activity intervention during pregnancy , which was based on social learning theory , was initiated in 4 Cree communities . METHODS A prospect i ve intervention compared dietary , weight and glycemic indicators for 107 control subjects and for 112 women who received the intervention during the course of their pregnancy . A control period in 4 communities ( July 1995-March 1996 ) was followed by an intervention period ( April 1996-January 1997 ) when subjects were offered regular , individual diet counselling , physical activity sessions and other activities related to nutrition . RESULTS The intervention and control groups did not differ at baseline regarding their mean age ( 24.3 years [ SD 6.29 ] v. 23.8 years [ SD 5.86 ] ) , mean prepregnancy weight ( 81.0 kg [ SD 19.46 ] v. 78.9 kg [ SD 17.54 ] ) and mean gestational age at recruitment ( 17.1 weeks [ SD 7.06 ] v. 18.5 weeks [ SD 6.92 ] ) . The intervention did not result in differences in diet measured at 24 - 30 weeks ' gestation , rate of weight gain over the second half of pregnancy ( 0.53 kg per week [ SD 0.32 ] v. 0.53 kg per week [ SD 0.27 ] ) or plasma glucose level ( 50 g oral glucose screen ) between 24 and 30 weeks ( 7.21 mmol/L [ SD 2.09 ] v. 7.43 mmol/L [ SD 2.10 ] ) . Mean birth weights were similar ( 3741 g [ SD 523 ] v. 3686 g [ SD 686 ] ) , as was maternal weight at 6 weeks post partum ( 88.1 kg [ SD 16.8 ] v. 86.4 kg [ SD 19.0 ] ) . The only changes in dietary intake were a reduction in caffeine ( pregnancy ) and an increase in folate ( post partum ) . INTERPRETATION This intervention had only a minor impact on diet ; finding ways of encouraging appropriate body weight and activity levels remains a challenge PURPOSE The objective of this study is to assess the effectiveness of a maternal exercise program ( l and /aquatic activities , both aerobic and muscular conditioning ) in preventing gestational diabetes mellitus ( GDM ) . METHODS Three hundred and forty-two pregnant women from Spain ( age , 33.24 ± 4.3 yr ) without obstetric contraindications were recruited for a clinical r and omized controlled trial . The intervention group ( IG , n = 101 ) exercised for 60 and 50 min on l and and in water , respectively , three times per week . The control group ( n = 156 ) received usual st and ard care .  RESULTS The prevalence of GDM was reduced in the IG group ( IG , 1 % , n = 1 , vs control group , 8.8 % , n = 13 ( χ1 = 6.84 , P = 0.009 ) ) with a significant risk estimate ( odds ratio = 0.103 ; 95 % confidence interval , 0.013 - 0.803 ) . CONCLUSION The exercise program performed during pregnancy reduced the prevalence of GDM by preserving glucose tolerance Purpose . The aim of the present study was to examine the influence of a program of moderate physical exercise throughout pregnancy on maternal and fetal parameters . Design . The study design was a r and omized controlled trial . Setting . The study took place at the Hospital of Fuenlabrada in Madrid , Spain . Sample . Analyzed were 200 pregnant women ( 31.54 ± 3.86 years ) , all of whom had uncomplicated and singleton gestation . Of these subjects , 107 were allocated to the  exercise group  ( EG ) and 93 to the  control group ( CG ) . Intervention . Women from EG participated in a physical conditioning program throughout pregnancy , which included a total of 55- to 60-minute weekly sessions , 3 days per week . Measures . Pregnancy outcomes . Maternal : gestational age , weight gain , type of delivery , blood pressure during pregnancy , gestational diabetes ( n/% ) . Fetal : birth weight , birth size , head circumference , Apgar score , pH of umbilical cord . Analysis . Student 's unpaired t-test and χ2 test were used ; p values of ≤ .05 indicated statistical significance . Cohen 's d was used to determine the effect size . Results . There were significantly more pregnant women in the CG who gained excessive weight during their pregnancies than in the EG group ( CG : N = 31 , 35.6 % versus N = 22 , 21.2 % ; χ2 = 4.95 ; p = .02 ) . The effect size was small ( Phi value = .16 ) . Other pregnancy outcome showed no differences between groups . Conclusion . A regular and moderate physical exercise program throughout pregnancy is not a risk to maternal and fetal well-being , and it helps to control excessive weight gain OBJECTIVE A prospect i ve r and omized controlled trial was design ed to assess the benefits and possible risks of aerobic exercise during pregnancy , using a fitness regimen based on the 2002 American College of Obstetricians and Gynecologists guidelines for exercise during pregnancy . METHODS Inactive women were r and omized at 12 - 14 wk gestation to a group that remained sedentary or to a group that performed moderate aerobic exercise 45 - 60 min , 4 d·wk , through 36 wk gestation . Thirty-one subjects in each group completed the study . RESULTS Compared with women who remained sedentary , active women improved aerobic fitness ( P < 0.05 ) and muscular strength ( P < 0.01 ) , delivered comparable size infants with significantly fewer cesarean deliveries ( P < 0.01 ) , and recovered faster postpartum ( P < 0.05 ) , at least related to the lower incidence of cesarean section . Active women developed no gestational hypertension ( P = 0.16 compared with controls ) and reported no injuries related to the exercise regimen . In the active group , there was one premature birth at 33 wk by a woman with a history of premature delivery of twins at 34 wk . There were no differences between groups in the incidence of gestational diabetes , musculoskeletal pains during pregnancy , flexibility on sit- and -reach test , mean length of pregnancy , neonatal Apgar scores , placenta weights , overall length of labor , weight gain during pregnancy , or weight retention postpartum . CONCLUSION Previously sedentary women who began exercising at 12 - 14 wk improved fitness and delivery outcomes BACKGROUND In spite of an extensive knowledge of the physiologic features of exercise during pregnancy , we still lack a comprehensive underst and ing of the effects of different types , intensities and duration of exercise throughout pregnancy on maternal and fetal well being . The aim of the current study was to examine the influence of an aerobic exercise program throughout pregnancy on gestational age at the moment of delivery . METHODS This study was a r and omized controlled trial . Three hundred and twenty Caucasian ( Spanish ) healthy pregnant women with singleton gestation were r and omly assigned to either an exercise ( n = 160 ) or a control ( n = 160 ) group . Gestational age ( weeks ) and other outcomes were measured . The exercise program included 85 sessions ( general fitness class , 3 times/week , 55 - 60 min/session from weeks 8 - 10 to weeks 38 - 39 of pregnancy ) . RESULTS Two hundred and ninety women were analyzed ( exercise group EG , n = 138 , control group CG , n = 152 ) . The mean gestational age did not differ between groups ( EG= 39.7 ± 1.3 vs CG= 39.6 ± 1.1 weeks , P = .81 ) . Relative to preterm deliveries in EG we found 6 ( 4.3 % ) and 11 ( 7.2 % ) in CG , ( P = .73 ) . CONCLUSIONS A supervised program of moderate exercise performed throughout pregnancy is not a risk of preterm delivery for healthy pregnant women OBJECTIVE The level of  physical activity ( PA ) of pregnant women in Finl and is unknown . Even more limited is our knowledge of PA of women at high risk for gestational diabetes mellitus ( GDM ) . METHODS The women ( n=54 ) were r and omly assigned to a lifestyle intervention group ( n=27 ) including exercise advice by a physiotherapist six times during pregnancy or to a control group ( n=27 ) without additional exercise advice . Outcomes of the present study were required sample size , timing of counselling and change of PA . PA was retrospectively reported during 12 months before pregnancy and recorded one week monthly during pregnancy . RESULTS Individualized counselling by a physiotherapist result ed in small changes of  recreational PA  ( 2.7 MET hours/week , p=0.056 ) up to gestational week 25 compared with the similar decreasing tendency of PA in the control group . The women decreased recreational PA  after week 30 . Sample size of 550 women at high risk for GDM per group would be needed for a PA study . CONCLUSIONS The optimal time window for increasing PA  must be earlier than in the last trimester of pregnancy . Sample size for a study to increase PA  by 2.7 MET hours/week on pregnant women at high risk of GDM should be about 550 per group
Background Gestational diabetes mellitus ( GDM ) is one of the most common complications during pregnancy , and it has both short- and long-term adverse effects on the health of mothers and fetuses .
To investigate the effect of exercise during pregnancy on the occurrence of GDM among normal-weight pregnant women .