A lifestyle intervention of weight-gain restriction: diet and exercise in obese women with gestational diabetes mellitus

被引:133
作者
Artal, Raul [1 ]
Catanzaro, Rosemary B.
Gavard, Jeffrey A.
Mostello, Dorothea J.
Friganza, Joann C.
机构
[1] St Louis Univ, Sch Med, Dept Obstet Gynecol & Womens Hlth, St Louis, MO 63117 USA
[2] St Marys Hlth Ctr, St Louis, MO 63117 USA
关键词
pregnancy; weight gain; gestational diabetes mellitus; obesity; exercise; diet;
D O I
10.1139/H07-024
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Objective: This study assessed whether a weight-gain restriction regimen, with or without exercise, would impact glycemic control, pregnancy outcome, and total pregnancy weight gain in obese subjects with gestational diabetes mellitus (GDM). A total of 96 subjects with GDM met the inclusion criteria and were sequentially recruited, with 39 subjects self-enrolled in the exercise and diet (ED) group, and the remaining 57 subjects self-enrolled in the diet (D) group owing to contraindications or a lack of personal preference to exercise. All patients were provided a eucaloric or hypo-caloric consistent carbohydrate meal plan and instructed in the self-monitoring of blood glucose. In addition, all ED subjects were prescribed an exercise routine equivalent to a 60% symptom-limited VO2 max. Subjects were followed at weekly or biweekly office visits. Results showed maternal weight and body mass index (35.2 +/- 7.2 (ED) vs. 33.5 +/- 9.2 (D)) at study entry as well as number of weeks into the study (7.7 +/- 5.7 (ED) vs. 9.4 +/- 4.7 (D)) were similar in both the ED and D groups. Weight gain per week was significantly lower in the ED group than in the D group (0.1 +/- 0.4 kg vs. 0.3 +/- 0.4 kg; p < 0.05). Subjects (either ED or D) who gained weight had a higher percentage of macrosomic infants than those subjects who lost weight or had no weight change during pregnancy. Other pregnancy and fetal outcomes such as complications, gestational age at delivery, and rate of cesarean delivery were similar in both groups. Conclusions of this study were that caloric restriction and exercise result in limited weight gain in obese subjects with GDM, less macrosomic neonates, and no adverse pregnancy outcomes. Pregnancy is an ideal time for behaviour modification, and this intervention may also help promote long-term healthy lifestyle changes.
引用
收藏
页码:596 / 601
页数:6
相关论文
共 20 条
[1]  
ACOG, 2002, OBSTET GYNECOL, V99, P869
[2]  
American Diabetes Association, 2002, DIABETES CARE S1, V25, pS94, DOI [DOI 10.2337/DIACARE.25.2007.S94), 10.2337/diacare.25.2007.S94, DOI 10.2337/DIACARE.25.2007.S94]
[3]  
Dooley Samuel W., 2008, Morbidity and Mortality Weekly Report, V57, P1
[4]   Outcome of fetuses in women with pregestational diabetes mellitus [J].
Artal, Raul .
JOURNAL OF PERINATAL MEDICINE, 2006, 34 (04) :332-332
[5]   BODY-WEIGHT IN PAROUS WOMEN - IS THERE ANY ALTERATION BETWEEN SUCCESSIVE PREGNANCIES [J].
BEAZLEY, JM ;
SWINHOE, JR .
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, 1979, 58 (01) :45-47
[6]   Medically advised, mother's personal target, and actual weight gain during pregnancy [J].
Cogswell, ME ;
Scanlon, KS ;
Fein, SB ;
Schieve, LA .
OBSTETRICS AND GYNECOLOGY, 1999, 94 (04) :616-622
[7]   Association between pre-pregnancy obesity and the risk of cesarean delivery [J].
Crane, SS ;
Wojtowycz, MA ;
Dye, TD ;
Aubry, RH ;
Artal, R .
OBSTETRICS AND GYNECOLOGY, 1997, 89 (02) :213-216
[8]  
Dye TD, 1997, AM J EPIDEMIOL, V146, P961, DOI 10.1093/oxfordjournals.aje.a009223
[9]  
Franz MJ, 2004, DIABETES CARE S1, V27, P36, DOI DOI 10.2337/DIACARE.27.2007.S36
[10]  
Galtier-Dereure F, 2000, AM J CLIN NUTR, V71, p1242S, DOI 10.1093/ajcn/71.5.1242s