The influence of lifestyle intervention on gestational diabetes in high risk Hong Kong women

Thursday, May 09, 2019

Reference:

Chan RS, Tam WH, Ho IC, Kwan MW, Li LS, Sea MM, Woo J. Randomized trial examining effectiveness of lifestyle intervention in reducing gestational diabetes in high risk Chinese pregnant women in Hong Kong. Sci Rep. 2018;8(1):13849.

Link to the article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6138708/pdf/41598_2018_Article_32285.pdf
 

Other online materials that you might be interested in:

Literature Library - Diet, physical activity and risk of gestational diabetes mellitus (GDM)

Background

  • No consensus on the best intervention for weight management and GDM reduction during prenatal period was noted
  •  This study aimed to examine:
    • Whether a clinically proven lifestyle medication program (LMP) during early pregnancy was superior to routine antenatal care in enhancing GDM, maternal and infant health outcomes
       

Study Design

  • A prospective parallel group, single-blind randomized controlled trial

 

Subjects

  • 220 Chinese pregnant women (age of 18 years old and above) at risk of GDM were recruited at or before 12 weeks of gestation
     

Method

  • Subjects were randomized to:
    • Routine care (i.e. control group)
      • Receiving routine antenatal care including body weight monitoring, educational booklet on diet and exercise recommendations and optional antenatal classes
    • Lifestyle modification program (LMP)
      • Receiving routine antenatal care and a dietitian-led lifestyle intervention from the 1st antenatal booking to 24 weeks of gestation
      • Biweekly face-to-face  or phone consultations in the first 2 months and monthly face-to-face consultations afterwards until the end of intervention
         

Key Findings

  • 93.8% women attended at least 70% of the dietetic consultations
  • 92.5% women attended at least 1 exercise consultation
  • Between the LMP and control groups, there was
    • No significant difference in the GDM incidence and total gestational weight gain
    • No significant difference in large-for-gestational-age, macrosomia and other maternal and infant outcomes
  • But, pre-pregnant BMI was a significant factor for GDM incidence and total gestational weight gain in the adjusted model
    • Higher pre-pregnant BMI was related to higher risk of GDM incidence [OR(95%CI):1.12(1.02 to 1.23), p = 0.022] and lower gestational weight gain [Beta(95%CI):-0.426(-0.631 to -0.220),  p< 0.001]
  • Despite no significant difference in GDM incidence and most outcomes, high LMP adherence group:
    • Showed a better control in total gestational weight gain than control in both crude and adjusted models
    • Tended to have a lower proportion of excessive gestational weight gain versus low LMP adherence group (0% vs. 21.3%, p = 0.099)
       

Conclusion

The LMP used in the study did not modify GDM risk and other maternal and infant outcomes in Chinese women at risk of GDM


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