[Local data] The influence of lifestyle intervention on gestational diabetes in high risk Hong Kong women

Background

• 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 1^st 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

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

Reference

Chan RS, et al. Sci Rep. 2018;8(1):13849.
 

Other online materials that you might be interested in:

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

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