Skip to main content
SpringerLink
Log in

Moderate and Vigorous Intensity Exercise During Pregnancy and Gestational Weight Gain in Women with Gestational Diabetes

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

An Erratum to this article was published on 03 June 2016

Abstract

Objectives To estimate the associations of moderate and vigorous intensity exercise during pregnancy with the rate of gestational weight gain (GWG) from gestational diabetes (GDM) diagnosis to delivery, overall and stratified by prepregnancy overweight/obesity. Methods Prospective cohort study with physical activity reported shortly after the GDM diagnosis and prepregnancy weight and post-diagnosis GWG obtained from electronic health records (n = 1055). Multinomial logistic regression models in the full cohort and stratified by prepregnancy overweight/obesity estimated associations of moderate and vigorous intensity exercise with GWG below and above the Institute of Medicine’s (IOM) prepregnancy BMI-specific recommended ranges for weekly rate of GWG in the second and third trimesters. Results In the full cohort, any participation in vigorous intensity exercise was associated with decreased odds of GWG above recommended ranges as compared to no participation [odds ratio (95 % confidence interval): 0.63 (0.40, 0.99)], with a significant trend for decreasing odds of excess GWG with increasing level of vigorous intensity exercise. Upon stratification by prepregnancy overweight/obesity, significant associations were only observed for BMI ≥ 25.0 kg/m2: any vigorous intensity exercise, as compared to none, was associated with 54 % decreased odds of excess GWG [0.46 (0.27, 0.79)] and significant trends were detected for decreasing odds of GWG both below and above the IOM’s recommended ranges with increasing level of vigorous exercise (both P ≤ 0.03). No associations were observed for moderate intensity exercise. Conclusions for Practice In women with GDM, particularly overweight and obese women, vigorous intensity exercise during pregnancy may reduce the odds of excess GWG.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

GWG:

Gestational weight gain

GDM:

Gestational diabetes mellitus

References

  1. Jovanovic, L., & Pettitt, D. J. (2001). Gestational diabetes mellitus. JAMA, 286(20), 2516–2518.

    Article  CAS  PubMed  Google Scholar 

  2. Bellamy, L., Casas, J. P., Hingorani, A. D., & Williams, D. (2009). Type 2 diabetes mellitus after gestational diabetes: A systematic review and meta-analysis. The Lancet, 373(9677), 1773–1779.

    Article  CAS  Google Scholar 

  3. Metzger, B. E., Buchanan, T. A., Coustan, D. R., de Leiva, A., Dunger, D. B., Hadden, D. R., et al. (2007). Summary and recommendations of the fifth international workshop-conference on gestational diabetes mellitus. Diabetes Care, 30(Suppl 2), 251–260.

    Article  Google Scholar 

  4. Dabelea, D., & Crume, T. (2011). Maternal environment and the transgenerational cycle of obesity and diabetes. Diabetes, 60(7), 1849–1855.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Abebe, D. S., Von, S. T., Von, H. A., Zerwas, S. C., Torgersen, L., & Bulik, C. M. (2014). Developmental trajectories of postpartum weight 3 years after birth: Norwegian mother and child cohort study. Maternal and Child Health Journal, 19, 917–925.

    Article  Google Scholar 

  6. Ehrlich, S. F., Hedderson, M. M., Feng, J., Davenport, E. R., Gunderson, E. P., & Ferrara, A. (2011). Change in body mass index between pregnancies and the risk of gestational diabetes in a second pregnancy. Obstetrics and Gynecology, 117(6), 1323–1330.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Stage, E., Ronneby, H., & Damm, P. (2004). Lifestyle change after gestational diabetes. Diabetes Research and Clinical Practice, 63(1), 67–72.

    Article  CAS  PubMed  Google Scholar 

  8. Mamun, A. A., Kinarivala, M., O’Callaghan, M. J., Williams, G. M., Najman, J. M., & Callaway, L. K. (2010). Associations of excess weight gain during pregnancy with long-term maternal overweight and obesity: Evidence from 21 y postpartum follow-up. American Journal of Clinical Nutrition, 91(5), 1336–1341.

    Article  CAS  PubMed  Google Scholar 

  9. Al, M. A., Mannan, M., O’Callaghan, M. J., Williams, G. M., Najman, J. M., & Callaway, L. K. (2013). Association between gestational weight gain and postpartum diabetes: Evidence from a community based large cohort study. PLoS One, 8(12), e75679.

    Article  Google Scholar 

  10. Peters, R. K., Kjos, S. L., Xiang, A., & Buchanan, T. A. (1996). Long-term diabetogenic effect of single pregnancy in women with previous gestational diabetes mellitus. The Lancet, 347, 227–230.

    Article  CAS  Google Scholar 

  11. IOM (Institutes of Medicine). (2009). Weight gain during pregnancy: Reexamining the guidelines. Washington, DC: The National Academic Press.

    Google Scholar 

  12. Artal, R., Catanzaro, R. B., Gavard, J. A., Mostello, D. J., & Friganza, J. C. (2007). A lifestyle intervention of weight-gain restriction: Diet and exercise in obese women with gestational diabetes mellitus. Applied Physiology, Nutrition and Metabolism, 32(3), 596–601.

    Article  Google Scholar 

  13. Han, S., Middleton, P., & Crowther, C. A. (2012). Exercise for pregnant women for preventing gestational diabetes mellitus. Cochrane Database of Systematic Reviews, 7, CD009021.

    PubMed  Google Scholar 

  14. Sanabria-Martinez, G., Garcia-Hermoso, A., Poyatos-Leon, R., Alvarez-Bueno, C., Sanchez-Lopez, M., & Martinez-Vizcaino, V. (2015). Effectiveness of physical activity interventions on preventing gestational diabetes mellitus and excessive maternal weight gain: A meta-analysis. BJOG, 122, 1167–1174.

    Article  CAS  PubMed  Google Scholar 

  15. Muktabhant, B., Lawrie, T. A., Lumbiganon, P., & Laopaiboon, M. (2015). Diet or exercise, or both, for preventing excessive weight gain in pregnancy. Cochrane Database of Systematic Reviews, 6, CD007145.

    PubMed  Google Scholar 

  16. American College of Obstetricians and Gynecologists. (2015). Physical activity and exercise during pregnancy and the postpartum period. Committee Opinion No. 650. Obstetrics and Gynecology, 126(6), e135–e142.

  17. Physical Activity Guidelines Committee. (2008). Physical activity guidelines advisory committee report. Washington, DC: Department of Health and Human Services.

    Google Scholar 

  18. Deputy, N. P., Sharma, A. J., Kim, S. Y., & Hinkle, S. N. (2015). Prevalence and characteristics associated with gestational weight gain adequacy. Obstetrics and Gynecology, 125(4), 773–781.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Gordon, N. (2007). Similarity of the adult Kaiser Permanente Membership in Northern California to the insured and general population in Northern California: Statistics from the 2007 California Health Interview Survey. Oakland, CA: Kaiser Permanente Northern California Division of Research.

    Google Scholar 

  20. Ferrara, A., Hedderson, M. M., Albright, C. L., Brown, S. D., Ehrlich, S. F., Caan, B. J., et al. (2014). A pragmatic cluster randomized clinical trial of diabetes prevention strategies for women with gestational diabetes: Design and rational of the Gestational Diabetes’ Effects on Moms (GEM) study. BMC Pregnancy Childbirth, 14(1), 21.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Committee opinion no. 504: Screening and diagnosis of gestational diabetes mellitus. Obstetrics and Gynecology, 118(3), 751–753 (2011).

  22. Carpenter, M. W., & Coustan, D. R. (1982). Criteria for screening tests for gestational diabetes. American Journal of Obstetrics and Gynecology, 144, 768–773.

    Article  CAS  PubMed  Google Scholar 

  23. Ehrlich, S. F., Crites, Y. M., Hedderson, M. M., Darbinian, J. A., & Ferrara, A. (2011). The risk of large for gestational age across increasing categories of pregnancy glycemia. American Journal of Obstetrics and Gynecology, 204(3), 240-e1.

    Article  Google Scholar 

  24. Chasan-Taber, L., Schmidt, M. D., Roberts, D. E., Hosmer, D., Markenson, G., & Freedson, P. S. (2004). Development and validation of a Pregnancy Physical Activity Questionnaire. Medicine and Science in Sports and Exercise, 36(10), 1750–1760.

    Article  PubMed  Google Scholar 

  25. Roberts, D. E., Fragala, M. S., Pober, D., Chasan-Taber, L., & Freedson, P. S. (2002). Energy cost of physical activities during pregnancy. Medicine and Science in Sports and Exercise, 34, S124.

    Article  Google Scholar 

  26. Ainsworth, B. E., Haskell, W. L., Whitt, M. C., Irwin, M. L., Swartz, A. M., Strath, S. J., et al. (2000). Compendium of physical activities: An update of activity codes and MET intensities. Medicine and Science in Sports and Exercise, 32(9 Suppl), S498–S504.

    Article  CAS  PubMed  Google Scholar 

  27. Block, G., Hartman, A. M., Dresser, C. M., Carroll, M. D., Gannon, J., & Gardner, L. (1986). A data-based approach to diet questionnaire design and testing. American Journal of Epidemiology, 124(3), 453–469.

    CAS  PubMed  Google Scholar 

  28. Tremblay, A., Despres, J. P., Leblanc, C., Craig, C. L., Ferris, B., Stephens, T., & Bouchard, C. (1990). Effect of intensity of physical activity on body fatness and fat distribution. American Journal of Clinical Nutrition, 51(2), 153–157.

    CAS  PubMed  Google Scholar 

  29. Lee, I. M., & Skerrett, P. J. (2001). Physical activity and all-cause mortality: What is the dose–response relation? Medicine and Science in Sports and Exercise, 33(6 Suppl), S459–S471.

    Article  CAS  PubMed  Google Scholar 

  30. Clapp, J. F, I. I. I., & Little, K. D. (1995). Effect of recreational exercise on pregnancy weight gain and subcutaneous fat deposition. Medicine and Science in Sports and Exercise, 27(2), 170–177.

    Article  PubMed  Google Scholar 

  31. Yoshioka, M., Doucet, E., St-Pierre, S., Almeras, N., Richard, D., Labrie, A., et al. (2001). Impact of high-intensity exercise on energy expenditure, lipid oxidation and body fatness. International Journal of Obesity and Related Metabolic Disorders, 25(3), 332–339.

    Article  CAS  PubMed  Google Scholar 

  32. Goedecke, J. H., & Micklesfield, L. K. (2014). The effect of exercise on obesity, body fat distribution and risk for type 2 diabetes. Medicine and Sport Science, 60, 82–93.

    Article  PubMed  Google Scholar 

  33. Kershaw, E. E., & Flier, J. S. (2004). Adipose tissue as an endocrine organ. Journal of Clinical Endocrinology and Metabolism, 89(6), 2548–2556.

    Article  CAS  PubMed  Google Scholar 

  34. Straughen, J. K., Trudeau, S., & Misra, V. K. (2013). Changes in adipose tissue distribution during pregnancy in overweight and obese compared with normal weight women. Nutrition & Diabetes, 3, e84.

    Article  CAS  Google Scholar 

  35. Kinoshita, T., & Itoh, M. (2006). Longitudinal variance of fat mass deposition during pregnancy evaluated by ultrasonography: The ratio of visceral fat to subcutaneous fat in the abdomen. Gynecologic and Obstetric Investigation, 61(2), 115–118.

    Article  PubMed  Google Scholar 

  36. Stuebe, A. M., Oken, E., & Gillman, M. W. (2009). Associations of diet and physical activity during pregnancy with risk for excessive gestational weight gain. American Journal of Obstetrics and Gynecology, 201(1), 58.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Haakstad, L. A., Voldner, N., Henriksen, T., & Bo, K. (2007). Physical activity level and weight gain in a cohort of pregnant Norwegian women. Acta Obstetricia et Gynecologica Scandinavica, 86(5), 559–564.

    Article  PubMed  Google Scholar 

  38. Chasan-Taber, L., Silveira, M., Lynch, K. E., Pekow, P., Solomon, C. G., & Markenson, G. (2013). Physical activity and gestational weight gain in Hispanic women. Obesity (Silver Spring), 22, 909–919.

    Article  Google Scholar 

Download references

Acknowledgments

This work was supported by Grant R01 HS019367 from the Agency for Healthcare Research and Quality to Dr. Ferrara, who was also supported by Grant P30 DK092924 from the National Institutes of Health. Data were presented at the American Diabetes Association’s 73rd Scientific Sessions. S.F.E. analyzed the data and drafted the manuscript; C.P.Q. and A.F. analyzed the data and revised the manuscript; B.S., A.E.K., M.M.H., S.D.B., A.M., and L.C.T. revised the manuscript.

Author information

Authors and Affiliations

  1. Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA

    Samantha F. Ehrlich, Barbara Sternfeld, Amy E. Krefman, Monique M. Hedderson, Susan D. Brown, Ashley Mevi, Charles P. Quesenberry Jr. & Assiamira Ferrara

  2. Department of Public Health, College of Education, Health and Human Sciences, University of Tennessee, Knoxville, TN, USA

    Samantha F. Ehrlich

  3. Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, MA, USA

    Lisa Chasan-Taber

Authors
  1. Samantha F. Ehrlich
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Barbara Sternfeld
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Amy E. Krefman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Monique M. Hedderson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Susan D. Brown
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ashley Mevi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Lisa Chasan-Taber
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Charles P. Quesenberry Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Assiamira Ferrara
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Samantha F. Ehrlich.

Ethics declarations

Conflict of interest

The authors have no relevant conflict of interest to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ehrlich, S.F., Sternfeld, B., Krefman, A.E. et al. Moderate and Vigorous Intensity Exercise During Pregnancy and Gestational Weight Gain in Women with Gestational Diabetes. Matern Child Health J 20, 1247–1257 (2016). https://doi.org/10.1007/s10995-016-1926-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-016-1926-z

Keywords

Search

Navigation