Physical activity, obesity, and diabetes in pregnancy
Physical activity, obesity, and diabetes in pregnancy
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DOI：
10.1093/oxfordjournals.aje.a009223
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发表时间：
1997-12-01
影响因子：
5
通讯作者：
Wojtowycz, MA
中科院分区：
文献类型：
--
作者：
Dye, TD;Knox, KL;Wojtowycz, MA
妊娠糖尿病 (GDM) 是妊娠期最常见的医疗并发症，患有 GDM 的女性发生多种孕产妇健康并发症的风险较高，其婴儿死亡和发病的风险也较高。传统上，GDM 的管理是通过饮食和密切监测血糖水平，当仅靠饮食无法维持血糖正常时，开始胰岛素治疗。然而，最近有人提出，运动等替代治疗方式可能会克服外周胰岛素抵抗，从而预防 GDM 或控制 GDM 女性的高血糖。在这项于 1995 年 10 月至 1996 年 7 月进行的研究中，作者使用基于人口的出生登记来确定运动是否对生活在纽约州中部的妇女患 GDM 具有预防作用。他们使用列联表和卡方统计来检查母亲和人口之间的双变量差异当按孕前体重指数类别分层时，仅在体重指数大于 33 的女性中，运动与 GDM 发生率降低相关（比值比 = 1.9，95% 置信区间 1.2-3.1）。运动对肥胖女性的影响因保险状况而变得更加复杂。当按保险状况对数据进行分层时，发现与社会经济地位较低的女性相比，社会经济地位较高但不运动的肥胖女性患 GDM 的风险显着升高。这项研究的结果表明，对于某些女性来说，运动可能有助于降低她们在怀孕期间患 GDM 的风险。
Gestational diabetes mellitus (GDM) is the most common medical complication of pregnancy, Women with GDM are at elevated risk for numerous maternal health complications, and their infants are at elevated risk for death and morbidity, Management of GDM has traditionally been through diet and close monitoring of glucose levels, with initiation of insulin therapy when diet alone fails to maintain euglycemia. Recently, however, it has been suggested that alternative treatment modalities, such as exercise, may overcome a peripheral resistance to insulin, thus preventing GDM or controlling hyperglycemia in women with GDM, In this study, conducted from October 1995 to July 1996, the authors used a population-based birth registry to determine whether exercise has a preventive role in the development of GDM in women living in central New York State, They used contingency tables and chi-square statistics to examine bivariate differences among maternal and demographic variables and the occurrence of GDM, When stratified by prepregnancy body mass index category, exercise was associated with reduced rates of GDM only among women with a body mass index greater than 33 (odds ratio = 1.9, 95% confidence interval 1.2-3.1). The effect of exercise in obese women was further complicated by insurance status, When the data were stratified by insurance status, it appeared that women of higher socioeconomic status who were obese and did not exercise were at a significantly elevated risk of GDM compared with their counterparts of lower socioeconomic status, The results of this study suggest that for some women exercise may play a role in reducing the risk that they will develop GDM during pregnancy.