An Exercise Intervention to Prevent Recurrent GDM

预防妊娠期糖尿病复发的运动干预

• 批准号: 8012865
• 负责人: LISA CHASAN-TABER
• 金额: $ 39.89万
• 依托单位: UNIVERSITY OF MASSACHUSETTS AMHERST
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-01-15 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8012865
• 关键词: Accounting; Acute; Adoption; American College of Obstetricians and Gynecologists; Apgar Score; Behavior; Biological Markers; Birth; C-reactive protein; Cardiovascular Diseases; Chronic; Collaborations; Development; Diagnosis; Discipline; Disease; Economics; Epidemic; Epidemiologic Studies; Exercise; Fasting; Gestational Diabetes; Glucose; Goals; Guidelines; Health; High Risk Woman; Infant; Institute of Medicine (U.S.); Insulin; Insulin Resistance; Intervention; Leptin; Life Style; Low Birth Weight Infant; Maintenance; Measures; Minority Groups; Modality; Morbidity - disease rate; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Patients; Physical activity; Population; Population Study; Pregnancy; Pregnant Women; Prenatal care; Protocols documentation; Randomized; Readiness; Recording of previous events; Recruitment Activity; Recurrence; Research Personnel; Risk; Risk Factors; Scientist; Serum; Staging; TNF gene; Testing; Translating; Underrepresented Minority; United States; Walking; Weight Gain; Woman; adiponectin; clinical practice; experience; fasting plasma glucose; follow-up; glucose tolerance; glycemic control; improved; infant outcome; innovation; intervention program; modifiable risk; novel; prevent; programs; racial and ethnic; resistin; social; social cognitive theory; socioeconomics; theories; therapy design; tool

DESCRIPTION (provided by applicant): Women diagnosed with gestational diabetes mellitus (GDM) are at substantially increased risk of developing type 2 diabetes and obesity, currently at epidemic rates in the United States. GDM, therefore, identifies a population of women at high risk of developing type 2 diabetes and thus provides an excellent opportunity to intervene years before the development of this disorder. It is well recognized that acute as well as chronic physical activity reduce fasting plasma glucose as well as improve glucose tolerance in type 2 diabetes. Recent epidemiologic studies have suggested that women with higher levels of physical activity have reduced risk of GDM. Therefore, we propose to test the hypothesis that an exercise intervention is an effective tool for preventing GDM among women with a history of GDM. The primary goals of the application are to investigate the effects of a motivationally-tailored, individually targeted 12-wk physical activity intervention on 1) risk of recurrent GDM, 2) serum biomarkers associated with insulin resistance, 3) and the adoption and maintenance of exercise during pregnancy. Secondary goals are to investigate the impact of the intervention on gestational weight gain and selected birth outcomes. A total of 364 multiparous women who had GDM in a prior pregnancy (49 percent will be from minority groups) will be recruited in early pregnancy (10 wks gestation) and randomized to either an Individually Targeted (IT) intervention (n=182) or a Comparison Health and Wellness (HW) intervention (n=182). The overall goal of the intervention is to encourage pregnant women to achieve the American College of Obstetricians and Gynecologists (ACOG) Guidelines for physical activity during pregnancy (30 minutes or more of moderate- intensity activity on most days of the week) through increasing walking and developing a more active lifestyle. The intervention draws from the theory of Stages of Motivational Readiness for Change and Social Cognitive Theory constructs for physical activity behavior and will take into account the specific social, cultural, economic, and physical environmental challenges faced by women of diverse socioeconomic and ethnic backgrounds. The application is innovative in being the first, to our knowledge, to test a physical activity intervention designed to prevent GDM among high risk women. The intervention protocol can readily be translated into clinical practice in underserved and minority populations.

描述（由申请人提供）：被诊断患有妊娠糖尿病 (GDM) 的女性患 2 型糖尿病和肥胖的风险大大增加，目前在美国呈流行趋势。因此，GDM 可以识别出罹患 2 型糖尿病的高风险女性群体，从而提供了在这种疾病发生前数年进行干预的绝佳机会。众所周知，急性和慢性体力活动可降低 2 型糖尿病的空腹血糖并改善糖耐量。最近的流行病学研究表明，体力活动水平较高的女性患 GDM 的风险较低。因此，我们建议检验以下假设：运动干预是预防有 GDM 病史的女性预防 GDM 的有效工具。该应用程序的主要目标是研究根据动机量身定制、个性化的 12 周体力活动干预对 1) 复发 GDM 风险、2) 与胰岛素抵抗相关的血清生物标志物、3) 以及孕期运动的采用和维持的影响。次要目标是调查干预措施对妊娠期体重增加和选定的出生结局的影响。总共 364 名在怀孕前患有 GDM 的经产妇女（49% 来自少数群体）将在怀孕早期（妊娠 10 周）被招募，并随机接受个体针对性 (IT) 干预 (n=182) 或比较健康与保健 (HW) 干预 (n=182)。干预措施的总体目标是鼓励孕妇通过增加步行和养成更积极的生活方式，达到美国妇产科医师学会 (ACOG) 孕期体力活动指南（每周大部分时间进行 30 分钟或更长时间的中等强度活动）。该干预措施借鉴了变革动机准备阶段理论和体育活动行为的社会认知理论构建，并将考虑不同社会经济和种族背景的女性面临的具体社会、文化、经济和物理环境挑战。据我们所知，该应用程序的创新之处在于，它是第一个测试旨在预防高危女性妊娠期糖尿病的身体活动干预措施的应用程序。干预方案可以很容易地转化为服务不足和少数群体的临床实践。

项目成果

Feasibility and Efficacy of a Physical Activity Intervention Among Pregnant Women: The Behaviors Affecting Baby and You (BABY) Study

• DOI: 10.1123/jpah.8.s2.s228
• 发表时间: 2011-09-01
• 期刊: JOURNAL OF PHYSICAL ACTIVITY & HEALTH
• 影响因子: 3.1
• 作者: Chasan-Taber, Lisa;Silveira, Marushka;Markenson, Glenn
• 通讯作者: Markenson, Glenn

Early pregnancy vitamin D status and risk for adverse maternal and infant outcomes in a bi-ethnic cohort: the Behaviors Affecting Baby and You (B.A.B.Y.) Study.

• DOI: 10.1017/s0007114515003980
• 发表时间: 2015-12-28
• 期刊: The British journal of nutrition
• 作者: Nobles CJ;Markenson G;Chasan-Taber L
• 通讯作者: Chasan-Taber L

The Effect of an Exercise Intervention on Gestational Weight Gain: The Behaviors Affecting Baby and You (B.A.B.Y.) Study: A Randomized Controlled Trial.

运动干预对妊娠体重增加的影响：影响婴儿和您的行为 (B.A.B.Y.) 研究：随机对照试验。

• DOI: 10.1177/0890117117732409
• 发表时间: 2018
• 期刊: American journal of health promotion : AJHP
• 作者: Nobles,Carrie;Marcus,BessH;Stanek3rd,EdwardJ;Braun,Barry;Whitcomb,BrianW;Manson,JoAnnE;Markenson,Glenn;Chasan-Taber,Lisa
• 通讯作者: Chasan-Taber,Lisa

In reply.

回复。

• DOI: 10.3949/ccjm.81c.12002
• 发表时间: 2014
• 期刊: Cleveland Clinic journal of medicine
• 影响因子: 6.1
• 作者: ChingSun,GraceE;Kashyap,SangeetaR;Nasr,Christian
• 通讯作者: Nasr,Christian

Effect of an exercise intervention on gestational diabetes mellitus: a randomized controlled trial.

• DOI: 10.1097/aog.0000000000000738
• 发表时间: 2015-05
• 期刊: Obstetrics and gynecology
• 影响因子: 7.2
• 作者: Nobles C;Marcus BH;Stanek EJ 3rd;Braun B;Whitcomb BW;Solomon CG;Manson JE;Markenson G;Chasan-Taber L
• 通讯作者: Chasan-Taber L