Physical activity in women with gestational diabetes
Physical activity has substantial benefits and minimal risks for pregnant women. This includes women diagnosed with gestational diabetes mellitus (GDM), which is glucose intolerance of variable severity that occurs during pregnancy.
GDM is a common complication of pregnancy, with reports of its incidence ranging from 3.5 to 12%. The associated risks include maternal hypertension and pre-eclampsia, birth trauma from macrosomia for the baby, and the longer-term risk of developing type 2 diabetes in both mother and baby.
Physical activity is recommended for women with GDM because it improves glycaemic control, which is a critical factor in reducing the associated risks for the mother and her baby. When performed at a moderate intensity for 30 minutes on most days of the week, physical activity is a safe and effective adjunctive intervention for GDM.
Experiencing GDM may influence women’s attitudes to physical activity, either negatively (eg, heightened perception of risk) or positively (eg, more frequent contact with health professionals providing advice about being physically active).
This study interviewed 27 women with GDM about their attitudes towards exercise and what would help or hinder their efforts to exercise during their pregnancy.
The women wanted information about physical activity from credible sources, with clear, specific information about safe physical activity during a GDM pregnancy. They reported that receiving information at GDM diagnosis would be helpful because this event triggered their desire to be more physically active. They also wanted to understand why physical activity was important to improving outcomes for themselves and their baby.
In addition to supplying the above information, physiotherapists could assist by helping the women to identify flexible, convenient and practical exercise options.
The knowledge that the baby's health was the women’s strong overriding motivator could be harnessed by clinicians in both pregnancy and postnatally.
Women may be motivated to stay physically active for their own health and wellbeing in the longer-term if messaging also emphasises the importance of staying active and healthy to look after their baby throughout its childhood and adolescence.
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> From: Harrison et al., J Physiother 65 (2019) 37-42. All rights reserved to the Australian Physiotherapy Association. Click here for the online summary.