Determinants of physical activity before and during pregnancy and impact of physical activity intervention on perinatal outcome in mothers with GDM and their offspring

The aim of this study was to examine the feasibility of an exercise program to improve physical activity and perinatal outcome in mothers with GDM (MUKIS study).

A total of 15 pregnant women with GDM diagnosed by an OGTT with 75-g glucose load were randomized to physical activity intervention (n = 7) or control group (n = 8). Intervention consisted in supervised exercise courses twice/week over 10 weeks starting at a mean of 28.5 (± 3.0 SD) weeks of pregnancy. Physical activity was assessed before and during pregnancy by questionnaire, expressed as metabolic equivalents (MET) and compared to 105 healthy pregnant mothers. Maternal fitness was assessed by ergometer at baseline and 24 weeks postpartum. Offspring outcome was assessed by questionnaires and fetal doppler ultrasound.

Physical activity level before pregnancy was comparable between mothers with GDM and healthy mothers. Both groups of mothers with GDM (intervention and control) increased their physical activity during pregnancy (Mean delta MET: 1,64 ± 3,16 and 2,88 ± 3,91) and displayed higher levels of physical activity during pregnancy compared to healthy mothers (p = 0.009). Compared to baseline levels maternal resting heart rate was significantly decreased in the intervention and control group (p = 0.003 and p = 0.002) during the final study visit. Offspring outcomes, including birth weight, BMI- percentile, Apgar 5' and ultrasound findings (A. umbilicalis RI, A. cerebri media RI, A. uterina RI) did not differ between both groups.

This study suggests that awareness of a potential benefit through exercise during pregnancy leads to an increase in physical activity in mothers with GDM.