Diet, physical activity and mental health status are associated with dysglycaemia in pregnancy: the Healthy Start Study

作者：Sauder K A; Starling A P; Shapiro A L; Kaar J L; Ringham B M; Glueck D H; Leiferman J A; Siega Riz A M; Dabelea D

来源：Diabetic Medicine, 2016, 33(5): 663-667.

DOI：10.1111/dme.13093

AimsTo examine the association between dysglycaemia and multiple modifiable factors measured during pregnancy.
MethodsThe Healthy Start Study collected self-reported data on modifiable factors in early and mid-pregnancy (median 17 and 27 weeks gestation, respectively) from 832 women. Women received one point for each modifiable factor for which they had optimum scores: diet quality (Healthy Eating Index score 64), physical activity level (estimated energy expenditure 170 metabolic equivalent task-h/week), and mental health status (Perceived Stress Scale score <6 and Edinburgh Postnatal Depression Scale score <13). Dysglycaemia during pregnancy was defined as an abnormal glucose challenge result, 1 abnormal results on an oral glucose tolerance test, or a clinical diagnosis of gestational diabetes. Logistic regression models estimated odds ratios for dysglycaemia as a function of each factor and the total score, adjusted for age, race/ethnicity, pre-pregnancy BMI, history of gestational diabetes, and family history of Type 2 diabetes.
ResultsIn individual analyses, only physical activity was significantly associated with a reduced risk of dysglycaemia (adjusted odds ratio 0.67, 95% CI 0.44-1.00). We observed a significant, dose-response association between increasing numbers of optimal factors and odds of dysglycaemia (adjusted P=0.01). Compared with having no optimal modifiable factors, having all three was associated with a 73% reduced risk of dysglycaemia (adjusted odds ratio 0.27, 95% CI 0.08-0.95).
ConclusionsAn increasing number of positive modifiable factors in pregnancy was associated with a dose-response reduction in risk of dysglycaemia. Our results support the hypothesis that modifiable factors in pregnancy are associated with the risk of prenatal dysglycaemia.
What's new?
We prospectively examined the association between modifiable factors (diet quality, physical activity level and mental health status) in early to mid-pregnancy with risk of prenatal dysglycaemia among 832 women. Compared to having no optimal levels of modifiable factors, having any one optimal modifiable factor reduced the risk of dysglycaemia by 42% (odds ratio 0.58, 95% CI 0.36-0.94), and having optimal levels of all three modifiable factors reduced the risk by 73% (odds ratio 0.27, 95% CI 0.08-0.95). Our results support the hypothesis that modifiable factors in pregnancy are associated with the risk of prenatal dysglycaemia.

• 出版日期2016-5