Moderate Physical Activity During Pregnancy Reduces Preterm Birth Risk in Women With Gestational Diabetes, Study Finds

The findings, published in JAMA Network Open, offer essential evidence highlighting the health benefits of MVPA during pregnancy and contribute to developing physical activity guidelines for pregnant women with gestational diabetes.

Physical activity, a modifiable factor, is a key intervention strategy for preventing and managing gestational diabetes. However, the relationship between physical activity during pregnancy and preterm birth among women with GD remains uncertain. To clarify the same, Wanglong Gou, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China, and colleagues aimed to investigate the association between accelerometer-measured physical activity metrics and patterns and the risk of preterm birth in women with GD.

For this purpose, the researchers conducted a prospective cohort study involving pregnant women with gestational diabetes in Hangzhou, China, from August 2019 to August 2023, as part of the Westlake Precision Birth Cohort study. Statistical analysis for the study was carried out between August and November 2023. Physical activity metrics and patterns were measured using wearable accelerometers at a median gestational age of 25.4 weeks (interquartile range: 24.6-26.6 weeks).

Preterm birth, the primary outcome, was identified through delivery records and defined as the delivery of infants before completing 37 weeks of gestation.

The following were the key findings of the study:

• Among the 1,427 women included in the study, the mean age was 31.3 years, with 80 cases of preterm birth recorded.
• An increase in moderate-to-vigorous intensity physical activity and the fraction of physical activity energy expenditure from MVPA showed an inverse association with preterm birth.
• The odds ratio for preterm birth per 30 additional minutes of MVPA was 0.64, and the odds ratio for an increase in MVPA-derived energy expenditure per standard deviation was 0.69.
• Dose-response analysis revealed a progressive reduction in the odds of preterm birth with increasing MVPA duration, reaching a plateau at approximately 74 minutes of MVPA per day.
• Engaging in active MVPA (≥30 minutes per day), whether concentrated over a few days or spread more evenly, demonstrated similar benefits in reducing the risk of preterm birth.

"Our study showed that MVPA during pregnancy was linked to a reduced risk of preterm birth among women with gestational diabetes. Notably, concentrated physical activity offered comparable benefits to regular activity in lowering the risk of preterm birth," the researchers wrote.

The authors present key evidence highlighting the health benefits of MVPA during pregnancy, contributing to the groundwork for developing physical activity guidelines tailored for pregnant women with gestational diabetes.

Reference:

Gou W, Xiao C, Liang X, et al. Physical Activity During Pregnancy and Preterm Birth Among Women With Gestational Diabetes. JAMA Netw Open. 2024;7(12):e2451799. doi:10.1001/jamanetworkopen.2024.51799