Diabetes risk status and physical activity in pregnancy: U.S. BRFSS 2011, 2013, 2015, 2017
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(2020) 20:743
RESEARCH ARTICLE
Open Access
Diabetes risk status and physical activity in pregnancy: U.S. BRFSS 2011, 2013, 2015, 2017 Bethany G. Rand1*, Tammie M. Johnson2, Samantha F. Ehrlich3, Laurie Wideman4, James M. Pivarnik5, Michael R. Richardson1, Michelle L. Stone1 and James R. Churilla1
Abstract Background: Pregnant women without complications are advised to engage in physical activity (PA) to mitigate adverse outcomes. Differences may exist among pregnant women of diverging diabetes status in meeting national PA recommendations. We sought to examine differences in aerobic activity (AA) and muscle strengthening activity (MSA) by diabetes risk status (DRS) among pregnant women in the United States. Methods: The sample (n = 9,597) included pregnant women, age 18–44 years, who participated in the 2011, 2013, 2015, and 2017 Behavioral Risk Factor Surveillance System. Levels of DRS include: no diabetes (ND), high risk for diabetes (HRD) due to self-reported gestational diabetes or pre-diabetes, and overt diabetes due to self-reported, clinically diagnosed diabetes (DM). Odds ratios (ORs) and 95% confidence intervals (CI) for meeting PA recommendations were obtained. Covariates included age, race, education, household child count, alcohol consumption, and smoking status. Results: Findings revealed that on average, DM had 46.5 fewer minutes of weekly AA compared to ND. Furthermore, a significantly lower OR (0.39; CI 0.19–0.82) for meeting both recommendations was observed in DM as compared to ND after adjustment. Conclusions: We observed that pregnant women with overt diabetes had a lower odds of engaging in PA, while those at high risk were similar in their PA engagement to ND. Future studies aimed at assessing determinants of PA behavior may help guide efforts to promote exercise in pregnant women with diabetes. Keywords: Pregnancy, diabetes, gestational diabetes, hyperglycemia, physical activity, muscle strengthening
Background Hyperglycemia generally refers to the presence of higher than normal glucose levels in the blood [1]. In pregnancy, hyperglycemia may be due to chronic conditions such as type 2 diabetes mellitus (T2DM) or prediabetes (PD), or gestational diabetes mellitus (GDM). These three manifestations of hyperglycemia differ in their diagnostic criteria and severity. The United States (U.S.) prevalence of * Correspondence: [email protected] 1 University of North Florida, Jacksonville, FL, USA Full list of author information is available at the end of the article
T2DM and PD in women aged 20 years and over has increased by at least two percentage points from 1999 to 2012, climbing to 13.8% and 35.9%, respectively [2]. The estimated prevalence of GDM in the U.S., based on data from the 2007–2014 National Health and Nutrition Examination Survey (NHANES) is 7.6% [3]. A T2DM diagnosis can be confirmed by: fasting plasma glucose (PG) ≥ 7 mmol/L, a two-hour (2-H) PG ≥ 11.1 mmol/L after a 75 g glucose load during oral glucose tolerance test (OGTT), or a glycohemoglobin (A1C) ≥ 6.5% [4]. Accurate d
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