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Am J Perinatol 2016; 33(13): 1291-1299
DOI: 10.1055/s-0036-1586504
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Windows of Opportunity for Lifestyle Interventions to Prevent Gestational Diabetes Mellitus

Suzanne Phelan
1   Department of Kinesiology, California Polytechnic State University, San Luis Obispo, California
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Further Information

Publication History

18 March 2016

18 June 2016

Publication Date:
03 August 2016 (online)

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Abstract

Gestational diabetes mellitus (GDM) is linked with several acute maternal health risks and long-term development of type 2 diabetes, metabolic syndrome, and cardiovascular disease. Intrauterine exposure to GDM similarly increases offspring risk of early-life health complications and later disease. GDM recurrence is common, affecting 40 to 73% of women, and augments associated maternal/fetal/child health risks. Modifiable and independent risk factors for GDM include maternal excessive gestational weight gain and prepregnancy overweight and obesity. Lifestyle interventions that target diet, activity, and behavioral strategies can effectively modify body weight. Randomized clinical trials testing the effects of lifestyle interventions during pregnancy to reduce excessive gestational weight gain have generally shown mixed effects on reducing GDM incidence. Trials testing the effects of postpartum lifestyle interventions among women with a history of GDM have shown reduced incidence of diabetes and improved cardiovascular disease risk factors. However, the long-term effects of interpregnancy or prepregnancy lifestyle interventions on subsequent GDM remain unknown. Future adequately powered and well-controlled clinical trials are needed to determine the effects of lifestyle interventions to prevent GDM and identify pathways to effectively reach reproductive-aged women across all levels of society, before, during, and after pregnancy.

Keywords

lifestyle intervention - gestational diabetes mellitus - postpartum - preconception - inter-pregnancy
 

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