26872289

PMC4883104

Aims

Prenatal dysglycaemia is associated with adverse maternal and offspring outcomes. This study examined the association between dysglycaemia and multiple modifiable factors measured during pregnancy.

Methods

The 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 1 point for each optimal modifiable factor: diet quality (Healthy Eating Index ≥64), physical activity level (estimated energy expenditure ≥170 MET-hours/week), and mental health status (Perceived Stress <6 and Edinburgh Postnatal Depression <13). Dysglycaemia during pregnancy was defined as an abnormal glucose challenge, ≥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-pregnant body mass index, history of gestational diabetes, and family history of type 2 diabetes.

Results

In individual analyses, only physical activity was significantly associated with a reduced risk of dysglycaemia (adjusted OR 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 to having no optimal modifiable factors, having all 3 was associated with a 73% reduced risk of dysglycaemia (adjusted OR 0.27, 95%CI 0.08–0.95).

Conclusions

An 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.

CDC Public Access

T32 DK007658/DK/NIDDK NIH HHS/United States
R01 DK076648/DK/NIDDK NIH HHS/United States
R01 DK076648-DD/DD/NCBDD CDC HHS/United States
UL1 TR001082/TR/NCATS NIH HHS/United States
P30 DK056350/DK/NIDDK NIH HHS/United States
P2C HD050924/HD/NICHD NIH HHS/United States