Prevention of gestational diabetes with a prepregnancy lifestyle intervention – findings from a randomized controlled trial
Kristiina Rönö,1 Beata Stach-Lempinen,2 Johan Gunnar Eriksson,3,4 Maritta Pöyhönen-Alho,1 Miira Marjuska Klemetti,1,2,5 Risto Paavo Roine,6,7 Emilia Huvinen,1 Sture Andersson,8 Hannele Laivuori,6,9–11 Anita Valkama,3,4 Jelena Meinilä,3,4 Hannu K...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2018-08-01
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| Series: | International Journal of Women's Health |
| Subjects: | |
| Online Access: | https://www.dovepress.com/prevention-of-gestational-diabetes-with-a-prepregnancy-lifestyle-inter-peer-reviewed-article-IJWH |
| _version_ | 1818515391412961280 |
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| author | Rönö K Stach-Lempinen B Eriksson JG Pöyhönen-Alho M Klemetti MM Roine RP Huvinen E Andersson S Laivuori H Valkama A Meinilä J Kautiainen H Tiitinen A Koivusalo SB |
| author_facet | Rönö K Stach-Lempinen B Eriksson JG Pöyhönen-Alho M Klemetti MM Roine RP Huvinen E Andersson S Laivuori H Valkama A Meinilä J Kautiainen H Tiitinen A Koivusalo SB |
| author_sort | Rönö K |
| collection | DOAJ |
| description | Kristiina Rönö,1 Beata Stach-Lempinen,2 Johan Gunnar Eriksson,3,4 Maritta Pöyhönen-Alho,1 Miira Marjuska Klemetti,1,2,5 Risto Paavo Roine,6,7 Emilia Huvinen,1 Sture Andersson,8 Hannele Laivuori,6,9–11 Anita Valkama,3,4 Jelena Meinilä,3,4 Hannu Kautiainen,3,12 Aila Tiitinen,1 Saila Birgitta Koivusalo1 1Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Women’s Hospital, Helsinki, Finland; 2Department of Obstetrics and Gynecology, South Karelia Central Hospital, Lappeenranta, Finland; 3Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 4Public Health Research Program, Folkhälsan Research Center, Helsinki, Finland; 5Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 6Department of Health and Social Management, Research Centre for Comparative Effectiveness and Patient Safety, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland; 7Group Administration, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 8University of Helsinki and Helsinki University Hospital, Children’s Hospital, Pediatric Research Center, Helsinki, Finland; 9Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland; 10Department of Obstetrics and Gynecology, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland; 11Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland; 12Department of General Practice and Primary Health Care, University of Eastern Finland, Kuopio, Finland Purpose: Lifestyle intervention studies performed during pregnancy have shown inconsistent results in relation to prevention of gestational diabetes mellitus (GDM). Therefore, the aim of this study was to assess the effect of an intervention initiated already before pregnancy in prevention of GDM in high-risk women.Patients and methods: A randomized controlled trial was conducted in four Finnish maternity hospitals between the years 2008 and 2014. Altogether 228 high-risk women planning pregnancy were randomized to an intervention (n=116) or a control group (n=112). The risk factors were body mass index ≥30 kg/m2 (n=46), prior GDM (n=120), or both (n=62), without manifest diabetes at study inclusion. Trained study nurses provided individualized lifestyle counseling every 3 months in addition to a group session with a dietician. The control group received standard antenatal care. GDM was defined as one or more pathological glucose values in a 75 g 2-hour oral glucose tolerance test, performed between 12 and 16 weeks of gestation and if normal repeated between 24 and 28 weeks of gestation.Results: Within 12 months, 67% of the women (n=72) in the intervention group and 63% of the women (n=71) in the control group (p=0.84) became pregnant. The cumulative incidence of GDM among the women available for the final analyses was 60% (n=39/65) in the intervention group and 54% (n=34/63) in the control group (p=0.49). GDM was diagnosed already before 20 weeks of gestation in 60% (n=44/73) of the cases.Conclusion: The preconceptional lifestyle intervention applied in the present study did not reduce the incidence of GDM. Keywords: preconception, pregnancy, obesity, nutrition, physical activity |
| first_indexed | 2024-12-11T00:28:17Z |
| format | Article |
| id | doaj.art-e40772306a6344888a12e93fd31ef4de |
| institution | Directory Open Access Journal |
| issn | 1179-1411 |
| language | English |
| last_indexed | 2024-12-11T00:28:17Z |
| publishDate | 2018-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of Women's Health |
| spelling | doaj.art-e40772306a6344888a12e93fd31ef4de2022-12-22T01:27:27ZengDove Medical PressInternational Journal of Women's Health1179-14112018-08-01Volume 1049350140082Prevention of gestational diabetes with a prepregnancy lifestyle intervention – findings from a randomized controlled trialRönö KStach-Lempinen BEriksson JGPöyhönen-Alho MKlemetti MMRoine RPHuvinen EAndersson SLaivuori HValkama AMeinilä JKautiainen HTiitinen AKoivusalo SBKristiina Rönö,1 Beata Stach-Lempinen,2 Johan Gunnar Eriksson,3,4 Maritta Pöyhönen-Alho,1 Miira Marjuska Klemetti,1,2,5 Risto Paavo Roine,6,7 Emilia Huvinen,1 Sture Andersson,8 Hannele Laivuori,6,9–11 Anita Valkama,3,4 Jelena Meinilä,3,4 Hannu Kautiainen,3,12 Aila Tiitinen,1 Saila Birgitta Koivusalo1 1Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Women’s Hospital, Helsinki, Finland; 2Department of Obstetrics and Gynecology, South Karelia Central Hospital, Lappeenranta, Finland; 3Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 4Public Health Research Program, Folkhälsan Research Center, Helsinki, Finland; 5Medical and Clinical Genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 6Department of Health and Social Management, Research Centre for Comparative Effectiveness and Patient Safety, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland; 7Group Administration, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 8University of Helsinki and Helsinki University Hospital, Children’s Hospital, Pediatric Research Center, Helsinki, Finland; 9Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland; 10Department of Obstetrics and Gynecology, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland; 11Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland; 12Department of General Practice and Primary Health Care, University of Eastern Finland, Kuopio, Finland Purpose: Lifestyle intervention studies performed during pregnancy have shown inconsistent results in relation to prevention of gestational diabetes mellitus (GDM). Therefore, the aim of this study was to assess the effect of an intervention initiated already before pregnancy in prevention of GDM in high-risk women.Patients and methods: A randomized controlled trial was conducted in four Finnish maternity hospitals between the years 2008 and 2014. Altogether 228 high-risk women planning pregnancy were randomized to an intervention (n=116) or a control group (n=112). The risk factors were body mass index ≥30 kg/m2 (n=46), prior GDM (n=120), or both (n=62), without manifest diabetes at study inclusion. Trained study nurses provided individualized lifestyle counseling every 3 months in addition to a group session with a dietician. The control group received standard antenatal care. GDM was defined as one or more pathological glucose values in a 75 g 2-hour oral glucose tolerance test, performed between 12 and 16 weeks of gestation and if normal repeated between 24 and 28 weeks of gestation.Results: Within 12 months, 67% of the women (n=72) in the intervention group and 63% of the women (n=71) in the control group (p=0.84) became pregnant. The cumulative incidence of GDM among the women available for the final analyses was 60% (n=39/65) in the intervention group and 54% (n=34/63) in the control group (p=0.49). GDM was diagnosed already before 20 weeks of gestation in 60% (n=44/73) of the cases.Conclusion: The preconceptional lifestyle intervention applied in the present study did not reduce the incidence of GDM. Keywords: preconception, pregnancy, obesity, nutrition, physical activityhttps://www.dovepress.com/prevention-of-gestational-diabetes-with-a-prepregnancy-lifestyle-inter-peer-reviewed-article-IJWHPreconceptionpregnancyobesitynutritionphysical activity |
| spellingShingle | Rönö K Stach-Lempinen B Eriksson JG Pöyhönen-Alho M Klemetti MM Roine RP Huvinen E Andersson S Laivuori H Valkama A Meinilä J Kautiainen H Tiitinen A Koivusalo SB Prevention of gestational diabetes with a prepregnancy lifestyle intervention – findings from a randomized controlled trial International Journal of Women's Health Preconception pregnancy obesity nutrition physical activity |
| title | Prevention of gestational diabetes with a prepregnancy lifestyle intervention – findings from a randomized controlled trial |
| title_full | Prevention of gestational diabetes with a prepregnancy lifestyle intervention – findings from a randomized controlled trial |
| title_fullStr | Prevention of gestational diabetes with a prepregnancy lifestyle intervention – findings from a randomized controlled trial |
| title_full_unstemmed | Prevention of gestational diabetes with a prepregnancy lifestyle intervention – findings from a randomized controlled trial |
| title_short | Prevention of gestational diabetes with a prepregnancy lifestyle intervention – findings from a randomized controlled trial |
| title_sort | prevention of gestational diabetes with a prepregnancy lifestyle intervention ndash findings from a randomized controlled trial |
| topic | Preconception pregnancy obesity nutrition physical activity |
| url | https://www.dovepress.com/prevention-of-gestational-diabetes-with-a-prepregnancy-lifestyle-inter-peer-reviewed-article-IJWH |
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