PHYSICAL-ACTIVITY, OBESITY, AND DIABETES IN PREGNANCY

Gestational diabetes mellitus (GDM) is the most common medical complic ation of pregnancy, Women with GDM are at elevated risk for numerous m aternal health complications, and their infants are at elevated risk f or death and morbidity, Management of GDM has traditionally been throu gh diet and close monitoring of glucose levels, with initiation of ins ulin therapy when diet alone fails to maintain euglycemia. Recently, h owever, it has been suggested that alternative treatment modalities, s uch as exercise, may overcome a peripheral resistance to insulin, thus preventing GDM or controlling hyperglycemia in women with GDM, In thi s study, conducted from October 1995 to July 1996, the authors used a population-based birth registry to determine whether exercise has a pr eventive role in the development of GDM in women living in central New York State, They used contingency tables and chi-square statistics to examine bivariate differences among maternal and demographic variable s and the occurrence of GDM, When stratified by prepregnancy body mass index category, exercise was associated with reduced rates of GDM onl y among women with a body mass index greater than 33 (odds ratio = 1.9 , 95% confidence interval 1.2-3.1). The effect of exercise in obese wo men was further complicated by insurance status, When the data were st ratified by insurance status, it appeared that women of higher socioec onomic status who were obese and did not exercise were at a significan tly elevated risk of GDM compared with their counterparts of lower soc ioeconomic status, The results of this study suggest that for some wom en exercise may play a role in reducing the risk that they will develo p GDM during pregnancy.