P37 Relationship between physical activity and blood glucose markers during pregnancy amongst a multi-ethnic maternal cohort: results from the born in bradford cohort study

E. Petherick, L. Sherar, S. Barber, M. Hamer, John Wright
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Abstract

Background Physical activity is associated with positive health biomarker profiles during pregnancy and resultant birth outcomes. Furthermore, there is some evidence to suggest that physical activity both prior to and during pregnancy may reduce the risk of gestational diabetes. In this study we aim to investigate the relationship between physical activity and biomarkers associated with gestational diabetes (GDM) risk and clinical diagnoses of GDM. Methods Participants were pregnant women recruited to the Born in Bradford cohort study who completed phase 1 or 2 of the baseline questionnaire and provided a fasting blood sample between approx. 26–28 weeks of gestation, and had a singleton birth. Where mothers had two births during the study period, only the first was included in the present analyses. Physical activity level was measured using the General Practice Physical Activity Questionnaire (GPPAQ) and questions about usual walking speed. The relationship of self-reported physical activity, using both of the two definitions above, with levels of fasting blood glucose was evaluated using multivariate linear regression. GDM risk was assessed using logistic regression analyses. Models were adjusted for other key covariables including age, ethnicity, body mass index and parity. Results Data were available for 6119 maternal participants. White British women reported higher levels of physical activity and physical function (i.e. higher self-reported average walking speed) relative to their Pakistani and Other ethnic group peers. Despite the higher GPPAQ scores in the White British group, over 67 per cent still fell into the inactive or moderately inactive category. Higher levels of activity as measured by GPPAQ scores was not associated with fasting blood glucose or odds of gestational diabetes. Walking speeds were associated with lower levels of fasting glucose, and remained so after adjustment for other relevant covariables (−0.04 (−0.08, –0.05). Adjusted odds of gestational diabetes diagnosis were also lower in those reporting the highest self-reported walking speeds OR 0.49 (0.27–0.87). Conclusion Faster self-reported walking speeds, which may result from greater residual fitness prior to pregnancy, were shown to be associated with lower fasting blood glucose levels and lower odds of a gestational diabetes diagnosis. These results provide first time evidence that self-reported walking speed, an indicator of functional reserve, is associated with positive pregnancy related biomarker profiles and require independent confirmation. Given the lower physical activity and functional profile of Pakistani women, there remains high potential for behaviour change interventions in this population group. To realise this ambition further research must focus on understanding specific cultural and socio-economic barriers to implementation.
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P37多民族产妇妊娠期间身体活动与血糖指标的关系:来自bradford队列研究的结果
研究背景:体育活动与妊娠期间的健康生物标志物阳性特征和由此产生的分娩结果相关。此外,有证据表明,怀孕前和怀孕期间的体育锻炼可能会降低患妊娠糖尿病的风险。在这项研究中,我们旨在探讨运动与妊娠糖尿病(GDM)风险和临床诊断相关的生物标志物之间的关系。方法参与者是在布拉德福德出生队列研究中招募的孕妇,她们完成了基线问卷的第1或第2阶段,并提供了大约在1 ~ 2岁之间的空腹血液样本。妊娠26-28周,单胎分娩。在研究期间,如果母亲生了两个孩子,那么本分析只包括第一个孩子。体力活动水平通过一般实践体力活动问卷(GPPAQ)和关于通常步行速度的问题来测量。使用上述两种定义的自我报告的体力活动与空腹血糖水平的关系使用多元线性回归进行评估。采用logistic回归分析评估GDM风险。对模型进行了其他关键协变量的调整,包括年龄、种族、体重指数和胎次。结果6119名产妇参与调查。与巴基斯坦和其他种族的同龄人相比,英国白人女性的体力活动和身体机能水平更高(即自我报告的平均步行速度更高)。尽管白种英国人的GPPAQ得分更高,但超过67%的人仍然属于不运动或中度不运动的类别。GPPAQ评分测量的较高活动量与空腹血糖或妊娠糖尿病的几率无关。步行速度与较低的空腹血糖水平相关,在校正其他相关协变量后仍然如此(- 0.04(- 0.08,-0.05)。在那些自我报告步行速度最高的人群中,妊娠期糖尿病诊断的调整后几率也较低,OR为0.49(0.27-0.87)。结论:更快的自我报告步行速度与较低的空腹血糖水平和较低的妊娠糖尿病诊断几率有关,这可能是怀孕前更大的剩余健康状况造成的。这些结果首次证明,自我报告的步行速度(功能储备指标)与妊娠相关的阳性生物标志物相关,需要独立证实。鉴于巴基斯坦妇女的体力活动和功能状况较低,在这一人群中进行行为改变干预的潜力仍然很大。为了实现这一目标,进一步的研究必须集中于了解具体的文化和社会经济障碍。
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