BMC Pregnancy and Childbirth最新文献

Objectives: This study examined whether early postpartum insulin response patterns (< 6 months) following a glucose load predict the emergence of abnormal glucose metabolism (AGM) in women who were previously diagnosed with gestational diabetes mellitus (GDM).

Methods: We conducted a prospective cohort study involving 308 women who had prior GDM. A 75-gram oral glucose tolerance test was administered to each participant within six months after delivery, and the participant's insulin levels were measured at baseline, 30 min, and 2 h following glucose administration. Participants were categorized as having delayed insulin secretion (In2h ≥ In30min; n = 196) or a normal insulin response (In2h < In30min; n = 112). Over an average follow-up period of 32.7 months, Cox proportional hazards models were employed to assess adjusted hazard ratios for AGM development.

Results: Among the 308 women, 153 (49.7%) developed AGM. The delayed insulin secretion group faced a significantly elevated risk (adjusted HR 1.739 [95% CI 1.141-2.649], P = 0.010). Other significant risk factors included elevated fasting glucose levels during pregnancy (adjusted HR 1.565 [95% CI 1.152-2.125], P = 0.004) and early postpartum hypertriglyceridemia (adjusted HR 1.448 [95% CI 1.029-2.039], P = 0.034).

Conclusions: A sluggish insulin response during the early postpartum phase is a robust predictor of future AGM in women with prior GDM.

Background: Leisure-time physical activity (LTPA) promotes pregnancy health, but few studies have investigated how yoga - a mind-body activity - is associated with pregnancy outcomes.

Objective: To determine if engaging in yoga was associated with lower risks of adverse pregnancy outcomes (APO).

Methods: The nuMoM2b prospective cohort study enrolled nulliparous women in their first trimester of pregnancy from eight U.S. clinical centers between October 2010-September 2013 and followed through delivery. LTPA was determined each trimester from an interview querying usual participation in up to three activities (including yoga). Yoga durations were averaged across trimesters. Participants were classified as: no yoga (0 min/week), low yoga (1-<30 min/week), some yoga (30-<75 min/week), or high yoga (≥ 75 min/week). APOs (hypertensive disorders of pregnancy, gestational diabetes, preterm birth (PTB), small-for-gestational age infants) and gestational weight gain (GWG) were prospectively assessed from medical records. Generalized logistic models calculated the risk ratio of outcomes by yoga group, adjusted for sociodemographic, lifestyle, and clinical covariates.

Results: Participants (n = 7,502) in the low/some/high yoga groups tended to be older, White, with higher socioeconomic status, and healthier lifestyle behaviors (all p < 0.001). Compared to no yoga in fully adjusted models, some and high yoga were associated with fewer APOs (RR = 0.86, 95%CI = 0.76-0.98; RR = 0.78, 95%CI = 0.63-0.96), and specifically PTB for high yoga (RR = 0.42, 95%CI = 0.20-0.87). Low yoga was associated with less inadequate GWG (RR = 0.51, 95%CI = 0.35-0.76) and excessive GWG (RR = 0.69, 95%CI = 0.55-0.86). Some yoga was associated with less excessive GWG (RR = 0.71, 95%CI = 0.57-0.88). Yoga was not associated with other outcomes.

Conclusions: Prenatal yoga may help to protect against some APOs and promote healthy GWG.