More Physical Exercise is Required for Overweight or Obese Women with Gestational Diabetes Mellitus to Achieve Good Plasma Glucose Control During Pregnancy: Finding from a Prospective Cohort in Shanghai

Figures & data

Figure 1 The technical flowchart of this study population.

Table 1 The Demographic Features Among Women with GDM (n = 1139)

Variable	Total Women (n=1139)	BMI<25 kg/m^2 Women (n=852)	BMI≥25 kg/m^2 Women (n=287)	t/χ^2	P
Age (years; Mean ± SD)	30.5±4.3	30.4±4.2	30.7±4.6	−0.97	0.330
Age group (years; n (%))				1.29	0.731
18–25	137 (12.0)	100 (11.7)	37 (12.9)
26–30	452 (39.7)	345 (40.5)	107 (37.3)
31–35	402 (35.3)	300 (35.2)	102 (35.5)
36–45	148 (13.0)	107 (12.6)	41 (14.3)
Education (n (%))				19.74	<0.001
Primary/junior high	236 (20.7)	153 (18.0)	83 (28.9)
Senior high	216 (19.0)	156 (18.3)	60 (20.9)
College and above	687 (60.3)	543 (63.7)	144(50.2)
Individual monthly income (RMB; n (%))				2.92	0.233
≤5000	268 (23.5)	190 (22.3)	78 (27.2)
5001–10,000	593 (52.1)	449 (52.7)	144 (50.2)
>10,000	278 (24.4)	213 (25.0)	65 (22.7)
Residency status (n (%))				0.07	0.795
Local resident	366 (32.1)	272 (31.9)	94 (32.8)
Non-local resident	773 (67.9)	580 (68.1)	193 (67.3)
Balanced diet with doctor’s suggestion (n (%))				0.01	0.907
Yes	461 (40.5)	344 (40.4)	117 (40.8)
No	678 (59.5)	508 (59.6)	170 (59.2)

Abbreviations: BMI, body mass index; SD, standard deviation; RMB, Chinese yuan.

Table 2 Moderate-Intensity Physical Exercise, Glucose Control, and Adverse Pregnancy Outcomes Status Among Women with GDM (n = 1139)

Variable	Total Women (n=1139)	BMI<25 kg/m^2 Women (n=852)	BMI≥25 kg/m^2 Women (n=287)	χ^2	P
Daily physical exercise time (min; Median (IQR))	65.0 (45.0–90.0)	65.0 (45.0–90.0)	65.0 (45.0–90.0)	0.62	0.803
Daily physical exercise time (min; n (%))				5.64	0.227
<30	55 (4.8)	46 (5.4)	9 (3.1)
30–59	393 (34.5)	285 (33.5)	108 (37.6)
60–89	378 (33.2)	288 (33.8)	90 (31.4)
90–119	224 (19.7)	162 (19.0)	62 (21.6)
≥120	89 (7.8)	71 (8.3)	18 (6.3)
Types of physical activity (Median (IQR))	3.0 (2.0–4.0)	3.0 (2.0–4.0)	3.0 (2.0–4.0)	0.06	0.810
Times of antenatal checkup (Median (IQR))	6.0 (5.0–7.0)	6.0 (4.0–7.0)	6.0 (5.0–7.0)	3.81	0.051
Percentage of abnormal PG (%; Median (IQR))	40.0 (20.0–66.7)	40.0 (20.0–60.0)	50.0 (25.0–71.4)	12.99	<0.001
Glucose control status (n (%))				9.12	0.003
Yes	576 (50.6)	453 (53.2)	123 (42.9)
No	563 (49.4)	399 (46.8)	164 (57.1)
Weight gain in gestation (kg, Median (IQR))	9.5 (7.0–12.3)	10.0 (7.6–12.8)	8.3 (5.4–11.1)	36.00	<0.001
Adverse pregnancy outcomes status (n (%))				8.60	0.003
Yes	335 (29.4)	231 (27.1)	104 (36.2)
No	804 (70.6)	621 (72.9)	183 (63.8)

Abbreviations: BMI, body mass index; PG, plasma glucose; IQR, interquartile range.

Table 3 Moderate-Intensity Physical Exercise Time Among GDM Women with Different Glucose Control Status (n = 1139)

Daily Physical Exercise Time (Min; n (%))	Total	Satisfactory Glycemic Control	Unsatisfactory Glycemic Control	χ^2	P
Total women (n=1139)		576 (50.6)	563 (49.4)	3.37	0.499
<30	55	25 (45.5)	30 (54.5)
30–59	393	192 (48.9)	201 (51.1)
60–89	378	191 (50.5)	187 (49.5)
90–119	224	116 (51.8)	108 (48.2)
≥120	89	52 (58.4)	37 (41.6)
BMI<25 kg/m^2 women (n=852)		453 (53.2)	399 (46.8)	1.35	0.852
<30	46	22 (47.8)	24 (52.2)
30–59	285	155 (54.4)	130 (45.6)
60–89	288	148 (51.4)	140 (48.6)
90–119	162	89 (54.9)	73 (45.1)
≥120	71	39 (54.9)	32 (45.1)
BMI≥25 kg/m^2 women (n=287)		123 (42.9)	164 (57.1)	10.80	0.029
<30	9	3 (33.3)	6 (66.7)
30–59	108	37 (34.3)	71 (65.7)
60–89	90	43 (47.8)	47 (52.2)
90–119	62	27 (43.6)	35 (56.5)
≥120	18	13 (72.2)	5 (27.8)

Abbreviation: BMI, body mass index.

Table 4 Moderate-Intensity Physical Exercise Time Among GDM Women with Different Pregnancy Outcome Status (n = 1139)

Daily Physical Exercise Time (Min; n (%))	Total	No Adverse Pregnancy Outcomes	Adverse Pregnancy Outcomes	χ2	P
Total women (n=1139)		804 (70.6)	335 (29.4)	9.74	0.045
<30	55	33 (60.0)	22 (40.0)
30–59	393	275 (70.0)	118 (30.0)
60–89	378	260 (68.8)	118 (31.2)
90–119	224	163 (72.8)	61 (27.2)
≥120	89	73 (82.0)	16 (18.0)
BMI<25 kg/m^2 women (n=852)		621 (72.9)	231 (27.1)	11.17	0.025
<30	46	26 (56.5)	20 (43.5)
30–59	285	209 (73.3)	76 (26.7)
60–89	288	208 (72.2)	80 (27.8)
90–119	162	118 (72.8)	44 (27.2)
≥120	71	60 (84.5)	11 (15.5)
BMI≥25 kg/m^2 women (n=287)		183 (63.8)	104 (36.2)	5.12	0.276
<30	9	7 (77.8)	2 (22.2)
30–59	108	66 (61.1)	42 (38.9)
60–89	90	52 (57.8)	38 (42.2)
90–119	62	45 (72.6)	17 (27.4)
≥120	18	13 (72.2)	5 (27.8)

Abbreviation: BMI, body mass index.

Figure 2 The influence of moderate-intensity physical exercise time on plasma glucose control during pregnancy among GDM women with different BMI levels.

Notes: Adjusted covariates include age group, education level, and individual monthly income level. The bold values indicate the OR was statistically significant (P <0.05).

Abbreviation: BMI, body mass index.

Figure 3 The association between moderate-intensity physical exercise time and the percentage of abnormal plasma glucose among totally GDM women (A), underweight or normal weight GDM women (B), overweight or obese GDM women (C).

Notes: Dashed vertical lines represent moderate-intensity physical exercise times of 60, 90, and 120 min/day. The dashed Horizontal lines represent the percentage of abnormal plasma glucose levels at 35%.