Healthy pre-pregnancy lifestyle may reduce risk of gestational diabetes

Adopting and adhering to a low-risk, healthy lifestyle before pregnancy is associated with a low risk of gestational diabetes and could be an effective way to prevent the complication, according to a new study in the BMJ.

Using data from the Nurses’ Health Study II, researchers from the National Institute of Child Health and Human Development and Harvard conducted a prospective cohort study of 20,136 singleton live births to 14,437 women who had no chronic disease. Self-reported incident gestational diabetes was diagnosed by a physician and validated using medical records from a previous study. Information regarding smoking status and weight was obtained twice a year. Food intake and physical activity were assessed via self-reports on Nurses’ Health Study II questionnaires.

Over 10 years of follow up, incident first-time gestational diabetes was identified in 823 pregnancies. Each lifestyle factor included and measured was independently and significantly associated with the risk of developing gestational diabetes. When compared with all other pregnancies, risk of gestational diabetes was 41% lower in pregnancies to women who had adopted a combination of 3 low-risk factors: not smoking, doing ≥150 minutes of moderate to vigorous physical activity per week, and eating a healthy diet (relative risk [RR] 0.59, 95% confidence interval [CI] 0.48 to 0.71). Adding a body mass index <25 before pregnancy, for a combination of 4 low-risk factors, was linked with a 52% lower risk of gestational diabetes compared with all other pregnancies (RR 0.48, 95% CI 0.38 to 0.61).

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Risk of developing gestational diabetes was 83% lower in women who met all 4 criteria than in those who did not meet a single low-risk lifestyle criterion (RR 0.17, 95% 0.12 to 0.25). The population attributable risk percentage for the 4 risk factors in combination (smoking, inactivity, overweight, and poor diet) was 47.5% (95% confidence interval 35.6% to 56.6%). A similar percentage was seen when the distributions of the 4 low-risk factors from the US National Health and Nutrition Examination Survey (2007-2010) data were applied to the calculation.

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