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Effects of a Lifestyle Intervention During Pregnancy and First Postpartum Year: Findings From the RADIEL Study
Emilia Huvinen1, Saila B Koivusalo1, Jelena Meinilä2
1Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Context:
Women with a history of gestational diabetes (GDM) have a sevenfold risk of developing type 2 diabetes.
Objective:
To assess the effects of a lifestyle intervention during pregnancy and first postpartum year on glucose regulation, weight retention, and metabolic characteristics among women at high GDM risk.
Design:
In the Finnish Gestational Diabetes Prevention study, trained study nurses provided lifestyle counseling in each trimester and 6 weeks, 6 months, and 12 months postpartum.
Setting:
Three maternity hospitals in the Helsinki area and one in Lappeenranta.
Patients:
In total, 269 women with previous GDM and/or a prepregnancy body mass index ≥30 kg/m2 were enrolled before 20 gestational weeks and allocated to either a control or an intervention group. This study includes the 200 participants who attended study visits 6 weeks and/or 12 months postpartum.
Intervention:
The lifestyle intervention followed Nordic diet recommendations and at least 150 minutes of moderate exercise was recommended weekly.
Main Outcome Measure:
The incidence of impaired glucose regulation (impaired fasting glucose, impaired glucose tolerance, or type 2 diabetes) during the first postpartum year.
Results:
Impaired glucose regulation was present in 13.3% of the women in the control and in 2.7% in the intervention group [age-adjusted odds ratio, 0.18 (95% confidence interval, 0.05 to 0.65), P = 0.009] during the first postpartum year. There were no differences between the groups in weight retention, physical activity, or diet at 12 months postpartum.
Conclusions:
A lifestyle intervention during pregnancy and the first postpartum year successfully reduced the incidence of postpartum impairment in glucose regulation.
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