Elina Engberg1,2, Beata Stach-Lempinen3, Kristiina Rönö4, Hannu Kautiainen5,6, Johan G Eriksson5,7,8, Saila B Koivusalo4. 1. a Department of Sports and Exercise Medicine, Clinicum , University of Helsinki , Helsinki , Finland. 2. b Foundation for Sports and Exercise Medicine , Clinic for Sports and Exercise Medicine , Helsinki , Finland. 3. c Department of Obstetrics and Gynecology , South-Karelia Central Hospital , Lappeenranta , Finland. 4. d Department of Obstetrics and Gynecology , University of Helsinki and Helsinki University Hospital , Helsinki , Finland. 5. e Department of General Practice and Primary Health Care , University of Helsinki and Helsinki University Hospital , Helsinki , Finland. 6. f Department of General Practice and Primary Health Care , University of Eastern Finland , Joensuu , Finland. 7. g Department of Chronic Disease Prevention , National Institute for Health and Welfare , Helsinki , Finland. 8. h Folkhälsan Research Center , Helsinki , Finland.
Abstract
INTRODUCTION: The purpose was to examine the effects of a randomized lifestyle intervention on self-rated health from pregnancy to postpartum in participants at high risk for gestational diabetes mellitus. METHODS: We included 266 women with a history of gestational diabetes and/or prepregnancy BMI ≥30 kg/m2. The intervention group (n = 144) received individualized counseling on diet, physical activity, and weight management from trained nurses at six timepoints between the first trimester of pregnancy and 12 months postpartum, and met three times with a dietitian. The control group (n = 122) received standard antenatal care. We assessed self-rated health at the six timepoints by means of a single question with five response options ranging from good (1) to poor (5). Baseline-adjusted mean changes in self-rated health level were assessed with a mixed model for repeated measure methods. RESULTS: The mean (SD) for self-rated health at baseline was 1.8 (0.8) in the intervention group and 2.1 (0.9) in the control group (p = 0.006). Self-rated health varied over time (time effect p < 0.001) and was the poorest in the third trimester. The sample indicated that self-rated health improved in the intervention group and deteriorated in the control group from the first trimester to 12 months postpartum, but the difference between the groups did not reach statistical significance (group effect p = 0.064). DISCUSSION: The self-rated health level varied over time from the first trimester of pregnancy to 12 months postpartum in women at risk for gestational diabetes. Improving self-rated health among high-risk pregnant women through lifestyle intervention calls for further research.
RCT Entities:
INTRODUCTION: The purpose was to examine the effects of a randomized lifestyle intervention on self-rated health from pregnancy to postpartum in participants at high risk for gestational diabetes mellitus. METHODS: We included 266 women with a history of gestational diabetes and/or prepregnancy BMI ≥30 kg/m2. The intervention group (n = 144) received individualized counseling on diet, physical activity, and weight management from trained nurses at six timepoints between the first trimester of pregnancy and 12 months postpartum, and met three times with a dietitian. The control group (n = 122) received standard antenatal care. We assessed self-rated health at the six timepoints by means of a single question with five response options ranging from good (1) to poor (5). Baseline-adjusted mean changes in self-rated health level were assessed with a mixed model for repeated measure methods. RESULTS: The mean (SD) for self-rated health at baseline was 1.8 (0.8) in the intervention group and 2.1 (0.9) in the control group (p = 0.006). Self-rated health varied over time (time effect p < 0.001) and was the poorest in the third trimester. The sample indicated that self-rated health improved in the intervention group and deteriorated in the control group from the first trimester to 12 months postpartum, but the difference between the groups did not reach statistical significance (group effect p = 0.064). DISCUSSION: The self-rated health level varied over time from the first trimester of pregnancy to 12 months postpartum in women at risk for gestational diabetes. Improving self-rated health among high-risk pregnant women through lifestyle intervention calls for further research.
Entities:
Keywords:
Gestational diabetes; lifestyle intervention; pregnancy; self-rated health; women