In the United States, three major health complications are associated with pregnancy; low birth weight,gestational diabetes and maternal pre-eclampsia. Evidence exists to support the benefits of pre-natal care,proper nutrition and regular physical activity as preventative measures to help reduce the risk of all three of thedocumented health complications(1-3). Although research in the area of exercise and nutrition duringpregnancy continues to grow, many gaps in the literature are still apparent including the inclusion of minoritypopulations in research studies. A growing body of literature suggests that healthy and well-nourished womencan safely participate in most forms of physical activity during pregnancy (4) but minimal research has beenconducted with minority populations. Ironically, many of the minority populations are at increased risk for lowbirth weight and gestational diabetes.The populations in two Montana counties, Gallatin (home to Bozeman) and Big Horn (home to Crowand part of Northern Cheyenne reservations) are 97% Caucasian and 1% Native American vs. 61% NativeAmerican and 36.3% Caucasian, respectively. The low birth weight incidence is 5% and 7% of all births forGallatin and Big Horn counties, respectively (5). In Montana from 1989-2000, the rate of any diabetes inpregnancy was significantly higher among Indian mothers compared to white mothers both at the beginning ofthe decade (31/1000 live births in American Indians; 18/1000 live births in whites; p<0.001) and at the end ofthe decade 41 to 26 per 1,000 live births, respectively. This data indicates that not only is the diabetesincidence greater in Native American mothers as compared to white mothers but also that the incidence ofdiabetes is increasing in both populations. Overall, 80% of mothers had GDM vs. pre-pregnancy diabetes.Although white Montana mothers have a higher incidence of GDM (80% vs. 71%), Indian mothers had a higherpre-pregnancy diabetes rate (29% vs. 20%)(5).This data demonstrates the apparent health disparities that exist particularly for the Native Americanpopulation in Montana, yet little research has been done to determine appropriate strategies to engagepregnant women in lifestyle activities that will confer risk reduction. The purpose of this 5 yr project is todocument the habits and beliefs regarding nutrition and physical activity in pregnant women living on the Crowreservation. A primary outcome of this project is to develop culturally appropriate nutrition education andphysical activity pre-natal programs to reduce gestational diabetes risk. A secondary outcome is to establish adatabase that allows for the follow-up of these women and their children to assess the relationship betweentheir pregnancy nutrition and physical activity habits and beliefs on future diabetes risk.
