Women diagnosed with gestational diabetes mellitus (GDM) are at substantially increased risk of developing type 2 diabetes and obesity, currently at epidemic rates in the United States. GDM, therefore, identifies a population of women at high risk of developing type 2 diabetes and thus provides an excellent opportunity to intervene years before the development of this disorder. It is well recognized that acute as well as chronic physical activity reduce fasting plasma glucose as well as improve glucose tolerance in type 2 diabetes. Recent epidemiologic studies have suggested that women with higher levels of physical activity have reduced risk of GDM. Therefore, we propose to test the hypothesis that an exercise intervention is an effective tool for preventing GDM among women with a history of GDM. The primary goals of the application are to investigate the effects of a motivationally-tailored, individually targeted 12-wk physical activity intervention on 1) risk of recurrent GDM, 2) serum biomarkers associated with insulin resistance, 3) and the adoption and maintenance of exercise during pregnancy. Secondary goals are to investigate the impact of the intervention on gestational weight gain and selected birth outcomes. A total of 364 multiparous women who had GDM in a prior pregnancy (49 percent will be from minority groups) will be recruited in early pregnancy (10 wks gestation) and randomized to either an Individually Targeted (IT) intervention (n=182) or a Comparison Health and Wellness (HW) intervention (n=182). The overall goal of the intervention is to encourage pregnant women to achieve the American College of Obstetricians and Gynecologists (ACOG) Guidelines for physical activity during pregnancy (30 minutes or more of moderate- intensity activity on most days of the week) through increasing walking and developing a more active lifestyle. The intervention draws from the theory of Stages of Motivational Readiness for Change and Social Cognitive Theory constructs for physical activity behavior and will take into account the specific social, cultural, economic, and physical environmental challenges faced by women of diverse socioeconomic and ethnic backgrounds. The application is innovative in being the first, to our knowledge, to test a physical activity intervention designed to prevent GDM among high risk women. The intervention protocol can readily be translated into clinical practice in underserved and minority populations.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK074876-05
Application #
8012865
Study Section
Psychosocial Risk and Disease Prevention Study Section (PRDP)
Program Officer
Jones, Teresa L Z
Project Start
2007-01-15
Project End
2012-12-31
Budget Start
2011-01-01
Budget End
2012-12-31
Support Year
5
Fiscal Year
2011
Total Cost
$398,935
Indirect Cost
Name
University of Massachusetts Amherst
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
153926712
City
Amherst
State
MA
Country
United States
Zip Code
01003
Nobles, Carrie J; Marcus, Bess H; Stanek 3rd, Edward J et al. (2018) The Health Behaviors of Ethnically Diverse Women at Increased Risk of Gestational Diabetes: The Behaviors Affecting Baby and You (B.A.B.Y.) Study. Matern Child Health J 22:735-744
Hawkins, Marquis; Braun, Barry; Marcus, Bess H et al. (2015) The impact of an exercise intervention on C - reactive protein during pregnancy: a randomized controlled trial. BMC Pregnancy Childbirth 15:139
Nobles, Carrie; Marcus, Bess H; Stanek 3rd, Edward J et al. (2015) Effect of an exercise intervention on gestational diabetes mellitus: a randomized controlled trial. Obstet Gynecol 125:1195-204
Nobles, Carrie J; Markenson, Glenn; Chasan-Taber, Lisa (2015) Early pregnancy vitamin D status and risk for adverse maternal and infant outcomes in a bi-ethnic cohort: the Behaviors Affecting Baby and You (B.A.B.Y.) Study. Br J Nutr 114:2116-28
Hawkins, Marquis; Chasan-Taber, Lisa; Marcus, Bess et al. (2014) Impact of an exercise intervention on physical activity during pregnancy: the behaviors affecting baby and you study. Am J Public Health 104:e74-81
Evenson, Kelly R; Chasan-Taber, Lisa; Symons Downs, Danielle et al. (2012) Review of self-reported physical activity assessments for pregnancy: summary of the evidence for validity and reliability. Paediatr Perinat Epidemiol 26:479-94
Chasan-Taber, Lisa (2012) Physical activity and dietary behaviors associated with weight gain and impaired glucose tolerance among pregnant Latinas. Adv Nutr 3:108-18
Downs, Danielle Symons; Chasan-Taber, Lisa; Evenson, Kelly R et al. (2012) Physical activity and pregnancy: past and present evidence and future recommendations. Res Q Exerc Sport 83:485-502
Chasan-Taber, Lisa; Silveira, Marushka; Marcus, Bess H et al. (2011) Feasibility and efficacy of a physical activity intervention among pregnant women: the behaviors affecting baby and you (B.A.B.Y.) study. J Phys Act Health 8 Suppl 2:S228-38
Chasan-Taber, Lisa; Marcus, Bess H; Stanek 3rd, Edward et al. (2009) A randomized controlled trial of prenatal physical activity to prevent gestational diabetes: design and methods. J Womens Health (Larchmt) 18:851-9

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