Exercise Guidelines for Women with Gestational Diabetes

1.1 Obesity and type 2 diabetes prevalence are increasing among women of childbearing age There has been a significant increase over the past few decades in the the prevalence of women of child-bearing age who are overweight (body mass index, BMI ≥ 25 kg/m2) or obese (BMI ≥ 30 kg/m2). Women of childbearing age are at an increased risk for obesity (Villamor & Cnattingius, 2006) and type 2 diabetes (Lipscombe & Hux, 2007) because of excessive weight gain during pregnancy and weight retention after delivery (Rooney et al., 2005). Data from the 2007-2008 “National Health and Nutrition Examination Survey” (NHANES) showed that 60% and 34% of American women aged 20-39 years were overweight or obese, respectively (Flegal et al., 2010). Abdominal obesity (i.e. waist circumference ≥ 88 cm; (Lean et al., 1995)), a risk factor for many chronic diseases (Després, 2001) also increased and reached 51.3% in 2007-2008 (Ford et al., 2010). Data from the “Pregnancy Risk Assessment Monitoring System” in nine states indicated that prepregnancy obesity increased from 13% to 22% between 1993 and 2002 (Kim et al., 2007). Worldwide population estimates of pre-pregnancy overweight is approximately 34% (Callaway et al., 2006; LaCoursiere et al., 2005) and that of pre-pregnancy obesity is 25% (Chu et al., 2009), which may be an underestimation. This escalating problem may contribute to the obesity and diabetes epidemics, as overweight women who gain 10% or more of their pre-pregnancy body mass are at higher risk for complications such as gestational diabetes mellitus (GDM; (Carducci et al., 1999)) and pregnancy-induced hypertension (Pole & Dodds, 1999). Additionally, higher recurrence of GDM has been associated with greater pre-pregnancy weight, BMI and excessive pregnancy weight gain (Foster-Powell & Cheung, 1998).