Association of Physical Activity with Gestational Diabetes Mellitus among Pregnant Women in a Rural Area of Maharashtra: A Community-based Cross-sectional Study

Objective:Our objective was to determine the association of physical activity with gestational diabetes mellitus (GDM) among pregnant women in a rural area of Maharashtra. Methods:The current community-based cross-sectional study was conducted among 965 pregnant women from 3 primary health centers of the field practice area of the Department of Community Medicine, MGIMS, Sevagram, who were included in the ICMR-funded Central India Rural Pregnancy Cohort Project from October 2016 to May 2018. After assuring informed written consent, a pretested semi-structured questionnaire was administered. The Diabetes in Pregnancy Study Group India criteria were used for screening. The level of 2-h plasma glucose >140 mg/dL with 75 g oral glucose load was used to diagnose GDM irrespective of the duration of the last meal. The Pregnancy Physical Activity Questionnaire (PPAQ) was administered to assess the association of physical activity and GDM among the participants. Results:Among all participants, 5.39% were GDM positive; 24.45% of pregnant women had metabolic equivalent of task (MET) score <8.5 MET-h/day, and 75.54% had MET-h/day score >8.5 MET-h/day. The odds of having GDM in participants with physical activity < 8.5 MET-h/day was 22% more than that of participants with >8.5 MET-h/day. Two hundred and thirty-six participants (24.45%) reported to have sedentary levels of physical activity, 437 (45.28%) had light-level physical activity, 255 (26.42%) had moderate physical activity, and only 37 (3.83%) had heavy physical activity. With respect to participants with sedentary lifestyle, participants performing light (odds ratio [OR]: 0.76; 95% confidence interval [CI]: 0.21-2.79), moderate (OR: 0.54; 95% CI: 0.15-1.92), and heavy physical activities (OR: 0.65; 95% CI: 0.17-2.41) had 24%, 46%, and 35% lesser odds of having GDM, respectively. Conclusions:The current study documented the inverse relationship of physical activity during pregnancy and the risk of developing GDM. With an increase in the intensity of exercise the risk of GDM became lesser respectively. It is advised to all the women to perform regular physical activity during family planning, as early as possible, and to continue during the span of pregnancy to avoid the risk of developing GDM.