Associations of physical activity and sedentary behavior during pregnancy with gestational diabetes mellitus among Asian women in Singapore

BMC Pregnancy Childbirth. 2017 Oct 18;17(1):364. doi: 10.1186/s12884-017-1537-8.


Background: Few studies have investigated physical activity (PA) and sedentary behavior (SB) in relation to fasting (FG) and 2-h postprandial plasma glucose (2hPG) levels and gestational diabetes mellitus (GDM); we investigated these associations among Asian pregnant women.

Methods: As part of the Growing Up in Singapore Towards healthy Outcomes cohort study, PA and SB (sitting and television times) were assessed by interviewer-administered questionnaire. During 75 g oral glucose tolerance tests at 26-28 weeks' gestation we measured FG, 2hPG levels and GDM (FG ≥ 7.0 mmol/L and/or 2hPG ≥ 7.8 mmol/L). Associations were analysed by multiple linear and logistic regression.

Results: Among the 1083 women studied, 18.6% had GDM. SB was not associated with FG, 2hPG and GDM. Higher categories of PA were associated with lower 2hPG and a lower likelihood of GDM (p-trend < 0.05), but not with FG levels. Compared to insufficiently active women, highly active women had lower 2hPG levels [β (95% CI): -0.32 (-0.59, -0.05), p = 0.020) and were less likely to have GDM [OR: 0.56 (0.32-0.98), p = 0.040]. Stratified analysis revealed no associations among under/normal-weight women, but significant associations among overweight/obese women; in those with BMI ≥23 kg/m2, sufficiently active and highly active women were less likely to have GDM [OR: 0.52, (0.29-0.93), p = 0.028, and OR: 0.34, (0.15-0.77), p = 0.010, respectively].

Conclusion: Higher PA was associated with lower 2hPG levels and a lower prevalence of GDM, particularly in overweight/obese women. Further studies are warranted to confirm these findings, and to examine the effectiveness of PA promotion strategies for the prevention of gestational hyperglycemia.

Keywords: Gestational diabetes mellitus; Maternal glucose levels; Physical activity; Pregnancy; Sedentary behavior.

MeSH terms

  • Adult
  • Asian Continental Ancestry Group / statistics & numerical data
  • Blood Glucose / analysis*
  • Cohort Studies
  • Diabetes, Gestational / etiology*
  • Exercise*
  • Fasting / blood
  • Female
  • Glucose Tolerance Test
  • Humans
  • Linear Models
  • Logistic Models
  • Overweight / blood
  • Overweight / complications
  • Postprandial Period
  • Pregnancy
  • Pregnancy Trimester, Second / blood
  • Pregnancy Trimester, Second / physiology*
  • Risk Factors
  • Sedentary Behavior*
  • Singapore


  • Blood Glucose