Exercise Intervention to Prevent Gestational Diabetes
Condition: Gestational Diabetes Mellitus
MeSH terms: Diabetes, Gestational; Diabetes Mellitus
Study type: Interventional

Summary: 
      This study evaluates the role of exercise intervention in reducing the risk of gestational
      diabetes mellitus(GDM) risk of overweight/obese(prepregnancy BMI≥24kg/m^2） Chinese pregnant
      women. Half of participants will have exercise intervention, while the other half will not.
      Both of the two group will have regular prenatal care.
    

Detailed description: 
      An increasing number of women are entering pregnancy in an overweight or obese state. The
      overweight/obesity epidemic among women of reproductive age has led to an increasing
      incidence of gestational diabetes mellitus (GDM)，and other metabolic and obstetric
      complications, such as fetal macrosomia, maternal obesity and type 2 diabetes.

      Exercise may be a non-invasive therapeutic option for preventing and managing GDM that can be
      readily applied to the antenatal population.But so far, the effects of exercise interventions
      on the incidence of GDM and other adverse perinatal outcomes have been scarce, especially in
      Chinese pregnant women.

      So the aim of the investigators study is to evaluate whether exercise intervention in
      overweight/obese(prepregnancy BMI≥24kg/m^2） Chinese pregnant women can reduce their risk of
      GDM and GDM related adverse pregnant outcomes.

      Overweight/obese Chinese pregnant women (prepregnancy BMI≥24kg/m^2） will be randomly divided
      into exercise intervention group and control group in their first trimester（less than 13
      gestational weeks), pregnant women randomised to the exercise intervention group will
      complete three supervised, exercise sessions each week by using a stational bike, and
      exercise sessions will be completed on alternate days. Both exercise group and control group
      have regular prenatal care.

      During 24-28 gestatioanl weeks,GDM will be diagnosed by an oral glucose tolerance test (OGTT)
      according to the new World Health Organization criteria as fasting glucose level in fasting
      whole blood 5.1 mmol/L or more, or 2-hour value 8.5mmol/L or more.Then the investigators can
      compare the GDM risk in each group, and find out if exercise intervention can reduce the risk
      of GDM in overweight/obese Chinese pregnant women.

      Following，no matter pregnant women who were diagnosed with GDM in the intervention group or
      the control group,they will all have standard medical managemen, and continue what they do
      before until they give birth. That means pregnnat women in the intervention group will
      continue to have exercise intervention and regular prenatal care despite whether they have
      GDM or not.

      So when they give birth, the investigators can compare pregnant outcomes between four groups,
      that is exercise group without GDM, exercise group with GDM, control group without GDM and
      control group with GDM.And the pregnant outcomes include preterm birth rates, fetal birth
      weight, Aparga score, cesarean rate and so on.

      In this study, the investigators will also collect participants' blood samples in first,
      second and third trimester respectively,and collect cord blood samples, placenta
      samples,muscle samples and aidpose tissues when they give birh.Thus the investigators can
      also do some basic reasearch about the potential mechanisms of exercise in preventing GDM.
    

Intervention name(s): Stationary bike
Intervention type(s): Behavioral
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: GDM; pregnancy outcome; obesity; exercise; overweight