title: Understanding health behaviours in a cohort of pregnant women at risk of gestational diabetes mellitus: an observational study.
abstract: OBJECTIVE
  To assess health behaviours, physical activity levels, weight gain and development of gestational diabetes mellitus (GDM) in high-risk women.
  
  
  METHODS
  An observational sub-study of a larger randomised controlled trial.
  
  
  METHODS
  A large tertiary hospital in Australia.
  
  
  METHODS
  Ninety-seven women (mean age 31.7 ± 4.5 years; body mass index 30.3 ± 5.9 kg/m(2) ) at risk of developing GDM.
  
  
  METHODS
  Women were identified as at risk of GDM based on a validated screening tool. Baseline measures were completed at 12-15 weeks of gestation and repeated at 26-28 weeks of gestation.
  
  
  METHODS
  Anthropometric (weight and height) and physical activity assessment (Yamax pedometer and International physical activity questionnaire), questionnaires (self-efficacy) and GDM screening.
  
  
  RESULTS
  By 28 weeks of gestation, there was a high GDM prevalence of 26% using the recent International Association of Diabetes and Pregnancy Study Group criteria. Weight gain in overweight (body mass index 25-29.9 kg/m(2)) and obese (body mass index >30.0 kg/m(2)) women exceeded minimum total weight gain recommendations set by the Institute of Medicine (P < 0.01). Physical activity levels were low and declined during pregnancy (5437 ± 2951 steps/day to 4096 ± 2438 steps/day, respectively, P < 0.001). Despite reduced activity levels, increased weight gain and high GDM incidence many women did not accurately perceive GDM risk and were confident in their ability to control weight. A significant association with physical activity, weight and GDM outcome was not observed.
  
  
  CONCLUSIONS
  Overweight and obese pregnant women at risk for developing GDM demonstrate excessive weight gain and a reduced level of physical activity observed from early pregnancy to 28 weeks of gestation. Results highlight the need for targeted intervention in women at risk for developing GDM.
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
authors.forename: C L
authors.initials: CL
authors.lastname: Harrison
authors.forename: C B
authors.initials: CB
authors.lastname: Lombard
authors.forename: H J
authors.initials: HJ
authors.lastname: Teede
mesh_terms: D000293:Adolescent; D000328:Adult; D016640:Diabetes, Gestational / Q000453:epidemiology*; D015444:Exercise; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011262:Pregnancy Trimester, Second; D012307:Risk Factors; D015430:Weight Gain; D055815:Young Adult