RESULTS
From February 2008 through April 2013, 109 consenting women were
randomized, 57 in the exercise group and 52 in the usual care group
(Figure 1). One woman was excluded because of diabetes type 1
(randomised in error) and another was lost to follow-up (was not
followed in our unit and delivered in another hospital), leaving 107
women for the analysis.
Baseline characteristics are summarised in Table 1. There were more
obese women (BMI 30 kg/m2 or more) randomized in the
intervention group and more nulliparous women in the usual care group.
In the intervention group, six women (11%) never attended the exercise
sessions and two women (4%) had minimal participation (one session
only). We considered as compliant to the intervention 35 women (64%),
32 because they attended more than 50% of the scheduled sessions
between randomisation and delivery and 3 because they did not, but
reached on average more than 5000 steps per day during the same period.
Average duration of the exercise sessions was 43 (SD 5) minutes, the
average heart rate during the exercise sessions was 114 (SD 12) bpm, and
the average peak heart rate was 142 (SD 17) bpm.
The incidence of insulin prescription was not significantly different
between groups: 31 women (56%) in the exercise group compared with 24
(46%) in the control group (relative risk 1.22, 95% CI 0.84 to 1.78;
P=0.39) (Table 2). Days between randomization and start of insulin
treatment were not significantly different: 16 (SD 13) and 17 (SD 15) in
the exercise and usual care group, respectively (P= 0.62). The means of
the maximal dose of insulin were similar in the two groups.
Between 26 and 32 weeks, mean postprandial glucose was 9.4 (SD 1.8)
mmol/L in the exercise group, compared to 8.9 (SD 2.0) mmol/L in the
usual care group, (P=0.22). The number of postprandial glucose values
per week above 8.0 mmol/L was similar (4.1, SD 3.4 and 3.8, SD 3.1; P=
0.77). Between 32 and 36 weeks, mean postprandial glucose was 9.0 (SD
2.1) mmol/L in the exercise group, compared to 8.9 (SD 1.8) mmol/L in
the usual care group, (P=0.75). The number of postprandial glucose
values above 8.0 mmol/L was also similar (3.9, SD 3.4 and 4.1, SD 3.4;
P=0.84).
Secondary outcomes, including gestational weight gain, caesarean
section, maternal complications, did not differ significantly between
groups. Neonatal outcomes were also similar between groups.