Mapping the Characteristics of Gestational Diabetes Prevention Lifestyle Interventions

Introduction: The literature on gestational diabetes mellitus (GDM) prevention lifestyle interventions is conflicting with heterogeneity across study characteristics. The purpose was to map the sample, intervention, and physiologic outcome characteristics of randomized control trials (RCT). Methods: Article inclusion criteria: lifestyle intervention RCTs (no medications), all ages and phenotypes, reported on GDM rates. We searched PubMed and CINAHL using key term combinations including lifestyle, physical activity, nutrition, exercise, dietary, intervention, program, gestational diabetes, diabetes during pregnancy, pregnant, pregnancy, nulliparous, gestation, prevention, prevent. Three reviewers considered 87 unique abstracts for full text review. Sample, intervention, and GDM-relevant physiologic outcome (beyond gestational weight gain) characteristics were mapped. Results: We reviewed 19 studies. Common sample inclusion criteria across studies were gestational age (63% studies), chronological age and weight status (each 58%), singleton pregnancy (47%), and GDM risk factors (26%). Studies represented adults with overweight (M±SD, Age 30.5±1.8 y, pre-pregnancy BMI 29.3±4.3 kg/m2) and gestational age <20 wk. Latinas (n=1 studies) and Blacks (n=4) were underrepresented. Six studies (32%) used multi-disciplinary teams. Dietitians (44% studies), nurses (22%) and exercise specialists (16%) were common implementers with nutritionists, physicians, lifestyle coaches, and research staff each used in <12% studies. Few studies used theoretical frameworks: Social Cognitive Theory (n=3 studies), Control Theory (n=2), Health Belief Model (n=1). GDM criteria most used were ADA (68% studies) compared to WHO (16%). Insulin sensitivity was the most common GDM risk factor (n=5). Conclusion: GDM prevention lifestyle interventions should prioritize high-risk racial/ethnic groups, multi-level frameworks, multi-disciplinary delivery, and novel biomarkers. Disclosure A.Pena: None. A.Miller: None. A.G.Campbell: None. C.M.Scifres: None.