A Randomized Controlled Pilot Trial of a Behavioral Physical Activity Intervention for Pregnancy Hyperglycemia
Samantha F. Ehrlich, Bethany R. Hallenbeck, Nikki B. Zite, Kimberly B. Fortner, Alissa Paudel, Hollie A. Raynor, Scott E. Crouter, Jill M. Maples
Abstract
Introduction
This randomized controlled pilot trial evaluated a behavioral physical activity (PA) intervention for individuals with pregnancy hyperglycemia and explored the feasibility of a fully powered efficacy trial.
Materials and Methods
The pilot trial sought to enroll and randomize participants to a 5-week-long behavioral PA intervention that promoted walking or stepping (i.e., in place or around a small area) versus a general wellness intervention (that provided no information on PA, diet, or metabolism), both delivered remotely via weekly, 10–20-min-long counseling sessions with a lifestyle coach. Participants (N = 20) completed surveys, including the Pregnancy Physical Activity Questionnaire, and wore ActiGraph CentrePoint watches for 7 days at baseline and at follow-up. Nineteen participants (95%) completed follow-up study visits. A subset (85%) had neonatal anthropometric measurements due to pandemic-related restrictions.
Results
One hundred and twenty individuals were screened, with 54% (n = 65) meeting eligibility criteria and receiving physician approval to contact; 26% of the eligible enrolled, were randomized, and completed a baseline visit. Ninety percent of those randomized to the PA intervention (n = 9) completed it, rating the PA intervention as excellent (56%) or very good (44%). The PA intervention mitigated late pregnancy declines in self-reported walking and running activity (follow-up minus baseline: 0.22 MET h/week [95% CI −0.41, 0.84] in the PA intervention vs. −0.70 [−1.31, −0.10] in controls), and there was the suggestion of improvements in neonatal birthweight for gestational age Z-score and subscapular skinfold.
Conclusion
Findings suggest that the behavioral PA intervention promoting unsupervised, moderate-intensity walking or stepping, which could easily be delivered in conjunction with clinical medical nutrition therapy, was acceptable. The intervention may mitigate late pregnancy declines in moderate-intensity PA and remains to be investigated in a full-scale randomized controlled efficacy trial.
Trial Registration
ClinicalTrials.gov identifier: NCT06125704