Lifestyle behaviours and beliefs of pregnant women with gestational diabetes: a longitudinal follow-up study

Master Thesis


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Women with gestational diabetes mellitus (GDM) have increased risk of adverse pregnancy outcomes such as delivering Large-for-gestational-age babies, preeclampsia or birth trauma, as well as increased risk of developing type 2 diabetes (T2DM) later in life. Lifestyle management through a healthy diet and physical activity both during and after a GDM pregnancy is the first line treatment option in GDM management and for delaying the onset of T2DM. The research for this Master thesis had two main aims: firstly, to investigate the dietary intake and beliefs related to dietary intake of pregnant women with GDM in Cape Town, and whether they adhere to established dietary recommendations and secondly, to investigate the change in dietary intake, physical activity and associated factors as well as beliefs related to these lifestyle behaviours in women with GDM from pregnancy to a postpartum follow-up assessment. Methods: For the first aim a cross-sectional study was conducted on 239 pregnant women with GDM in Cape Town and for the second aim, 98 women were followed-up 3 to 15 months postpartum. Assessments included: a quantified Food Frequency Questionnaire (qFFQ), General Practice Physical Activity Questionnaire (GPPAQ) and beliefs relating to specific dietary components were assessed using the Theory of Planned Behaviour (TPB). Results: At baseline, the majority of the sample had inadequate intakes of vitamin D (87.4%), folate (96.5%) and iron (91.3%), and the dietary intake of these women was not optimal and fell short in meeting several nutritional guidelines for pregnant women with hyperglycaemia. At follow-up, the dietary changes made during pregnancy were not maintained postpartum. Fruit and vegetable intake (F&V) fell short of the recommended 400g intake at both baseline and follow-up. The intake of carbohydrates, added sugar, table sugar, sugar sweetened beverages (SSBs), pulses and energy-dense foods increased significantly from pregnancy to postpartum. In conclusion, women with prior GDM fail to maintain the dietary changes made during pregnancy. These women being at risk for the development of T2DM would benefit from interventions supporting behaviour change towards a healthier lifestyle in pregnancy and continued in the postpartum period.