Gestasyonel Diyabetes Mellitus Riski Olan Gebelerde Egzersiz Tutumlarının, Egzersizi Engelleyen ve Kolaylaştıran Faktörlerin İncelenmesi

Abstract

ABSTRACT ÖZDEMİR, M. Investigation of Exercise Attitudes and Factors That Prevent and Facilitate Exercise in Pregnant Women at Risk of Gestational Diabetes Mellitus. Hacettepe University, Graduate School of Health Sciences, Physical Therapy and Rehabilitation Program, Master Thesis, Ankara, 2023. This study was planned to examine and compare exercise attitudes, factors that prevent and facilitate exercise and physical activity levels in pregnant women who are at high and low risk of Gestational Diabetes Mellitus (GDM). A total of 183 pregnant women who met the inclusion criteria were divided into two groups as those at high GDM risk (n=86; age=31,00±4,00 years; pre-pregnancy Body Mass Index (BMI)=27,97±2,99 kg/m²) and at low GDM risk (n=97; age=29,00±4,00 years; pre-pregnancy BMI=21,43±1,81 kg/m²). Physical and socio-demographic characteristics, chronic diseases, characteristics of current and previous pregnancies, information about GDM, physical activity level and exercise habits before and during pregnancy, the stage of change in the transtheoretical model, and Oral Glucose Tolerance Test (OGTT) results were recorded. In addition, the psychological state was evaluated by the State-Trait Anxiety Inventory–state version and the Perceived Stress Scale. Exercise attitudes and factors that prevent and facilitate exercise were assessed by self-reported questions prepared based on the previous research. The level of physical activity was assesssed with the Pregnancy Physical Activity Questionnaire (PPAQ) and the SenseWear Pro3 Armband. As a result of this study, it was found that there was no significant difference between the high and low GDM risk groups in terms of self-reported exercise attitudes (p>0,05). Compared to pregnants with high GDM risk, pregnant women with low GDM risk reported that fatigue more frequently prevented participation in exercise (p<0,05). Compared to pregnant women who are at low-risk of GDM, the presence of stress urinary incontinence, gestational weight gain, and child care and family responsibilities are reported more frequently prevented the exercise participation of pregnant women at high GDM risk (p<0,05). It was found that improved health status by exercise and easy access to gyms/parks encouraged pregnant women with low GDM risk to exercise more frequently than pregnant women with high GDM risk (p<0,05). It was found that the amount of energy spent in physical activities (low, moderate, high-intensity and total activity), housework/family care and sports/exercise activities evaluated with the PPAQ was higher in pregnant women with high GDM risk than those with low GDM risk (p<0,05). Consistent with these findings, it was found that the amount of energy spent in sedentary behaviour was higher in pregnant women with low GDM risk than those with high GDM risk (p<0,05). However, physical activity duration and mean MET values evaluated by the accelerometer were found to be higher in pregnant women with low GDM risk than those with high GDM risk (p<0,05). The results of this study can guide health professionals in developing appropriate physical activity and exercise programs for pregnant women. Exercise programs designed by considering the exercise barriers and facilitators which are identified in this study may encourage the participation of pregnant women with GDM risk in exercise programs and may lead to behavioral changes in this pregnant population. Thus, the risk and prevalence of GDM may decrease in the Turkish population.

Keywords: Gestational diabetes mellitus, physical activity, attitudes, barriers, facilitators