Physical activity, obesity, gestational diabetes and type 2 diabetes in pregnancy, short and long term outcomes in a multiethnic population

Background The life course approach may be a rational manner to study the epidemic of obesity and type 2 diabetes (T2DM) and to identify entry points for preventive measures. Gestational diabetes (GDM) is a risk factor for mother and child, and in additio n identifies a population of high risk for later T2DM. Certain ethnic groups are at special high risk. Aim In a multiethnic community in Eastern Oslo, to develop methods for identification of high risk pregnancies to reduce pregnancy and delivery complica tions and improve long term health for mother and child. Methods Population based, prospective cohort study of 1000 pregnant women (70% non-western). A wide range of exposures (socioeconomic and cultural factors, nutrition, physical activity, biochemical markers) and outcome data (GDM, T2DM, fetal growth, birth weight, complications for mother and child) will be collected. Associations between exposures and outcomes will be studied Two main research topics, each with four subtopics I: GDM, T2DM, complicat ions and predictive factors 1. Ethnic differences in the prevalence of GDM, T2DM, physical inactivity and obesity. 2. Predictors of hyperglycaemia and GDM by ethnicity. 3. Pregnancy outcomes (mother and child) by ethnicity and diabetes status. 4. GDM and glucose metabolism 12 weeks p.partum II: Fetal growth, birth weight, pregnancy and delivery complications and predictive factors 1. Fetal growth, birth weight, pregnancy complications by ethnicity. 2.Associations of mothers' life style, adiposity, metabol ic factors and fetal growth/birth weight. 3. Association of inflammatory and hormonal factors with fetal growth/birth weight 4. Comparison of estimated and actual birth weight in women with/without GDM. Societal relevance The project highlights potential health hazards of women in multiethnic districts with low socioeconomic status. Knowledge is needed about societal and individual health determinants in these groups for later planned culture sensitive interventions