محمدحسین باقیانی مقدم

Progressive insulin resistance (IR) is a physiologic state during pregnancy which could be ended to gestational diabetes. Given the relationship between weight and insulin resistance (IR), the study of the association between nutrients intake and insulin resistance is particularly rational and predictive.

The current descriptive cross-sectional study was performed on 138 nulliparous women with healthy and single pregnancies. Individual characteristics were collected by a researcher-administered questionnaire. At 6th</sup>-10th</sup> weeks of pregnancy, physical activity scores and nutrients intake were determined using the Pregnancy Physical Activity Questionnaire and 24-hour recall for three consecutive days, respectively. At the same time, fasting serum glucose and insulin levels were also measured to calculate IR by the formula.

Square root transformation of IR index at the first trimester was significantly correlated with household income, occupational activity, pre-pregnancy body mass index (BMI), weight, and physical activity at 6th</sup>-10th</sup> weeks of gestation. However, after adjusting the effect of related variables, household income and maternal weight were significantly associated with IR, and occupational activity had a trend toward the significant association. Moreover, vitamin D, linolenic acid, beta-carotene, vitamin E, and carbohydrate intake were significantly correlated with IR index. However, after adjusting for the related variables, vitamin E had a direct significant relationship with IR, and glucose and maltose intakes were inversely associated with IR.</div>

Significant association between household income and maternal weight at the first trimester can be used to control IR, which is a key component for gestational diabetes. The association of vitamin E, glucose, and maltose intakes with IR may be a guide to get new results. We suggest further studies about the association between occupational activity and insulin resistance in pregnant women.

Weight gain more than the recommended range by the Institute of Medicine (IOM) is one of the most common complications of pregnancy, which would be ended to gestational diabetes, preeclampsia, cesarean section, or maternal, and child obesity. Few successful studies in this area include nutrition and physical activity. We examined a simple, practical, and cost-effective solution as nutrition training based on the Pender’s model, because this is one of the most effective patterns for nutritional behavior.

This single-blind randomized controlled clinical trial study was performed on 192 nulliparous pregnant women. During training sessions, mothers of intervention group learned how to prevent excessive weight gain over healthy eating habits. Mothers’ weight, nutrients intake, and physical activity levels were estimated before, during, and after intervention.

The constructs of perceived benefits, perceived self-efficacy, behavior-related feelings, interpersonal influences, competing demands and preferences, and commitment to action increased significantly. In the intervention group, 58.6% gained weight within the recommended range compared to 50.0% in control group. Moreover, 28.7% in the intervention group versus 45.6% in the control gained weight more than the IOM limits while 12.6% in the intervention group and 4.4% in the control gained weight less (P = 0.020). The perceived self-efficacy and commitment to the plan constructs were associated with normal weight gaining.

Pender model-based nutrition education considering the national guideline prevented excessive gestational weight gain in pregnant women.