{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T15:04:07Z","timestamp":1772118247179,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["2022XD004"],"award-info":[{"award-number":["2022XD004"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Emerging evidence links low physical activity (PA) and dysregulated lipid metabolism to gestational diabetes mellitus (GDM) risk. This study aimed to determine which gestational stage is more vulnerable to low PA and whether changes in blood lipids mediate this risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted among 3997 pregnant women (614 with GDM) during the COVID\u201019 lockdown in Shanghai, a unique natural experiment provided by the uniform imposition of PA restrictions. Multivariable logistic regression estimated the association between low PA at different gestational stages and GDM risk, while mediation analyses explored the role of blood lipids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Women with GDM were older and had higher rates of overweight\/obesity compared with non\u2010GDM participants. Notably, the GDM group exhibited a higher prevalence of low PA during early pregnancy and elevated lipid levels. Logistic regression demonstrated that low PA during early pregnancy was significantly associated with increased GDM risk (OR\u00a0=\u00a02.041, 95% CI: 1.577\u20132.644). Moreover, low PA was significantly linked to dysregulated lipid profiles in both early and mid\u2010pregnancy. Mediation analysis further indicated that elevated total cholesterol (TC) levels partially mediated this relationship. In contrast, low PA in mid\u2010pregnancy was not directly linked to GDM (OR\u00a0=\u00a01.244, 95% CI: 0.966\u20131.6), although increased triglyceride (TG) levels during this stage mediated an effect on GDM risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early pregnancy is a critical window for GDM prevention. Additionally, these findings advocate for stage\u2010specific exercise and lipid management strategies to reduce GDM risk and improve maternal and neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dmrr.70082","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T05:54:59Z","timestamp":1756187699000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Differential Impact of Early Versus Mid\u2010Pregnancy Physical Activity on Gestational Diabetes Mellitus: The Mediation Effect of Blood Lipid Profiles"],"prefix":"10.1002","volume":"41","author":[{"given":"Jing","family":"Peng","sequence":"first","affiliation":[{"name":"Shanghai Key Laboratory of Embryo Original Diseases The International Peace Maternity and Child Health Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Department of Obstetrics and Gynecology Hainan Branch Shanghai Children's Medical Center School of Medicine Shanghai Jiao Tong University  Sanya China"},{"name":"Department of Obstetrics and Gynecology Shanghai First Maternity and Infant Hospital School of Medicine Tongji University  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Jiao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hainan Branch Shanghai Children's Medical Center School of Medicine Shanghai Jiao Tong University  Sanya China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen","family":"Huang","sequence":"additional","affiliation":[{"name":"Changning Maternity and Infant Health Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feixue","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Shanghai First Maternity and Infant Hospital School of Medicine Tongji University  Shanghai 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