Summary: In a feasibility pilot in people with pregnancy hyperglycaemia, a 5-week remote coaching programme promoting walking was highly acceptable and mitigated the usual late-pregnancy decline in moderate activity, with only a preliminary suggestion of improved neonatal body composition.
PICO Summary
| Element | Detail |
|---|---|
| Population | 20 individuals with pregnancy hyperglycaemia; randomised controlled pilot trial, USA. |
| Intervention | 5-week behavioural physical-activity programme promoting unsupervised walking or stepping, delivered remotely via weekly 10–20 minute coaching sessions (n=10). |
| Comparison | General wellness counselling without physical-activity, diet, or metabolism guidance. |
| Outcome | The primary aim was feasibility: 26% of eligible individuals enrolled, 95% completed follow-up, and 90% of the activity group completed the programme, rating it excellent (56%) or very good (44%). The intervention mitigated late-pregnancy decline in self-reported walking/running activity (+0.22 vs -0.70 MET h/week). There was a suggestion of better neonatal birthweight-for-gestational-age score and subscapular skinfold, but the pilot was not powered for these. |
Expert Commentary
This is a feasibility pilot, and it should be read as one: its job was to establish whether a remotely delivered walking-coaching programme can be recruited to and completed in pregnancy hyperglycaemia, not to prove it improves outcomes. On that question it did reasonably well, with high completion and excellent acceptability, and the brief remote format is attractive because it fits telehealth workflows and the late-pregnancy period when activity typically falls. The behavioural signal, maintaining activity against the usual third-trimester decline, is plausible and worthwhile. The neonatal findings, however, must be reported with restraint, since the study itself frames them only as a suggestion, and with 20 participants and self-reported activity subject to recall and social-desirability bias, they are hypothesis-generating at most. The active wellness comparator makes this a conservative test, and glycaemic outcomes were not detailed. Can I use this with my patients? Yes, in spirit rather than as proven therapy. Encouraging safe walking in pregnancy hyperglycaemia, absent obstetric contraindications, is sound advice regardless of this trial, and brief coaching is a reasonable support, while I await an adequately powered efficacy trial before claiming benefit for the baby.
References
Ehrlich SF, Hallenbeck BR, Zite NB, et al. A randomized controlled pilot trial of a behavioral physical activity intervention for pregnancy hyperglycemia. J Pregnancy. 2025;2025:7485092. doi:10.1155/jp/7485092