human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective The study was to examine whether gestational diabetes mellitus ( GDM ) can be prevented by early trimester lifestyle counseling in a high-risk population . Methods From September 2012 to January 2013 , 1664 pregnancies in the Department of Obstetrics and Gynecology of First Hospital of Peking University were enrolled in the study during their first prenatal care visit before the 8 gestational weeks visit and asked to fill out a question naire on GDM risk evaluation . According to the question naire and medical records , those with at least one risk factor of GDM were included in the intervention study and r and omly allocated to two groups , intervention group and control group . Routine prenatal care was offered , while st and ardized two-step lifestyle intervention was provided to the intervention group during 6–8 gestational weeks , and at 12–13 gestational weeks , enforcement intervention based on maternal anthropometrics were offered . Both groups were followed until 75 g oral glucose tolerance test ( OGTT ) testing at 24–28 gestational weeks . The weight gain after intervention and the prevalence of GDM were used to evaluate the effect . Results ( 1 ) According to the International Association of Diabetes and Pregnancy Study Groups ( IADPSG ) criteria , the positive rate of GDM for the intervention group was 17.16 % ( 23/134 ) , lower than the control group which was 23.91 % ( 33/138 ) , P = 0.168 . ( 2 ) The weight gain during the first and second trimester for the intervention group was ( 1.38 ± 2.34 ) kg and ( 5.51 ± 2.18 ) kg , lower than in the control group which was ( 1.41 ± 2.58 ) kg and ( 5.66 ± 2.25 ) kg , ( P = 0.905 , P = 0.567 ) . ( 3 ) Positive rate of GDM for those fasting plasma glucose ( FPG ) ≥5.1 mmol/L during early pregnancy was 11/36 ( 30.55 % ) for the intervention group that was lower than 17/37 ( 45.95 % ) for the control group , but the statistical difference was not significant ( P = 0.076 ) . Conclusion The positive rate of GDM could be reduced by a certain amount lifestyle intervention from the beginning of pregnancy . More vali date d effective intervention should be explored in the high-risk pregnant women Background In conjunction with the growing prevalence of obesity and the older age of pregnant women gestational diabetes ( GDM ) is a major health problem . The aim of the study was to evaluate if a lifestyle intervention since early pregnancy is feasible in improving the glucose tolerance of women at a high-risk for GDM in Finl and . Methods A 75-g oral glucose tolerance test ( OGTT ) was performed in early pregnancy ( n = 102 ) . Women at high risk for GDM ( n = 54 ) were r and omized at weeks 8 - 12 from Apr 2005 to May 2006 to a lifestyle intervention group ( n = 27 ) or to a close follow-up group ( n = 27 ) . An OGTT was performed again at weeks 26 - 28 for the lifestyle intervention and close follow-up groups . Results The values of the OGTT during the second trimester did not differ between the lifestyle intervention and close follow-up groups . In the lifestyle intervention group three women had GDM in the second trimester and respectively one woman in the close follow up group . Insulin therapy was not required in both groups . The intervention result ed in somewhat lower weight gain 11.4 ± 6.0 kg vs. 13.9 ± 5.1 kg , p = 0.062 , adjusted by the prepregnancy weight . Conclusions Early intervention with an OGTT and simple lifestyle advice is feasible . A more intensive lifestyle intervention did not offer additional benefits with respect to glucose tolerance , although it tended to ameliorate the weight gain . Trial Registration Clinical Trials.gov : OBJECTIVE While previous studies have shown the potential effects of yoga in normal pregnancies , this r and omized controlled trial investigated the effects of yoga in prevention of pregnancy complications in high-risk pregnancies for the first time . METHODS 68 high-risk pregnant women were recruited from two maternity hospitals in Bengaluru , India and were r and omized into yoga and control groups . The yoga group ( n=30 ) received st and ard care plus one-hour yoga sessions , three times a week , from the 12th to the 28th week of gestation . The control group ( n=38 ) received st and ard care plus conventional antenatal exercises ( walking ) during the same period . RESULTS Significantly fewer pregnancy induced hypertension ( PIH ) , preeclampsia , gestational diabetes ( GDM ) and intrauterine growth restriction ( IUGR ) cases were observed in the yoga group ( p=0.018 , 0.042 , 0.049 , 0.05 respectively ) . Significantly fewer Small for Gestational Age ( SGA ) babies and newborns with low APGAR scores ( p=0.006 ) were born in the yoga group ( p=0.033 ) . CONCLUSION This first r and omized study of yoga in high-risk pregnancy has shown that yoga can potentially be an effective therapy in reducing hypertensive related complications of pregnancy and improving fetal outcomes . Additional data is needed to confirm these results and better explain the mechanism of action of yoga in this important area In this prospect i ve study 246 women with gestational diabetes were followed up to determine the characteristics of metabolic control associated with large-for-gestational-age infants . Memory-based reflectance meters were used for self-monitoring blood glucose . Ambulatory glucose profiles were produced to characterize glycemic control levels throughout pregnancy . With these novel approaches to the collection and representation of glucose data , the severity of glucose intolerance ( hyperglycemia ) was found to be associated with both maternal and neonatal morbidity in terms of infant size and cesarean section rate . By use of hierarchical cluster analysis to identify three groups on the basis of control levels ( low less than 87 mg/dl , mid 87 to 105 mg/dl , high greater than 105 mg/dl ) we were able to show a positive outcome in the low group with reduced rates of large-for-gestational-age ( 2 % ) and macrosomatic ( 0 % ) infants . Furthermore , we showed that as mean blood glucose levels and instability in glycemic control increased from group to group , incidence of large-for-gestational-age and macrosomatic infants increased . Whereas obesity increased the relative risk of adverse neonatal outcome , type of treatment ( insulin versus diet ) did not appear to be significant . Appropriately monitored toward stability within a narrow range to achieve tight metabolic control , ambulatory glycemia in pregnancy is associated with a decreased risk of maternal and fetal complications OBJECTIVE : To examine the effect of an individually tailored , motivationally matched prenatal exercise intervention on gestational diabetes mellitus ( GDM ) and other measures of glucose intolerance among ethnically diverse prenatal care patients at increased risk for GDM . METHODS : The Behaviors Affecting Baby and You study r and omized eligible women at a mean ( st and ard deviation ) of 18.2 ( 4.1 ) weeks of gestation to a 12-week individually tailored , motivationally matched exercise intervention or a comparison health and wellness intervention . The goal of the exercise intervention was to achieve the American College of Obstetricians and Gynecologists ' guidelines for physical activity during pregnancy . Diagnosis of GDM , impaired glucose tolerance , abnormal glucose screen , and screening glucose values ( mg/dL ) were abstract ed from medical records . A sample size of 352 women ( 176 per group ) was planned to have 80 % power to detect reductions in risk of 35 % or larger . RESULTS : From July 2007 to December 2012 , a total of 251 ( 86.5 % ) women completed the intervention ; n=124 and 127 in the exercise and comparison interventions , respectively . Based on an intention-to-treat analysis , no statistically significant differences between the intervention groups were observed ; the relative odds of GDM in the exercise group was 0.61 ( 95 % confidence interval [ CI ] 0.28–1.32 ) as compared with the health and wellness comparison group . Odds ratios for impaired glucose tolerance and abnormal glucose screen were 0.68 ( 95 % CI 0.35–1.34 ) and 0.86 ( 95 % CI 0.51–1.47 ) , respectively . The intervention had no effect on birth outcomes . CONCLUSION : In this r and omized trial among ethnically diverse pregnant women at increased risk for GDM , we found that a prenatal exercise intervention implemented in the second trimester did not result in a statistically significant reduction in relative odds for GDM , impaired glucose tolerance , or abnormal glucose screen . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT00728377 . LEVEL OF EVIDENCE : BACKGROUND We conducted a r and omized clinical trial to determine whether treatment of women with gestational diabetes mellitus reduced the risk of perinatal complications . METHODS We r and omly assigned women between 24 and 34 weeks ' gestation who had gestational diabetes to receive dietary advice , blood glucose monitoring , and insulin therapy as needed ( the intervention group ) or routine care . Primary outcomes included serious perinatal complications ( defined as death , shoulder dystocia , bone fracture , and nerve palsy ) , admission to the neonatal nursery , jaundice requiring phototherapy , induction of labor , cesarean birth , and maternal anxiety , depression , and health status . RESULTS The rate of serious perinatal complications was significantly lower among the infants of the 490 women in the intervention group than among the infants of the 510 women in the routine-care group ( 1 percent vs. 4 percent ; relative risk adjusted for maternal age , race or ethnic group , and parity , 0.33 ; 95 percent confidence interval , 0.14 to 0.75 ; P=0.01 ) . However , more infants of women in the intervention group were admitted to the neonatal nursery ( 71 percent vs. 61 percent ; adjusted relative risk , 1.13 ; 95 percent confidence interval , 1.03 to 1.23 ; P=0.01 ) . Women in the intervention group had a higher rate of induction of labor than the women in the routine-care group ( 39 percent vs. 29 percent ; adjusted relative risk , 1.36 ; 95 percent confidence interval , 1.15 to 1.62 ; P<0.001 ) , although the rates of cesarean delivery were similar ( 31 percent and 32 percent , respectively ; adjusted relative risk , 0.97 ; 95 percent confidence interval , 0.81 to 1.16 ; P=0.73 ) . At three months post partum , data on the women 's mood and quality of life , available for 573 women , revealed lower rates of depression and higher scores , consistent with improved health status , in the intervention group . CONCLUSIONS Treatment of gestational diabetes reduces serious perinatal morbidity and may also improve the woman 's health-related quality of life Objective The influence of an exercise programme performed by healthy pregnant women on maternal glucose tolerance was studied . Study design A physical activity ( PA , l and /aquatic activities ) programme during the entire pregnancy ( three sessions per week ) was conducted by a qualified instructor . 83 healthy pregnant women were r and omly assigned to either an exercise group ( EG , n=40 ) or a control ( CG , n=43 ) group . 50 g maternal glucose screen ( MGS ) , maternal weight gain and several pregnancy outcomes were recorded . Results Significant differences were found between study groups on the 50 g MGS . Values corresponding to the EG ( 103.8±20.4 mg/dl ) were better than those of the CG ( 126.9±29.5 mg/dl ) , p=0.000 . In addition , no differences in maternal weight gain and no cases of gestational diabetes in EG versus 3 in CG ( 7 % ) ( p>0.05 ) were found . Conclusion A moderate PA programme performed during pregnancy improves levels of maternal glucose tolerance The ten- to 16-year predictive value of body weight for diabetes mellitus was evaluated prospect ively in two groups of women with initially normal results of glucose tolerance tests . The incidence of diabetes in 602 high-risk ( previous transient gestational glucose intolerance ) participants was significantly higher for overweight subjects ( 46.7 % ) than for those of normal weight ( 25.6 % ) . In 328 concurrently selected negative control subjects ( without previous intolerance ) , the difference was not significant ( 4.5 % v 1.9 % ) . Another definition of diabetes , indicating further deterioration , gave similar results , although high-risk overweight women had disproportionately higher incidence rates . Being overweight had no substantial predictive value for diabetes mellitus 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective The study was to examine whether gestational diabetes mellitus ( GDM ) can be prevented by early trimester lifestyle counseling in a high-risk population . Methods From September 2012 to January 2013 , 1664 pregnancies in the Department of Obstetrics and Gynecology of First Hospital of Peking University were enrolled in the study during their first prenatal care visit before the 8 gestational weeks visit and asked to fill out a question naire on GDM risk evaluation . According to the question naire and medical records , those with at least one risk factor of GDM were included in the intervention study and r and omly allocated to two groups , intervention group and control group . Routine prenatal care was offered , while st and ardized two-step lifestyle intervention was provided to the intervention group during 6–8 gestational weeks , and at 12–13 gestational weeks , enforcement intervention based on maternal anthropometrics were offered . Both groups were followed until 75 g oral glucose tolerance test ( OGTT ) testing at 24–28 gestational weeks . The weight gain after intervention and the prevalence of GDM were used to evaluate the effect . Results ( 1 ) According to the International Association of Diabetes and Pregnancy Study Groups ( IADPSG ) criteria , the positive rate of GDM for the intervention group was 17.16 % ( 23/134 ) , lower than the control group which was 23.91 % ( 33/138 ) , P = 0.168 . ( 2 ) The weight gain during the first and second trimester for the intervention group was ( 1.38 ± 2.34 ) kg and ( 5.51 ± 2.18 ) kg , lower than in the control group which was ( 1.41 ± 2.58 ) kg and ( 5.66 ± 2.25 ) kg , ( P = 0.905 , P = 0.567 ) . ( 3 ) Positive rate of GDM for those fasting plasma glucose ( FPG ) ≥5.1 mmol/L during early pregnancy was 11/36 ( 30.55 % ) for the intervention group that was lower than 17/37 ( 45.95 % ) for the control group , but the statistical difference was not significant ( P = 0.076 ) . Conclusion The positive rate of GDM could be reduced by a certain amount lifestyle intervention from the beginning of pregnancy . More vali date d effective intervention should be explored in the high-risk pregnant women Background In conjunction with the growing prevalence of obesity and the older age of pregnant women gestational diabetes ( GDM ) is a major health problem . The aim of the study was to evaluate if a lifestyle intervention since early pregnancy is feasible in improving the glucose tolerance of women at a high-risk for GDM in Finl and . Methods A 75-g oral glucose tolerance test ( OGTT ) was performed in early pregnancy ( n = 102 ) . Women at high risk for GDM ( n = 54 ) were r and omized at weeks 8 - 12 from Apr 2005 to May 2006 to a lifestyle intervention group ( n = 27 ) or to a close follow-up group ( n = 27 ) . An OGTT was performed again at weeks 26 - 28 for the lifestyle intervention and close follow-up groups . Results The values of the OGTT during the second trimester did not differ between the lifestyle intervention and close follow-up groups . In the lifestyle intervention group three women had GDM in the second trimester and respectively one woman in the close follow up group . Insulin therapy was not required in both groups . The intervention result ed in somewhat lower weight gain 11.4 ± 6.0 kg vs. 13.9 ± 5.1 kg , p = 0.062 , adjusted by the prepregnancy weight . Conclusions Early intervention with an OGTT and simple lifestyle advice is feasible . A more intensive lifestyle intervention did not offer additional benefits with respect to glucose tolerance , although it tended to ameliorate the weight gain . Trial Registration Clinical Trials.gov : OBJECTIVE While previous studies have shown the potential effects of yoga in normal pregnancies , this r and omized controlled trial investigated the effects of yoga in prevention of pregnancy complications in high-risk pregnancies for the first time . METHODS 68 high-risk pregnant women were recruited from two maternity hospitals in Bengaluru , India and were r and omized into yoga and control groups . The yoga group ( n=30 ) received st and ard care plus one-hour yoga sessions , three times a week , from the 12th to the 28th week of gestation . The control group ( n=38 ) received st and ard care plus conventional antenatal exercises ( walking ) during the same period . RESULTS Significantly fewer pregnancy induced hypertension ( PIH ) , preeclampsia , gestational diabetes ( GDM ) and intrauterine growth restriction ( IUGR ) cases were observed in the yoga group ( p=0.018 , 0.042 , 0.049 , 0.05 respectively ) . Significantly fewer Small for Gestational Age ( SGA ) babies and newborns with low APGAR scores ( p=0.006 ) were born in the yoga group ( p=0.033 ) . CONCLUSION This first r and omized study of yoga in high-risk pregnancy has shown that yoga can potentially be an effective therapy in reducing hypertensive related complications of pregnancy and improving fetal outcomes . Additional data is needed to confirm these results and better explain the mechanism of action of yoga in this important area In this prospect i ve study 246 women with gestational diabetes were followed up to determine the characteristics of metabolic control associated with large-for-gestational-age infants . Memory-based reflectance meters were used for self-monitoring blood glucose . Ambulatory glucose profiles were produced to characterize glycemic control levels throughout pregnancy . With these novel approaches to the collection and representation of glucose data , the severity of glucose intolerance ( hyperglycemia ) was found to be associated with both maternal and neonatal morbidity in terms of infant size and cesarean section rate . By use of hierarchical cluster analysis to identify three groups on the basis of control levels ( low less than 87 mg/dl , mid 87 to 105 mg/dl , high greater than 105 mg/dl ) we were able to show a positive outcome in the low group with reduced rates of large-for-gestational-age ( 2 % ) and macrosomatic ( 0 % ) infants . Furthermore , we showed that as mean blood glucose levels and instability in glycemic control increased from group to group , incidence of large-for-gestational-age and macrosomatic infants increased . Whereas obesity increased the relative risk of adverse neonatal outcome , type of treatment ( insulin versus diet ) did not appear to be significant . Appropriately monitored toward stability within a narrow range to achieve tight metabolic control , ambulatory glycemia in pregnancy is associated with a decreased risk of maternal and fetal complications OBJECTIVE : To examine the effect of an individually tailored , motivationally matched prenatal exercise intervention on gestational diabetes mellitus ( GDM ) and other measures of glucose intolerance among ethnically diverse prenatal care patients at increased risk for GDM . METHODS : The Behaviors Affecting Baby and You study r and omized eligible women at a mean ( st and ard deviation ) of 18.2 ( 4.1 ) weeks of gestation to a 12-week individually tailored , motivationally matched exercise intervention or a comparison health and wellness intervention . The goal of the exercise intervention was to achieve the American College of Obstetricians and Gynecologists ' guidelines for physical activity during pregnancy . Diagnosis of GDM , impaired glucose tolerance , abnormal glucose screen , and screening glucose values ( mg/dL ) were abstract ed from medical records . A sample size of 352 women ( 176 per group ) was planned to have 80 % power to detect reductions in risk of 35 % or larger . RESULTS : From July 2007 to December 2012 , a total of 251 ( 86.5 % ) women completed the intervention ; n=124 and 127 in the exercise and comparison interventions , respectively . Based on an intention-to-treat analysis , no statistically significant differences between the intervention groups were observed ; the relative odds of GDM in the exercise group was 0.61 ( 95 % confidence interval [ CI ] 0.28–1.32 ) as compared with the health and wellness comparison group . Odds ratios for impaired glucose tolerance and abnormal glucose screen were 0.68 ( 95 % CI 0.35–1.34 ) and 0.86 ( 95 % CI 0.51–1.47 ) , respectively . The intervention had no effect on birth outcomes . CONCLUSION : In this r and omized trial among ethnically diverse pregnant women at increased risk for GDM , we found that a prenatal exercise intervention implemented in the second trimester did not result in a statistically significant reduction in relative odds for GDM , impaired glucose tolerance , or abnormal glucose screen . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , www . clinical trials.gov , NCT00728377 . LEVEL OF EVIDENCE : BACKGROUND We conducted a r and omized clinical trial to determine whether treatment of women with gestational diabetes mellitus reduced the risk of perinatal complications . METHODS We r and omly assigned women between 24 and 34 weeks ' gestation who had gestational diabetes to receive dietary advice , blood glucose monitoring , and insulin therapy as needed ( the intervention group ) or routine care . Primary outcomes included serious perinatal complications ( defined as death , shoulder dystocia , bone fracture , and nerve palsy ) , admission to the neonatal nursery , jaundice requiring phototherapy , induction of labor , cesarean birth , and maternal anxiety , depression , and health status . RESULTS The rate of serious perinatal complications was significantly lower among the infants of the 490 women in the intervention group than among the infants of the 510 women in the routine-care group ( 1 percent vs. 4 percent ; relative risk adjusted for maternal age , race or ethnic group , and parity , 0.33 ; 95 percent confidence interval , 0.14 to 0.75 ; P=0.01 ) . However , more infants of women in the intervention group were admitted to the neonatal nursery ( 71 percent vs. 61 percent ; adjusted relative risk , 1.13 ; 95 percent confidence interval , 1.03 to 1.23 ; P=0.01 ) . Women in the intervention group had a higher rate of induction of labor than the women in the routine-care group ( 39 percent vs. 29 percent ; adjusted relative risk , 1.36 ; 95 percent confidence interval , 1.15 to 1.62 ; P<0.001 ) , although the rates of cesarean delivery were similar ( 31 percent and 32 percent , respectively ; adjusted relative risk , 0.97 ; 95 percent confidence interval , 0.81 to 1.16 ; P=0.73 ) . At three months post partum , data on the women 's mood and quality of life , available for 573 women , revealed lower rates of depression and higher scores , consistent with improved health status , in the intervention group . CONCLUSIONS Treatment of gestational diabetes reduces serious perinatal morbidity and may also improve the woman 's health-related quality of life Objective The influence of an exercise programme performed by healthy pregnant women on maternal glucose tolerance was studied . Study design A physical activity ( PA , l and /aquatic activities ) programme during the entire pregnancy ( three sessions per week ) was conducted by a qualified instructor . 83 healthy pregnant women were r and omly assigned to either an exercise group ( EG , n=40 ) or a control ( CG , n=43 ) group . 50 g maternal glucose screen ( MGS ) , maternal weight gain and several pregnancy outcomes were recorded . Results Significant differences were found between study groups on the 50 g MGS . Values corresponding to the EG ( 103.8±20.4 mg/dl ) were better than those of the CG ( 126.9±29.5 mg/dl ) , p=0.000 . In addition , no differences in maternal weight gain and no cases of gestational diabetes in EG versus 3 in CG ( 7 % ) ( p>0.05 ) were found . Conclusion A moderate PA programme performed during pregnancy improves levels of maternal glucose tolerance The ten- to 16-year predictive value of body weight for diabetes mellitus was evaluated prospect ively in two groups of women with initially normal results of glucose tolerance tests . The incidence of diabetes in 602 high-risk ( previous transient gestational glucose intolerance ) participants was significantly higher for overweight subjects ( 46.7 % ) than for those of normal weight ( 25.6 % ) . In 328 concurrently selected negative control subjects ( without previous intolerance ) , the difference was not significant ( 4.5 % v 1.9 % ) . Another definition of diabetes , indicating further deterioration , gave similar results , although high-risk overweight women had disproportionately higher incidence rates . Being overweight had no substantial predictive value for diabetes mellitus 
    Output:
    