Structured group education programme and accompanying mHealth intervention to promote physical activity in women with a history of gestational diabetes (Baby Steps): 4-year follow-up of a randomised controlled trial

<p dir="ltr">Gestational diabetes mellitus (GDM) is associated with a substantially increased risk of developing type 2 diabetes mellitus (T2DM), with up to 50% of women progressing to prediabetes or T2DM within 10 years postnatal.1 Despite guidance from the National Institute for Health and Care Excellence recommending postnatal lifestyle advice and monitoring,2 long-term engagement remains low.3 We developed and evaluated the Baby Steps programme, a group-based education intervention and mHealth application, designed to promote physical activity (PA) in a multi-ethnic UK cohort of women with recent GDM.4</p><p dir="ltr"><br></p><p dir="ltr">In our previously published randomised controlled trial (RCT), the Baby Steps intervention led to improvements in self-efficacy for exercise, quality of life, and anxiety, and the primary outcome of objectively measured PA showed a non-significant but potentially clinically significant between-group difference at 12 months (equivalent to an additional ~500 steps/day).5 The intervention was shown to be cost-effective and has been implemented into routine care internationally.</p><p dir="ltr"><br></p><p dir="ltr">Few studies have reported long-term outcomes following lifestyle interventions in women with prior GDM. In this study, we report 4-year follow-up data from the Baby Steps trial cohort,5 assessing the long-term impact of the intervention on behavioural, psychosocial, and clinical outcomes.</p>