Exercise in pregnant women and birth weight: a randomized controlled trial (original) (raw)
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Journal of Clinical Medicine, 2020
We studied the influence of pregnancy exercise on maternal/offspring cardiometabolic health until delivery and at follow-up. We pooled data from two randomized controlled trials from our group that were performed following the same methodology (one unpublished). We also collected follow-up data de novo from the participants of both trials and their offspring. In total, 1348 women with uncomplicated, singleton gestations were assigned to an intervention (n = 688, performing a supervised, moderate-intensity exercise program (three sessions/week)) or control group (n = 660). Maternal outcomes were excessive gestational weight gain (EGWG), gestational hypertension/diabetes and, at follow-up, return to pre-pregnancy weight within six months, hypertension, overweight/obesity, and other cardiometabolic conditions. Offspring outcomes were macrosomia and low-birthweight and, at follow-up, overweight/obesity, low-weight, and cardiometabolic conditions. Adherence to the intervention, which pro...
Physical Activity Assessment During Gestation and Its Outcomes: A Review
Background: Physical activity recommendations emphasize a positive influence of exercise on health. It is particularly recognized during pregnancy for both the mother and fetus. Aim: This review aims to identify the main trends of activity undertaken by women during gestation and to find out how it affects the expecting mother and her child. Methods: Review of the literature comprising the following databases: PubMed, Academic Search Complete, Health Source—Consumer Edition, Health Source: Nursing/Academic Edition, EMBASE (2000 to May 2013), used detailed search strategies. The review was restricted to experimental studies. Trials were excluded if they met any of the following criteria: reviews, letters, commentaries or editorials, only abstracts available, and any kind of pathology during pregnancy. Three assessors reviewed the titles, abstracts, and full articles using standardized data abstraction forms, and they assessed the study quality. A total of 474 potential articles remained for analyses. Findings: Twenty-eight articles were eligible for inclusion in the present review: randomized controlled trials and observational studies that evaluated maternal and offspring outcomes as a result of physical activity during pregnancy. Quasi-randomized trials were excluded. The activities that were most frequently assessed included occupational activity, housework/caregiving, sport/exercise, and active living, as well as habits. The authors evaluated different types of physical activity in the loading conditions. The aerobic activities most frequently used for assessment included treadmill walking program; step aerobics or stair stepper; aerobics; bicycle ergometer; combination of rowing, stationary cycling, and walk jogging; rhythmic calisthenics class and step class; brisk walks; stretching; and relaxation. The benefits following being active during pregnancy are associated with improved maternal psychological well-being, a reduced risk of preterm birth and excessive gestational weight gain, and lower risk of birth-related complications. Conclusions: Patterns of activity change during pregnancy. Although exercise is safe for both the mother and fetus, most women reduce their activity level during the first weeks of gestation. Specifically, physical activity tends to be of lower duration, frequency, and intensity. Therefore, women should be encouraged by professionals to initiate or continue exercising during a healthy pregnancy. Target Audience: Obstetricians and gynecologists, family physicians. Learning Objectives: After completing this activity, the learner should be better able to identify the main trends among pregnant women in terms of physical activity, investigate the main benefits following exercising during pregnancy, recognize the most popular forms of physical activity in pregnant population, and realize health professionals to make women more aware of the importance of exercise.
Background: Women with overweight or obesity (OWOB) have an increased risk of cesarean birth, preterm birth (PTB), and high birth weight infants. Although regular exercise decreases this risk in healthy weight women, these associations have not been explored in OWOB.Methods: Women were randomized at 13-16 weeks’ gestation to 150-minutes of moderate-intensity exercise (n=131) or non-exercising control (n=61). Delivery mode, gestational age (GA), and birth weight (BW) were obtained via electronic health records.Results: Pregnant exercisers had no differences in risk of cesarean birth, PTB, or BW compared to control participants. OWOB exercisers had higher rates of cesarean birth (27.1% vs. 11.1%), trends of higher PTB (15.3% vs. 5.6%), but normal weight babies relative to normal weight exercisers. Controlling for race and body mass index (BMI), maternal exercise reduced the relative risk (RR) for cesarean birth from 1.63 to 1.43. Cesarean births predicted by pre-pregnancy BMI and fitn...
BACKGROUND: Preterm birth (PTB) is the major cause of perinatal mortality in the United States. In the past, pregnant women have been recommended against exercise because of presumed risks of PTB. Physical activity has been theoretically related to PTB as it increases the release catecholamines, especially norepinephrine, which might stimulate myometrial activity. Conversely, exercise may reduce the risk of PTB by other mechanisms such as decreased oxidative stress or improved placenta vascularization. Therefore, the safety of exercise regarding PTB and its effects on gestational age at delivery remain controversial. OBJECTIVE: To evaluate the effects of exercise during pregnancy on the risk of PTB. DATA SOURCES: MEDLINE, EMBASE, Web of Sciences, Scopus, ClinicalTrial.gov, OVID and Cochrane Library were searched from the inception of each database to April 2016. METHODS OF STUDY SELECTION: Selection criteria included only randomized clinical trials (RCTs) of pregnant women randomized before 23 weeks to an aerobic exercise regimen or not. Types of participants included women mainly of normal weight with uncomplicated, singleton pregnancies without any obstetric contraindication to physical activity. The summary measures were reported as relative risk (RR) or as mean difference (MD) with 95% confidence intervals (CI). The primary outcome was the incidence of PTB <37weeks. TABULATION, INTEGRATION, AND RESULTS: Of the 2,059 women included in the meta-analysis, 1,022 (49.6%) were randomized to the exercise group and 1,037 (50.4%) to the control group. Aerobic exercise lasted about 35-90 minutes 3-4 times per week. Women who were randomized to aerobic exercise had a similar incidence of PTB<37 weeks (4.5% vs 4.4%; RR 1.01, 95% CI 0.68-1.50) and a similar mean gestational age at delivery (MD 0.05 week, 95% CI - 0.07 to 0.17) compared to controls. Women in the exercise group had a significantly higher incidence of vaginal delivery (73.6% vs 67.5%; RR 1.09, 95% CI 1.04-1.15) and significantly lower incidence of cesarean delivery (17.9% vs 22%; RR 0.82, 95% CI 0.69-0.97) compared to controls. The incidence of operative vaginal delivery (12.9% vs 16.5%; RR 0.78, 95% CI 0.61-1.01) was similar in both groups. Women in the exercise group had a significantly lower incidence of gestational diabetes mellitus (2.4% vs 5.9%; RR 0.41, 95% CI 0.24-0.68) and significantly lower incidence of hypertensive disorders (1.9% vs 5.1%; RR 0.36, 95% CI 0.19-0.69) compared to controls. No differences in low birth weight (5.2% vs 4.7%; RR 1.11, 95% CI 0.72-1.73) and mean birth weight (MD -10.46 grams, 95% CI -47.10 to 26.21) between exercise group and controls were found. CONCLUSION: Aerobic exercise for 35-90 minutes 3-4 times per week during pregnancy can be safely performed by normal-weight women with singleton, uncomplicated gestations, as this is not associated with an increased risk of PTB or with a reduction in mean gestational age at delivery. Exercise was associated with a significantly higher incidence of vaginal delivery and a significantly lower incidence of cesarean delivery, with a significantly lower incidence of gestational diabetes mellitus and hypertensive disorders, and therefore should be encouraged.
Influence of exercise mode on pregnancy outcomes: ENHANCED by Mom project
BMC pregnancy and childbirth, 2015
The extent of the benefits of exercise training during pregnancy on maternal, fetal, and neonatal health outcomes has not been sufficiently addressed. While aerobic exercise training has been determined as safe and efficacious throughout pregnancy, the effects of other training modes on fetal health and development as well as any continued benefits for the neonate, especially with regards to cardiovascular development and function, is largely unknown. In the ENHANCED by Mom study we aim to determine the effects of different modes of exercise training (aerobic, circuit, and resistance) throughout pregnancy on childhood health by controlling individual exercise programs and assessing the effects of each on fetal and neonatal health adaptations. ENHANCED by mom is a cross sectional comparison study utilizing 3 intervention groups in comparison to a control group. Participants will complete three 5 min warmup + 45 min sessions weekly from 16 weeks to 36 weeks gestation of aerobic, resis...
The Effect of Aerobic Exercises on Maternal Outcomes: A Randomized Controlled Clinical Trial
Women's Health Bulletin, 2016
Background: Exercise can play a major role in health during pregnancy. Therefore, it is essential to consider the physiological conditions of females regarding the exercise. Objectives: The present study aimed to determine the effect of a cycle of exercises on pregnancy outcomes. Methods: In this clinical trial, 120 pregnant females referring to Shiraz hospitals in 2015 were randomly divided into the intervention and control groups. The intervention group subjects were required to do aerobic exercises for eight weeks since the 20th week of gestation in addition to receiving the routine care. However, mothers in the control group only received the routine pregnancy care. Then, pregnancy outcomes such as length of pregnancy, delivery phases, type of delivery and infants' physiological indexes such as Apgar score, weight, height and head circumference were measured. Finally, the data were transferred into the SPSS statistical software and analyzed using T-test and Chi-square test. Results: The two study groups were similar based on their age, level of education, income, employment status and satisfaction with their husbands. Also, no significant difference was observed between the two groups regarding the length of pregnancy, weight, height and Apgar score at birth. However, a significant difference was observed between the two groups concerning type of delivery, duration of active phase of delivery and pain intensity in the active phase of delivery. In addition, back pain intensity significantly decreased in the intervention group, but increased with progress in pregnancy in the control group. Conclusions: Special attention is paid to supportive methods such as exercising during pregnancy in the recent years. Exercising has positive effects on mothers and infants health. Thus, these exercises are recommended to be incorporated in pregnancy care.
The Journal of Maternal-Fetal & Neonatal Medicine, 2019
Background: Growing evidence supports that physical activity and exercise during pregnancy is favourable for the mother, with persisting benefits in the postpartum period. However, there is scant knowledge of the effect of a prenatal exercise program on long-term health and lifestyle habits. Objectives: This 6-year follow-up study of a randomized controlled trial had two aims: 1) compare body weight, weight retention and body mass index (BMI) in the intervention group and control group, and 2) evaluate effects on physical activity level and recreational exercise. positive intervention effect at long-term follow up in body weight (kg) (62.8 ±7.9 vs. 70.8 ±11.8, p=0.03) and BMI (kg/m2) (22.5±3.1 vs. 24.8 ±4.0, p=0.05), and none (vs. 11 in the control group) had gained ≥ 5kg compared to pre-pregnancy weight (p=0.02). Conclusions: Women who adhered to the original prenatal exercise intervention demonstrated significantly lower body weight and BMI at 6-year follow-up. Otherwise, no long-term intervention effect was observed.
BMC Pregnancy and Childbirth
Background To investigate the effects of two different exercise interventions during pregnancy on gestational weight gain (GWG) and obstetric and neonatal outcomes compared to standard care. Additionally, we aimed to improve standardization of GWG measurements by developing a model to estimate GWG for a standardized pregnancy period of 40 weeks and 0 days accounting for individual differences in gestational age (GA) at delivery. Methods In a randomized controlled trial we compared the effects of structured supervised exercise training (EXE) three times per week throughout pregnancy versus motivational counselling on physical activity (MOT) seven times during pregnancy with standard care (CON) on GWG and obstetric and neonatal outcomes. Uniquely, to estimate GWG for a standardized pregnancy period, we developed a novel model to predict GWG based on longitudinally observed body weights during pregnancy and at admission for delivery. Observed weights were fitted to a mixed effects mode...