Abstract
Prenatal physical activity (PA) was discussed to decrease the incidence of obstetric and neonatal complications. In this secondary cohort analysis of the cluster-randomized GeliS (“healthy living in pregnancy”) trial, associations between prenatal PA and such outcomes were investigated. PA behavior was assessed twice, before or during the 12th week (baseline, T0) and after the 29th week of gestation (T1), using the self-reported Pregnancy Physical Activity Questionnaire. Obstetric and neonatal data were collected in the routine care setting. Data were available for 87.2% (n = 1994/2286) of participants. Significant differences between the offspring of women who adhered to PA recommendations at T1 and offspring of inactive women were found in birth weight (p = 0.030) but not in other anthropometric parameters. Sedentary behavior was inversely associated with birth weight at T1 (p = 0.026) and, at both time points, with an increase in the odds of low birth weight (T0: p = 0.004, T1: p = 0.005). Light-intensity PA at T0 marginally increased the odds of caesarean section (p = 0.032), but neither moderate-intensity nor vigorous-intensity activity modified the risk for caesarean delivery at any time point. The present analyses demonstrated associations between prenatal PA and some neonatal and obstetric outcomes.
Highlights
Worldwide, more than 41 million children under 5 years of age are affected by childhood obesity and being overweight, which poses one of the major challenges of the 21st century [1]
Significant differences between the offspring of women who adhered to physical activity (PA) recommendations at T1 and offspring of inactive women were found in birth weight (p = 0.030) but not in other anthropometric parameters
We found evidence that infants of women who adhered to PA recommendations at both time points were more likely of being born large for gestational age (LGA) when compared to infants of women who either met the recommendations once or at no time point (Table S2, adjusted p = 0.025)
Summary
More than 41 million children under 5 years of age are affected by childhood obesity and being overweight, which poses one of the major challenges of the 21st century [1]. Neonatal outcomes such as high birth weight (>4000 g) and being born large for gestational age (LGA; >90th percentile for gestational age) were shown to be early markers for an increased obesity risk in infancy [3,4]. A healthy lifestyle during pregnancy is discussed to enhance the maternal health status, positively impact fetal development, and improve neonatal as well as obstetric outcomes [5,6]. While some reported PA to lower the risk for LGA and high birth weight [8,9], others suggested positive associations between PA and birth weight dependent on the PA intensity [10]. The activity mode, time point during pregnancy, and intensity seem to be important in this heterogeneous picture on the effect of PA on neonatal and obstetric parameters. No negative effects of prenatal PA on obstetric or neonatal outcomes have been found so far
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