Improvements In Maternal Health Research Articles

Exploring the association between the constitutional right to health and reproductive health outcomes in 157 countries

Panel data from 157 countries, between 1970 and 2007, were used to study the associations between introducing an explicit and enforceable right to health into national constitutions and subsequent reductions in neonatal, infant, and maternal mortality and the probability of dying for adult women. The introduction of a right to health in a national constitution was significantly associated with subsequent reductions in neonatal and infant mortality rates. However, it was not associated with reductions in maternal mortality ratios and the probability of dying for adult women. The reduction in neonatal and infant mortality rates was large in countries with high scores for democratic governance, but approximately half as great in countries with low scores for democratic governance. The results suggest that introducing a constitutional right to health is likely to be an effective mechanism for improving infant health in countries with a high level of democratic governance. This health benefit is not seen in maternal and women’s health outcomes. There is an imminent need to translate the constitutional promise of a right to health into the improvement of maternal health for all in the era of the Sustainable Development Goals.

The Role of Midwives and Traditional Birth Attendant Partnership Program in Empowering Traditional Birth Attendant to Improve Maternal Health in Klaten, Central Java

Background: It cannot be denied that the dependence of pregnant women on the knowledge, knowledge and experience of traditional birth attendant is still very high. Traditional birth attendants are considered as figures who have abilities related to local culture. On the other hand midwives are the most well-known health care workers to rural areas, have medical knowledge, knowledge and technology, on average young, but have not fully gained public trust. Subjects and Method: This was a qualitative study with case study approach. The study was conducted in North Klaten District, Klaten Regency, Central Java. Results: Traditional birth attendants were people who were trusted by the community to have knowledge and experience in the health of pregnancy. Partnership Guidelines for Midwives and traditional birth attendant issued by the Ministry of Health are divided into stages of pregnancy, and childbirth. Conclusion: The implementation of midwive and TBA partnership in accordance with govern­ment guidelines can begin with regional regulations that stipulate the implementation of the WB, followed by providing physiotherapy training to traditional birth attendants in postpartum maternal massage and baby massage, so that the competency of the traditional birth attendant is more targeted. Keywords: empowerment, midwives, traditional birth attendant, partnership Correspondence: Sri Panuntun. Doctoral Program in Health Promotion/Community Development, SebelasMaret University, Jl. Ir. Sutami 36 A,Surakarta 57126, Central Java. Email: ichaku06@yahoo.com. Journal of Maternal and Child Health (2019), 4(4): 279-286 https://doi.org/10.26911/thejmch.2019.04.04.07

Millennium Development Goals and Role on Heath in India

The Millennium Development Goals (MDG) was originated from the Millennium Declaration adopted by the General Assembly of the United Nations in September 2000. The MDGs helped in bringing out a much needed focus and pressure on basic development issues, which in turn led the governments at national and sub-national levels to do better planning and implement more intensive policies and programmes. The MDGs consisted of eight goals, and these eight goals addressed multiple development issues. This paper Focus on the fourth goal of the Reduce the Child Mortality Rate under 5 per 1000 live births. Secondly focus on the fifth goal of the Improve Maternal Health Status. Improving the maternal and child health and their survival are central to the achievement of national health goals under the National Rural Health Mission (NRHM) as well as the Millennium Development Goals (MDG) 4 and 5.

La consejería en anticoncepción y los proveedores de salud

Objetivo: Caracterizar los aspectos presentes en torno a la consejería en anticoncepción que realizan los proveedores de salud.
 Metodología: Se realizó la búsqueda de artículos científicos de forma manual y en las bases de datos Science Direct, PubMed, Clinical Key y Google Académico, se formularon ecuaciones de búsqueda con la combinación de las palabras clave implementadas en el estudio. Después de evaluar los criterios de inclusión y exclusión a 424 piezas de análisis identificadas, se efectuó el análisis crítico del Critical Appraisal Skills Programme español (CASPe) a 89 estudios considerados como potencialmente elegibles. 
 Resultados: Fueron incluidos 10 estudios en la revisión, el proceso de análisis y sistematización de los datos expresados en los estudios permitió la constitución de cuatro bloques temáticos que están presentes durante la consejería en anticoncepción y que tienen relación con, I. La influencia sociocultural, II. Los proveedores de salud, III. El compromiso social y IV. Los Conocimientos y prácticas.
 Conclusiones: La caracterización de los aspectos presentes en torno a la consejería en anticoncepción que es llevada a cabo por los proveedores de salud, sensibiliza sobre la necesidad de implementar estrategias que la fortalezcan, y la proyecten como un espacio vital que busca el mejoramiento de la salud materna y la disminución de la mortalidad materna perinatal. No obstante, la mejora de esta atención demanda replantear las condiciones bajo la cual se oferta en las regiones que registran mayor problemática.

The Influence of Acceptability of the Roll Back Malaria Programme on Maternal Health in Ibadan, Nigeria

The Roll Back Malaria (RBM) initiative was conceived to bolster appreciable reduction in the impact of malaria on pregnant women through Intermittent Preventive Treatment (IPT) and the use of Insecticide-treated Net (ITN). This study examines the association between knowledge and acceptability of the RBM programme on maternal health in Ibadan classified among areas with records of high prevalence of malaria-implicated maternal mortality. A survey of 407 pregnant women attending antenatal clinics at various Primary Health Centres (PHCs) in six selected Local Government Areas (LGAs) in Ibadan was undertaken. This clinic based approach was adopted to ensure that selected respondents were among those exposed to the RBM programme as antenatal care clinic attendees. Results show that increase in the knowledge of RBM related activities led to a corresponding increase in acceptability of the initiative, which ultimately led to marked improvement in maternal health. Thus, there is need to ensure that more women become aware of the RBM project as the surest trajectory for positive disposition to the RBM intervention, with a predictable concomitant improvement in maternal health status of childbearing women in Ibadan, Nigeria.

Implementation project of the non-pneumatic anti-shock garment and m-communication to enhance maternal health care in rural Tanzania

BackgroundObstetric hemorrhage (OH) remains one of the leading causes of maternal mortality, particularly in rural Africa. Tanzania has a high maternal mortality ratio, and approximately 80% of the population accesses health care lower level facilities, unable to provide Comprehensive Emergency Obstetric Care (CEmOC). The non-pneumatic anti-shock garment (NASG) has been demonstrated to reduce mortality as it buys time for women in shock to be transported to or to overcome delays at referral facilities.MethodsThis report describes one component of an ongoing maternal health improvement project, Empower, implemented in 280 facilities in four regions in rural Tanzania. The NASG along with a Closed User Group (CUG) mobile phone network were implemented within the overall EmOC project. Simulation trainings, repeated trainings, and close hands-on supportive supervision via site visits and via the CUG network were the training/learning methods. Data collection was conducted via the CUG network, with a limited data collection form, which also included free text options for project improvement. One-to-one interviews were also conducted. Outcome Indicators included appropriate use of NASG for women with hypovolemic shock We also compared baseline case fatality rates (CFR) from OH with endline CFRs.Data were analyzed using cohort study Risk Ratio (RR). Qualitative data analysis was conducted by content analysis.ResultsOf the 1713 women with OH, 419 (24.5%) met project hypovolemic shock criteria, the NASG was applied to 70.8% (n = 297), indicating high acceptability and utilization. CFR at baseline (1.70) compared to CFR at endline (0.76) showed a temporal association of a 67% reduced risk for women during the project period (RR: 0.33, 95% CI = .19, .60). Qualitative feedback was used to make course corrections during the project to enhance training and implementation.ConclusionsThis implementation project with 280 facilities and over 1000 providers supported via CUG demonstrated that NASG can have high uptake and appropriate use for hypovolemic shock secondary to OH. With the proper implementation strategies, NASG utilization can be high and should be associated with decreased mortality among mothers at risk of death from obstetric hemorrhage.

Effect of maternal mental health improvement programs on obesity in pediatric populations: a protocol for a systematic review and meta-analysis

BackgroundChildhood obesity has become a global epidemic irrespective of the socioeconomic status of a country or nation. Obesity increases the risk of various diseases in children, for example asthma, sleep apnea, bone and joint problems, type-2 diabetes, and heart problems. The existing literature informs us of the many factors associated with childhood obesity. Among these factors, maternal mental health has been found to be a strong predictor. Maternal mental health programs were implemented to address the issue of childhood obesity but with little or no improvement. It suggests systematically reviewing the literature to assess the contents of these programs and carrying out meta-analysis for the overall effect of these interventions.MethodsThe studies included in this review will be experimental designs such as randomized controlled trials (RCTs) which provide information on interventions to improve maternal mental health and its effects on childhood obesity. We plan to search MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, PsycINFO, ERIC, CINAHL, ProQuest Dissertations and Theses Global, Scopus, and Web of Science with no restrictions as to language. Reference lists of the selected articles will also be searched for additional articles. The Cochrane EPOC Risk of Bias Tool will be used to assess the quality of studies. If the studies lend themselves to a statistical analysis, we will also carry out a meta-analysis.DiscussionThis review will help determine the effect of maternal health improvement programs on childhood obesity. These findings, in turn, will guide the research community on the development of related programs in the future.Systematic review registrationPROSPERO: CRD42017072737.

Maternal near-miss and the risk of adverse perinatal outcomes: a prospective cohort study in selected public hospitals of Addis Ababa, Ethiopia

BackgroundPresence of maternal near-miss conditions in women is strongly associated with the occurrence of adverse perinatal outcomes, but not well-understood in low-income countries. The study aimed to ascertain the effect of maternal near-miss on the risk of adverse perinatal outcomes in Ethiopia.MethodsA prospective cohort study was conducted in five public hospitals of Addis Ababa, Ethiopia. Women admitted from May 1, 2015 to April 30, 2016 were recruited for the study. We followed a total of 828 women admitted for delivery or treatment of pregnancy-related complications along with their singleton newborn babies. Maternal near-miss was the primary exposure and was ascertained using the World Health Organization criteria. Women who delivered without complications were taken as the non-exposed groups. The main outcome was adverse perinatal outcomes. Data on maternal near-miss and perinatal outcomes were abstracted from medical records of the participants. Exposed and non-exposed women were interviewed by well-trained data collectors to obtain information about potential confounding factors. Logistic regressions were performed using Stata version 13.0 to determine the adjusted odds of adverse perinatal outcomes.ResultsA total of 207 women with maternal near-miss and 621 women with uncomplicated delivery were included in the study. After adjusting for potential confounders, women with maternal near-miss condition had more than five-fold increased odds of adverse perinatal outcomes compared to women who delivered without any complications (AOR = 5.69: 95% CI; 3.69–8.76). Other risk factors that were independently associated with adverse perinatal outcomes include: rural residence, history of prior stillbirth and primary educational level.ConclusionsPresence of maternal near-miss in women is an independent risk factor for adverse perinatal outcomes. Hence, interventions rendered at improvement in maternal health of Ethiopia can lead to an improvement in perinatal outcomes.

India’s Story of Reducing Maternal Mortality - Achievement so far and Commitments Ahead

In the year 2000, the United Nations (UN) Member States pledged to work towards a series of Millennium Development Goals (MDGs), including the target of a three-quarters reduction in the 1990 Maternal Mortality Ratio (MMR; maternal deaths per 100 000 live births), to be achieved by 2015. This target (MDG 5A) and that of achieving universal access to reproductive health (MDG 5B) together formed the two targets for MDG 5: Improve maternal health (1).

Reducing Maternal Mortality in Papua New Guinea: Contextualizing Access to Safe Surgery and Anesthesia

(Anesth Analg. 2018;126(1):252–259) Papua New Guinea (PNG), a low–middle-income country with a population of 7.6 million and a poverty ranking of 158 of 188 countries, has an estimated maternal mortality rate of 215 (range, 98 to 733) per 100,000 live births. This is one of the world’s highest maternal mortality rates, with the comparable statistic in Australia being 7.1 deaths per 100,000 live births. Reasons for maternal death in PNG are not limited to pathologies usually associated with maternal death, such as obstetric hemorrhage, sepsis, high blood pressure, etc., but also to fundamental in-country systemic issues, including leadership and governance, a dispersed population in the rural highlands, shortage of health workers, limited access to water and information systems, fragile health infrastructure, poor focus on the social determinants of health, and limited access to safe surgery and anesthesia. Therefore, addressing pathologies that result in death will have little impact on the maternal mortality issue in PNG. Instead, as discussed by the World Health Organization’s 2015 publication on “global strategy for women’s, children’s, and adolescent’s health,” key areas for improvement in maternal health lie in strong country plans, integrated health delivery services, life-saving interventions and commodities, adequate number of skilled and well-equipped health workers, access to safe surgery and anesthesia, and improved monitoring/evaluation/accountability. The authors of the present narrative discussed the current situation in PNG and possible approaches to reducing maternal mortality via a discussion of enabling environments and key times for intervention.

The Efficacy of Using Peer Mentors to Improve Maternal and Infant Health Outcomes in Hispanic Families: Findings from a Randomized Clinical Trial

Introduction The Maternal Infant Health Outreach Worker (MIHOW) program is a home visiting program, utilizing peer mentors to improve maternal/child health outcomes in underserved communities. Findings are presented from a randomized clinical trial (RCT) testing the efficacy of the MIHOW model in a sample of Hispanic women in Tennessee. We hypothesized maternal and infant outcomes would be better in women assigned to MIHOW than women assigned to the minimal education intervention (MEI) group (receipt of educational materials). Methods Women entered the study during pregnancy (< 26 weeks gestation) and were followed through 6 months postpartum. A total of 188 women were enrolled and randomly assigned (MEI = 94; MIHOW = 94), with 178 women completing the study (MEI = 87; MIHOW = 91). Results Positive and statistically significant (p < 0.01) effects of MIHOW were observed on breastfeeding self-efficacy and exclusivity, levels of depressive symptoms and parenting stress, safe sleep practices, and infant stimulation in the home. No statistically significant differences were noted in number of prenatal visits. Discussion Results expand limited empiric evidence and provide strong support of the effectiveness of MIHOW on improving health outcomes in this sample of Hispanic mothers and their infants. MIHOW is a viable option for providing culturally sensitive services to immigrant and underserved families.

Mobile Health Solutions for Hypertensive Disorders in Pregnancy: Scoping Literature Review.

BackgroundHypertensive disorders are the most common complications during pregnancy, occurring in 5% to 11% of pregnancies; gestational hypertension and preeclampsia are the leading causes of perinatal and maternal morbidity and mortality, especially in low- and middle-income countries (LMIC) where maternal and perinatal mortality ratios are still high. Pregnant women with hypertensive disorders could greatly benefit from mobile health (mHealth) solutions as a novel way to identify and control early symptoms, as shown in an increasing number of publications in the field. Such digital health solutions may overcome access limiting factors and the lack of skilled medical professionals and finances commonly presented in resource-poor environments.ObjectiveThe aim of this study was to conduct a literature review of mHealth solutions used as support in hypertensive disorders during pregnancy, with the objective to identify the most relevant protocols and prototypes that could influence and improve current clinical practice.MethodsA methodological review following a scoping methodology was conducted. Manuscripts published in research journals reporting technical information of mHealth solutions for hypertensive disorders in pregnancy were included, categorizing articles in different groups: Diagnosis and Monitoring, mHealth Decision Support System, Education, and Health Promotion, and seven research questions were posed to study the manuscripts.ResultsThe search in electronic research databases yielded 327 articles. After removing duplicates, 230 articles were selected for screening. Finally, 11 articles met the inclusion criteria, and data were extracted from them. Very positive results in the improvement of maternal health and acceptability of solutions were found, although most of the studies involved a small number of participants, and none were complete clinical studies. Accordingly, none of the reported prototypes were integrated in the different health care systems. Only 4 studies used sensors for physiological measurements, and only 2 used blood pressure sensors despite the importance of this physiological parameter in the control of hypertension. The reported mHealth solutions have great potential to improve clinical practice in areas lacking skilled medical professionals or with a low health care budget, of special relevance in LMIC, although again, no extensive clinical validation has been carried out in these environments.ConclusionsmHealth solutions hold enormous potential to support hypertensive disorders during pregnancy and improve current clinical practice. Although very positive results have been reported in terms of usability and the improvement of maternal health, rigorous complete clinical trials are still necessary to support integration in health care systems. There is a clear need for simple mHealth solutions specifically developed for resource-poor environments that meet the United Nations Sustainable Development Goal (SDG); of enormous interest in LMIC.

"I am not telling. The mobile is telling": Factors influencing the outcomes of a community health worker mHealth intervention in India.

IntroductionImproving maternal health outcomes remains a priority in Low and Middle Income Countries. With the rapid proliferation of mobile health technologies, there is an increased interest in understanding how these technologies can effectively improve maternal health outcomes particularly maternal health seeking knowledge and behaviors. However, few studies present clear explanations of the program developers’ rationale (theory of change) and contextual factors that could influence program outcomes. This mixed-methods study assesses Mobile for Mothers, a community health workers (CHW) utilized maternal mHealth intervention. We present the program developers’ rationale and utilize it as a framework to guide our study that aimed to identify intervention-related and contextual factors, which influence the observed outcomes of a CHW, utilized mHealth intervention.Materials and methodsQuantitative methods (a questionnaire with 740 women who received the intervention and survey of 57 CHWs who utilized the intervention) and qualitative methods (12 interviews and 4 group discussions with CHWs and 20 interviews and 5 group discussions with pregnant and lactating women and 15 interviews and 2 group discussions with men) were conducted. These were used to understand how the mHealth intervention was implemented and to gain insight into contextual factors that potentially influenced the observed intervention outcomes.ResultsResults were grouped following three categories: (1) perceptions and experiences of CHWs utilizing the mHealth technology; (2) CHW-related outcomes; and (3) contextual factors that influence maternal health-seeking behavior. The overall response of CHWs and community members to the intervention was positive. However, contextual factors like the relationship between the CHWs and their respective communities, the pregnant women’s decision-making power and lack of access due to financial influenced the observed outcomes.ConclusionMobile health applications are promising interventions for improving the performance of CHWs and health-seeking behavior of pregnant women. However, the contextual factors play a crucial role in intervention outcomes and need to be explicated by program developers during intervention design and implementation.

Effectiveness of postpartum homecare program as a new method on mothers' knowledge about the health of the mother and the infant

Background:Reduced maternal mortality due to pregnancy and delivery is one of the priorities of reproductive health programs of World Health Organization. Benefiting from appropriate social support, such as receiving homecare, has an important role in mothers’ adaptation and health. Lack of access to comprehensive and desirable health services is the most important barrier to improvement of maternal health. In this study, the effect of postpartum homecare on mother's knowledge about maternal and child health is evaluated.Materials and Methods:This study was two-group field trial which was conducted in 2015 on 62 postpartum mothers who were selected randomly in Shahid Beheshti Hospital of Isfahan. Mothers and infants of the intervention (experimental) groups were first visited at the hospital and then received two visits at home. The control group received routine postpartum care. A researcher-designed questionnaire was used for data collection. Data analysis was conducted using SPSS18 and independent, paired t-test, and Chi-square tests.Results:Comparing the demographic characteristics between both groups revealed no significant difference. After the intervention mothers’ knowledge about maternal (t = 4.26; p < 0.001) and child (t = 3.19; p = 0.003) health showed a significant difference between the intervention (experimental) and control groups.Conclusions:Performance of postpartum homecare as a new and useful method in the health system of Iran can increase mothers’ knowledge about their own health and their children, enhance their ability to adapt with the postpartum period, and improve the health level of vulnerable populations.

A Mixed-Methods Evaluation of a Community-Based Behavior Change Program to Improve Maternal Health Outcomes in the Upper West Region of Ghana

Background: The Community Benefits Health (CBH) program introduced a community-based behavior change intervention to address social norms and cultural practices influencing maternal health and breastfeeding behaviors in rural Ghana. The purpose of this study was to determine if CBH influenced maternal health outcomes by stimulating community-level support in woman’s social networks.Methods: A mixed-methods study was conducted to evaluate changes in six antenatal/postpartum care, birth attendance, and breastfeeding behaviors in response to the CBH intervention and to assess how the program was implemented and to what extent conditions during implementation influenced the results.Results: We found increases in five of the six outcomes in both the intervention and control areas. Qualitative findings indicated that this may have resulted from program spillover. We considered the dose of exposure to program activities and found that women were significantly more likely to practice maternal health behaviors with increased exposure to program activities while controlling for study area and time.Conclusions: Overall, we determined that exposure to the CBH program significantly improved uptake of three of the six study outcomes, indicating that efforts aimed at increasing communication across women and their social networks may lead to improved health outcomes.

Implementing CDC's Level of Care Assessment Tool (LOCATe): A National Collaboration to Improve Maternal and Child Health.

Perinatal regionalization, or risk-appropriate care, is an approach that classifies facilities based on capabilities to ensure women and infants receive care at a facility that aligns with their risk. The CDC designed the Levels of Care Assessment Tool (LOCATe) to assist jurisdictions working in risk-appropriate care in assessing a facility's level of maternal and neonatal care aligned with the most current American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine (ACOG/SMFM) and American Academy of Pediatrics (AAP) guidelines. LOCATe produces standardized assessments for each hospital that participates and facilitates conversations among stakeholders in risk-appropriate care. This article describes how public health departments implement and use LOCATe in their jurisdictions.

Maternal Health Behaviors and Outcomes in a Nomadic Tibetan Population.

Introduction Despite significant global improvements in maternal health, large disparities persist. In China, rural women and women who live in western regions experience lower rates of maternal healthcare utilization and higher rates of maternal mortality than women elsewhere in the country. This paper examines maternal health care-seeking among nomadic Tibetan women in rural western China, a particularly understudied group. Methods Secondary data analysis was conducted with survey data collected in 2014 in Qinghai Province, China. Participants (rural, nomadic, adult women) provided birth histories and information on care received during antenatal, intrapartum and/or postpartum period(s). Using bivariate and multivariable logistic regression models, these outcomes were explored in relation to maternal characteristics (e.g., educational attainment and parity), use of health insurance, and time. Results Approximately half of all women had ever used antenatal care, institutional delivery, and/or skilled birth attendance. The utilization of these services has increased over time, from 10% of births prior to the year 2000, to approximately 50% since 2000. Utilization increased by year (odds ratios ranging from 1.1 to 1.3) even after controlling for covariates. Women with health insurance coverage were significantly more likely to use these services than women without insurance, although less than 20% of women reported that insurance paid for any antenatal and/or childbirth care. Discussion Utilization of maternal care is improving among this population but rates remain low in comparison to other women in rural, western China. Further targeted interventions may be needed to reach and adequately address the maternal health needs of this unique population.

La Mujer Marroquí y los Objetivos de Desarrollo del Milenio

En las últimas décadas, la situación de la mujer marroquí ha conocido un cambio a nivel social, económico y político, lo que ha propiciado el camino hacia la consecución de un desarrollo sostenible. En este sentido, Marruecos se comprometió a lograr los ocho Objetivos de Desarrollo del Milenio (ODM) entre los que se encuentran dos directamente relacionados con la mujer, que son el tercero y el quinto. El objetivo de este artículo es analizar los esfuerzos y los avances realizados mediante datos cualitativos y cuantitativos y centrándonos en el ámbito de la promoción de la igualdad entre géneros y la autonomía de la mujer, así como la mejora de la salud materna.

Promoting evidence informed policy making in Nigeria: a review of the maternal, newborn and child health policy development process.

Background: There is increasing recognition worldwide that health policymaking process should be informed by best available evidence. The purpose of this study was to review the policy documents on maternal, newborn and child health (MNCH) in Nigeria to assess the extent evidence informed policymaking mechanism was employed in the policy formulation process. Methods: A comprehensive literature search of websites of the Federal Ministry of Health(FMOH) Nigeria and other related ministries and agencies for relevant health policy documents related to MNCH from year 2000 to 2015 was undertaken. The following terms were used interchangeably for the literature search: maternal, child, newborn, health, policy, strategy,framework, guidelines, Nigeria. Results: Of the 108 policy documents found, 19 (17.6%) of them fulfilled the study inclusion criteria. The policy documents focused on the major aspects of maternal health improvements in Nigeria such as reproductive health, anti-malaria treatment, development of adolescent and young people health, mid wives service scheme, prevention of mother to child transmission of HIV and family planning. All the policy documents indicated that a consultative process of collection of input involving multiple stakeholders was employed, but there was no rigorous scientific process of assessing, adapting, synthesizing and application of scientific evidence reported in the policy development process. Conclusion: It is recommended that future health policy development process on MNCH should follow evidence informed policy making process and clearly document the process of incorporating evidence in the policy development.

Maternal low intensity physical exercise prevents obesity in offspring rats exposed to early overnutrition

Low intensity exercise during pregnancy and lactation may create a protective effect against the development of obesity in offspring exposed to overnutrition in early life. To test these hypotheses, pregnant rats were randomly assigned into 2 groups: Sedentary and Exercised, low intensity, on a rodent treadmill at 30% VO2Max /30-minute/session/3x/week throughout pregnancy and the lactation. Male offspring were raised in small litters (SL, 3 pups/dam) and normal litters (NL, 9 pups/dam) as models of early overnutrition and normal feed, respectively. Exercised mothers showed low mesenteric fat pad stores and fasting glucose and improved glucose-insulin tolerance, VO2max during lactation and sympathetic activity. Moreover, the breast milk contained elevated levels of insulin. In addition, SL of sedentary mothers presented metabolic dysfunction and glucose and insulin intolerance and were hyperglycemic and hyperinsulinemic in adulthood. SL of exercised mothers showed lower fat tissue accretion and improvements in glucose tolerance, insulin sensitivity, insulinemia and glycemia. The results suggest that maternal exercise during the perinatal period can have a possible reprogramming effect to prevent metabolic dysfunction in adult rat offspring exposed to early overnutrition, which may be associated with the improvement in maternal health caused by exercise.