Maternal Physical Activity Research Articles

Maternal physical activity, cervical length and its relation to spontaneous vaginal birth at term

Physical activity during pregnancy is known to be beneficial, however there are controversies about the risk of preterm labor, and there is no published data to assess the association between cervical length and maternal physical activity during pregnancy. Therefore, the objective of the study was to describe the cervical length in the second and third trimesters, correlating with physical activity, anthropometric characteristics, and obstetric results. Prospective cohort with 56 pregnant women, allocated in two groups according to the answers obtained by a validating questionnaire on physical activity. It was considered significant p < 0.05. The length of the uterine cervix was similar between active and sedentary women, from the 22nd to the 24th week of pregnancy (p = 0.58), and from the 32nd to the 34th week (p = 0.59). Gestational age at delivery was lower among active women than among sedentary ones, although without clinical repercussion, 38.2 ± 1.2 vs. 39.1 ± 1.2 weeks, respectively (p = 0.02). Among active women, 33 (89.1 %) had natural labor, while among sedentary ones, only 13 (68.4 %) (p = 0.05). The Apgar score was higher among children of active mothers (p = 0.04). Despite being the data still to small to allow final conclusions, maternal physical activity, cervical length and its relation to spontaneous vaginal birth at term is a relevant topic for the information of women in early pregnancy. More investigations directly after specific activities such as riding, walking, and biking are needed to answer the questions we receive from our pregnant patients.

Community engagement approach: developing a culturally appropriate intervention for Hispanic mother-child dyads.

Childhood obesity affects approximately 20% of U.S. preschool children. Early prevention is needed to reduce young children's risks for obesity, especially among Hispanic preschool children who have one of the highest rates of obesity. Vida Saludable was an early childhood obesity intervention designed to be culturally appropriate for low-income Hispanic mothers with preschool children to improve maternal physical activity and reduce children's sugar-sweetened beverage consumption. It was conducted at a large southwestern United States urban health center. Presented here are the methods and rationale employed to develop and culturally adapt Vida Saludable, followed by scoring and ranking of the intervention's cultural adaptations. An empowered community helped design the customized, culturally relevant program via a collaborative partnership between two academic research institutions, a community health center, and stakeholders. Improved health behaviors in the participants may be attributed in part to this community-engagement approach. The intervention's cultural adaptations were scored and received a high comprehensive rank. Postprogram evaluation of the intervention indicated participant satisfaction. The information presented provides investigators with guidelines, a template, and a scoring tool for developing, implementing, and evaluating culturally adapted interventions for ethnically diverse populations.

Impact of maternal physical activity during gestation on porcine fetal, neonatal, and adolescent ovarian development

To determine how exercise from mid to late (days 40–104) gestation impacts offspring body, uterine and ovarian weight, and ovarian cell proliferation at three different developmental stages, Yorkshire gilts were either exercised by walking (EX) or not exercised (CON). In parity 1, ovaries and uteri were collected from the heaviest (H) and lightest (L) neonates and adolescent (6 mo) offspring. In parity 2, mothers were assigned the same treatment groups, and ovaries and uteri were collected from H and L fetuses on day 94 of gestation. Body weight was greater (P < 0.02) for H than L fetuses and neonates but not affected by EX treatment at any developmental stage. Ovarian weight in L but not H neonates was greater (P < 0.02) in EX than CON. Labeling index (LI; percentage of proliferating cells) was greater (P < 0.01) in cortex than medulla regions of fetal and neonatal ovaries. In fetal ovaries, EX enhanced LI (P < 0.01), and LI was greater (P < 0.01) in H compared with L offspring. In adolescent ovaries, LI was greatest (P < 0.01) in healthy antral and least in atretic antral follicles, and LI was greater (P < 0.01) in granulosa than theca cells of healthy antral follicles. Thus, exercise increased LI in fetal but not neonatal or adolescent ovaries. Although maternal exercise during gestation influences fetal and neonatal ovarian development, impacts on fertility remain unknown.

Exposure analysis methods impact associations between maternal physical activity and cesarean delivery.

Previous studies report conflicting results regarding a possible association between maternal physical activity (PA) and cesarean delivery. Seven-day PA recalls were collected by telephone from pregnant women (n = 1205) from North Carolina, without prior cesarean, during 2 time windows: 17 to 22 weeks and 27 to 30 weeks completed gestation. PA was treated as a continuous, nonlinear variable in binomial regressions (log-link function); models controlled for primiparity, maternal contraindications to exercise, preeclampsia, pregravid BMI, and percent poverty. We examined both total PA and moderate-to-vigorous PA (MVPA) at each time. Outcomes data came from medical records. The dose-response curves between PA or MVPA and cesarean risk at 17 to 22 weeks followed an inverse J-shape, but at 27 to 30 weeks the curves reversed and were J-shaped. However, only (total) PA at 27 to 30 weeks was strongly associated with cesarean risk; this association was attenuated when women reporting large volumes of PA (> 97.5 percentile) were excluded. We did not find evidence of an association between physical activity and cesarean birth. We did, however, find evidence that associations between PA and risk of cesarean may be nonlinear and dependent on gestational age at time of exposure, limiting the accuracy of analyses that collapse maternal PA into categories.

Amount of Physical Activity in Pregnancy and Infant Heart Outcomes

Purpose: Our previous findings demonstrated that the amount (dose) of maternal physical activity during pregnancy was associated with changes in fetal heart autonomic control, similar to an adult exercise trained response. The purpose of this study was to determine if the dose of maternal physical activity during association persists after birth. Methods: We analyzed 43 maternal-infant pairs. Since the majority of measures were not normally distributed, the correlations between infant heart rate (HR) and HR Variability (HRV) metrics and maternal physical activity measures were assessed by the Spearman correlation coefficient. The Spearman procedure also was used to examine relationships among the physical activity variables. Results: The median values for maternal physical activity duration were 1140 min (~90 min/wk), for energy expenditure 6,635 kcal, and the intensity was 5.4 kcal.min-1 (Table 1). Based on the average maternal weight, average intensity is near the cut-off (6.0 kcal.min-1) for moderate and vigorous intensity level of physical activity. There was a significant positive correlation between the duration of maternal physical and infant Low Frequency (LF) HRV power (p=0.02), as well as the amount of energy expenditure (i.e. calories burned) in physical activity with infant short-term HRV (RMSSD, p=0.03), LF power (p=0.01) and high frequency (HF) HRV power (p=0.03). Conclusion: The amount of time and energy expended during physical activity during gestation positively influences the development of neonatal cardiac autonomic control. Coupled with our previous findings of positive fetal dose associated with physical activity during pregnancy suggests, the prenatal period may be the earliest time at which the cardiac health of infants can be positively influenced to decrease risk of heart disease.

Demographic factors and determinants of physical activity and breast feeding practices during puerperium in saudi women.

Aim:This cross-sectional study describes the practice of different myths regarding newborns and maternal physical activity among Saudi women during puerperium.Material and Methods:The study was conducted at Mother and Child Hospital, Buraidah from January to December 2011.Results:The multinomial logistic regression (MRA) on age, education, occupation, parity and mode of delivery was statistically significant (χ2 (60) = 487.656, p < .001). Individuals who were between 25 and 30, had education level primary or below, para2 -4 were more likely to limit household activities. Women in the age group of 25-30 were 41 times more likely to have no exercise. Women with parity 2-4 were 24 times more likely to abstain from sex during puerperium as compared to Para 5 and above. Individuals who had a normal vaginal birth were approximately 9 times less likely to be in the kofalaya’s group. Individuals below college level education were more likely to believe that breast feeding in front of others may steal mother’s milk. Women below 25 years of age and women with vaginal delivery were more likely to avoid colostrums feeding. Conclusion:Health Education programs are needed to encourage women to increase physical activity during puerperium and encourage breast feeding. Focus groups for improving physical activity should include age group 25-30 and women with primary and below level education. Women with cesarean delivery should be counseled against kofalayas and women with vaginal delivery should be encouraged for colostrums feeding.

Factors Influencing Maternal Support for Physical Activity of Preschool Children.

PURPOSE: The purpose of this study was to explore maternal physical activity support for preschool children.METHODS: Survey methodology using a self-administered questionnaire was employed. Mothers with preschool children from a daycare center in Daejeon participated in the study.One hundred and fifty-six questionnaires were analyzed.RESULTS: Mothers with preschool children showed a moderate level of physical activity support for their children.Significant factors affecting physical activity support of mothers were monthly household income (beta=.417, p=.002), maternal self-efficacy for physical activity support (beta=.231, p=.003), information for physical activity support (beta=.173, p=.022), and experience of education about physical activity support (beta=.237, p=.002). These variables explained 26.4% of the variance in physical activity support (F=7.628, p&lt;.001).CONCLUSION: To improve maternal support for increasing physical activity of preschool children, maternal education and appropriate information should be provided to improve self-efficacy for physical activity support.

Aerobic exercise during pregnancy influences infant heart rate variability at one month of age

BackgroundPreviously, we reported that regular maternal aerobic exercise during pregnancy was associated with lower fetal heart rate (HR) and higher heart rate variability (HRV) at 36weeks gestation. We now report the effect of maternal exercise on infant HR and HRV in subjects who remained active in the study at the one-month follow up visit. AimsWe aimed to determine whether differences in fetal cardiac autonomic control related to maternal physical activity were an in utero phenomenon or would persist 1month after birth. Study designMagnetocardiograms (MCGs) of infants born to regularly exercising (≥30min of aerobic activity, 3 times per week; N=16) and non-exercising (N=27) pregnant women were recorded using a fetal biomagnetometer. Normal R-peaks were marked to derive infant HR and HRV in time and frequency domains, including the root mean square of successive differences (RMSSD), the standard deviation of normal-to-normal interbeat intervals (SDNN), and power in the low frequency (LF) and high frequency (HF) bands. Group differences were examined with Student's t-tests. ResultsInfants born to exercising women had significantly higher RMSSD (P=0.010), LF power (P=0.002), and HF power (P=0.004) than those born to women who did not engage in regular physical activity while pregnant. ConclusionInfants born to women who participated in regular physical activity during pregnancy continued to have higher HRV in the infant period. This suggests that the developing cardiac autonomic nervous system is sensitive to the effects of maternal physical activity and is a target for fetal programming.

Prevalence of physical inactivity and associated factors among adolescents from public schools in Uruguaiana, Rio Grande do Sul State, Brazil

This study aimed to identify the prevalence of physical inactivity and associated factors in adolescents, using a cross-sectional design with a sample of 1,455 adolescents (741 females). Data were collected using a questionnaire consisting of socio-demographic, perceptual, and behavioral variables. Physical activity was estimated with the Physical Activity Questionnaire for Older Children and Adolescents. Prevalence of physical inactivity was 68% (95%CI: 65.6%-70.4%). The following variables remained associated with physical inactivity in the adjusted analysis (p &lt; 0.05): living in an apartment, female gender, older adolescents, lower self-rated physical activity compared to peers, low perception of maternal physical activity, passive commuting to school, non-participation in physical education at school, non-enjoyment of physical education classes, and limited involvement in other types of physical exercise besides physical education at school. There were a high proportion of inactive adolescents. Strategies to prevent physical inactivity in adolescents should be elaborated with a central role for the school and family.

Physical activity during pregnancy and offspring cardiovascular risk factors: findings from a prospective cohort study

ObjectivesThe long-term consequences of maternal physical activity during pregnancy for offspring cardiovascular health are unknown. We examined the association of maternal self-reported physical activity in pregnancy (18 weeks gestation) with...

The effect of maternal exercise during pregnancy on abnormal fetal growth

AimTo assess the effect of maternal physical activity during pregnancy on abnormal fetal growth.MethodsThe study group of 166 women in gestational week 6-8 exercised regularly three days per week at submaximal intensity during their entire pregnancy and the control group of 168 women received standard antenatal care. The main outcomes were macrosomia and intrauterine growth restriction.ResultsThe study group had a lower frequency of macrosomia in newborns (6.0% vs 12.5%, P = 0.048) and gestational diabetes (1.8% vs 8.3%, P = 0.008) than the control-group, but there was no significant difference in intrauterine growth restriction (7.2% vs 6.5%). There was also no significant differences in other perinatal outcomes.ConclusionsThe beneficial effect of maternal physical activity on fetal growth may be caused the impact of aerobic exercise on glucose tolerance. Fitness trainers and kinesiologists, as well as health care providers, should be educated on the benefits of regular exercise during pregnancy and safe physical exercise for pregnant women.

Aboriginal birth cohort (ABC): a prospective cohort study of early life determinants of adiposity and associated risk factors among Aboriginal people in Canada.

BackgroundAboriginal people living in Canada have a high prevalence of obesity, type 2 diabetes, and cardiovascular disease (CVD). To better understand the pre and postnatal influences on the development of adiposity and related cardio-metabolic factors in adult Aboriginal people, we will recruit and follow prospectively Aboriginal pregnant mothers and their children – the Aboriginal Birth Cohort (ABC) study.Methods/designWe aim to recruit 300 Aboriginal pregnant mothers and their newborns from the Six Nations Reserve, and follow them prospectively to age 3 years. Key details of environment and health including maternal nutrition, glucose tolerance, physical activity, and weight gain will be collected. At birth, cord blood and placenta samples will be collected, as well as newborn anthropometric measurements. Mothers and offspring will be followed annually with serial measurements of diet and physical activity, growth trajectory, and adiposity.DiscussionThere is an urgent need to understand maternal and child factors that underlie the early development of adiposity and type 2 diabetes in Aboriginal people. The information generated from this cohort will assist the Six Nations community in developing interventions to prevent early adiposity in Aboriginal children.

Risk factors associated with overweight and obesity among urban school children and adolescents in Bangladesh: a case–control study

BackgroundChildhood obesity has become an emerging urban health problem in urban cities in Bangladesh, particularly in affluent families. Risk factors for obesity in this context have not been explored yet. The objective of this study was to identify the risk factors associated with overweight and obesity among school children and adolescents in Dhaka, Bangladesh.MethodsFrom October through November 2007, we conducted a case–control study among children aged 10–15 years in seven schools in Dhaka. We assessed body mass index (weight in kg/height in sq. meter) to identify the cases (overweight/obese) and controls (healthy/normal weight) following the Centers for Disease Control and Prevention age and sex specific growth chart. We used a structured questionnaire to collect demographic information and respondent’s exposure to several risk factors such as daily physical activity at home and in school, hours spent on computer games and television watching, maternal education level and parents’ weight and height.ResultsWe enrolled 198 children: 99 cases, 99 controls. Multiple logistic regression analysis revealed that having at least one overweight parent (OR = 2.8, p = 0.001) and engaging in sedentary activities for >4 hours a day (OR = 2.0, p = 0.02) were independent risk factors for childhood overweight and/or obesity while exercising ≥ 30 minutes a day at home was a protective factor (OR = 0.4, p = 0.02). There were no significant associations between childhood overweight and sex, maternal education or physical activity at school.ConclusionHaving overweight parents along with limited exercise and high levels of sedentary activities lead to obesity among school children in urban cities in Bangladesh. Public health programs are needed to increase awareness on risk factors for overweight and obesity among children and adolescents in order to reduce the future burden of obesity-associated chronic diseases.

Physical Activity During Pregnancy and Language Development in the Offspring

In rodents, physical activity during pregnancy has been associated with improved learning and memory in the offspring. We used data from the Avon Longitudinal Study of Parents and Children (born in 1991-92) to investigate maternal physical activity during pregnancy and offspring language development. At 18 weeks of gestation, women reported the hours per week they participated in 11 leisure-time physical activities and the hours per week spent in general physical activity (leisure, household and occupational). Caregivers completed a modified MacArthur Infant Communication scale at 15 months. Verbal intelligence quotient (IQ) was measured at age 8 years. Regression analysis was used to examine the associations of physical activity with MacArthur score (more than 75th percentile) and verbal IQ. The number of participants available for analyses ranged from 4529 to 7162. Children of women in the two highest quintiles of leisure activity (compared with no leisure activity) were more likely to have high 15-month MacArthur scores (adjusted odds ratio 1.2 [95% confidence interval 0.9, 1.4] and adjusted odds ratio 1.4 [95% CI 1.1, 1.7], respectively). Leisure activity was not associated with IQ, while general physical activity was linked with lower verbal IQ (1 and 3 points lower for the two highest quintiles). The most robust finding was a transient increase in offspring vocabulary score at young ages with maternal leisure activity. Differences in the associations with leisure-time physical activity compared with general physical activity need further exploration.

Toddler Obesity Prevention Study (TOPS) increases toddler health‐promoting behaviors

ObjectiveTo examine if an 8 session RCT grounded in social cognitive theory (SCT) and focused either on maternal diet and physical activity (PA) or on responsivity and behavior management increases toddler health promoting behaviors.Method274 low‐income mother‐toddlers completed a baseline evaluation: PA (ankle accelerometer worn 7 days, average time/day in moderate/vigorous physical activity), diet (USDA Automated Multi‐Pass Method), video‐taped meal (Emotional Availability Scales), weight &amp; height (converted to age &amp; gender‐specific z‐scores). Randomized to MOM TOPS: maternal diet and PA, TOT TOPS: responsivity and behavior management, or SAFE TOPS: toddler safety (placebo). Follow‐up at 6 months. Intent‐to‐treat longitudinal mixed modeling and generalized estimating equations, adjusted for baseline.ResultsBaseline: 17% toddlers and 51% mothers were obese, 70% Black, 2% Hispanic, &amp; 22% White. At follow‐up, MOM TOPS/TOP TOPS improved over SAFE TOPS in fruit intake (0.49 and 0.93 servings, p=0.014, 0.014) and PA (14.7 and 14.6 minutes, p=0.025, p=0.025. TOT TOPS improved significantly over MOM TOPS in 5 of 6 EAS categories (child involvement &amp; responsively, parent sensitivity, structure, &amp; parent non‐hostility).ConclusionsA brief intervention built on principles of SCT is effective in increasing toddler health‐promoting behaviors of diet, PA, and mealtime responsivity.

Hyperglycemia and lower diet quality in pregnant overweight women and increased infant size at birth and at 13 months of age — STEPS study

AimsTo study whether maternal overweight and/or hyperglycemia combined with life-style factors in healthy women predisposes to adverse pregnancy or infant health outcomes, such as differences in growth. MethodsAt 26–28weeks of gestation 82 overweight pregnant women (prepregnancy BMI≥25kg/m2) and 67 normal weight pregnant women (prepregnancy BMI<25kg/m2) participating to STEPS study attended 2-hour oral glucose tolerance test (OGTT) with measurement of plasma glucose and insulin and calculation of HOMA, QUICKI and Matsuda ISI indices. Birth weights and lengths were obtained from hospital records and weights and heights at 13months from study visits. Maternal physical activity and diet quality were studied with questionnaires. ResultsGlucose concentrations were higher in overweight non-diabetic women (0h=4.9, 1h=7.7, 2h=6.2mmol/l, n=80) than normal weight women (0h=4.5, 1h=6.8, 2h=5.6mmol/l, all P<0.05, n=66) as were insulin concentrations at baseline (12.3 vs. 9.0mU/l, P<0.05), but not later (1h=88.1 vs. 72.8mU/l; 2h=63.5 vs. 55.5mU/l, both P>0.05). Insulin resistance was higher and sensitivity lower (P<0.05 for all) in overweight than in normal weight women. The offspring of overweight mothers were 273g heavier at birth and 700g heavier at 13months of age than the offspring of normal weight women (P<0.001). Normal weight women had preferable diet quality (P=0.023). No differences were seen in self-reported physical activity between overweight and normal weight women. ConclusionsMaternal prepregnancy overweight increases risk of hyperglycemia in late-pregnancy and increased infant size at birth and 13months possibly predisposing the infant to health risks later in life.

Maternal Physical Activity and Insulin Action in Pregnancy and Their Relationships With Infant Body Composition

OBJECTIVEWe sought to assess the association between maternal gestational physical activity and insulin action and body composition in early infancy.RESEARCH DESIGN AND METHODSAt 28–32 weeks' gestation, pregnant women participating in an observational study in Sweden underwent assessments of height, weight, and body composition, an oral glucose tolerance test, and 10 days of objective physical activity assessment. Thirty mothers and infants returned at 11–19 weeks postpartum. Infants underwent assessments of weight, length, and body composition.RESULTSEarly insulin response was correlated with total physical activity (r = −0.47; P = 0.007). Early insulin response (r = −0.36; P = 0.045) and total physical activity (r = 0.52; P = 0.037) were also correlated with infant fat-free mass. No maternal variable was significantly correlated with infant adiposity.CONCLUSIONSThe relationships between maternal physical activity, insulin response, and infant fat-free mass suggest that physical activity during pregnancy may affect metabolic outcomes in the mother and her offspring.

Maternal fitness at the onset of the second trimester of pregnancy: correlates and relationship with infant birth weight

What is already known about this subject A healthy life begins in utero and a healthy pregnancy requires a fit and healthy mother. Physical activity during pregnancy provides a stimulation that is essential for promoting optimal body oxygenation and composition as well as metabolic fitness during pregnancy. Although a higher maternal fitness is expected to provide a beneficial fetal environment, it is still unclear whether physical fitness during pregnancy contributes to perinatal health. What this study adds Participation in sports and exercise previously and at the beginning of pregnancy can benefit maternal health by improving cardiorespiratory fitness during pregnancy, irrespective of maternal body mass index. Maternal strength, an indicator of muscular fitness, is an independent determinant of infant fetal growth and can positively influence birth weight. It is still unclear whether maternal physical activity and fitness during pregnancy contributes to perinatal health. The aims of this study were to characterize maternal physical fitness at 16 weeks of pregnancy and to examine its effects on infant birth weight. Maternal anthropometry (body mass index [BMI] and skin-folds), physical activity, cardiorespiratory fitness (VO2 peak) and muscular fitness (handgrip strength) were assessed at 16 weeks of gestation in 65 healthy pregnant women. Offspring birth weight was collected from maternal charts after delivery. A higher VO2 peak was associated with physical activity spent at sports and exercise before and in early pregnancy (P = 0.0005). Maternal BMI was negatively associated with cardiorespiratory fitness (P < 0.0001) but positively related to muscular strength (P = 0.0001). Unlike maternal cardiorespiratory fitness, handgrip strength was positively associated with infant birth weight (r = 0.34, P = 0.0068) even after adjustment for confounders (adjusted r = 0.27, P = 0.0480). A positive relationship between maternal muscular fitness and infant birth weight highlighted maternal strength in pregnancy as a new determinant of infant birth weight.

Do active mothers have active preschool-aged children? An analysis of concurrently measured activity patterns

Introduction: Physical activity (PA) from a young age is likely to confer long-lasting health and developmental benefits. Parents have a significant influence over their young children's behaviour but little is known about the association between maternal and preschool-aged children's PA. This study aimed to determine whether patterns of mothers’ objectively measured PA are associated with those of their children and whether this association differed by demographic and temporal factors.

Predictors of physical activity change during adolescence: a 3·5-year follow-up

To investigate the predictors of change in physical activity (PA) from early to mid adolescence in a cohort of adolescents. Prospective, population-based birth cohort study. PA level was evaluated by means of questionnaire, and was analysed in continuous form (min/week) and as a trajectory (inactive-inactive, inactive-active, active-inactive, active-active) based on the cut-off point of 300 min/week. Pelotas, a city of 340 000 inhabitants in southern Brazil. Adolescents (n 4120) followed from 11 to 15 years of age. Maternal PA change and more exposure to outdoors were directly associated with a positive change in PA level (min/week) for both genders. Higher maturation status (among boys) and later menarche were also associated with positive PA change in min/week. Predictors to remain inactive were: maternal PA change (inverse association), more exposure to outdoors, higher socio-economic level, fear of living in the neighbourhood and non-overweight girls. Predictors to become inactive were higher socio-economic level among boys and increase in screen time among girls. The study demonstrates that social, family, biological, behavioural and environmental factors exert an important role in the PA change among youngsters as they move into adolescence. These findings may be relevant to the design of policies and intervention programmes aimed at promoting PA in teenagers.