Pre-pregnancy Physical Activity Research Articles

Maternal physical activity, sitting, and risk of non-cardiac birth defects.

The relationship between maternal physical activity (PA)/sitting and birth defects is largely unexplored. We examined whether pre-pregnancy PA/sitting were associated with having a pregnancy affected by a birth defect. We used data from two United States population-based case-control studies: 2008-2011 deliveries from the National Birth Defects Prevention Study (NBDPS; 9 states) and 2014-2018 deliveries from the Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS; 7 states). Cases with one of 12 non-cardiac birth defects (n = 3798) were identified through population-based registries. Controls (n = 2682) were live-born infants without major birth defects randomly sampled using vital/hospital records. Mothers self-reported pre-pregnancy PA/sitting. Unconditional logistic regression models estimated associations between PA/sitting categories and the 12 birth defects. Mothers engaging in pre-pregnancy PA was associated with a reduced odds of five (spina bifida, cleft palate, anorectal atresia, hypospadias, transverse limb deficiency) and a higher odds of two (anencephaly, gastroschisis) birth defects. Mothers spending less time sitting in pre-pregnancy was associated with a reduced odds of two (anorectal atresia, hypospadias) and a higher odds of one (cleft lip with or without cleft palate) birth defect. Reasonable next steps include replication of these findings, improved exposure assessment, and elucidation of biologic mechanisms. Using data from two population-based case-control studies, we found that mothers engaging in different types of physical activity in the 3 months before pregnancy had an infant with a reduced odds of five and a higher odds of two birth defects. Mothers spending less time sitting in the 3 months before pregnancy had an infant with a reduced odds of two and a higher odds of one birth defect. Clarification and confirmation from additional studies are needed using more precise exposure measures, distinguishing occupational from leisure-time physical activity, and elucidation of mechanisms supporting these associations.

Factors Influencing Attitudes Toward Physical Activity and Exercise Education in Pregnant Women

Background: The aim of this study was to report on attitudes of pregnant women regarding exercise and exercise education and to identify factors influencing their interest in receiving exercise education. Methods: A cross-sectional survey was completed by 134 women being evaluated for a routine obstetrical visit. Self-reported information regarding demographics, physical activity participation, confidence in knowledge about pregnancy exercise guidelines, and interest in receiving information about exercise during pregnancy was obtained. Descriptive statistics were used to summarize the data. Multiple logistic regressions were performed to measure associations between patient characteristics and exercise decline, confidence, and interest. Results: Participants had a mean age of 33.6 ± 4.3 years, mean BMI of 27.9 ± 5.0, and a mean gestational age of 26 ± 10 weeks. Reported level of physical activity decreased during pregnancy for 73.9 % of women. A significant association was found between pre-pregnancy physical activity (OR 2.00 (1.21-3.52), p = 0.010) and exercise decline. Significant, independent relationships were identified between increased confidence in exercise education and younger patient age (OR 0.89(0.82-0.98), p = 0.015), previous pregnancies (OR 0.43 (0.21-0.86), p = 0.060), higher level of pre-pregnancy exercise (OR 1.73 (1.19-2.53), p = 0.004), and more education received from physicians (OR 1.94 (1.54-2.49), p < 0.001). Interest in education was associated with higher level of physical activity before pregnancy (OR 1.75(1.21-2.57), p = 0.004) and lower amount of education received from physicians (OR 0.78(0.63-0.97), p = 0.025). Conclusions: Women commonly report a decline in exercise during pregnancy, particularly among women with high levels of physical activity prior to pregnancy. Attitudes toward pregnancy exercise education were found to be correlated with patient characteristics including age, nulliparity, level of physical activity before pregnancy, and education received from physicians. These associations can be used to identify target populations for future interventions.

MATERNAL AND FETAL RESPONSE ON PRENATAL EXERCISE: AN QUASI EXPERIMENTAL PILOT STUDY

Despite the positive effects of exercise during pregnancy, only a small percentage of pregnant women choose to exercise because of concerns about fetal safety. The purpose of this study was to determine if the selected physiological functions of pregnant women increase or decrease to a limit that is still safe, and what effect this has on fetal heart rate and movement, depending on the type of exercise and physical activity of the pregnant women prior to pregnancy. An experimental study was conducted. Measurements of the pregnant women's heart rate, saturation, blood pressure, and body temperature, fetal heart rate, and fetal movements before and after exercise were collected. Exercises with two different levels of intensities (yoga-low and pilates-moderate) were compared. Thirty-one pregnant Slovenian women with gestational age between 20 and 37 weeks were included in the sample. When comparing pre and post exercise measurements, statistically significant differences were found in post exercise body temperature (p = 0.005) and systolic blood pressure (p = 0.007) compared with pre-exercise measurements. When comparing the results between yoga and Pilates exercise sessions, no statistically significant differences were found. When comparing results related to pre-pregnancy physical activity, significant differences in pre-exercise saturation were found (p = 0.041). Despite small sample size, results indicate that moderate physical activity in pregnancy has no significant effect on the vital functions of the pregnant woman that could indirectly endanger foetus. Larger study should be performed, to confirm these preliminary results.

Population characteristics associated with adherence to prenatal group-based exercise programs

ABSTRACT Community-based supervised group exercise may be an effective option to increase activity levels throughout pregnancy. Previous studies that have explored predictors of low adherence to exercise during pregnancy have not examined group-based settings. We analysed an international cohort of 347 pregnant women who participated in group-based prenatal exercise interventions (from <20 weeks to 34–36 weeks pregnant). Probable adherence predictors informed by previous literature that were assessed included: pre-pregnancy physical activity level and body mass index (BMI) classification, age, number of previous pregnancies, and education level. Adherence was measured by attendance. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated to explore the relationship between the selected predictors and high adherence (≥70%). Post-secondary education level versus only secondary (aOR 5.28; CI 1.67; 16.72) or primary level (aOR 13.82; CI 4.30; 44.45) presented greater likelihood to have high adherence to the exercise intervention than low adherence. Future research and public health initiatives should consider implementing strategies to overcome education-related barriers to improve accessibility to prenatal exercise.

Patterns of physical activity and sedentary behavior before and during pregnancy and cardiometabolic outcomes

ObjectiveTo assess how physical activity and sedentary behavior change from pre-pregnancy to pregnancy, and if pre-pregnancy and pregnancy physical activity and sedentary behavior are related to gestational weight gain, blood pressure, or blood glucose across pregnancy. DesignSecondary analysis of two prospective cohort studies. SettingPrenatal research centers in Pittsburgh, PA and Iowa City, IA. ParticipantsPregnant individuals (n=131), 18-45 years old, of any BMI, with no medical condition limiting physical activity or use of hypertension/diabetes medications. MethodsParticipants self-reported physical activity and sedentary behavior pre-pregnancy and in each trimester using validated questionnaires. Blood pressure, blood glucose, and weight were obtained from study visits and/or electronic medical records. Multivariable regression examined associations between pre-pregnancy, trimester-specific, and changes in physical activity and sedentary behavior with weight gain and blood pressure outcomes in each trimester, and blood glucose in the second trimester. ResultsCompared to pre-pregnancy, physical activity was lower in each trimester, and sedentary behavior was higher in each trimester (p<0.05). Increasing physical activity from pre-pregnancy levels was associated with lower first trimester SBP (p<0.05). Unexpectedly, higher pre-pregnancy physical activity was associated with higher SBP in the first trimester (p=0.02) and higher weight gain in the third trimester (p=0.02). Higher and increasing sedentary behavior was associated with greater weight gain in the third trimester (p=0.03). ConclusionFuture research should investigate the opportune time (before or during pregnancy) to deliver behavior modification interventions that could prevent excessive gestational weight gain or elevated blood pressure to improve maternal health outcomes.

Association of prepregnancy physical activity with obesity in offspring: The Japan Environment and Children's Study.

The aim of this study was to investigate the association between maternal prepregnancy physical activity (PA) and overweight/obesity in 3-year-old children. Using data from the Japan Environment and Children's Study (a birth cohort study), maternal prepregnancy PA was categorized into low, moderate, and high with the International Physical Activity Questionnaire (IPAQ). The reference group was defined as children born to mothers with moderate PA. The association between prepregnancy PA and overweight/obesity or obesity in children was investigated using univariable and multivariable logistic regression analyses. Of the 65,245 participants, 48.7%, 32.7%, and 18.6% were born to mothers in the low, moderate, and high PA groups, respectively. Furthermore, 24.9%, 24.6%, and 25.9% of children with overweight/obesity and 9.4%, 9.2%, and 10.4% of children with obesity were born to mothers in the low, moderate, and high PA groups, respectively. The adjusted odds ratios for overweight/obesity in the low and high PA groups were 1.02 (95% CI: 0.98-1.06) and 1.04 (95% CI: 0.98-1.09), and those for obesity were 1.03 (95% CI: 0.97-1.09) and 1.08 (95% CI: 0.99-1.16), respectively. Maternal prepregnancy PA was not associated with overweight/obesity or obesity in 3-year-old children.

Physical activity before pregnancy and the risk of hypertensive disorders of pregnancy

It is unclear whether prepregnancy physical activity influences the risk of hypertensive disorders of pregnancy and whether any impact is similar for preeclampsia and gestational hypertension. To evaluate the relation of prepregnancy physical activity with hypertensive disorders of pregnancy and its alignment with the current recommendations for physical activity for the general population. We studied 28,147 singleton pregnancies from 18,283 women without chronic hypertension, cardiovascular disease, or cancer, participating in the Nurses' Health Study-II between 1989 and 2010. The women self-reported their physical activity before pregnancy and pregnancy complications, including preeclampsia and gestational hypertension. Logistic regression models using generalized estimating equations to account for within-woman correlations across pregnancies were used to estimate the relative risk (95% confidence interval) of preeclampsia and gestational hypertension across quartiles of prepregnancy physical activity, adjusting for age at pregnancy, parity, smoking, multivitamin use, infertility history, marital status, race, year of pregnancy, and history of preeclampsia. We identified 842 (3.0%) pregnancies with preeclampsia and 905 (3.2%) pregnancies with gestational hypertension. Physical activity before pregnancy was related to a lower risk of hypertensive disorders of pregnancy (relative risk, 0.75 [95% confidence interval, 0.65-0.87] for women in the highest quartile compared with the lowest quartile). This relation was driven by a 39% lower risk of gestational hypertension (relative risk, 0.61; 95% confidence interval, 0.50-0.76) comparing women in the highest quartile of physical activity (≥30.6 metabolic equivalents of task-hours/week) vs women in the lowest quartile (<6.0 metabolic equivalents of task-hours/week). Women whose moderate physical activity levels exceeded those recommended in the Physical Activity Guidelines for Americans (>5 hours/week) had a 50% lower (relative risk, 0.50; 95% confidence interval, 0.36-0.69) risk of gestational hypertension than women who did not meet this recommendation (<2.5 hours/week). For vigorous physical activity, the risk of gestational hypertension was lower among the women who met (1.25-2.5 hours/week; relative risk, 0.77; 95% confidence interval, 0.64-0.93) or exceeded (>2.5 hours/week; relative risk, 0.76; 95% confidence interval, 0.62-0.92) the recommendations than women whose activity levels were below those recommended. Physical activity was not related to the risk of preeclampsia (relative risk, 0.93; 95% confidence interval, 0.76-1.14). Physical activity before pregnancy may lower the risk of developing gestational hypertension but not preeclampsia.

Associations of maternal non-nutritive sweetener intake during pregnancy with offspring body mass index and body fat from birth to adolescence.

The evidence that maternal non-nutritive sweetener (NNS) intake during pregnancy increases childhood obesity risk is conflicting. A potential reason for this is that all prior studies examined childhood body mass index (BMI) at only one timepoint and at different ages. We examined the extent to which NNS intake during pregnancy is associated with offspring BMI z-score and body fat longitudinally from birth to 18 years. A total of 1683 children from Project Viva, a prospective pre-birth cohort, were recruited from 1999 to 2002 in Massachusetts. We assessed maternal NNS intake in the first and second trimesters of pregnancy using a semiquantitative food frequency questionnaire. Our outcomes were offspring BMI z-score, (at birth, infancy (median 6.3 months), early childhood (3.2 years), mid-childhood (7.7 years), and early adolescence (12.9 years)), sum of skinfolds (SS), fat mass index (FMI) measured by dual x-ray absorptiometry, and BMI z-score trajectory from birth to 18 years. We adjusted models for maternal pre-pregnancy BMI, age, race/ethnicity, education, parity, pre-pregnancy physical activity, smoking, and paternal BMI and education. A total of 70% of mothers were white and pre-pregnancy BMI was 24.6 ± 5.2 kg/m2. The highest quartile of NNS intake (Q4: 0.98 ± 0.91 servings/day) was associated with higher BMI z-score in infancy (β 0.20 units; 95% CI 0.02, 0.38), early childhood (0.21; 0.05, 0.37), mid-childhood (0.21; 0.02, 0.40), and early adolescence (0.14; -0.07, 0.35) compared with Q1 intake (Q1: 0.00 ± 0.00 servings/day). Q4 was also associated with higher SS in early childhood (1.17 mm; 0.47, 1.88), mid-childhood (2.33 mm; 0.80, 3.87), and early adolescence (2.27 mm; -0.06, 4.60) and higher FMI in mid-childhood (0.26 kg/m2; -0.07, 0.59). Associations of maternal NNS intake with offspring BMI z-score became stronger with increasing age from 3 to 18 years (Pinteraction < 0.0001). Maternal NNS intake during pregnancy is associated with increased childhood BMI z-score and body fat from birth to teenage years. This is relevant given the escalating obesity epidemic, and popularity of NNS.

Maternal prepregnancy BMI and physical activity and type 1 diabetes in the offspring.

Previous studies showed conflicting results on the association between maternal prepregnancy body mass index (BMI) and type 1 diabetes in the offspring, and the role of maternal prepregnancy physical activity is unclear. We aimed to assess whether maternal prepregnancy BMI and physical activity predict type 1 diabetes in their offspring. Prospective study including women participating in the Nurses' Health Study II with follow-up from 1989 to 2011. Women repeatedly reported their BMI and physical activity, from which prepregnancy exposures were derived; and retrospectively reported their BMI at age 18 and physical activity at ages 18-22, considered early adulthood exposure. We estimated risk ratios (RR) and 95% confidence intervals (95%CI) using generalized estimating equations, adjusted for covariates. Findings at p < 0.05 were considered statistically significant. We identified 276 cases of type 1 diabetes among offspring (n=70,168) with maternal prepregnancy information and 448 cases among offspring (n=111,692) with maternal early adulthood information. Prepregnancy and early adulthood maternal BMI and physical activity were not associated with offspring type 1 diabetes. The RR comparing overweight to normal weight mothers was 1.08 (95%CI: 0.73-1.59) and comparing obese to normal weight was 0.94 (95%CI: 0.49-1.79, p-trend: 0.98). Comparing highest to lowest quartile of maternal physical activity the RR was 0.90 (95%CI: 0.61-1.32; p-trend: 0.73). Maternal type 2 diabetes was associated with an increased risk of type 1 diabetes in the offspring (RR=1.87; 95%CI: 1.25-2.80). Our findings do not support a relationship between maternal prepregnancy BMI or physical activity and the risk of type 1 diabetes in the offspring.

Physical activity before and during pregnancy: A cohort study.

To estimate physical activity (PA) in healthy women before and during pregnancy and to evaluate the features associated with moderate PA (MPA). A prospective cohort study was conducted on women selected 14weeks of pregnancy during 2013-2015 in primary public health service centers in southern Spain. Type, duration, and frequency of PA (IPAQ questionnaire in first, second, and third trimesters [T1, T2, T3]) were measured. Variables associated with MPA were evaluated using multiple logistic regressions controlling for age, pre-pregnancy obesity, level of education, number of living children, pre-pregnancy PA, and adherence to Mediterranean diet (AMD). Out of 463 women, MPA was estimated in 64% pre-pregnancy, and 54%, 61%, and 59% in T1, T2, and T3, respectively. MPA was associated with greater AMD in T2 (adjusted odds ratio [aOR] 1.17, 95% confidence interval [CI] 1.04-1.33) and T3 (aOR 1.16, 95% CI 1.02-1.31), previous PA (aOR 13.5, 95% CI 8.12-22.5 in T1; aOR 2.61, 95% CI 1.72-3.96 in T2; aOR 2.59, 95% CI 1.65-4.05 in T3), and pre-pregnancy obesity (aOR 2.97, 95% CI 1.28-6.89 in T1; aOR 2.69, 95% CI 1.23-3.60 in T3). PA decreased at the beginning of pregnancy, but compliance remained over 50%. MPA was associated with diet, pre-pregnancy PA, and obesity.

Healthy eating and physical activity among breastfeeding women: the role of misinformation

BackgroundEating healthy, being physically active and breastfeeding can greatly support a new mother’s physiological and psychological health. However, within the United States, only 8.5% of women are meeting fruit and vegetable recommendations and only 35% of women are maintaining their pre-pregnancy physical activity after childbirth. Preliminary investigations suggest barriers such as lack of time and knowledge hinder a breastfeeding woman’s ability to eat well and be physically active. The purpose of this study was to explore women’s perceptions of healthy eating and physical activity while breastfeeding.MethodsThis qualitative study utilized a 33-question semi-structured interview guide developed using the constructs of Self-Determination Theory. Data were analyzed via the process of immersion/crystallization.ResultsA total of 24 breastfeeding women completed a roughly 40-min telephone interview. The mean age of the mother was 32 ± .88 and the mean age of the child being breastfed was 8.5 ± 1.4 months old. Findings demonstrate mothers see value in engaging in physical activity primarily for reasons related to self-care. In addition, breastfeeding women have a lack of information and support regarding healthy eating and physical activity while breastfeeding and many are receiving misinformation through resources such as Facebook support groups. Finally, mothers want more resources available that focus specifically on healthy behaviors while breastfeeding.ConclusionWomen need greater access to education and resources regarding healthy eating and physical activity while breastfeeding. Ideally, information and resources would come from an educated health professional such as their healthcare provider rather than an internet source.

Physical Activity and Body Composition in Children and Their Mothers According to Mother's Gestational Diabetes Risk: A Seven-Year Follow-Up Study.

Background and Objectives: There is lack of knowledge on whether mothers’ gestational diabetes (GDM) risk is related to their physical activity (PA) or their children’s PA and body composition. We aimed to examine the difference in (1) change in self-reported PA from pre-pregnancy to seven-year follow-up and (2) accelerometer-based PA at seven years after delivery between the mothers having GDM risk (GDMRyes-mothers) and not having GDM risk (GDMRno-mothers). Furthermore, we examined the difference in children’s PA and/or body composition at six years of age according to their mothers’ GDM risk. Materials and Methods: The study included 199 Finnish women. GDM risk factors were screened at the beginning of pregnancy, and the women were classified as GDMRyes-mothers if they had at least one GDM risk factor (body mass index ≥25 kg/m2; age ≥40 years; family history of diabetes; GDM, signs of glucose intolerance, or newborn’s macrosomia (≥4500 g) in earlier pregnancy) or as GDMRno-mothers if they had no risk factors. Mothers’ PA was assessed by self-reporting at 8–12 gestational weeks concerning pre-pregnancy PA and at a follow-up seven years after the delivery. Moreover, mothers’ and their children’s PA was measured using a triaxial Hookie AM20-accelerometer at seven years after delivery. Children’s body composition was assessed using a TANITA bioelectrical impedance device. Adjusted linear regression analyses were applied. Results: GDMRno-mothers increased their self-reported PA more than GDMRyes-mothers from pre-pregnancy to the seven-year follow-up. Concerning women’s measured PA as well as children’s PA and body composition at seven years after delivery, the differences were non-significant between GDMRyes-mothers and GDMRno-mothers. However, of the GDM risk factors, mothers’ pre-pregnancy body mass index was positively related to unhealthier body composition in boys at six years of age. Conclusion: Health promotion should be targeted at women with GDM risk factors, in particular overweight women, in enhancing women’s PA in the long term and their children’s healthy body composition.

Association of pre-pregnancy physical activity level and physical activity in the first trimester

Association of pre-pregnancy physical activity level and physical activity in the first trimester

Risk Factors for Gestational Diabetes Mellitus: A Case-Control Study.

Background: The underlying causes of gestational diabetes mellitus (GDM) are important because they are effective for the diagnosis and prevention of this condition. The aim of this study was to identify the risk factors for GDM and the possible etiological agents. Materials and Methods: This case-control study was conducted with 100 women with GDM and 100 healthy pregnant women at a tertiary care hospital, affiliated to Babol University. GDM was identified by impaired oral glucose tolerance test based on the Carpenter and Coustan criteria. Healthy women were randomly selected from the prenatal health care clinic of the same center and were matched to gestational age of 24 to 28 weeks. Descriptive and inferential statistics were used for data analysis via the SPSS software. Results: After adjusting variables, multivariate analysis identified 4 significant risk factors of GDM, including prepregnancy low physical activity (odds ratio [OR] = 2.85, 95% confidence interval [CI]= 0.97-8.34), advanced maternal age (OR = 1.24, 95% CI = 1.13-1.35), body mass index ⩾ 30 kg/m2 (OR = 1.10, 95% CI = 1.02-1.20), and family history of diabetes mellitus (OR = 5.62, 95% CI = 2.26-13.96). Conclusion: We observed significant associations between low prepregnancy physical activity and obesity with GDM risk. Thus the finding of this study can help devise strategies for the prevention of GDM.

Healthy Lifestyle During Early Pregnancy and Risk of Gestational Diabetes Mellitus.

Previous studies have found associations between individual healthy behaviors and reduced risk of gestational diabetes mellitus (GDM); however, the association of composite healthy lifestyle during pregnancy with GDM has not been examined. Participants in the Omega Study (n=3,005), a pregnancy cohort study conducted in Washington State (1996-2008), reported information on diet, physical activity, smoking, and stress during early pregnancy. Lifestyle components were dichotomized into healthy/unhealthy and then combined into a total lifestyle score (range, 0-4). Regression models were used to determine relative risk of GDM (n=140 cases) in relation to healthy lifestyle. Twenty percent of participants had a healthy diet, 66% were physically active, 95% were nonsmokers, and 55% had low stress. Each 1-point increase in lifestyle score was associated with a 21% lower risk of GDM (95% confidence interval: 0.65, 0.96) after adjustment for age, race, and nulliparity. Adjustment for prepregnancy body mass index, prepregnancy physical activity, and prepregnancy smoking attenuated the associations slightly. Associations were similar in normal-weight and overweight/obese women. In this study, a composite measure of healthy lifestyle during early pregnancy was associated with substantially lower GDM risk. Public health messaging and interventions promoting multiple aspects of a healthy lifestyle during early pregnancy should be considered for GDM prevention.

Influence of pre-pregnancy leisure time physical activity on gestational and postpartum weight gain and birth weight – a cohort study

In order to examine the association between pre-pregnancy leisure time physical activities and gestational weight gain, postpartum weight gain and birth weight, we analysed prospectively collected data from 1827 women with singleton term pregnancies. Women were categorised in groups of sedentary women, light exercisers, moderate exercisers and competitive athletes. The results showed that sedentary women on average gained 14.1 kg during pregnancy, whereas light exercisers gained 13.7 kg, moderate exercisers gained 14.3 kg and competitive athletes 16.1 kg. Competitive athletes had an increased risk of having a gestational weight gain above Institute of Medicine (IOM) recommendations with an odds ratio of 2.60 (1.32–5.15) compared to light exercisers. However, birth weight and one year postpartum weight was similar for all four groups. Thus, although competitive athletes gain more weight than recommended during pregnancy, this may not affect birth weight or postpartum weight.Impact statementWhat is already known on this subjectPrevious studies have found that increased pre-pregnancy physical activity is associated with lower gestational weight gain during the last trimester, but showed no association between the pre-pregnancy level of physical activity and mean birth weight.What the results of this study addWe found that women classified as competitive exercisers had a 2.6-fold increased risk of gaining more weight than recommended compared to light exercisers. Nearly 6 out of 10 women among the competitive exercisers gained more weight than recommended by IOM. Surprisingly, this did not appear to increase birth weight or post-partum weight gain, but other adverse effects cannot be excluded.What the implications are of these findings for clinical practice and/or further researchIn the clinical practice it may be relevant to focus on and advise pre-pregnancy competitive exercisers in order to prevent excessive gestational weight gain.

Physical Activity Patterns in Normal-Weight and Overweight/Obese Pregnant Women.

The aims of the present study were to assess the volume of physical activity (PA) throughout pregnancy in normal-weight vs overweight/obese women, and to investigate which factors may predict compliance to PA recommendations in these women throughout gestation. In 236 pregnant women, 177 normal-weight and 59 overweight/obese (median[IQR] BMI 21.2[19.9–22.8] vs 26.5[25.5–29.0] kg/m2, respectively), medical history, anthropometry and clinical data, including glucose tolerance, were recorded. In addition, pre-pregnancy PA was estimated by the Kaiser questionnaire, while total, walking and fitness/sport PA during pregnancy were assessed by the Physical Activity Scale for the Elderly (PASE) modified questionnaire, at 14–16, 24–28 and 30–32 weeks of gestation. PA volume was very low in the first trimester of pregnancy in both groups of women. However, it increased in the second and third trimester in normal-weight, but not in overweight/obese subjects. Higher pre-pregnancy PA was a statistically significant predictor of being physically active (>150 minutes of PA per week) during all trimesters of gestation. In conclusion, physical activity volume is low in pregnant women, especially in overweight/obese subjects. PA volume increases during pregnancy only in normal-weight women. Pre-pregnancy PA is an independent predictor of achieving a PA volume of at least 150 min per week during pregnancy.

Ethnic differences in blood pressure from early pregnancy to postpartum: a Norwegian cohort study.

To examine blood pressure (BP) differences and changes between and within ethnic Western European, South Asian, Middle Eastern, East Asian, African, and East European living in Norway, from early pregnancy to postpartum and to explore associations between BP and explanatory variables. This was a population-based cohort study of 811 healthy pregnant women, 59% had ethnic minority origin. Participants were from Western Europe, Eastern Europe, South Asia, East Asia, Middle East, and Africa. We performed ANOVA, generalized estimating equations linear regression and multiple linear regression analysis. At 15 weeks' gestation, mean SBP were 4.9-7.0 mmHg lower and mean DBP 2.1-3.4 mmHg lower for the non-Europeans compared with Western Europeans. SBP increased in all non-European groups from 15 weeks' gestation to 14 weeks' postpartum (P < 0.01), but not in Europeans. Ethnic differences were further reduced postpartum, with only South Asians having lower mean SBP than Western Europeans (P < 0.01). The ethnic differences persisted after adjusting for age, family history of cardiovascular disease, prepregnancy BMI, and prepregnancy physical activity. Age, prepregnancy BMI, prepregnancy physical activity, postpartum weight retention, and breastfeeding were independently associated with postpartum BP (P < 0.05). Pregnancy may have a more adverse effect on BP trajectories from early pregnancy to postpartum among non-European women compared with Western Europeans, despite their more favorable BP in early pregnancy.

A follow-up study to assess the determinants and consequences of physical activity in pregnant women of Cuenca, Spain.

BackgroundIn recent years, the influence of physical exercise on pregnancy outcomes has been widely debated. Despite the numerous studies addressing the relationship between maternal physical activity and pregnancy outcomes, the evidence for consistent and significant impact of regular exercise during pregnancy on fetal growth remains lacking. The aims of this study were, first, to assess the level of physical activity performed throughout the pregnancy by objective (accelerometer) and self-reported (questionnaire) measurements, and, second, to ascertain pre-pregnancy physical activity levels, to estimate the relationship between levels of physical activity and some pregnancy and neonatal outcomes.Methods/designThis was a prospective cohort study. Participants were pregnant women (n = 194) aged 18 to 40 years who attended for three quarterly appointments for pregnancy ultrasound scans at the Virgen de la Luz Hospital in Cuenca, Spain. All participants provided written informed consents to participate in the study. Physical activity during the pregnancy follow-up was assessed by a self-reported Pregnancy Physical Activity Questionnaire and sleep log; also objectively by a GT3X accelerometer (ActiGraph). Furthermore, pregnancy symptoms inventory, nutritional behavioural assessment, socio-demographic characteristics, and anthropometry and body composition were measured.At the end of the follow up, the following main outcomes were determined: pregnancy outcomes (incidence of gestational diabetes mellitus, pre-eclampsia, pregnancy-induced hypertension, weight gain during pregnancy, type of delivery, and neonatal outcomes (gestational age, birth weight, gender, Apgar score 1 min/5 min, type of resuscitation (I/II/III/IV), and pH of umbilical cord blood). Descriptive statistics for cross-sectional data, linear mixed regression models for absolute differences in changes baseline-final measurements were used as statistical analyses.DiscussionAlthough the effectiveness of physical activity programmes on improving maternal and neonatal outcomes has heretofore been studied, the impact of free time physical activity during pregnancy has not been assessed using objective measures. This paper reports the design of a prospective cohort study that aims to assess the physical activity levels of pregnant women, and to estimate the relationship between those physical activity levels with maternal and neonatal outcomes.This study could contribute to providing evidence for the formulation of recommendations for physical activity for pregnant women.

Maternal Physical Activity During Pregnancy

PURPOSE: Maternal physical activity during pregnancy influences infant’s birth weight and body composition, but its association with bone health has been poorly evaluated. This study aims at documenting in a longitudinal study the effect of objectively measured physical activity during pregnancy on infant’s bone mineral content (BMC) and density (BMD). METHODS: 7-day accelerometry recordings (Actigraph GT3X+) were performed in low-risk pregnant women at 17 and 36 weeks of gestation. BMC and BMD were evaluated by DXA in mothers and infants within 2 weeks after birth. Sociodemographics, maternal lifestyle habits, pre-pregnancy physical activity, medical history and pregnancy outcomes were collected through interview and charts’ review. Mean counts per minute (CPM) and daily time spent at moderate and vigorous physical activity (MVPA) were calculated for each period from accelerometry data. The association between physical activity data and infant’s BMC and BMD was evaluated through multiple regression models, adjusting for infant sex and length, parity, maternal pre-pregnancy BMI, gestational weight gain, multivitamin use, gestational age at delivery, infant’s age at DXA, maternal BMD and pre-pregnancy physical activity. RESULTS: : For this preliminary analysis, DXA assessment and accelerometry data for at least one visit were available for 108 pregnant women (age=29.7 ± 3.7 y; pre-pregnancy BMI=23.6 ± 4.7 kg/m2; 59.3% nulliparous) and their baby (birth weight=3451 ± 424 g; gestational age=39.7 ± 1.2 weeks; 45.4% boys). Daily time spent at MVPA at 17 weeks was negatively associated with infant’s BMC and BMD (β= -0.45 g and -0.0009 g/cm3 per 10 min of MVPA, p=0.033 and 0.026), after adjustment for confounders. Similarly, mean CPM at 17 weeks was significantly associated with infant’s BMC and BMD (β= -1.92 g and -0.004 g/cm3 per 100 CPM, p=0.010 and p=0.004). Mean CPM at 36 weeks was also associated with child’s BMC (β= -0.004 g/cm3 per 100 CPM, p=0.024). CONCLUSIONS: Higher levels of maternal physical activity measured by accelerometry during pregnancy were associated with a decrease in infant’s BMC and BMD. The impact of maternal nutrition on this association remains to be investigated. Supported by the Fondation des Étoiles, Canadian Institutes of Health Research and Fonds de Recherche du Québec-Santé.