Gestational Exercise and Maternal and Child Health: Effects Until Delivery and at Post-Natal Follow-up

J Clin Med. 2020 Jan 31;9(2):379. doi: 10.3390/jcm9020379.

Abstract

We studied the influence of pregnancy exercise on maternal/offspring cardiometabolic health until delivery and at follow-up. We pooled data from two randomized controlled trials from our group that were performed following the same methodology (one unpublished). We also collected follow-up data de novo from the participants of both trials and their offspring. In total, 1348 women with uncomplicated, singleton gestations were assigned to an intervention (n = 688, performing a supervised, moderate-intensity exercise program (three sessions/week)) or control group (n = 660). Maternal outcomes were excessive gestational weight gain (EGWG), gestational hypertension/diabetes and, at follow-up, return to pre-pregnancy weight within six months, hypertension, overweight/obesity, and other cardiometabolic conditions. Offspring outcomes were macrosomia and low-birthweight and, at follow-up, overweight/obesity, low-weight, and cardiometabolic conditions. Adherence to the intervention, which proved safe, was > 95%. Pregnancy exercise reduced the risk of EGWG, gestational hypertension, and diabetes (adjusted odds ratio (OR) and 95% confidence interval: 0.60 (0.46-0.79), 0.39 (0.23-0.67), and 0.48 (0.28-0.84)), and it was associated with a greater likelihood of returning to pre-pregnancy weight (2.37 (1.26-4.54)) and a lower risk of maternal cardiometabolic conditions (0.27 (0.08-0.95)) at the end of follow-up (median 6.1 years (interquartile range 1.8)). Pregnancy exercise also reduced the risk of macrosomia (0.36 (0.20-0.63)) and of childhood overweight/obesity during the first year (0.20 (0.06-0.63)). Our findings suggest that pregnancy exercise might protect maternal/offspring health.

Keywords: diabetes; hypertension; obesity; physical activity; pregnancy; training.