Introduction: The aim of this study was to assess the long-term metabolic effects of gestational exercise on women with overweight/obesity and their offspring 8-10 years post-intervention.
Methods: We conducted a follow-up of a randomized controlled trial that originally investigated the effects of prenatal exercise on the incidence of gestational diabetes mellitus. Mother‒offspring pairs underwent comprehensive metabolic evaluations, including anthropometric measurements (weight, skinfold thickness, and body composition), blood pressure assessment, oral glucose tolerance tests, insulin release tests, and lipid profiling.
Results: A total of 118 mothers and 110 offspring were included in this longitudinal follow-up study. Compared with the controls, the mothers in the exercise group demonstrated superior glycemic control, with lower fasting plasma glucose [5.00 (4.61, 5.23) vs. 5.08 (4.89, 5.52) mmol/L, adj. P < 0.001], 2-h plasma glucose [6.54 (5.64, 8.10) vs. 7.17 (6.28, 9.59) mmol/L, adj. P < 0.001], fasting insulin [9.14 (6.38, 14.40) vs. 12.5 (9.52, 16.10) mU/L, adj. P < 0.001], and 2-h insulin [52.85 (40.60, 105.50) vs. 100.85 (66.90, 146.00) mU/L, adj. P < 0.001] levels, along with reduced insulin resistance [homeostasis model assessment of insulin resistance, HOMA-IR: 1.96 (1.47, 3.29) vs. 3.00 (2.10, 3.94), P = 0.008]. The mothers in the exercise group also exhibited improved body composition, including a lower body mass index (27.15 ± 3.25 vs. 29.45 ± 4.24 kg/m2, adj. P = 0.001), a lower fat percentage (36.31 ± 5.21% vs. 39.07 ± 5.21%, adj. P = 0.006), a lower visceral fat area (128.79 ± 40.21 vs. 151.62 ± 38.54 cm2, adj. P = 0.003), and lower abdominal (91.68 ± 9.34 vs. 96.92 ± 9.40 cm, adj. P = 0.004) and hip (104.16 ± 7.37 vs. 108.88 ± 8.65 cm, adj. P = 0.002) circumferences. The offspring of the mothers in the exercise group showed a significantly lower prevalence of overweight and obesity (37.93% vs. 48.07%, adj. P = 0.002), as well as non-significant reductions in body mass index Z-scores, fasting glucose levels, and abdominal and hip circumferences.
Conclusions: This longitudinal study provides evidence that moderate-intensity exercise during pregnancy confers lasting metabolic benefits on mothers with overweight/obesity, including improved glucose regulation and body composition, and may also exert favorable effects on the health of their offspring. Trial registration ClinicalTrials.gov identifier, NCT07435857.
Keywords: Exercise; Follow-up; Metabolism; Mother–offspring; Obesity.
© 2026. The Author(s), under exclusive licence to Springer Healthcare Ltd., part of Springer Nature.