TY - JOUR

T1 - Effects of prenatal exercise on gestational weight gain, obstetric and neonatal outcomes

T2 - FitMum randomized controlled trial

AU - Roland, Caroline B.

AU - Knudsen, Signe d.P.

AU - Alomairah, Saud A.

AU - Jessen, Anne D.

AU - Jensen, Ida K.B.

AU - Brændstrup, Nina

AU - Molsted, Stig

AU - Jensen, Andreas K.

AU - Stallknecht, Bente

AU - Bendix, Jane M.

AU - Clausen, Tine D.

AU - Løkkegaard, Ellen

N1 - Publisher Copyright: © 2023, The Author(s).

PY - 2023

Y1 - 2023

N2 - Background: To investigate the effects of two different exercise interventions during pregnancy on gestational weight gain (GWG) and obstetric and neonatal outcomes compared to standard care. Additionally, we aimed to improve standardization of GWG measurements by developing a model to estimate GWG for a standardized pregnancy period of 40 weeks and 0 days accounting for individual differences in gestational age (GA) at delivery. Methods: In a randomized controlled trial we compared the effects of structured supervised exercise training (EXE) three times per week throughout pregnancy versus motivational counselling on physical activity (MOT) seven times during pregnancy with standard care (CON) on GWG and obstetric and neonatal outcomes. Uniquely, to estimate GWG for a standardized pregnancy period, we developed a novel model to predict GWG based on longitudinally observed body weights during pregnancy and at admission for delivery. Observed weights were fitted to a mixed effects model that was used to predict maternal body weight and estimate GWG at different gestational ages. Obstetric and neonatal outcomes, among them gestational diabetes mellitus (GDM) and birth weight, were obtained after delivery. GWG and the investigated obstetric and neonatal outcomes are secondary outcomes of the randomized controlled trial, which might be underpowered to detect intervention effects on these outcomes. Results: From 2018–2020, 219 healthy, inactive pregnant women with median pre-pregnancy BMI of 24.1 (21.8–28.7) kg/m2 were included at median GA 12.9 (9.4–13.9) weeks and randomized to EXE (n = 87), MOT (n = 87) or CON (n = 45). In total 178 (81%) completed the study. GWG at GA 40 weeks and 0 days did not differ between groups (CON: 14.9 kg [95% CI, 13.6;16.1]; EXE: 15.7 kg [14.7;16.7]; MOT: 15.0 kg [13.6;16.4], p = 0.538), neither did obstetric nor neonatal outcomes. For example, there were no differences between groups in the proportions of participants developing GDM (CON: 6%, EXE: 7%, MOT: 7%, p = 1.000) or in birth weight (CON: 3630 (3024–3899), EXE: 3768 (3410–4069), MOT: 3665 (3266–3880), p = 0.083). Conclusions: Neither structured supervised exercise training nor motivational counselling on physical activity during pregnancy affected GWG or obstetric and neonatal outcomes compared to standard care. Trial registration: ClinicalTrials.gov; NCT03679130; 20/09/2018.

AB - Background: To investigate the effects of two different exercise interventions during pregnancy on gestational weight gain (GWG) and obstetric and neonatal outcomes compared to standard care. Additionally, we aimed to improve standardization of GWG measurements by developing a model to estimate GWG for a standardized pregnancy period of 40 weeks and 0 days accounting for individual differences in gestational age (GA) at delivery. Methods: In a randomized controlled trial we compared the effects of structured supervised exercise training (EXE) three times per week throughout pregnancy versus motivational counselling on physical activity (MOT) seven times during pregnancy with standard care (CON) on GWG and obstetric and neonatal outcomes. Uniquely, to estimate GWG for a standardized pregnancy period, we developed a novel model to predict GWG based on longitudinally observed body weights during pregnancy and at admission for delivery. Observed weights were fitted to a mixed effects model that was used to predict maternal body weight and estimate GWG at different gestational ages. Obstetric and neonatal outcomes, among them gestational diabetes mellitus (GDM) and birth weight, were obtained after delivery. GWG and the investigated obstetric and neonatal outcomes are secondary outcomes of the randomized controlled trial, which might be underpowered to detect intervention effects on these outcomes. Results: From 2018–2020, 219 healthy, inactive pregnant women with median pre-pregnancy BMI of 24.1 (21.8–28.7) kg/m2 were included at median GA 12.9 (9.4–13.9) weeks and randomized to EXE (n = 87), MOT (n = 87) or CON (n = 45). In total 178 (81%) completed the study. GWG at GA 40 weeks and 0 days did not differ between groups (CON: 14.9 kg [95% CI, 13.6;16.1]; EXE: 15.7 kg [14.7;16.7]; MOT: 15.0 kg [13.6;16.4], p = 0.538), neither did obstetric nor neonatal outcomes. For example, there were no differences between groups in the proportions of participants developing GDM (CON: 6%, EXE: 7%, MOT: 7%, p = 1.000) or in birth weight (CON: 3630 (3024–3899), EXE: 3768 (3410–4069), MOT: 3665 (3266–3880), p = 0.083). Conclusions: Neither structured supervised exercise training nor motivational counselling on physical activity during pregnancy affected GWG or obstetric and neonatal outcomes compared to standard care. Trial registration: ClinicalTrials.gov; NCT03679130; 20/09/2018.

KW - Delivery

KW - Gestational weight gain

KW - Maternal exercise interventions

KW - Obstetric and neonatal outcomes

KW - Physical activity

KW - Pregnancy

UR - http://www.scopus.com/inward/record.url?scp=85151170035&partnerID=8YFLogxK

U2 - 10.1186/s12884-023-05507-7

DO - 10.1186/s12884-023-05507-7

M3 - Journal article

C2 - 36991380

AN - SCOPUS:85151170035

VL - 23

JO - B M C Pregnancy and Childbirth

JF - B M C Pregnancy and Childbirth

SN - 1471-2393

IS - 1

M1 - 214

ER -