Water aerobics II: maternal body composition and perinatal outcomes after a program for low risk pregnant women Physical and psychological changes with vigorous exercise in sedentary primigravidae. Adherence to walking or stretching, and risk of preeclampsia in sedentary pregnant women. Supervised home-based exercise may attenuate the decline of glucose tolerance in obese pregnant women. Nutrition and exercise reduce excessive weight gain in normal-weight pregnant women. Resistance exercise training during pregnancy and newborn's birth size: a randomised controlled trial Aerobic Exercise and Submaximal Functional Capacity in Overweight Pregnant Women: A Randomized Trial Supervised exercise-based intervention to prevent excessive gestational weight gain: a randomized controlled trial. The effects of exercise intensity on body composition, weight loss, and dietary composition in women. Effect of fat and fat-free mass deposition during pregnancy on birth weight. Beginning regular exercise in early pregnancy: effect on fetoplacental growth. The effect of exercise on the intensity of low back pain in pregnant women. A walking intervention improves capillary glucose control in women with gestational diabetes mellitus: a pilot study. The effect of an antenatal physical exercise programme on maternal/perinatal outcomes and quality of life in overweight and obese pregnant women: a randomised clinical trial Effect of regular exercise on prevention of excessive weight gain in pregnancy: A randomised controlled trial Changes in energy expenditure resulting from altered body weight. Effect of exercise on blood pressure in pregnant women with a high risk of gestational hypertensive disorders. A Program of Exercise Throughout Pregnancy. Is it Safe to Mother and Newborn? Exercise in pregnancy: effect on fitness and obstetric outcomes-a randomized trial. Exercise training in pregnancy reduces offspring size without changes in maternal insulin sensitivity. Continuing regular exercise during pregnancy: effect of exercise volume on fetoplacental growth.
Background To evaluate the effectiveness and safety of water aerobics during pregnancy . Methods A r and omized controlled trial carried out in 71 low-risk sedentary pregnant women , r and omly allocated to water aerobics or no physical exercise .  Maternal body composition and perinatal outcomes were evaluated . For statistical analysis Chi-square , Fisher 's or Student 's t-tests were applied . Risk ratios and their 95 % CI were estimated for main outcomes . Body composition was evaluated across time using MANOVA or Friedman multiple analysis . Results There were no significant differences between the groups regarding maternal weight gain , BMI or percentage of body fat during pregnancy . Incidence of preterm births ( RR = 0.84 ; 95%CI:0.28–2.53 ) , vaginal births ( RR = 1.24 ; 95%CI:0.73–2.09 ) , low birthweight ( RR = 1.30 ; 95%CI:0.61–2.79 ) and adequate weight for gestational age ( RR = 1.50 ; 95%CI:0.65–3.48 ) were also not significantly different between groups . There were no significant differences in systolic and diastolic blood pressure and heart rate between before and immediately after the water aerobics session . Conclusion Water aerobics for sedentary pregnant women proved to be safe and was not associated with any alteration in maternal body composition , type of delivery , preterm birth rate , neonatal well-being or weight PURPOSE The present study examined the effects of exercise on physical and psychological variables in sedentary primigravidae ( PRA ) . METHODS A total of nine women r and omly assigned to an exercise ( E ) ( mean age = 31.3 + /- 3.1 yr ) and six subjects r and omly assigned to a control ( C ) group ( mean age = 27.8 + /- 3.1 yr ) fulfilled all requirements for the study . Exercise included a variety of exercise activities performed to a target heart rate of 150 - 156 beats x min(-1 ) , three times per week for 15 wk . RESULTS Results showed no significant differences between E and C groups in physical characteristics initially . A repeated measures ANOVA showed a significant group effect ( P < 0.05 ) and a significant group by time interaction ( P = 0.001 ) with the E group showing a significantly longer amount of time on the PWC150 test than the C group . There was no significant group , time , or group by time interaction for lactate accumulation . This occurred , despite the fact that the E group spent 56 % longer on the PWC150 test and the C group spent 30 % less time on the same test at the conclusion of the study . Finally , the E group in comparison to the C group showed more favorable improvements in several items related to health and well-being on the Body Cathexis Scale . There were no significant differences between E and C groups in any pregnancy outcome measures . All babies were delivered healthy  at term . CONCLUSIONS These data suggest that a vigorous exercise program can lead to significant improvements in aerobic fitness at similar lactate concentrations compared to a control group and can be well tolerated by low risk sedentary PRA without any deleterious effects occurring to herself or unborn child Pregnant women at risk for preeclampsia may benefit from the positive effects of exercise , but they may be unlikely to adhere to an exercise program . A r and omized trial was conducted with 124 sedentary pregnant women to compare the effects of walking exercise to a stretching exercise on adherence and on the preeclampsia risk factors of heart rate ( HR ) , blood pressure , and weight gain .  Walkers exercised less than stretchers both overall and as pregnancy advanced . HR and blood pressure were lower among stretchers than walkers , but weight gain did not differ between the groups . For sedentary pregnant women , a stretching exercise may be more effective than walking in mitigating the risk of preeclampsia due to higher adherence and possible cardiac-physiologic effects AIM The significant deterioration of insulin sensitivity and glucose tolerance during pregnancy can have serious health implication s for both the pregnant woman and her baby . Although it is well established that regular exercise benefits insulin sensitivity in the nonpregnant population , the effect on glucose tolerance in obese pregnant women is not known . The purpose of this study was to investigate the effect of a supervised 10-week , home-based , exercise programme , beginning at week 18 of gestation , on glucose tolerance and aerobic fitness in previously sedentary obese women . METHODS Twelve sedentary obese women were r and omized into an exercise ( EX ; n=6 ) or control ( CON ; n=6 ) group at 18 weeks of gestation . Those r and omized to EX engaged in 10 weeks of supervised home-based exercise ( three sessions a week of stationary cycling ) , while those in the CON group maintained their usual daily activity . Their glucose and insulin responses to an oral glucose tolerance test ( OGTT ) , as well as their aerobic fitness , were assessed both pre- and postintervention . RESULTS Reduced glucose tolerance in the CON , but not EX , group was indicated by a tendency postintervention towards higher blood glucose levels at 1h of the OGTT ( P=0.072 ) . Furthermore , at 2h of the postintervention OGTT , blood glucose tended to remain elevated from baseline in the CON ( P=0.077 ) . There was also a trend towards increased fitness in the EX ( P=0.064 ) , but not the CON group . CONCLUSION Regular aerobic exercise begun during pregnancy may have favourable effects on glucose tolerance and fitness in obese women , and warrants further investigation in a larger sample population PURPOSE This study aim ed to evaluate the effect of an exercise program of two different intensities , with nutritional control , on gestational weight gain ( GWG ) , infant birth weight , and maternal weight retention at 2 months postpartum ( 2 mopp ) . METHODS Pregnant women ( prepregnancy body mass index = 18.5 - 24.9 kg·m ) were r and omized at study entry ( 16 - 20 wk of gestation ) to a low-intensity ( LI , 30 % HR reserve ( HRR ) , n = 23 ) or moderate-intensity ( MI , 70 % HRR , n = 26 ) exercise program , with nutritional control . The exercise program consisted of walking sessions three to four times per week , gradually increasing exercise time from 25 to 40 min per session . Forty-five normal-weight women who did not participate in any structured exercise program during pregnancy and had singleton births were used as a historical control group .  RESULTS Total GWG was higher in the control group ( 18.3 ± 5.3 kg ) compared with the LI ( 15.3 ± 2.9 kg , P = 0.01 ) and MI ( 14.9 ± 3.8 kg , P = 0.003 ) groups . During the intervention , GWG was similar in both intervention groups , with weekly rates of weight gain of 0.49 ± 0.1 and 0.47 ± 0.1 kg·wk in the LI and MI groups , respectively . Excessive GWG during the intervention was prevented in 70 % of the women in the LI group and 77 % of those in the MI group . Excessive GWG occurred before the intervention began . At 2 mopp , 18 % and 28 % of the women in the LI and MI groups , respectively , retained ≤2.0 kg compared with only 7 % of those in the control group . Infant birth weight was not different between the groups . CONCLUSIONS Results suggest that a prenatal nutrition and exercise program regardless of exercise intensity , reduced excessive GWG and decreased weight retention at 2 mopp in women of normal weight before pregnancy Objective : We examined the effect of light intensity resistance exercise training performed during the second and third trimester of pregnancy on the  newborn 's birth size . We also studied the association between  maternal body weight prior to pregnancy and newborn 's birth size .  Design : R and omised controlled trial . Subjects : We r and omly assigned 160 sedentary gravidae to either a training ( n=80 ) or a control ( n=80 ) group . The training programme focused on light resistance and toning exercises ( three times per week , 35–40 min per session ) . We recorded the Apgar score , birth weight , birth length , and head circumference of the newborn , as well as gestational age at time of delivery from hospital perinatal records . We also measured maternal weight and height before parity and gestational weight gain . Results : Maternal characteristics neither differed between groups ( all P>0.1 ) nor newborn characteristics ( all P>0.1 ) . Maternal body weight was positively and significantly associated with newborn 's birth weight and length only in the control group ( β=19.20 and 0.065 , respectively , P<0.01 ) . Conclusion : Light intensity resistance training performed over the second and third trimester of pregnancy does not have a negative impact on the newborn 's body size or overall health . Exercise interventions might attenuate the adverse consequences of maternal body weight before pregnancy on the newborn 's birth size Objective : To evaluate the effects of aerobic training on submaximal cardiorespiratory capacity in overweight pregnant women . Methods : We conducted a r and omized clinical trial in a referral center prenatal clinic during the period 2000–2002 . Of 132 overweight ( body mass index 26–31 kg/m2 ) but otherwise healthy volunteers , at 20 years of age or older , with gestational age of 20 weeks or less , and without diabetes or hypertension , 92 consented to participate and were r and omized . Intervention consisted of 3 one-hour aerobic exercise sessions per week ; the control group received weekly relaxation and focus group discussion s. The main outcome measure was submaximal exercise capacity evaluated by oxygen uptake at the anaerobic ( first ventilatory ) threshold during cardiopulmonary treadmill testing 12 weeks after r and omization . Results : Oxygen uptake at the anaerobic threshold increased 18 % ( 15.9 ± 2.6 to 18.1 ± 3.1 mL · min−1 · kg−1 ) in the exercise group but decreased 16 % ( 16.9 ± 3.0 to 15.8 ± 2.6 mL · min−1 · kg−1 ) among the control group . Oxygen consumption at the anaerobic threshold , adjusted through analysis of covariance for baseline oxygen uptake , was 2.68 ( 95 % confidence interval 1.23 to 4.12 ) mL · min−1 · kg−1 greater in the exercise group . Women in the exercise group were approximately 5 times more likely than those in the control group to have regular or good cardiorespiratory capacity ( 12/38 versus 2/38 ; relative risk 5.2 , 95 % confidence interval 1.2 to 22.0 , number needed to treat 5 ) . Conclusion : Aerobic training in overweight pregnant women  substantially increases submaximal exercise capacity , overcoming the otherwise negative effects of pregnancy in this regard . Additional studies are required to evaluate its effect on major clinical outcomes . LEVEL OF EVIDENCE : OBJECTIVE To study the effect on  maternal weight gain of a supervised light- to moderate-intensity exercise-based intervention performed from the ninth week of pregnancy . PARTICIPANTS AND METHODS A total of 962 healthy pregnant women were r and omly assigned to a st and ard care or exercise intervention group conducted between September 1 , 2007 , and January 31 , 2011 . The intervention included light- to moderate-intensity aerobic and resistance exercises performed 3 days a week ( 50 - 55 minutes per session ) . Excessive gestational weight gain was calculated on the basis of the 2009 Institute of Medicine ( IOM ) recommendations . Gestational body weight gain was calculated on the basis of the weight measured at the first prenatal visit ( fifth to sixth weeks of gestation ) and weight measured at the last visit to the clinic before delivery . Women were categorized into normal weight or overweight or obese . RESULTS Women in the intervention group gained less weight ( adjusted mean difference , 1.039 kg ; 95 % CI , 0.534 - 1.545 kg ; P<.001 ) and were less likely to gain weight above the IOM recommendations ( odds ratio , 0.625 ; 95 % CI , 0.461 - 0.847 ) compared with those in the st and ard care group . The main treatment effects according to body mass index category were that normal weight women in the intervention group gained less weight ( adjusted mean difference , 1.393 kg ; 95 % CI , 0.813 - 1.972 kg ; P<.001 ) and were less likely to gain weight above the IOM recommendations ( odds ratio , 0.508 ; 95 % CI , 0.334 - 0.774 ) than normal weight women who received st and ard care . No significant treatment effect was observed in overweight or obese women . CONCLUSION Supervised exercise of light to moderate intensity can be used to prevent excessive gestational weight gain , especially in normal weight women . TRIAL REGISTRATION clinical trials.gov Identifier : NCT01790347 OBJECTIVE There is controversy over whether exercise and /or exercise intensity has an effect on total caloric intake or diet composition . The purpose of this study was to test the effect of exercise intensity without dietary manipulation on body composition and /or weight loss and to determine whether exercise intensity affected total caloric intake or diet composition in normal weight young women . METHODS Fifteen women aged 18 to 34 years with a maximal oxygen consumption average or below on the Palo Alto norms served as subjects . Subjects were r and omly assigned to : 1 ) low heart rate intensity exercise group ( LI , N = 7 ) which exercised 40 to 45 minutes approximately four times weekly at a mean heart rate of 132 beats per minute ( bpm ) ; 2 ) high heart rate intensity group ( HI , N = 8) which exercised 40 to 45 minutes approximately four times weekly at a mean HR of 163 bpm . All subjects were given a maximal exercise test prior to and during weeks eight , 12 and 16 . The first 4 weeks served as a control period , followed by approximately 11 weeks of exercise . Each subject recorded her dietary intake for 1 complete week , including a weekend , during weeks 2 , 6 , 10 and 14 of the study . RESULTS VO2 max increased ( p < .05 ) in HI ( 29 + /- 6 ml/kg/minute to 38 + /- 7 ) but did not change in LI ( 36 + /- 5 to 38 + /- 7 ) . Percent fat decreased in HI ( p < .05 ) ( 27 + /- 7 to 22 + /- 4 ) but was unchanged in LI ( 22 + /- 6 to 21 + /- 6 ) . The weekly intake of total kcal , carbohydrate , protein and fat did change significantly for either group . The weekly intake of saturated fat declined significantly ( p < .05 ) in HI ( 21.2 + /- 5.8 g to 14.9 + /- 5.5 g ) ; their weekly intake of cholesterol also decreased ( p < .05 ) between months 2 to 3 ( 249 + /- 109 mg to 159 + /- 58 mg ) . No other differences in dietary intake between groups were found . CONCLUSION High heart rate intensity exercise training without dietary manipulation result ed in a decrease in body fat , but not weight change , as well as a decrease in the intake of saturated fat and cholesterol in normal weight young women . These changes were not observed after low heart rate intensity training OBJECTIVES The purpose s of our study were to describe the patterns and location of fat and fat-free mass deposition during pregnancy and to evaluate their effects on fetal growth . STUDY DESIGN Our study is a prospect i ve follow-up of 105 healthy pregnant women who were delivered of term infants .  Body composition was evaluated eight times during gestation with anthropometric measures and bioimpedance techniques .  Body fat and fat-free mass were calculated with equations specifically developed for this population . RESULTS Total weight gain was 10.0 + /- 3.5 kg ; net weight gain was 3.7 + /- 0.31 kg ; birth weight was 3211 + /- 467 gm ( values are mean + /- SEM ) . In these women fat was deposited mostly in the thigh and subscapular region for a total of 6.23 + /- 0.19 kg at term . The period of pregnancy of the largest maternal fat deposition per week is between the twentieth and thirtieth weeks . After adjusting by prepregnancy weight , birth weight is associated with maternal changes in thigh skin folds and fat gain before the thirtieth week of gestation . Infants born to mothers with low fat gain before the thirtieth week were 204 gm lighter than infants born to mothers with fat gain > or = 25th percentile of this population . CONCLUSION Maternal nutritional status at the beginning of gestation and the rate of fat gain early in pregnancy are the two nutritional indicators most strongly associated with fetal growth in this population OBJECTIVE Our purpose was to test the null hypothesis that beginning regular , moderate-intensity exercise in early pregnancy has no effect on fetoplacental growth . STUDY DESIGN Forty-six women who did not exercise regularly were r and omly assigned at 8 weeks either to no exercise ( n = 24 ) or to weight-bearing exercise ( n = 22 ) 3 to 5 times a week for the remainder of pregnancy . Outcome variables included antenatal placental growth rate and neonatal and placental morphometric measurements . RESULTS The offspring of the exercising women were significantly heavier ( corrected birth weight : 3.75 + /- 0.08 kg vs 3.49 + /- 0.07 kg ) and longer ( 51.8 + /- 0.3 cm vs 50.6 + /- 0.3 cm ) than those born to control women . The difference in birth weight was the result of an increase in both lean body mass and fat mass . In addition , midtrimester placental growth rate was faster ( 26 + /- 2 cm(3)/wk vs 21 + /- 1 cm(3)/wk ) and morphometric indexes of placental function were greater in the exercise group . There were no significant differences in neonatal percentage body fat , head circumference , ponderal index , or maternal weight gain . CONCLUSIONS These data indicate that beginning a moderate regimen of weight-bearing exercise in early pregnancy enhances fetoplacental growth OBJECTIVE To investigate the effect of exercise during pregnancy on the intensity of  low back pain  and kinematics of spine . METHOD A prospect i ve r and omized study was design ed . 107 women participated in an exercise program three times a week during second half of pregnancy for 12 weeks and 105 as control group . All filled a question naire between 17 - 22 weeks of gestation and 12 weeks later for assessment of their back pain intensity . Lordosis and flexibility of spine were measured by Flexible ruler and Side bending test , respectively , at the same times . Weight gain during pregnancy , Pregnancy length and neonatal weight were recorded . RESULT Low back pain intensity was increased in the control group . The exercise group showed significant reduction in the intensity of low back pain after exercise ( p<0.0001 ) . Flexibility of spine decreased more in the exercise group ( p<0.0001 ) . Weight gain during pregnancy , pregnancy length and neonatal weight were not different between the two groups . CONCLUSION Exercise during second half of the pregnancy significantly reduced the intensity of low back pain , had no detectable effect on lordosis and had significant effect on flexibility of spine Exercise prescriptions that can be translated into clinical recommendations are clearly needed for women with gestational diabetes mellitus ( GDM ) . A pilot project was developed to document the effectiveness of a structured low-intensity walking protocol on capillary glucose control in GDM women . Ten GDM women followed conventional management of diet and insulin therapy , plus a low-intensity walking program ( W ) from diagnosis to delivery . Capillary glucose concentrations , insulin requirements , and pregnancy outcomes were compared with a matched cohort by body mass index ( BMI ) , age , and insulin usage ( 20 GDM women who followed conventional management alone ( C ) ) . Baseline capillary glucose concentrations were not significantly different between the W and C groups . The W group had an average acute drop in capillary glucose concentration from pre- to post-exercise of 2.0 mmol x L(-1 ) . In addition , the W group had significantly lower mean glucose concentrations in the fasted state and 1 h after meals than the C group in the week prior to delivery . These lower glucose concentrations were achieved while requiring fewer units of insulin per day ( C , 0.50 + /- 0.37 U x kg(-1 ) ; W , 0.16 + /- 0.13 U x kg(-1 ) ; p < 0.05 ) , injected less frequently . These results suggest an effective role in glucose regulation for this structured walking program Please cite this paper as : Nascimento S , Surita F , Parpinelli M , Siani S , Pinto e Silva J. The effect of an antenatal physical exercise programme on maternal/perinatal outcomes and quality of life in overweight and obese pregnant women : a r and omised clinical trial . BJOG 2011;118:1455–1463 Objectives To assess whether a 12-week supervised exercise-programme with an additional 30 min of moderate self-imposed physical activity on the non-supervised weekdays prevents excessive weight gain in pregnancy  , as well as postpartum weight retention . Methods One hundred and five sedentary , nulliparous pregnant women with a mean age of 30.7 ± 4.0 years and a pre-pregnancy body mass index of 23.8 ± 4.3 kg/m2 were r and omised to either an exercise group ( EG , n = 52 ) or a control group ( CG , n = 53 ) . The exercise programme consisted of 60 min supervised aerobic dance and strength training for 60 min , at least twice per week for a minimum of 12 weeks . Results Drop-out rates were 19 % and 21 % in the EG and CG , respectively . Fewer women in the EG than in the CG exceeded the Institute of Medicine recommendations ; however , only EG participants who attended 24 exercise sessions ( n = 14 ) differed significantly from controls ( p = 0.006 ) with regard to weight gain during pregnancy ( 11.0 ± 2.3 vs. 13.8 ± 3.8 kg , p < 0.01 ) and postpartum weight retention ( 0.8 ± 1.7 vs. 3.3 ± 4.1 kg , p < 0.01 ) . Conclusions Regular participation in aerobic dance exercise can contribute to significantly reduce weight gain during pregnancy BACKGROUND No current treatment for obesity reliably sustains weight loss , perhaps because compensatory metabolic processes resist the maintenance of the altered body weight . We examined the effects of experimental perturbations of body weight on energy expenditure to determine whether they lead to metabolic changes and whether obese subjects and those who have never been obese respond similarly . METHODS We repeatedly measured 24-hour total energy expenditure , resting and nonresting energy expenditure , and the thermic effect of feeding  in 18 obese subjects and 23 subjects who had never been obese . The subjects were studied at their usual body weight and after losing 10 to 20 percent of their body weight by underfeeding or gaining 10 percent by overfeeding . RESULTS Maintenance of a body weight at a level 10 percent or more below the initial weight was associated with a mean ( + /- SD ) reduction in total energy expenditure of 6 + /- 3 kcal per kilogram of fat-free mass per day in the subjects who had never been obese ( P < 0.001 ) and 8 + /- 5 kcal per kilogram per day in the obese subjects ( P < 0.001 ) . Resting energy expenditure and nonresting energy expenditure each decreased 3 to 4 kcal per kilogram of fat-free mass per day in both groups of subjects . Maintenance of body weight at a level 10 percent above the usual weight was associated with an increase in total energy expenditure of 9 + /- 7 kcal per kilogram of fat-free mass per day in the subjects who had never been obese ( P < 0.001 ) and 8 + /- 4 kcal per kilogram per day in the obese subjects ( P < 0.001 ) . The thermic effect of feeding and nonresting energy expenditure increased by approximately 1 to 2 and 8 to 9 kcal per kilogram of fat-free mass per day , respectively , after weight gain . These changes in energy expenditure were not related to the degree of adiposity or the sex of the subjects . CONCLUSIONS Maintenance of a reduced or elevated body weight is associated with compensatory changes in energy expenditure , which oppose the maintenance of a body weight that is different from the usual weight . These compensatory changes may account for the poor long-term efficacy of treatments for obesity OBJECTIVE To prospect ively determine whether moderate exercise during pregnancy lowers blood pressure . STUDY DESIGN A r and omized , controlled trial with one test group and one control group . All subjects have a history of mild hypertension , gestational hypertensive disorders or a family history of hypertensive disorders . Subjects were recruited before 14 weeks ' gestation . After four weeks of observation , the subjects were r and omly assigned to either the exercise or control group . The exercise group visited the laboratory three times a week for 10 weeks ( 18 - 28 gestation weeks ) to perform 30 minutes of exercise at Rating of Perceived Exertion level 13 . RESULTS A total of 16 pregnant women ( mean age , 30 years ) participated . The mean metabolic equivalent during exercise sessions was 4.7 ( SD = 0.8 ) . Blood pressure measurements were compared before and after the 10-week exercise period in the two groups . Systolic blood pressures did not change significantly , but diastolic blood pressure ( DBP ) in the exercise group decreased by 3.5 mm Hg , while that in the control group increased by 1.1 mm Hg . Thus , the pre-post change in DBP differed by 4.6 mm Hg between groups . Exercise treatment reduced the diastolic blood pressure to a near-significant level in the exercise group ( t = 2.34 , df = 7 , P = .052 ) . Percent body fat did not differ between the exercise and control groups either before or after exercise treatment . ANOVA revealed that pregnancy had a significant effect ( F(1 , 14 ) = 5.7 , P = .03 ) on increasing the percentage of fat , but exercise treatment did not ( F(1 , 14 ) = .18 , P = .68 ) . Estimated energy expenditure in overall daily physical activities during the intervention did not differ between the two groups despite the inclusion of exercise . CONCLUSION This study detected a strong trend that 10 weeks of moderate exercise lowered the  diastolic blood pressure among pregnant women at risk of hypertensive disorders . The reductions were probably due to the effect of exercise itself , not to weight or overall daily physical activity levels Purpose . The aim of the present study was to examine the influence of a program of moderate physical exercise throughout pregnancy on maternal and fetal parameters . Design . The study design was a r and omized controlled trial . Setting . The study took place at the Hospital of Fuenlabrada in Madrid , Spain . Sample . Analyzed were 200 pregnant women ( 31.54 ± 3.86 years ) , all of whom had uncomplicated and singleton gestation . Of these subjects , 107 were allocated to the  exercise group  ( EG ) and 93 to the  control group ( CG ) . Intervention . Women from EG participated in a physical conditioning program throughout pregnancy , which included a total of 55- to 60-minute weekly sessions , 3 days per week . Measures . Pregnancy outcomes . Maternal : gestational age , weight gain , type of delivery , blood pressure during pregnancy , gestational diabetes ( n/% ) . Fetal : birth weight , birth size , head circumference , Apgar score , pH of umbilical cord . Analysis . Student 's unpaired t-test and χ2 test were used ; p values of ≤ .05 indicated statistical significance . Cohen 's d was used to determine the effect size . Results . There were significantly more pregnant women in the CG who gained excessive weight during their pregnancies than in the EG group ( CG : N = 31 , 35.6 % versus N = 22 , 21.2 % ; χ2 = 4.95 ; p = .02 ) . The effect size was small ( Phi value = .16 ) . Other pregnancy outcome showed no differences between groups . Conclusion . A regular and moderate physical exercise program throughout pregnancy is not a risk to maternal and fetal well-being , and it helps to control excessive weight gain OBJECTIVE A prospect i ve r and omized controlled trial was design ed to assess the benefits and possible risks of aerobic exercise during pregnancy , using a fitness regimen based on the 2002 American College of Obstetricians and Gynecologists guidelines for exercise during pregnancy . METHODS Inactive women were r and omized at 12 - 14 wk gestation to a group that remained sedentary or to a group that performed moderate aerobic exercise 45 - 60 min , 4 d·wk , through 36 wk gestation . Thirty-one subjects in each group completed the study . RESULTS Compared with women who remained sedentary , active women improved aerobic fitness ( P < 0.05 ) and muscular strength ( P < 0.01 ) , delivered comparable size infants with significantly fewer cesarean deliveries ( P < 0.01 ) , and recovered faster postpartum ( P < 0.05 ) , at least related to the lower incidence of cesarean section . Active women developed no gestational hypertension ( P = 0.16 compared with controls ) and reported no injuries related to the exercise regimen . In the active group , there was one premature birth at 33 wk by a woman with a history of premature delivery of twins at 34 wk . There were no differences between groups in the incidence of gestational diabetes , musculoskeletal pains during pregnancy , flexibility on sit- and -reach test , mean length of pregnancy , neonatal Apgar scores , placenta weights , overall length of labor , weight gain during pregnancy , or weight retention postpartum . CONCLUSION Previously sedentary women who began exercising at 12 - 14 wk improved fitness and delivery outcomes CONTEXT Epidemiological studies have identified the importance of the in utero environment in providing a healthy start to life . Previous studies have suggested that the maternal environment , in particular a reduction in maternal insulin sensitivity , contributes significantly to fetal growth . Regular aerobic exercise , through an effect on maternal insulin sensitivity , may influence offspring size by regulating nutrient supply to the fetus . OBJECTIVE The aim of the study was to determine the effects of aerobic exercise training in the second half of pregnancy on maternal insulin sensitivity and neonatal outcomes . DESIGN AND SETTING We conducted a community-based , r and omized , controlled trial of exercise in pregnancy . PARTICIPANTS Eighty-four healthy nulliparous women ( mean + /- sd , age , 30 + /- 4 yr ; body mass index , 25.5 + /- 4 kg/m(2 ) ) participated in the study . INTERVENTION Subjects participated in a home-based stationary cycling program from 20 wk gestation to delivery . MAIN OUTCOME MEASURES Maternal insulin sensitivity , neonatal auxology , body composition , and growth-related peptides in cord blood were measured . RESULTS Offspring of  exercisers  had lower birth weight ( sd score , control , 0.23 + /- 0.8 ; exercise , -0.19 + /- 0.9 ; P = 0.03 ) and body mass index at birth ( sd score , control , 0.40 + /- 0.9 ; exercise , -0.01 + /- 0.09 ; P = 0.04 ) . The reduction in maternal insulin sensitivity in late gestation was not affected by exercise ( P = 0.45 ) and was unrelated to offspring size . Exercise offspring had lower cord serum IGF-I ( P = 0.03 ) and IGF-II ( P = 0.04 ) . CONCLUSIONS Regular exercise was associated with lower birth weights and reduced cord concentrations of growth-related peptides , suggesting an influence of exercise on endocrine regulation of fetal growth . These effects on offspring growth were not associated with an exercise training effect on maternal insulin sensitivity OBJECTIVE The purpose of this study was to test the null hypothesis that the volume of exercise at different times during pregnancy has no effect on fetoplacental growth . STUDY DESIGN Seventy-five women who exercised regularly were evaluated before pregnancy and r and omly assigned at 8 weeks ' gestation to one of 3 exercise regimens for the remainder of pregnancy . Primary outcome variables included placental growth rate , birth weight , and placental volume at term . RESULTS The offspring of the women who were r and omly assigned to a high volume of exercise in mid and late pregnancy were significantly lighter ( 3.39 kg vs 3.81 kg ) and thinner ( 8.3 % fat vs 12.1 % fat ) than those offspring born of women who were r and omly assigned to reduce their exercise volume after the 20th week . Maternal weight gain , fresh placental volumes , and histomorphometric indices of placental function were greater in the high-low group . CONCLUSION These data indicate that a high volume of moderate-intensity , weight-bearing exercise in mid and late pregnancy symmetrically reduces fetoplacental growth , whereas a reduction in exercise volume enhances fetoplacental growth with a proportionally greater increase in fat mass than in lean body mass
OBJECTIVES The purpose of this review was to examine the relationship between exercise dose and reductions in weight gain during pregnancy in exercise interventions .