The Protective Role of Physical Fitness on Cardiometabolic Risk During Pregnancy: The GESTAtion and FITness Project

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Pedro Acosta-Manzano PA-HELP “Physical Activity for Health Promotion, CTS-1018” Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
Institute of Human Movement Science, Sport and Health, University of Graz, Austria

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Francisco M. Acosta Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
PROFITH “PROmoting FITness and Health through physical activity” Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
Turku PET Centre, University of Turku, Turku, Finland
Turku PET Centre, Turku University Hospital, Turku, Finland

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Marta Flor-Alemany Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology (INYTA), University of Granada, Granada, Spain

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Blanca Gavilán-Carrera PA-HELP “Physical Activity for Health Promotion, CTS-1018” Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain

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Manuel Delgado-Fernández PA-HELP “Physical Activity for Health Promotion, CTS-1018” Research Group, Department of Physical Education and Sports, Faculty of Sports Science, University of Granada, Granada, Spain
Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain

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Laura Baena-García Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain

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Víctor Segura-Jiménez Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Spain
Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, Cádiz, Spain
Hospital Universitario Virgen de las Nieves, Granada, Spain
Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain

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Virginia A. Aparicio Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology (INYTA), University of Granada, Granada, Spain

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Physical fitness (PF) is a cornerstone of metabolic health. However, its role in maternal–fetal metabolism during pregnancy is poorly understood. The present work investigates: (i) the association of PF with maternal and fetal cardiometabolic markers, and with clustered cardiometabolic risk during pregnancy, and (ii) whether being fit counteracts cardiometabolic abnormalities associated with overweight/obesity. Several PF components (flexibility, lower and upper body strength, and cardiorespiratory fitness [CRF]) were objectively assessed in 151 pregnant women at gestational weeks 16 and 33, and an overall PF cluster score calculated. At the same times, maternal glycemic and lipid markers, cortisol, and C-reactive protein were assessed with standard biochemical methods, along with blood pressure and a proxy for insulin resistance, and a cardiometabolic risk cluster score determined. These analytes were also measured in maternal and umbilical cord arterial and venous blood collected at delivery. PF was found to be associated with several maternal and a small number of fetal cardiometabolic markers (p < .05). Lower and upper body muscle strength, CRF, overall PF (week 16), and CRF changes (weeks 16–33) were inversely associated with clustered cardiometabolic risk (p < .05). Normal weight fit women had lower values for insulin level, insulin resistance, triglycerides, low-density lipoprotein cholesterol, C-reactive protein, and diastolic blood pressure than did overweight/obese unfit women at week 16 (p < .05). In conclusion, greater PF, especially muscle strength and CRF in early–middle pregnancy, appears to be associated with a better metabolic phenotype, and may protect against maternal cardiometabolic risk. “Keep yourself fit and normal weight before and during early pregnancy” should be a key public health message.

P. Acosta-Manzano and F.M. Acosta contributed equally to this work.

Acosta-Manzano (pacostamanzano@gmail.com) is corresponding author, https://orcid.org/0000-0002-4494-2353

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