Effects of Regular Exercise During Pregnancy on Early Childhood Neurodevelopment: The Physical Activity for Mothers Enrolled in Longitudinal Analysis Randomized Controlled Trial

in Journal of Physical Activity and Health

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Otávio Amaral de Andrade Leão
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Marlos Rodrigues Domingues
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Andréa Dâmaso Bertoldi
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Luiza Isnardi Cardoso Ricardo
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Werner de Andrade Müller
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Luciana Tornquist
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Rafaela Costa Martins
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Joseph Murray
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Mariângela Freitas Silveira
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Inácio Crochemore-Silva
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Pedro Curi Hallal
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Gregore Iven Mielke
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DOI:
https://doi.org/10.1123/jpah.2021-0477
Keywords:
child development; gestation; neuroscience
First Published Online:
15 Feb 2022
In Print:
Volume 19: Issue 3
Page Range:
203–210
Restricted access

Background: The aim of this study was to investigate the effect of exercise during pregnancy on early childhood neurodevelopment (cognitive, motor, and language domains). Methods: A randomized controlled trial nested into the 2015 Pelotas (Brazil) Birth Cohort was conducted. Healthy pregnant women were enrolled between 16 and 20 weeks of gestation; 424 women and their children (intervention [n = 141]; control [n = 283]) were analyzed. An exercise-based intervention 3 times per week was delivered over 16 weeks. Child neurodevelopment and its domains were assessed at 1, 2, and 4 years. Standardized mean differences and 95% confidence intervals are presented. Results: No effects of exercise during pregnancy on child neurodevelopment and its domains at age 1 year were observed. Compared with the control group, children from women in the exercise group had higher language score at age 2 years (standardized mean differences = 0.23; 95% confidence intervals, 0.02 to 0.44) and higher cognitive score (standardized mean differences = 0.22; 95% confidence intervals, 0.03 to 0.41) at age 4 years. No effects of exercise during pregnancy were observed in the motor domain at 1, 2, and 4 years. Conclusions: No detrimental effects of exercise during pregnancy on child neurodevelopment were observed. In addition, these findings suggest that exercise during pregnancy can result in small benefits for language and cognitive development.

Leão, Bertoldi, Ricardo, Silveira, and Hallal are with the Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil. Domingues, Müller, Tornquist, and Crochemore-Silva are with the Postgraduate Program in Physical Education, Federal University of Pelotas, Brazil. Martins and Murray are with the Postgraduate Program in Epidemiology and Human Development, and the Violence Research Centre (DOVE), Federal University of Pelotas, Pelotas, Brazil. Mielke is with the School of Public Health, The University of Queensland, Brisbane, QLD, Australia.

Leão (otavioaaleao@gmail.com) is corresponding author.

Supplementary Materials

    • Supplementary Table S1 (PDF 247 KB)
    • Supplementary Table S2 (PDF 182 KB)
    • Supplementary Table S3 (PDF 188 KB)
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  • 1.

    World Health Organization. WHO Guidelines on Physical Activity and Sedentary Behaviour. Geneva, Switzerland: World Health Organization; 2020.

    • Search Google Scholar
    • Export Citation
  • 2.

    Brown WJ, Hayman M, Haakstad LAH, et al. Evidence-Based Physical Activity Guidelines for Pregnant Women. Canberra: Australian Government Department of Health; 2020.

    • Search Google Scholar
    • Export Citation
  • 3.

    Mielke G, Tomicki C, Botton C, et al. Atividade física para gestantes e mulheres no pós-parto: Guia de Atividade Física para a População Brasileira. Rev Bras Ativ Fís Saúde. 2021;26:1–10.

    • Search Google Scholar
    • Export Citation
  • 4.

    Mottola MF, Davenport MH, Ruchat S-M, et al. 2019 Canadian guideline for physical activity throughout pregnancy. Br J Sports Med. 2018;52(21):1339–1346. PubMed ID: 30337460 doi:10.1136/bjsports-2018-100056

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    DiPietro L, Evenson KR, Bloodgood B, et al. Benefits of physical activity during pregnancy and postpartum: an umbrella review. Med Sci Sports Exerc. 2019;51(6):1292. PubMed ID: 31095086 doi:10.1249/MSS.0000000000001941

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Downs DS, Chasan-Taber L, Evenson KR, Leiferman J, Yeo S. Physical activity and pregnancy: past and present evidence and future recommendations. Res Q Exerc Sport. 2012;83(4):485–502. PubMed ID: 23367811

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    da Silva SG, Ricardo LI, Evenson KR, Hallal PC. Leisure-time physical activity in pregnancy and maternal-child health: a systematic review and meta-analysis of randomized controlled trials and cohort studies. Sports Med. 2017;47(2):295–317. PubMed ID: 27282925 doi:10.1007/s40279-016-0565-2

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Davenport MH, Kathol AJ, Mottola MF, et al. Prenatal exercise is not associated with fetal mortality: a systematic review and meta-analysis. Br J Sports Med. 2019;53(2):108–115. PubMed ID: 30337346 doi:10.1136/bjsports-2018-099773

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Davenport MH, McCurdy AP, Mottola MF, et al. Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: a systematic review and meta-analysis. Br J Sports Med. 2018;52(21):1376–1385. PubMed ID: 30337464 doi:10.1136/bjsports-2018-099697

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Davenport MH, Ruchat S-M, Poitras VJ, et al. Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysis. Br J Sports Med. 2018;52(21):1367–1375. PubMed ID: 30337463 doi:10.1136/bjsports-2018-099355

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Coll CV, Domingues MR, Gonçalves H, Bertoldi AD. Perceived barriers to leisure-time physical activity during pregnancy: a literature review of quantitative and qualitative evidence. J Sci Med Sport. 2017;20(1):17–25. PubMed ID: 27372276 doi:10.1016/j.jsams.2016.06.007

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Hayman M, Reaburn P, Alley S, Cannon S, Short C. What exercise advice are women receiving from their healthcare practitioners during pregnancy? Women Birth. 2020;33(4):e357–e362. PubMed ID: 31466828 doi:10.1016/j.wombi.2019.07.302

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Domingues MR, Barros AJ. Leisure-time physical activity during pregnancy in the 2004 Pelotas Birth Cohort Study. Rev Saude Publica. 2007;41(2):173–180. PubMed ID: 17420903 doi:10.1590/S0034-89102007000200002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Davenport MH, Meah VL, Ruchat S-M, et al. Impact of prenatal exercise on neonatal and childhood outcomes: a systematic review and meta-analysis. Br J Sports Med. 2018;52(21):1386–1396. PubMed ID: 30337465 doi:10.1136/bjsports-2018-099836

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Moyer C, Reoyo OR, May L. The influence of prenatal exercise on offspring health: a review. Clin Med Insights Womens Health. 2016;9:37–42. PubMed ID: 27777506

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Niño Cruz GI, Ramirez Varela A, da Silva ICM, Hallal PC, Santos IS. Physical activity during pregnancy and offspring neurodevelopment: a systematic review. Paediatr Perinat Epidemiol. 2018;32(4):369–379. PubMed ID: 29727034 doi:10.1111/ppe.12472

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Clapp JF III, Kim H, Burciu B, Lopez B. Beginning regular exercise in early pregnancy: effect on fetoplacental growth. Am J Obstet Gynecol. 2000;183(6):1484–1488. PubMed ID: 11120515 doi:10.1067/mob.2000.107096

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Clapp J. Influence of endurance exercise and diet on human placental development and fetal growth. Placenta. 2006;27(6-7):527–534. PubMed ID: 16165206 doi:10.1016/j.placenta.2005.07.010

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Domingues MR, Matijasevich A, Barros AJ, Santos IS, Horta BL, Hallal PC. Physical activity during pregnancy and offspring neurodevelopment and IQ in the first 4 years of life. PLoS One. 2014;9(10):e110050. PubMed ID: 25350666 doi:10.1371/journal.pone.0110050

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Ellingsen M, Pettersen A, Stafne S, Mørkved S, Salvesen K, Evensen K. Neurodevelopmental outcome in 7‐year‐old children is not affected by exercise during pregnancy: follow up of a multicentre randomised controlled trial. BJOG. 2020;127(4):508–517. PubMed ID: 31749301 doi:10.1111/1471-0528.16024

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Jukic AMZ, Lawlor DA, Juhl M, et al. Physical activity during pregnancy and language development in the offspring. Paediatr Perinat Epidemiol. 2013;27(3):283–293. PubMed ID: 23574417 doi:10.1111/ppe.12046

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Domingues MR, Bassani DG, da Silva SG, Coll CdVN, da Silva BGC, Hallal PC. Physical activity during pregnancy and maternal-child health (PAMELA): study protocol for a randomized controlled trial. Trials. 2015;16(1):1–7. doi:10.1186/s13063-015-0749-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Hallal PC, Bertoldi AD, Domingues MR, et al. Cohort profile: the 2015 Pelotas (Brazil) birth cohort study. Int J Epidemiol. 2018;47(4):1048–1048h. PubMed ID: 29126133 doi:10.1093/ije/dyx219

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    American College of Obstetricians Gynecologists. Physical activity and exercise during pregnancy and the postpartum period. Committee Opinion No. 650. Obstet Gynecol. 2015;126(6):e135–e142. doi:10.1097/AOG.0000000000001214

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Fernandes M, Stein A, Newton CR, et al. The INTERGROWTH-21st Project Neurodevelopment Package: a novel method for the multi-dimensional assessment of neurodevelopment in pre-school age children. PLoS One. 2014;9(11):e113360. PubMed ID: 25423589 doi:10.1371/journal.pone.0113360

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Murray E, Fernandes M, Newton CR, et al. Evaluation of the INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) in 2 year-old children. PLoS One. 2018;13(2):e0193406. PubMed ID: 29489865 doi:10.1371/journal.pone.0193406

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Cruz GIN. Desenvolvimento neuropsicomotor em crianças de 12 meses pertencentes à Coorte de Nascimentos de 2015 de Pelotas. In: Epidemiologia UFPel [database online]. Pelotas, RS: Federal University of Pelotas; 2019. https://www.epidemio-ufpel.org.br/uploads/teses/Tese%20Gloria%20Cruz.pdf. Accessed March 8, 2021.

    • Search Google Scholar
    • Export Citation
  • 28.

    Newborg J, Stock J, Wnek L, Guidubaldi J, Svinicki A. Battelle Developmental Inventory: Examiner’s Manual. Allen, TX: DLMeaching Resources; 1988.

    • Search Google Scholar
    • Export Citation
  • 29.

    Barros AJ, Matijasevich A, Santos IS, Halpern R. Child development in a birth cohort: effect of child stimulation is stronger in less educated mothers. Int J Epidemiol. 2010;39(1):285–294. PubMed ID: 19717543 doi:10.1093/ije/dyp272

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Behl DD, Akers JF. The use of the Battelle Developmental Inventory in the prediction of later development. Diagnostique. 1996;21(4):1–16. doi:10.1177/073724779602100401

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Weight Gain During Pregnancy. Reexamining the Guidelines. Washington, DC: National Academy of Sciences; 2009.

  • 32.

    Mielke GI, Crochemore-Silva I, Domingues MR, Silveira MF, Bertoldi AD, Brown WJ. Physical activity and sitting time from 16 to 24 weeks of pregnancy to 12, 24, and 48 months postpartum: findings from the 2015 Pelotas (Brazil) Birth Cohort Study. J Phys Act Health. 2021;18(5):587–593. PubMed ID: 33863852 doi:10.1123/jpah.2020-0351

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Polańska K, Muszyński P, Sobala W, Dziewirska E, Merecz-Kot D, Hanke W. Maternal lifestyle during pregnancy and child psychomotor development—Polish Mother and Child Cohort study. Early Hum Dev. 2015;91(5):317–325. PubMed ID: 25846841 doi:10.1016/j.earlhumdev.2015.03.002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34.

    Hellenes OM, Vik T, Løhaugen GC, et al. Regular moderate exercise during pregnancy does not have an adverse effect on the neurodevelopment of the child. Acta Paediatr. 2015;104(3):285–291. PubMed ID: 25471255 doi:10.1111/apa.12890

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35.

    McMillan AG, May LE, Gaines GG, Isler C, Kuehn D. Effects of aerobic exercise during pregnancy on one-month infant neuromotor skills. Med Sci Sports Exerc. 2019;51(8):1671–1676. PubMed ID: 30817721 doi:10.1249/MSS.0000000000001958

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36.

    Labonte-Lemoyne E, Curnier D, Ellemberg D. Exercise during pregnancy enhances cerebral maturation in the newborn: a randomized controlled trial. J Clin Exp Neuropsychol. 2017;39(4):347–354. PubMed ID: 27622854 doi:10.1080/13803395.2016.1227427

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Tinius R, Rajendran N, Miller L, et al. Maternal factors related to infant motor development at 4 months of age. Breastfeed Med. 2020;15(2):90–95. PubMed ID: 31944825 doi:10.1089/bfm.2019.0243

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    da Silva SG, Hallal PC, Domingues MR, et al. A randomized controlled trial of exercise during pregnancy on maternal and neonatal outcomes: results from the PAMELA study. Int J Behav Nutr Phys Act. 2017;14(1):1–11.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39.

    Bauer I, Hartkopf J, Kullmann S, et al. Spotlight on the fetus: how physical activity during pregnancy influences fetal health: a narrative review. BMJ Open Sport Exerc Med. 2020;6(1):e000658. PubMed ID: 32206341 doi:10.1136/bmjsem-2019-000658

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Perales M, Valenzuela PL, Barakat R, et al. Gestational exercise and maternal and child health: effects until delivery and at post-natal follow-up. J Clin Med. 2020;9(2):379. doi:10.3390/jcm9020379

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41.

    Hinman SK, Smith KB, Quillen DM, Smith MS. Exercise in pregnancy: a clinical review. Sports Health. 2015;7(6):527–531. PubMed ID: 26502446 doi:10.1177/1941738115599358

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Hegaard HK, Damm P, Hedegaard M, et al. Sports and leisure time physical activity during pregnancy in nulliparous women. Matern Child Health J. 2011;15(6):806–813. PubMed ID: 20680672 doi:10.1007/s10995-010-0647-y

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43.

    Owe KM, Nystad W, Bø K. Correlates of regular exercise during pregnancy: the Norwegian Mother and Child Cohort Study. Scand J Med Sci Sports. 2009;19(5):637–645. PubMed ID: 18627550 doi:10.1111/j.1600-0838.2008.00840.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Coll CdVN, Domingues MR, Hallal PC, et al. Changes in leisure-time physical activity among Brazilian pregnant women: comparison between two birth cohort studies (2004–2015). BMC Public Health. 2017;17(1):1–14. doi:10.1186/s12889-017-4036-y

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 45.

    Gaston A, Vamos CA. Leisure-time physical activity patterns and correlates among pregnant women in Ontario, Canada. Matern Child Health J. 2013;17(3):477–484. PubMed ID: 22488158 doi:10.1007/s10995-012-1021-z

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 46.

    Zhang Y, Dong S, Zuo J, Hu X, Zhang H, Zhao Y. Physical activity level of urban pregnant women in Tianjin, China: a cross-sectional study. PLoS One. 2014;9(10):e109624. PubMed ID: 25286237 doi:10.1371/journal.pone.0109624

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 47.

    Coll C, Domingues M, Santos I, Matijasevich A, Horta BL, Hallal PC. Changes in leisure-time physical activity from the prepregnancy to the postpartum period: 2004 Pelotas (Brazil) Birth Cohort Study. J Phys Act Health. 2016;13(4):361–365. PubMed ID: 26383057 doi:10.1123/jpah.2015-0324

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 48.

    Minig L, Trimble EL, Sarsotti C, Sebastiani MM, Spong CY. Building the evidence base for postoperative and postpartum advice. Obstet Gynecol. 2009;114(4):892–900. PubMed ID: 19888050 doi:10.1097/AOG.0b013e3181b6f50d

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
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