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Ruben Barakat, Mireia Pelaez, Rocio Montejo, Ignacio Refoyo and Javier Coteron

Background:

In spite of an extensive knowledge of the physiologic features of exercise during pregnancy, we still lack a comprehensive understanding of the effects of different types, intensities and duration of exercise throughout pregnancy on maternal and fetal well being. The aim of the current study was to examine the influence of an aerobic exercise program throughout pregnancy on gestational age at the moment of delivery.

Methods:

This study was a randomized controlled trial. Three hundred and twenty Caucasian (Spanish) healthy pregnant women with singleton gestation were randomly assigned to either an exercise (n = 160) or a control (n = 160) group. Gestational age (weeks) and other outcomes were measured. The exercise program included 85 sessions (general fitness class, 3 times/week, 55–60 min/session from weeks 8–10 to weeks 38–39 of pregnancy).

Results:

Two hundred and ninety women were analyzed (exercise group EG, n = 138, control group CG, n = 152). The mean gestational age did not differ between groups (EG= 39.7± 1.3 vs CG= 39.6 ± 1.1 weeks, P = .81). Relative to preterm deliveries in EG we found 6 (4.3%) and 11 (7.2%) in CG, (P = .73).

Conclusions:

A supervised program of moderate exercise performed throughout pregnancy is not a risk of preterm delivery for healthy pregnant women.

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Rebecca A. Schlaff, Claudia Holzman, Lanay M. Mudd, Karin A. Pfeiffer and James M. Pivarnik

Background:

Little is known about how leisure-time physical activity (LTPA) influences gestational weight gain (GWG) among body mass index (BMI) categories. The purpose of this study was to examine the relationship between pregnancy LTPA and the proportion of normal, overweight, and obese women who meet GWG recommendations.

Methods:

Participants included 449 subcohort women from the Pregnancy Outcomes and Community Health (POUCH) study. LTPA was collapsed into 3 categories [(None, < 7.5 kcal/kg/wk (low), ≥ 7.5 kcal/kg/wk (recommended)]. GWG was categorized according to IOM recommendations (low, recommended, or excess). Chi-square and logistic regression analyses were used to evaluate relationships among LTPA, BMI, and GWG.

Results:

Overweight women were more likely to have high GWG vs. normal weight women (OR = 2.3, 95% CI 1.3–4.0). Obese women were more likely to experience low GWG (OR = 7.3, 95% CI 3.6–15.1; vs. normal and overweight women) or excess GWG (OR = 3.5, 95% CI 1.9–6.5; vs. normal weight women). LTPA did not vary by prepregnancy BMI category (P = .55) and was not related to GWG in any prepregnancy BMI category (P = .78).

Conclusions:

Regardless of prepregnancy BMI, LTPA did not affect a woman’s GWG according to IOM recommendations. Results may be due to LTPA not differing among BMI categories.

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Lanay M. Mudd, Jim Pivarnik, Claudia B. Holzman, Nigel Paneth, Karin Pfeiffer and Hwan Chung

Background:

Leisure-time physical activity (LTPA) is recommended during pregnancy and has been associated with lower risk of delivering a large infant. We sought to characterize the effect of LTPA across the entire birth weight distribution.

Methods:

Women enrolled in the Pregnancy Outcomes and Community Health (POUCH) Study (1998–2004) were followed-up in 2007. Follow-up efforts were extensive for a subcohort and minimal for the remainder (nonsubcohort). Thus, 596 subcohort and 418 nonsubcohort women who delivered at term participated. Offspring were categorized as small-, appropriate-, or large-for-gestational-age (SGA, AGA, and LGA, respectively) based on gender and gestational age-specific birth weight z-scores (BWz). At follow-up, women recalled pregnancy LTPA and were classified as inactive, insufficiently active or meeting LTPA recommendations. Linear, logistic, and quantile regression analyses were conducted separately by subcohort status.

Results:

Meeting LTPA recommendations decreased odds of LGA significantly among the nonsubcohort (aOR = 0.30, 95% CI: 0.14–0.64) and nonsignificantly among the subcohort (aOR = 0.68, 95% CI: 0.34–1.34). In quantile regression, meeting LTPA recommendations reduced BWz among the upper quantiles in the nonsubcohort.

Conclusions:

LTPA during pregnancy lowered odds of LGA and reduced BWz among the upper quantiles, without shifting the entire distribution. LTPA during pregnancy may be useful for reducing risks of large fetal size.

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Lanay M. Mudd, Jim M. Pivarnik, Karin A. Pfeiffer, Nigel Paneth, Hwan Chung and Claudia Holzman

Background:

We sought to evaluate the effects of maternal leisure-time physical activity (LTPA) during pregnancy and current child LTPA on child weight status.

Methods:

Women with term pregnancies in the Pregnancy Outcomes and Community Health Study (1998–2004) were followed-up. A race-stratified subset of participants (cohort A) received extensive follow-up efforts leading to better response rates (592/926 = 64%) and diversity. The remainder (Cohort B) had a lower response rate (418/1629 = 26%). Women reported child height, weight and LTPA at 3 to 9 years (inactive vs. active), and recalled pregnancy LTPA (inactive vs. active). A 4-category maternal/child LTPA variable was created (reference: active pregnancy + active child). Children were classified as healthy weight, overweight, or obese using age- and sex-specific Body Mass Index percentiles. Logistic regression was used to assess the odds of child obesity (reference: healthy weight).

Results:

In unadjusted analyses, pregnancy inactivity increased odds for obesity when the child was active (1.6 [95% CI, 1.0−2.6] in Cohort A; 2.1 [95% CI, 1.1−4.0] in Cohort B), and more so when the child was inactive (2.4 [95% CI, 1.2−4.9] in Cohort A; 3.0 [95% CI, 1.0−8.8] in Cohort B). Adjustment for covariates attenuated results to statistical nonsignificance but the direction of relations remained.

Conclusions:

Maternal inactivity during pregnancy may contribute to child obesity risk.

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Danielle Symons Downs, Courtenay A. Devlin and Ryan E. Rhodes

Background:

Nearly 50% of U.S. women enter pregnancy as overweight or obese (OW/OB). There is a critical need to understand how to motivate OW/OB pregnant women for exercise behavior to improve their health and reduce adverse pregnancy outcomes.

Purpose:

To examine salient Theory of Planned Behavior belief predictors of normal weight (NW) and OW/OB pregnant women’s exercise behavior (EXB) across pregnancy.

Methods:

Pregnant women (N = 357) self-reported their exercise beliefs and behavior during each pregnancy trimester. Pearson correlations were used to examine exercise beliefs-behavior associations. Stepwise regressions were used to identify trimester (TRI) 1 and TRI 2 belief predictors of TRI 2 and TRI 3 EXB, respectively, for each weight status group. Belief endorsement was examined to identify critical beliefs.

Results:

TRI 1 EXB beliefs explained 58% of the total variance (22% NW, 36% OW/OB) in TRI 2 EXB. TRI 2 EXB beliefs explained 32% of the total variance (17% NW, 15% OW/OB) in TRI 3 EXB. Individual beliefs varied by weight status and trimester. Control beliefs emerged with the lowest endorsement; making them most critical to target for exercise interventions.

Conclusion:

Prenatal exercise interventions should be weight status specific and target salient beliefs/barriers unique to the pregnancy trimesters.

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Esra Uzelpasaci, Türkan Akbayrak, Serap Özgül, Ceren Orhan, Emine Baran, Gülbala Nakip, Sinan Beksac and Semra Topuz

between pregnancy outcomes and physical activity level. 11 , 12 There are a limited number of valid and reliable questionnaires used in the literature to assess physical activity in pregnancy. 7 , 13 – 15 The Turkish version of the International Physical Activity Questionnaire has been used in some

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Carina Bauer, Christine Graf, Anna M. Platschek, Heiko K. Strüder and Nina Ferrari

-pregnancy does not reduce sedentary time: an observational study . Int J Behav Nutr Phys Act . 2015 ; 12 ( 1 ): 27 . doi:10.1186/s12966-015-0191-7 10.1186/s12966-015-0191-7 28. Clapp JF , Dickstein S . Endurance exercise and pregnancy outcome . Med Sci Sports Exerc . 1984 ; 16 ( 6 ): 556 – 562 . 10

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Lindsey M. Russo, Megan W. Harvey, Penelope Pekow and Lisa Chasan-Taber

26564274 23. Melzer K , Schutz Y , Soehnchen N , et al . Effects of recommended levels of physical activity on pregnancy outcomes . Am J Obstet Gynecol . 2010 ; 202 ( 3 ): 266.e1 – 266.e6 . doi:10.1016/j.ajog.2009.10.876 10.1016/j.ajog.2009.10.876 24. Chasan-Taber L , Fortner R

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Danielle Symons Downs, Krista S. Leonard, Jessica S. Beiler and Ian M. Paul

. 2013 ; 56 ( 6 ): 372 – 378 PubMed doi:10.1016/j.ypmed.2013.02.015 10.1016/j.ypmed.2013.02.015 23454595 16. Haugen M , Brantsaeter AL , Winkvist A , et al . Associations of pre-pregnancy body mass index and gestational weight gain with pregnancy outcome and postpartum weight retention: a

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Sylvia E. Badon, Alyson J. Littman, K.C. Gary Chan, Michelle A. Williams and Daniel A. Enquobahrie

pregnancy outcomes: the UPBEAT pilot study . Ann Nutr Metab . 2014 ; 64 ( 3–4 ): 239 – 246 . PubMed doi:10.1159/000365027 10.1159/000365027 25300266 10. Aune D , Sen A , Henriksen T , Saugstad OD , Tonstad S . Physical activity and the risk of gestational diabetes mellitus: a systematic