Beth Lopez

The one-year morphometric and neurodevelopmental outcome of the offspring of women who continued to exercise regularly throughout pregnancy

OBJECTIVE Our purpose was to test the hypothesis that continuing regular exercise throughout pregnancy alters morphometric and neurodevelopmental outcome at 1 year. STUDY DESIGN The offspring of 52 women who exercised were compared with those of 52 control subjects who were similar in terms of multiple prenatal and postnatal variables known to influence outcome. All women were enrolled before pregnancy and had clinically normal antenatal and postnatal courses. Neurodevelopment was assessed by blinded examiners at 1 year of age, and morphometrics were obtained at birth and at 1 year of age. RESULTS At birth, the offspring of the exercising women weighed less (3.38 +/- 0.06 kg vs 3.58 +/- 0.07 kg) and had less body fat (9.5% +/- 0.8% vs 12.6% +/- 0.6%). However, at 1 year, all morphometric parameters were similar, and no clinically significant between-group differences were observed in performance on either the Bayley psychomotor (108 +/- 1 vs 101 +/- 2) or mental (120 +/- 1 vs 118 +/- 1) scales. CONCLUSIONS These data indicate that the offspring of exercising mothers have normal growth and development during the first year of life.

Neonatal behavioral profile of the offspring of women who continued to exercise regularly throughout pregnancy

OBJECTIVE The objective of the study was to test the hypothesis that continuing regular exercise throughout pregnancy alters early neonatal behavior. STUDY DESIGN The offspring of 34 women who exercised were compared with those of 31 demographically similar control subjects. All women had normal antenatal courses. Behavior was assessed at 5 days after birth with the Brazelton Scales. RESULTS The offspring of the exercising women performed better in 2 of the 6 behavioral constellations when examined at 5 days after birth. The scores reflecting their ability to orient to environmental stimuli were (mean +/- SEM) 7.6 +/- 0.1 and 6.5 +/- 0. 3, respectively, and the scores reflecting their ability to regulate their state or quiet themselves after sound and light stimuli were 6. 6 +/- 0.2 and 4.9 +/- 0.3, respectively. The scores reflecting habituation (7.9 +/- 0.2 and 8.0 +/- 0.1, respectively), motor organization (5.7 +/- 0.1 and 5.5 +/- 0.1, respectively), autonomic stability (5.9 +/- 0.2 and 5.5 +/- 0.3, respectively), and behavioral state range (4.1 +/- 0.2 and 4.5 +/- 0.3, respectively) were not significantly different. CONCLUSIONS These data indicate that the neonates born of exercising mothers have a different neurobehavioral profile as early as the fifth day after birth.

Nuchal cord and neurodevelopmental performance at 1 year.

Objective: To test the null hypothesis that the presence of a nuchal cord at delivery has no effect on neurodevelopmental performance at 1 year of age. Methods: The offspring of 190 women with clinically normal antenatal courses were evaluated within 1 month of their first birthday by a blinded observer using the Bayley Scales of Infant Development. The cases were grouped based on the presence of a symptomatic nuchal cord during labor (abnormal fetal heart rate patterns or meconium), and significant differences were detected using analysis of variance. Results: A symptomatic nuchal cord was present during labor and delivery in 24% of the 190 cases. At 1 year of age scores on both Bayley scales were slightly but significantly (P < .01) lower in the offspring delivered with a symptomatic nuchal cord. The mental index was 116 ± 9 versus 120 ± 7, and the psychomotor index was 101 ± 11 versus 107 ± 9. These differences were accentuated (P = .09) when the symptomatic cases complicated by extreme tightness, multiple loops, or antenatal detection were compared to symptomatic cases without these additional complications (overall index 110 ± 8 versus 105 ± 10). There were no between group differences in multiple potential confounding obstetric or demographic variables. Conclusions: These data do not support the null hypothesis and suggest that symptomatic nuchal cords, which are identified before labor as being extremely tight or having multiple loops, may be associated with a subclinicaln deficit in neurodevelopmental performance at 1 year of age.

Uterine blood flow during supine rest and exercise after 28 weeks of gestation

Objective  To test the null hypothesis that, after 28 weeks of gestation, uterine blood flow during supine rest and supine exercise is no different than uterine blood flow at left‐lateral rest.

Low-versus high-glycemic index diets in women: effects on caloric requirement, substrate utilization and insulin sensitivity.

BACKGROUND Lowering dietary glycemic index appears to have positive health effects in obese and/or insulin resistant individuals. However, detailed studies in lean young men show no effect. METHODS This study was designed to test the null hypothesis that a diet rich in low-glycemic carbohydrate has no effect on lipid profile, caloric requirements, fat oxidation, or insulin sensitivity in adult women when compared to one rich in high-glycemic carbohydrate. The metabolic feeding protocol used was conducted in both a free-living and in-patient setting using a randomized crossover design. Seven women were studied on each of 2 diets in which 60% of the calories were from either high- or low-glycemic carbohydrate sources. Each diet lasted 20 days with measurements of caloric requirement, resting metabolic rate, glucose and insulin responses to diet and activity, insulin sensitivity, and lipid profile over the last 7 days. Caloric requirement was determined by bomb calorimetry. Other techniques included indirect calorimetry, hydrodensitometry, stable isotope tracers, and the euglycemic clamp. RESULTS On the low-glycemic index diet the womens caloric requirements were 11% +/- 1% higher, fat oxidation at fasted rest supplied an average of 45% +/- 4% versus 28% +/- 5% of oxidative requirements, average glucose and insulin levels were approximately 40% lower, low density lipoproteins (LDL) and leptin concentrations were lower, and various indices of insulin sensitivity were > 20% higher. CONCLUSIONS In this group of adult women, a diet that lowered glycemic index well below that typically found in western diets increased both daily caloric requirement and fat oxidation, decreased insulin and glucose concentrations and increased insulin sensitivity.