Ruben Barakat

Resistance exercise training during pregnancy and newborn's birth size: a randomised controlled trial.

Objective:We examined the effect of light intensity resistance exercise training performed during the second and third trimester of pregnancy on the newborns birth size. We also studied the association between maternal body weight prior to pregnancy and newborns birth size.Design:Randomised controlled trial.Subjects:We randomly 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 newborns 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 newborns body size or overall health. Exercise interventions might attenuate the adverse consequences of maternal body weight before pregnancy on the newborns birth size.

Exercise during pregnancy improves maternal glucose screen at 24–28 weeks: a randomised controlled trial

Objective The influence of an exercise programme performed by healthy pregnant women on maternal glucose tolerance was studied. Study design A physical activity (PA, land/aquatic activities) programme during the entire pregnancy (three sessions per week) was conducted by a qualified instructor. 83 healthy pregnant women were randomly assigned to either an exercise group (EG, n=40) or a control (CG, n=43) group. 50 g maternal glucose screen (MGS), maternal weight gain and several pregnancy outcomes were recorded. Results Significant differences were found between study groups on the 50 g MGS. Values corresponding to the EG (103.8±20.4 mg/dl) were better than those of the CG (126.9±29.5 mg/dl), p=0.000. In addition, no differences in maternal weight gain and no cases of gestational diabetes in EG versus 3 in CG (7%) (p>0.05) were found. Conclusion A moderate PA programme performed during pregnancy improves levels of maternal glucose tolerance.

Does exercise training during pregnancy affect gestational age? A randomised controlled trial

Background: Some controversy exists over the possibility that exercise during pregnancy might increase the risk of preterm delivery. Objective: This study aimed to determine the possible cause–effect relationship between regular exercise performed during the second and third trimesters of pregnancy by previously sedentary, healthy gravidae and gestational age at the moment of delivery. Methods: Caucasian (Spanish) women with singleton gestation were assigned to either a training (n = 72) or a control (n = 70) group. The supervised training programme focused mainly on very light resistance and toning exercises and included ∼80 sessions (three times/week, 35 min/session from weeks 12–13 to weeks 38–39 of pregnancy). Results: No significant differences were found (p>0.05) between the groups in those maternal characteristics (age, smoking habits, number of hours standing or prior parity history) that could potentially influence gestational age. The mean gestational age did not differ (p = 0.745) between the training (39 weeks,3 days (SD 1 day)) and the control group (39 weeks,4 days (SD 1 day)). Conclusions: Previously sedentary, healthy gravidae with singleton gestation can safely engage in moderate, supervised exercise programmes until the end of gestation as this would not affect gestational age.

Exercise during pregnancy and gestational diabetes-related adverse effects: a randomised controlled trial

Objective To examine the effect of regular moderate-intensity exercise (three training sessions/week) on the incidence of gestational diabetes mellitus (GDM, primary outcome). We also examined if the exercise intervention modifies the association between GDM and birth weight and risk of macrosomia, gestational age, risk of caesarean delivery and maternal weight gain (secondary outcomes). Methods We randomly assigned 510 healthy gravida to either an exercise intervention or a usual care (control) group (n=255 each). The exercise programme focused on moderate-intensity resistance and aerobic exercises (three times/week, 50–55 min/session). GDM diabetes was diagnosed according to the WHO criteria and the International Association for Diabetes in Pregnancy Study Group (IADPSG). Results The intervention did not reduce the risk of developing GDM (OR 0.84, 95% CI 0.50 to 1.40) when using the WHO criteria. We observed that the intervention reduced by 58% the GDM-related risk (WHO criteria) of having a newborn with macrosomia (OR 1.76, 95% CI 0.04 to 78.90 vs 4.22, 95% CI 1.35 to 13.19) in exercise and control groups, respectively), and by 34% the GDM-related risk of having acute and elective caesarean delivery (OR 1.30, 95% CI 0.44 to 3.84 vs 1.99, 95% CI 0.98 to 4.06 in exercise and control groups, respectively). Gestational age was similar across the treatment groups (control, exercise) and GDM category (GDM or non-GDM), and maternal weight gain was ∼12% lower in the exercise group independent of whether women developed GDM. The results were similar when the IADPSG criteria were used instead. Conclusions Regular moderate-intensity exercise performed over the second-third trimesters of pregnancy can be used to attenuate important GDM-related adverse outcomes.

Supervised Exercise–Based Intervention to Prevent Excessive Gestational Weight Gain: A Randomized Controlled Trial

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 randomly assigned to a standard 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 standard 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 standard 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 clinicaltrials.gov Identifier: NCT01790347.

Type of delivery is not affected by light resistance and toning exercise training during pregnancy: a randomized controlled trial

OBJECTIVE We examined the effect of light-intensity resistance exercise training that is performed during the second and third trimester of pregnancy by previously sedentary and healthy women on the type of delivery and on the dilation, expulsion, and childbirth time. STUDY DESIGN We randomly assigned 160 sedentary women to either a training (n=80) or a control (n=80) group. We recorded several maternal and newborn characteristics, the type of delivery (normal, instrumental, or cesarean), and dilation, expulsion, and childbirth time. RESULTS The percentage of women who had normal, instrumental, or cesarean delivery was similar in the training (70.8%, 13.9%, and 15.3%, respectively) and control (71.4%, 12.9%, and 15.7%, respectively) groups. The mean dilation, expulsion, and childbirth time did not differ between groups. CONCLUSION Light-intensity resistance training that is performed over the second and third trimester of pregnancy does not affect the type of delivery.

Guidelines for Physical Activity During Pregnancy Comparisons From Around the World

Introduction. Women attain numerous benefits from physical activity during pregnancy. However, because of physical changes that occur during pregnancy, special precautions are also needed. This review summarizes current guidelines for physical activity among pregnant women worldwide. Methods. We searched PubMed (MedLINE) for country-specific governmental and clinical guidelines on physical activity during pregnancy through the year 2012. We cross-referenced with articles referring to guidelines, with only the most recent included. An abstraction form was used to extract key details and summarize. Results. In total, 11 guidelines were identified from 9 countries (Australia, Canada, Denmark, France, Japan, Norway, Spain, United Kingdom, United States). Most guidelines supported moderate-intensity physical activity during pregnancy (10/11) and indicated specific frequency (9/11) and duration/time (9/11) recommendations. Most guidelines provided advice on initiating an exercise program during pregnancy (10/11). Six guidelines included absolute and relative contraindications to exercise. All guidelines generally ruled-out sports with risks of falls, trauma, or collisions. Six guidelines included indications for stopping exercise during pregnancy. Conclusion. This review contrasted pregnancy-related physical activity guidelines from around the world, and can help inform new guidelines as they are created or updated and facilitate the development of a worldwide guideline.

Exercise Is Associated with a Reduction in Gestational Diabetes Mellitus.

PURPOSE The objective of this study is to assess the effectiveness of a maternal exercise program (land/aquatic activities, both aerobic and muscular conditioning) in preventing gestational diabetes mellitus (GDM). METHODS Three hundred and forty-two pregnant women from Spain (age, 33.24 ± 4.3 yr) without obstetric contraindications were recruited for a clinical randomized controlled trial. The intervention group (IG, n = 101) exercised for 60 and 50 min on land and in water, respectively, three times per week. The control group (n = 156) received usual standard care. RESULTS The prevalence of GDM was reduced in the IG group (IG, 1%, n = 1, vs control group, 8.8%, n = 13 (χ1 = 6.84, P = 0.009)) with a significant risk estimate (odds ratio = 0.103; 95% confidence interval, 0.013-0.803). CONCLUSION The exercise program performed during pregnancy reduced the prevalence of GDM by preserving glucose tolerance.

A program of exercise throughout pregnancy. Is it safe to mother and newborn

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 randomized 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. Students unpaired t-test and χ2 test were used; p values of ≤ .05 indicated statistical significance. Cohens 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.

Exercise during pregnancy reduces the rate of cesarean and instrumental deliveries: results of a randomized controlled trial.

Objective: In this study, the authors assessed the effects of a structured, moderate-intensity exercise program during the entire length of pregnancy on a woman’s method of delivery. Methods: A randomized controlled trial was conducted with 290 healthy pregnant Caucasian (Spanish) women with a singleton gestation who were randomly assigned to either an exercise (n = 138) or a control (n = 152) group. Pregnancy outcomes, including the type of delivery, were measured at the end of the pregnancy. Results: The percentage of cesarean and instrumental deliveries in the exercise group were lower than in the control group (15.9%, n = 22; 11.6%, n = 16 vs. 23%, n = 35; 19.1%, n = 29, respectively; p = 0.03). The overall health status of the newborn as well as other pregnancy outcomes was unaffected. Conclusions: Based on these results, a supervised program of moderate-intensity exercise performed throughout pregnancy was associated with a reduction in the rate of cesarean, instrumental deliveries and can be recommended for healthy women in pregnancy.