Michelle F Mottola

The University of Western Ontario | UWO · School of Kinesiology

Miscarriage is an inability to complete the normal process of pregnancy and childbirth and represents a major concern for pregnant women that can be an emotionally devastating event. While it has been suggested that engaging in strenuous physical activity might be associated with an elevated risk of miscarriage, there is a recent systematic review...

It has been only recently that female endurance athletes have been deemed capable of training and being successful in endurance sports. This unfortunate attitude has resulted in limited research regarding female endurance over the life course. In this chapter we overview the impact of key life events over the life span of female endurance athletes,...

Background: In trials testing the efficacy of diet and exercise modifications during pregnancy on health outcomes, assessment of participant adherence to interventions of diet and exercise is rarely reported, with few standard methods existing to measure adherence. Objective: We aimed to assess the maternal diet quality and create an algorithm t...

Evidence suggests that exercise during pregnancy is beneficial to both parent and fetus. However, there are high-risk pregnancy conditions that may warrant hospitalization. In our narrative review, we first describe the clinical implications for activity restriction in pregnancy, the effects of hospitalization, and the impact of bed rest on non-pre...

Lifestyle interventions focusing on prenatal physical activity (PA) and healthy nutritional habits can carry forward into the postpartum period. As many health resources, like PA facilities and postpartum support groups, were inaccessible due to the Coronavirus-19 (COVID-19) pandemic restrictions, it may be plausible that individuals who participat...

Objectives To systematically review studies evaluating one or more components of physical fitness (PF) in pregnant women, to answer two research questions: (1) What tests have been employed to assess PF in pregnant women? and (2) What is the validity and reliability of these tests and their relationship with maternal and neonatal health? Design A...

Objective Excess gestational weight gain (GWG) is associated with adverse long and short-term outcomes for both woman and child, yet evidence demonstrates pregnant women are frequently not engaging in healthy behaviours linked to appropriate weight gain. The purpose of the current study was to explore women’s values and beliefs related to weight, n...

Apply It! By reading this article, exercise professionals will learn: • Physical fitness has an important role during pregnancy, specifically in maternal and neonatal health. • An individualized, client-specific approach to selection and administration of physical fitness tests ensures safe and specific exercise program interventions and optimizes...

During the COVID-19 pandemic, pregnant women have been at high risk for psychological distress. Lifestyle factors may be modifiable elements to help reduce and promote resilience to prenatal stress. We used Machine-Learning (ML) algorithms applied to questionnaire data obtained from an international cohort of 804 pregnant women to determine whether...

The intrauterine environment is key to health from a short- and long-term perspective. Birth weight is an important indicator that may influence the fetal environment due to epigenetics. Considering physical inactivity, in parallel with higher levels of stress, affecting smoking patterns and the physical and emotional health of the pregnant populat...

Background : Rates of prenatal and postpartum stress and depression in pregnant individuals have increased during the COVID-19 pandemic. Perinatal maternal mental health has been linked to worse motor development in offspring, with motor deficits appearing in infancy and early childhood. We aimed to evaluate the relationship between prenatal and po...

*Lifelong Learning Standard (LLL) definition describes the essential, knowledge, skills, responsibility and autonomy written as Learning Outcomes, required to work in the European Fitness and Physical Activity Sector as a professional qualified in the relevant field e.g. pregnancy and postpartum exercise. Qualification against a Lifelong Learning S...

Background Pregnancy induces bone mineral mobilization, which may be further compromised if diet and physical activity are sub-optimal. Objectives We aimed to determine the effects of a Nutrition + Exercise intervention during pregnancy on maternal calciotropic and bone biomarker profiles throughout pregnancy and the postpartum. Design In the Be...

The purpose of this study was to examine the effects of a virtual exercise program throughout pregnancy during the COVID-19 pandemic on maternal weight gain. A randomized clinical trial (NCT NCT04563065) was performed. In total, 300 pregnant individuals were assessed for eligibility, and a total of 157 were randomized, of which 79 were in the contr...

Objective: This cross-sectional study examined students' perspectives on the ramifications of obesity being recognized as a chronic disease in Canada. Participants: Undergraduate and graduate students (n = 150) in health-related programs at a major Canadian university. Methods: An online survey featured open-ended questions to capture student...

Background Prenatal anxiety and depressive symptoms have significantly increased since the onset of the coronavirus (COVID-19) pandemic In addition, home confinement regulations have caused a drastic increase in time spent sedentary. Online group fitness classes may be an effective strategy that can increase maternal physical activity levels and im...

During the COVID-19 pandemic, pregnant women have been at high risk for psychological distress. Lifestyle factors may be modifiable elements to help reduce and promote resilience to prenatal stress. We used Machine-Learning (ML) algorithms applied to questionnaire data obtained from an international cohort of 804 pregnant women to determine whether...

Background & aims Excessive adiposity in pregnancy is associated with an altered cardiometabolic profile and adverse maternal and offspring outcomes. Pre-pregnancy body mass index (pBMI) is a proxy measure for adiposity that is most often used in clinical settings; however, it may not identify at-risk pregnancies caused by adiposity-related cardiom...

A randomized two-arm prospective superiority trial tested the efficacy of a novel structured and monitored nutrition (bi-weekly counselling for individualized energy and high dairy protein diet) and exercise program (walking goal of 10,000 steps/day) (intervention) compared to usual care (control) in pregnant women to achieve gestational weight gai...

Background Rates of prenatal and postpartum stress and depression in pregnant individuals have increased during the COVID-19 pandemic. Perinatal maternal mental health has been linked to worse motor development in offspring, with motor deficits appearing in infancy and early childhood. We aimed to evaluate the relationship between prenatal and post...

Adherence may be an important factor to consider when interpreting the results of an exercise intervention. This article will discuss the importance of measuring and reporting adherence to exercise interventions that are designed to improve targeted health outcomes. Additionally, we will propose and describe a universal method to measure and report...

The complications associated with COVID-19 confinement (impossibility of grouping, reduced mobility, distance between people, etc.) influence the lifestyle of pregnant women with important associated complications regarding pregnancy outcomes. Therefore, perineal traumas are the most common obstetric complications during childbirth. The aim of th...

Background: Rising demands for traditional postpartum depression (PPD) treatment options (e.g., psychiatry), especially in the context of the COVID-19 pandemic, are increasingly difficult to meet. More accessible treatment options (e.g., walking) are needed. Our objective is to determine the impact of walking on PPD severity. Methods: A structured...

Evidence suggests that pregnant women who test positive for COVID-19 may develop more severe illness than non-pregnant women and may be at greater risk for psychological distress. The relationship between COVID-19 status (positive, negative, never tested) and symptoms of depression was examined in a survey study (May to September 2020) of pregnant...

Evidence-based guidelines represent the highest level of scientific evidence to identify best practices for clinical/public health. However, the availability of guidelines do not guarantee their use, targeted knowledge translation strategies and tools are necessary to help promote uptake. Following publication of the 2019 Canadian Guideline for Phy...

Physical activity (PA) and exercise are tools to help improve a variety of health outcomes, including body mass index (BMI), cardiovascular endurance, and muscular endurance. In postpartum women, specifically, the impact of an exercise intervention on these health outcomes has been understudied in the literature, despite potential benefits. PURPOSE...

BACKGROUND Guidelines on physical activity/exercise during pregnancy recommend all women without contraindications engage in regular physical activity to improve both their own health and the health of their baby. Many women are uncertain how to safely engage in physical activity/exercise during this life-stage and are increasingly using mobile app...

Background: Guidelines for physical activity and exercise during pregnancy recommend that all women without contraindications engage in regular physical activity to improve both their own health and the health of their baby. Many women are uncertain how to safely engage in physical activity and exercise during this life stage and are increasingly...

Purpose: Despite immense research highlighting maternal-fetal benefits of exercise during pregnancy, there remain concerns that exercise may undermine placental function. Although maternal exercise has demonstrated favorable aerobic conditioning responses in the mother, it is not known whether maternal exercise promotes increased angiogenesis in t...

Background: Prenatal anxiety and depressive symptoms have significantly increased since the onset of the coronavirus (COVID-19) pandemic. Furthermore, home confinement regulations have caused a drastic increase in time spent sedentary. Online group fitness classes may be an effective strategy that can increase maternal physical activity and improve...

Women who have an overweight or obese pre-pregnancy body mass index (BMI) may be recommended to lose weight before pregnancy, however the association of preconception weight fluctuations and prenatal adherence to nutrition and exercise recommendations with gestational weight gain (GWG) have not been assessed. One hundred women with a pre-pregnancy...

Purpose: The purpose of this systematic review was to evaluate fetal and maternal pregnancy outcomes of elite athletes who had participated in competitive sport immediately prior to conception. Methods: Online databases were searched up to March 24, 2020. Studies of any design and language were eligible if they contained information on the relev...

Background Physical activity during pregnancy is associated with several health benefits for the mother and child. However, very few women participate in regular physical activity during pregnancy. eHealth platforms (internet and mobile apps) have become an important information source for pregnant women. Although the use of pregnancy-related apps...

According to The Developmental Origins of Health and Disease theory, the intra-uterine environment of the developing fetus may impact later life physiology, including susceptibility to chronic disease conditions. Maternal exposures during pregnancy can affect the intra-uterine environment and result in fetal programming for chronic diseases through...

Excess gestational weight gain is associated with short‐ and long‐term pregnancy complications. Although a healthy diet and physical activity during pregnancy are recommended and shown to reduce the risk of complications and improve outcomes, adherence to these recommendations is low. The aims of this study were to explore women's view of nutrition...

Physical activity (PA) has many implications for health, including effects on weight loss, body mass index (BMI), and sleep behaviours. The literature has established a relationship between mother-child physical activity, however, the impact of this interaction is unknown during the postpartum period. PURPOSE: To determine if a structured postpartu...

Gestational hypertension disorders and diabetes affect 6-15% of all pregnancies worldwide and are associated with adverse maternal and neonatal outcomes that can have a programming effect on future chronic disease risk. Pregnant women who receive lifestyle interventions, including healthy eating and/or physical activity, may have a decreased risk o...

Exercise and healthy eating are integral parts of a comprehensive healthy lifestyle intervention during pregnancy. Women who volunteer to participate in such an intervention in early to mid-pregnancy may already be practicing healthy lifestyle habits such as walking 10,000 steps/day (active), and consuming 1800-2252 kilocalories/day (kcal), whereas...

Physical activity (PA) has many implications for health, including effects on weight loss, body mass index (BMI), and sleep behaviours. The literature has established a relationship between mother-child physical activity, however, the impact of this interaction is unknown during the postpartum period. PURPOSE: To determine if a structured postpartu...

Background Previous literature supports exercise as a preventative agent for prenatal depression; however, treatment effects for women at risk for prenatal depression remain unexplored. The purpose of the study was to examine whether exercise can lower depressive symptoms among women who began pregnancy at risk for depression using both a statistic...

Purpose: To determine the associations between glycated hemoglobin (A1C) values at three, 12 and 24 months postpartum taken during the Families Defeating Diabetes trial. Methods: The Families Defeating Diabetes trial was a randomized 12 month lifestyle intervention delivered in the first year postpartum. Women were reviewed at three, 6 12 and 24...

Background Adhering to nutrition and exercise recommendations simultaneously during pregnancy may be challenging. The purpose was to examine adherence to the sequential introduction of nutrition and exercise behaviors during pregnancy in comparison with a simultaneous approach. Method A randomized controlled trial including nutrition and exercise...

Background: Vitamin D deficiency in pregnancy is reported as a prevalent public health problem. Objectives: We aimed to evaluate, in pregnant Canadian women, 1) vitamin D intake, 2) maternal and cord serum 25-hydroxycholecalciferol [25(OH)D] and maternal 1,25-dihydroxycholecalciferol [1,25(OH)2D], and 3) factors associated with maternal serum 25...

Background: Excess gestational weight gain has long- and short-term implications for women and children, and postpartum weight retention is associated with an increased risk of long-term obesity. Despite the existence of dietary and exercise guidelines, many women struggle to return to pre-pregnancy weight. Experiences of women in tackling postpar...

De forma tradicional e histórica, las recomendaciones referidas al ejercicio físico durante el embarazo han estado basadas en cuestiones culturales y sociales, más que en evidencias científicas. De tal forma, la información científica disponible a través de guías de actuación profesional ha sido escasa o prácticamente inexistente. Ante esta situaci...

Purpose: Prenatal multivitamins are recommended in pregnancy. This study assessed food and supplement intakes of folate, vitamin B12 (B12), vitamin D, and choline in pregnant women living in Southern Ontario in comparison with current recommendations. Methods: Women recruited to the Be Healthy in Pregnancy RCT (NCT01693510) completed 3-day diet/sup...

Importance: Physical activity during pregnancy can offer many maternal and fetal health benefits. Objective: The aim was to summarize American, Canadian, and international recommendations published recently on physical activity during pregnancy to aid health care providers in their delivery of advice on the topic. Evidence acquisition: A descr...

Objectives: Maternal bone health can be compromised in pregnancy if diet and exercise are inadequate. Our objective was to determine the changes of calciotropic hormones and bone biomarkers in response to a maternal high-dairy diet plus exercise intervention compared to usual care from early to late pregnancy. Methods: As part of the Be Healthy...

Physical activity during pregnancy is known to bring benefits not only for the mother but also for the fetus. Water-based exercises have been recommended as an adequate modality of exercise during pregnancy, however, no meta-analysis has analyzed the effects of water exercise programs on maternal weight gain and fetal outcomes including birthweight...

Background Evidence from epidemiological and animal studies support the concept of programming fetal, neonatal, and adult health in response to in utero exposures such as maternal obesity and lifestyle variables. Excess gestational weight gain (GWG), maternal physical activity, and sub-optimal and excess nutrition during pregnancy may program the o...

Objective To examine the relationships between prenatal physical activity and prenatal and postnatal urinary incontinence (UI). Design Systematic review with random effects meta-analysis and meta-regression. Data sources Online databases were searched up to 6 January 2017. Study eligibility criteria Studies of all designs were included (except c...

Objective We aimed to identify the relationship between maternal prenatal exercise and birth complications, and neonatal and childhood morphometric, metabolic and developmental outcomes. Design Systematic review with random-effects meta-analysis and meta-regression. Data sources Online databases were searched up to 6 January 2017. Study eligibil...

Objective To examine the influence of prenatal exercise on depression and anxiety during pregnancy and the postpartum period. Design Systematic review with random effects meta-analysis and meta-regression. Data sources Online databases were searched up to 6 January 2017. Study eligibility criteria Studies of all designs were included (except cas...

Objective: To perform a systematic review and meta-analysis to explore the relationship between prenatal exercise and glycaemic control. Design: Systematic review with random-effects meta-analysis and meta-regression. Data sources: Online databases were searched up to 6 January 2017. Study eligibility criteria: Studies of all designs were in...

The objective is to provide guidance for pregnant women and obstetric care and exercise professionals on prenatal physical activity. The outcomes evaluated were maternal, fetal or neonatal morbidity, or fetal mortality during and following pregnancy. Literature was retrieved through searches of MEDLINE, EMBASE, PsycINFO, Cochrane Database of System...

Objective Gestational diabetes mellitus (GDM), gestational hypertension (GH) and pre-eclampsia (PE) are associated with short and long-term health issues for mother and child; prevention of these complications is critically important. This study aimed to perform a systematic review and meta-analysis of the relationships between prenatal exercise an...

Objective Gestational weight gain (GWG) has been identified as a critical modifier of maternal and fetal health. This systematic review and meta-analysis aimed to examine the relationship between prenatal exercise, GWG and postpartum weight retention (PPWR). Design Systematic review with random effects meta-analysis and meta-regression. Online dat...

The objective is to provide guidance for pregnant women and obstetric care and exercise professionals on prenatal physical activity. The outcomes evaluated were maternal, fetal or neonatal morbidity, or fetal mortality during and following pregnancy. Literature was retrieved through searches of MEDLINE, EMBASE,

Objective The purpose of this review was to investigate the relationship between prenatal exercise, and low back (LBP), pelvic girdle (PGP) and lumbopelvic (LBPP) pain. Design Systematic review with random effects meta-analysis and meta-regression. Data sources Online databases were searched up to 6 January 2017. Study eligibility criteria Studi...

Objective To perform a systematic review of the relationships between prenatal exercise and maternal harms including labour/delivery outcomes. Design Systematic review with random effects meta-analysis and meta-regression. Datasources Online databases were searched up to 6 January 2017. Study eligibility criteria Studies of all designs were incl...

Objective Theoretical concerns regarding the supine position at rest due to the gravid uterus obstructing aorta and vena caval flow may impinge uterine blood flow (UBF) to the fetus and maternal venous return. Design Systematic review. Data sources Online databases up to 11 December 2017. Study criteria Eligible population (pregnant without cont...

Objective To investigate the relationships between exercise and incidence of congenital anomalies and hyperthermia. Design Systematic review with random-effects meta-analysis . Data sources Online databases were searched from inception up to 6 January 2017. Study eligibility criteria Studies of all designs were eligible (except case studies and...

Objective To perform a systematic review and meta-analysis examining the influence of acute and chronic prenatal exercise on fetal heart rate (FHR) and umbilical and uterine blood flow metrics. Design Systematic review with random-effects meta-analysis and meta-regression. Data sources Online databases were searched up to 6 January 2017. Study e...

Objective To perform a systematic review of the relationship between prenatal exercise and fetal or newborn death. Design Systematic review with random-effects meta-analysis and meta-regression. Data sources Online databases were searched up to 6 January 2017. Study eligibility criteria Studies of all designs were included (except case studies)...

Objective: The objective is to provide guidance for pregnant women, and obstetric care and exercise professionals, on prenatal physical activity. Outcomes: The outcomes evaluated were maternal, fetal, or neonatal morbidity or fetal mortality during and following pregnancy. Evidence: Literature was retrieved through searches of Medline, EMBASE,...

Objectif: L'objectif est de guider les femmes enceintes et les professionnels de l'obstétrique et de l'exercice en ce qui concerne l'activité physique prénatale. RéSULTATS: Les issues évaluées étaient la morbidité maternelle, fœtale ou néonatale et la mortalité fœtale pendant et après la grossesse. DONNéES: Nous avons interrogé MEDLINE, Embase, Ps...