Leisure time physical activity during pregnancy and impact on gestational diabetes mellitus, pre-eclampsia, preterm delivery and birth weight: A review

Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Central Jutland, Denmark
Acta Obstetricia Et Gynecologica Scandinavica (Impact Factor: 2.43). 02/2007; 86(11):1290-6. DOI: 10.1080/00016340701647341
Source: PubMed


It has been questioned whether leisure time physical activity (LTPA) during pregnancy is beneficial or deleterious to pregnancy outcome, and whether a sedentary lifestyle during pregnancy has a negative impact on pregnancy. Answers to these questions are of general interest, since some young women are very physically active during leisure time, while others have a sedentary lifestyle.
In this review, we analysed the association between LTPA and the selected pregnancy outcomes, gestational diabetes mellitus (GDM), pre-eclampsia, preterm delivery, and birth weight.
The prevailing literature clearly indicates that LTPA before and/or during pregnancy has a protective effect on the development of GDM and pre-eclampsia. Furthermore, LTPA does not seem to have a negative impact on the rate of preterm delivery or on birth weight.
Thus, it seems relevant that health authorities recommend 30 min of daily physical activity to healthy pregnant women.

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Available from: Hanne K Hegaard, Nov 27, 2014
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    • "In recent years, evidence has accumulated to support the popular belief that physical activity is associated with better psychological health during pregnancy [5], [6]. The American College of Obstetricians and Gynecologists (ACOG) [7] recommend regular exercise for pregnant women, including those who are sedentary, for its overall benefits on physical and psychological health. "
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    ABSTRACT: To determine the effects of combined aerobic and resistance exercise training during the second half of pregnancy on endothelial NOS expression (eNOS), nitric oxide (NO) production and oxygen metabolism in human placenta. The study included 20 nulliparous in gestational week 16-20, attending prenatal care at three tertiary hospitals in Colombia who were randomly assigned into one of two groups: The exercise group (n = 10) took part in an exercise session three times a week for 12 weeks which consisted of: aerobic exercise at an intensity of 55-75% of their maximum heart rate for 60 min and 25 mins. Resistance exercise included 5 exercise groups circuit training (50 repetitions of each) using barbells (1-3 kg/exercise) and low-to-medium resistance bands. The control group (n = 10) undertook their usual physical activity. Mitochondrial and cytosol fractions were isolated from human placental tissue by differential centrifugation. A spectrophotometric assay was used to measure NO production in cytosolic samples from placental tissue and Western Blot technique to determine eNOS expression. Mitochondrial superoxide levels and hydrogen peroxide were measured to determine oxygen metabolism. Combined aerobic and resistance exercise training during pregnancy leads to a 2-fold increase in eNOS expression and 4-fold increase in NO production in placental cytosol (p = 0.05). Mitochondrial superoxide levels and hydrogen peroxide production rate were decreased by 8% and 37% respectively in the placental mitochondria of exercising women (p = 0.05). Regular exercise training during the second half of pregnancy increases eNOS expression and NO production and decreases reactive oxygen species generation in human placenta. Collectively, these data demonstrate that chronic exercise increases eNOS/NO production, presumably by increasing endothelial shear stress. This adaptation may contribute to the beneficial effects of exercise on the vascular and antioxidant system and in turn reduce the risk of preeclampsia, diabetes or hypertension during pregnancy.
    Full-text · Article · Nov 2013 · PLoS ONE
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    • "Moreover, daily exercises can prevent gestational diabetes and excessive gestational weight gain [2-4]. There is evidence that physical exercise during pregnancy does not increase the risk of muscle injuries or changes in arterial blood pressure [5], and does not increase the risk of preterm labor or low fetal weight [3,6-8]. "
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    ABSTRACT: Antenatal preparation programmes are recommended worldwide to promote a healthy pregnancy and greater autonomy during labor and delivery, prevent physical discomfort and high levels of anxiety. The objective of this study was to evaluate effectiveness and safety of a birth preparation programme to minimize lumbopelvic pain, urinary incontinence, anxiety, and increase physical activity during pregnancy as well as to compare its effects on perinatal outcomes comparing two groups of nulliparous women. A randomized controlled trial was conducted with 197 low risk nulliparous women aged 16 to 40 years, with gestational age ≥ 18 weeks. Participants were randomly allocated to participate in a birth preparation programme (BPP; n=97) or a control group (CG; n=100). The intervention was performed on the days of prenatal visits, and consisted of physical exercises, educational activities and instructions on exercises to be performed at home. The control group followed a routine of prenatal care. Primary outcomes were urinary incontinence, lumbopelvic pain, physical activity, and anxiety. Secondary outcomes were perinatal variables. The risk of urinary incontinence in BPP participants was significantly lower at 30 weeks of pregnancy (BPP 42.7%, CG 62.2%; relative risk [RR] 0.69; 95% confidence interval [CI] 0.51-0.93) and at 36 weeks of pregnancy (BPP 41.2%, CG 68.4%; RR 0.60; 95%CI 0.45-0.81). Participation in the BPP encouraged women to exercise during pregnancy (p=0.009). No difference was found between the groups regarding to anxiety level, lumbopelvic pain, type or duration of delivery and weight or vitality of the newborn infant. The BPP was effective in controlling urinary incontinence and to encourage the women to exercise during pregnancy with no adverse effects to pregnant women or the fetuses. Trial registration, (NCT01155804)
    Full-text · Article · Jul 2013 · BMC Pregnancy and Childbirth
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    • "Our study sample, however, only included women residing in urban Ethiopia, whose activity level may not be comparable to pregnant women living in rural areas. Low levels of physical activity have been linked to increased risk of diabetes and cardiovascular diseases in adult Cameroonian [27,32], and to increased risk of gestational diabetes mellitus as well as preeclampsia in high-income countries [33-35]. However, it is unclear whether or not the low physical activity observed in the present study carry the same increased risks or simply is an appropriate adaptation to a low energy intake. "
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    ABSTRACT: Background Women in low-income countries are generally considered to have a high physical workload which is sustained during pregnancy. Although most previous studies have been based on questionnaires a recent meta-analysis of doubly labeled water data has raised questions about the actual amount of physical activity performed. In this study we report objectively assessed levels of physical activity, cardiorespiratory fitness and muscular fitness among pregnant urban Ethiopian women, and their association with demographic characteristics and anthropometric measures. Methods Physical activity was measured for seven consecutive days in 304 women using a combined uniaxial accelerometer and heart rate sensor. Activity energy expenditure was determined using a group calibration in a branched equation model framework. Type and duration of activities were reported using a 24-hour physical activity recall and grip strength was assessed using a dynamometer. Results Median (interquartile-range, IQR) activity energy expenditure was 31.1 (23.7-42.0) kJ/kg/day corresponding to a median (IQR) physical activity level of 1.46 (1.39-1.58). Median (IQR) time in sedentary, light, and moderate-to-vigorous intensity was 1100 (999–1175), 303 (223–374) and 40 (22–69) min/day, respectively. Mean (standard deviation) sleeping heart rate was 73.6 (8.0) beats/min and grip strength was 21.6 (4.5) kg. Activity energy expenditure was 14% higher for every 10 cm2 difference in arm muscle area and 10% lower for every 10 cm2 difference in arm fat area and 10-week difference in gestational age. Conclusion The level and intensity of physical activity among pregnant women from urban Ethiopia is low compared to non-pregnant women from other low income countries as well as pregnant European women from high-income countries.
    Full-text · Article · Dec 2012 · BMC Pregnancy and Childbirth
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