Predictive factors of compliance with a program of supervised exercise during pregnancy.

post-print247 K

Does exercise during pregnancy impact on maternal weight gain and fetal cardiac function? A Randomized controlled study.

OBJECTIVE: To evaluate the association between physical exercise during pregnancy and maternal gestational weight gain and fetal cardiac function. METHODS: This was a randomized controlled trial of women with a singleton pregnancy managed from the first trimester at the Hospital de Torrejón, Madrid, between November 2014 and June 2015. Women were randomized to either follow a supervised physical conditioning program, consisting of a 60-min session 3 days per week for the duration of pregnancy, or not attend any exercise program (controls). The primary outcome was maternal weight gain during pregnancy. Secondary outcomes included fetal cardiac function parameters evaluated at 20, 28 and 36 weeks' gestation, Cesarean section, preterm delivery, induction of labor and birth weight. A sample size of 45 in each group was planned to detect differences in maternal weight gain of at least 1 kg, with a power of > 80% and α of 0.05. RESULTS: During the study period, 120 women were randomized into the exercise (n = 75) and control (n = 45) groups. Following exclusions, the final cohort consisted of 42 women in the exercise group and 43 in the control group. Baseline characteristics (maternal age, prepregnancy body mass index, parity, conception by in-vitro fertilization, Caucasian ethnicity, physical exercise prior to pregnancy and smoker) were similar between the two groups. No differences were found between the groups in maternal weight at 20, 28, 36 and 38 weeks' gestation or in weight gain at 38 weeks. However, the proportion of women with weight loss ≥ 9 kg at 6 weeks postpartum was higher in the exercise compared with the control group (68.2% vs 42.8%; relative risk 1.593; P = 0.02). The ductus arteriosus pulsatility index (DA-PI) at 20 weeks (2.43 ± 0.40 vs 2.26 ± 0.33, P < 0.05) and the ejection fraction (EF) at 36 weeks (0.85 ± 0.13 vs 0.81 ± 0.11, P < 0.05) were higher in the exercise compared with the control group. All other evaluated fetal cardiac function parameters were similar between the two groups. CONCLUSIONS: Performing exercise during pregnancy is not associated with a reduction in maternal weight gain but increases weight loss at 6 weeks postpartum. Physical exercise during pregnancy is associated with increased fetal DA-PI at 20 weeks and EF at 36 weeks, which could reflect adaptive mechanismspre-print493 K

Maternal physiological changes at rest induced by exercise during pregnancy: A randomized controlled trial.

Objective: to analyse maternal physiological changes in several areas (cardiovascular, metabolic, renal and hepatic) related to the regular practice of a supervised exercise program. Methods: This is an unplanned secondary analysis from a randomized controlled trial carried out in a single maternity unit in Madrid, Spain (NCT 02,756,143). From November 2014 to June 2015, 92 women were randomly assigned to perform a mild-moderate supervised exercise program during pregnancy (Intervention group, IG) or to continue with their routine pregnancy care (control group, CG). For the purpose of this study we collected clinical and analytical data (heart blood pressure, weight, blood glucose, AST, ALT, blood Creatinine and blood Uric acid) available from all obstetric visits and examined the differences between groups. Results: We did not find any differences in: pregnancy weight (IG: 11.4 ± 4.4 Kg vs. CG: 10.1 ± 5.3 Kg; p = 0.173); fasting glucose at 10+0–12+6 weeks (IG: 78.48±8.34 vs. CG: 76±13.26, p = 0.305) or at 34+0–36+4 weeks (IG: 73.25±10.27 vs CG: 73.45± 8.29,p = 0.920), and 50 gs glucose tolerance at 24+4–26+6weeks (IG: 116.23±35.07 vs CG: 116.36±25.98, p = 0.984); Aspartate-amino-transferase at 10+0–12+6 weeks (IG: 15.38±4.17 vs CG: 17.33±7.05, p = 0.124) and at 34+0–36+4 weeks (IG: 21.65±5.25 vs CG: 19.53±8.32, p = 0.165) or Alanine-amino- transferase at 10+0–12+6 weeks (IG: 27.50±10.63 vs CG: 28.27±11.77, p = 0.746) or at 34+0–36+4 weeks (IG: 22.93±9.23 vs CG: 20.84±13.49, p = 0.407); blood Creatinine concentrations at 34+0–36+4 weeks (IG: 0.595±0.401 vs CG: 0.575±0.100, p = 0.757) and blood uric acid concentrations at 34+0–36+4 weeks (IG: 3.526 ± 0.787 vs CG: 3.262±0.672, p = 0.218). Heart blood pressure was similar between groups except at 27+0–28+6 weeks, where systolic blood pressure was significantly lower in the CG in comparison to the IG (116.31±10.8 mmHg vs. 120.22 ± 10.3 mmHg, p = 0.010). Conclusion: Regular supervised exercise during pregnancy does not alter normal maternal physiologypre-print609 K

Efecto del ejercicio físico durante el embarazo en el peso feto-placentario y el riesgo de depresión perinatal materna: Ensayo Clínico Aleatorizado = Effect of physical exercise during pregnancy on feto-placental weight and risk of maternal perinatal depression: a Randomized Clinical Trial

Introducción: Durante el embarazo el organismo de la mujer experimenta numerosos e importantes cambios que afectan tanto al ámbito fisiológico como al psicológico. Objetivo: Examinar el efecto de un programa de ejercicio físico desarrollado durante el embarazo en el riesgo de depresión perinatal y en el peso feto-placentario. Métodos: Embarazadas con una edad gestacional 0,05) ni en el porcentaje de mujeres con riesgo de depresión al inicio del estudio (20,0 % vs. 18,5 %; χ2 = 0,043; p = 0,836). Se identificó un porcentaje menor de mujeres con riesgo de depresión en el GI en comparación con el GC a las 38 semanas de gestación (18,6 % vs. 35,6 %; χ2 = 4,190; p = 0,041) y a las 6 semanas postparto (14,5 % vs. 29,8 %; χ2 = 3,985; p = 0,046) en el análisis por protocolo. No se encontraron diferencias significativas usando los análisis por intención a tratar, excepto en el análisis de imputación múltiple en la semana 38 (18,6 % vs. 34,4 %; χ2 = 4,085; p = 0,049). No se encontraron diferencias significativas entre grupos en el peso de nacimiento, peso placentario o índice feto-placentario (p > 0,05). Conclusiones: Un programa de ejercicio físico realizado durante el embarazo puede reducir el riesgo de depresión prenatal y de depresión postparto. La práctica regular de ejercicio físico durante el embarazo no produce cambios en el peso del recién nacido, peso placentario ni índice feto-placentario. ----------ABSTRACT---------- Introduction: The woman's body experiences numerous and important changes during pregnancy that affect both the physiological and the psychological. Objective: To examine the effect of an exercise program during pregnancy on the risk of perinatal depression and feto-placental weight. Methods: Healthy pregnant women who were 0.05) and in the percentage of women at risk of depression at baseline (20.0 % vs. 18.5 %) (χ2 = 0.043; p = 0.836). A smaller percentage of women at risk of depression were identified in the IG compared to the CG at 38 gestational weeks (18.6 % vs. 35.6 %) (χ2 = 4.190; p = 0.041) and at 6 weeks postpartum (14.5 % vs. 29.8 %) (χ2 = 3.985; p = 0.046) using the per-protocol analysis. No significant differences were found using the intention to treat analyses, except in the multiple imputation analysis at week 38 (18.6 % vs. 34.4 %) (χ2 = 4.085; p = 0.049). No significant differences were found between groups in birth weight, placental weight or fetus-placental index (p > 0.05). Conclusion: An exercise program performed during pregnancy may reduce the risk of prenatal depression and postpartum depression. The regular practice of physical exercise during pregnancy does not produce changes in the weight of the newborn, placental weight or feto-placental index