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The Association Between Physical Activity and Maternal and Neonatal Outcomes: A Prospective Cohort

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Abstract

Some evidence, but not enough to be conclusive, suggests that physical activity in pregnancy reduces the risk of perinatal complications. Our objective was to examine if physical activity in the year before pregnancy and in the first half of pregnancy is associated with maternal and neonatal outcomes. Associations between physical activity and maternal and neonatal outcomes were examined in a prospective cohort (n = 1,749) in Halifax, Canada. The Kaiser Physical Activity Survey, completed at approximately 20 weeks’ gestation, requested information regarding physical activity during the year before the pregnancy and the first 20 weeks of pregnancy. Outcomes were assessed by medical chart review. Multiple logistic regression was used to estimate odds ratios (OR) with 95 % confidence intervals (CI). Women with prepregnancy physical activity levels in the middle and highest tertiles were more likely to have high gestational weight gain relative to women in the lowest tertile [OR (CI): 1.40 (1.06–1.85) and 1.57 (1.18–2.09), respectively]. Higher physical activity in the first half of pregnancy decreased the odds of delivering a macrosomic infant (p trend = 0.005). Associations were not observed between total physical activity and gestational diabetes, gestational hypertension, pre-eclampsia, preterm birth, and low birth weight. Physical activity before, but not in the first half of pregnancy, is associated with high gestational weight gain. Physical activity in the first half of pregnancy may reduce the occurrence of macrosomia without affecting preterm birth or low birth weight.

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References

  1. Davies, G. A., Wolfe, L. A., Mottola, M. F., & MacKinnon, C. (2003). Joint SOGC/CSEP clinical practice guideline: Exercise in pregnancy and the postpartum period. Canadian Journal of Applied Physiology, 28(3), 330–341.

    Article  PubMed  Google Scholar 

  2. U.S. Department of Health and Human Services. (2008). 2008 Physical activity guidelines for Americans. ODPHP Publication No. U0036 [www.health.gov/paguidelines]. Report.

  3. American College of Obstetricians and Gynecologists, Committee on Obstetrical Practice. (2002). ACOG Committee Opinion: Exercise during pregnancy and the postpartum period. No. 267 (Reaffirmed 2009).

  4. Bell, B. B., & Dooley, M. M. P. (2006). Exercise in pregnancy. Royal College of Obstetricians and Gynaecologists. Statement No.4.

  5. Fell, D. B., Joseph, K. S., Armson, B. A., & Dodds, L. (2009). The impact of pregnancy on physical activity level. Maternal and Child Health Journal, 13(5), 597–603.

    Article  PubMed  Google Scholar 

  6. Gaston, A., & Cramp, A. (2011). Exercise during pregnancy: A review of patterns and determinants. Journal of Science and Medicine in Sport, 14(4), 299–305.

    Article  PubMed  Google Scholar 

  7. Dodds, L., Fell, D. B., Dooley, K. C., Armson, B. A., Allen, A. C., Nassar, B. A., et al. (2008). Effect of homocysteine concentration in early pregnancy on gestational hypertensive disorders and other pregnancy outcomes. Clinical Chemistry, 54(2), 326–334.

    Article  PubMed  CAS  Google Scholar 

  8. Schmidt, M. D., Freedson, P. S., Pekow, P., Roberts, D., Sternfeld, B., & Chasan-Taber, L. (2006). Validation of the Kaiser Physical Activity Survey in pregnant women. Medicine and Science in Sports and Exercise, 38(1), 42–50.

    Article  PubMed  Google Scholar 

  9. Ainsworth, B. E., Sternfeld, B., Richardson, M. T., & Jackson, K. (2000). Evaluation of the Kaiser Physical Activity Survey in women. Medicine and Science in Sports and Exercise, 32(7), 1327–1338.

    Article  PubMed  CAS  Google Scholar 

  10. Sternfeld, B., Ainsworth, B. E., & Quesenberry, C. P. (1999). Physical activity patterns in a diverse population of women. Preventive Medicine, 28(3), 313–323.

    Article  PubMed  CAS  Google Scholar 

  11. Joseph, K. S., & Fahey, J. (2009). Validation of perinatal data in the Discharge Abstract Database of the Canadian Institute for Health Information. Chronic Diseases in Canada, 29(3), 96–100.

    PubMed  CAS  Google Scholar 

  12. Berger, H., Crane, J., Farine, D., Armson, A., De La, R. S., Keenan-Lindsay, L., et al. (2002). Screening for gestational diabetes mellitus. Journal of Obstetrics and Gynaecology Canada, 24(11), 894–912.

    PubMed  Google Scholar 

  13. Magee, L. A., Helewa, M., Moutquin, J. M., & von Dadelszen, P. (2008). Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Journal of Obstetrics and Gynaecology Canada, 30(3 Suppl), S1–S48.

    PubMed  Google Scholar 

  14. IOM Committee to Reexamine IOM Pregnancy Weight Guidelines. (2009). In: K. M. Rasmussen & A. L. Yatkine (Eds.), Weight gain during pregnancy: Reexamining the guidelines (pp. 1–324). Institute of Medicine, National Research Council.

  15. Health Canada. (2011). Canadian gestational weight gain recommendations. http://www.hc-sc.gc.ca/fn-an/nutrition/prenatal/qa-gest-gros-qr-eng.php. Accessed 22 Nov 2013.

  16. Kramer, M. S., Platt, R. W., Wen, S. W., Joseph, K. S., Allen, A., Abrahamowicz, M., et al. (2001). A new and improved population-based Canadian reference for birth weight for gestational age. Pediatrics, 108(2), E35.

    Article  PubMed  CAS  Google Scholar 

  17. Chasan-Taber, L., Schmidt, M. D., Pekow, P., Sternfeld, B., Solomon C. G. & Markenson G. (2008). Predictors of excessive and inadequate gestational weight gain in Hispanic women. Obesity (Silver.Spring) 16(7), 1657–1666.

    Google Scholar 

  18. Stuebe, A. M., Oken, E., & Gillman, M. W. (2009). Associations of diet and physical activity during pregnancy with risk for excessive gestational weight gain. American Journal of Obstetrics and Gynecology, 201(1), 58.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Haakstad, L. A., Voldner, N., Henriksen, T., & Bo, K. (2007). Physical activity level and weight gain in a cohort of pregnant Norwegian women. Acta Obstetricia et Gynecologica Scandinavica, 86(5), 559–564.

    Article  PubMed  Google Scholar 

  20. Juhl, M., Olsen, J., Andersen, P. K., Nohr, E. A., & Andersen, A. M. (2010). Physical exercise during pregnancy and fetal growth measures: A study within the Danish National Birth Cohort. American Journal of Obstetrics and Gynecology, 202(1), 63–68.

    Article  PubMed  Google Scholar 

  21. Montpetit, A. E., Plourde, H., Cohen, T. R., & Koski, K. G. (2011). Modeling the impact of prepregnancy BMI, physical activity and energy intake on gestational weight gain, infant birth weight, and postpartum weight retention. Journal of Physical Activity and Health, 9, 1020–1029.

    Google Scholar 

  22. Kramer, M. S., & McDonald, S. W. (2006). Aerobic exercise for women during pregnancy. Cochrane Database of Systematic Reviews, (3), CD000180.

  23. Haakstad, L. A., & Bo, K. (2011). Effect of regular exercise on prevention of excessive weight gain in pregnancy: A randomised controlled trial. European Journal of Contraception and Reproductive Health Care, 16(2), 116–125.

    Article  PubMed  Google Scholar 

  24. Gardner, B., Wardle, J., Poston, L., & Croker, H. (2011). Changing diet and physical activity to reduce gestational weight gain: A meta-analysis. Obesity Reviews, 12(7), e602–e620.

    Article  PubMed  CAS  Google Scholar 

  25. Vinter, C. A., Jensen, D. M., Ovesen, P., Beck-Nielsen, H., & Jorgensen, J. S. (2011). The LiP (Lifestyle in Pregnancy) Study: A randomized controlled trial of lifestyle intervention in 360 obese pregnant women. Diabetes Care, 34(12), 2502–2507.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Lof, M., Hilakivi-Clarke, L., Sandin, S., & Weiderpass, E. (2008). Effects of pre-pregnancy physical activity and maternal BMI on gestational weight gain and birth weight. Acta Obstetricia et Gynecologica Scandinavica, 87(5), 524–530.

    Article  PubMed  Google Scholar 

  27. Clapp, J. F., I. I. I., Kim, H., Burciu, B., Schmidt, S., Petry, K., & Lopez, B. (2002). Continuing regular exercise during pregnancy: Effect of exercise volume on fetoplacental growth. American Journal of Obstetrics and Gynecology, 186(1), 42–147.

    Article  Google Scholar 

  28. Hopkins, S. A., Baldi, J. C., Cutfield, W. S., McCowan, L., & Hofman, P. L. (2010). Exercise training in pregnancy reduces offspring size without changes in maternal insulin sensitivity. Journal of Clinical Endocrinology and Metabolism, 95(5), 2080–2088.

    Article  PubMed  CAS  Google Scholar 

  29. Hegaard, H. K., Pedersen, B. K., Nielsen, B. B., & Damm, P. (2007). Leisure time physical activity during pregnancy and impact on gestational diabetes mellitus, pre-eclampsia, preterm delivery and birth weight: A review. Acta Obstetricia et Gynecologica Scandinavica, 86(11), 1290–1296.

    Article  PubMed  Google Scholar 

  30. Leet, T., & Flick, L. (2003). Effect of exercise on birthweight. Clinical Obstetrics and Gynecology, 46(2), 423–431.

    Article  PubMed  Google Scholar 

  31. Jukic, A. M., Evenson, K. R., Daniels, J. L., Herring, A. H., Wilcox, A. J., & Hartmann, K. E. (2011). A prospective study of the association between vigorous physical activity during pregnancy and length of gestation and birthweight. Maternal and Child Health Journal, 16(5), 1031–1044.

    Article  Google Scholar 

  32. Fleten, C., Stigum, H., Magnus, P., & Nystad, W. (2010). Exercise during pregnancy, maternal prepregnancy body mass index, and birth weight. Obstetrics and Gynecology, 115(2 Pt 1), 331–337.

    Article  PubMed  Google Scholar 

  33. Perkins, C. C., Pivarnik, J. M., Paneth, N., & Stein, A. D. (2007). Physical activity and fetal growth during pregnancy. Obstetrics and Gynecology, 109(1), 81–87.

    Article  PubMed  Google Scholar 

  34. Thangaratinam, S., Rogozinska, E., Jolly, K., Glinkowski, S., Roseboom, T., Tomlinson, J. W., et al. (2012). Effects of interventions in pregnancy on maternal weight and obstetric outcomes: Meta-analysis of randomised evidence. British Medical Journal, 344, e2088.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  35. Voldner, N., Froslie, K. F., Bo, K., Haakstad, L., Hoff, C., Godang, K., et al. (2008). Modifiable determinants of fetal macrosomia: Role of lifestyle-related factors. Acta Obstetricia et Gynecologica Scandinavica, 87(4), 423–429.

    Article  PubMed  Google Scholar 

  36. Gollenberg, A. L., Pekow, P., Bertone-Johnson, E. R., Freedson, P. S., Markenson, G., & Chasan-Taber, L. (2011). Physical activity and risk of small-for-gestational-age birth among predominantly Puerto Rican women. Maternal and Child Health Journal, 15(1), 49–59.

    Article  PubMed  Google Scholar 

  37. Leiferman, J. A., & Evenson, K. R. (2003). The effect of regular leisure physical activity on birth outcomes. Maternal and Child Health Journal, 7(1), 59–64.

    Article  PubMed  Google Scholar 

  38. Hegaard, H. K., Hedegaard, M., Damm, P., Ottesen, B., Petersson, K., & Henriksen, T. B. (2008). Leisure time physical activity is associated with a reduced risk of preterm delivery. American Journal of Obstetrics and Gynecology, 198(2), 180–185.

    Article  PubMed  Google Scholar 

  39. Juhl, M., Andersen, P. K., Olsen, J., Madsen, M., Jorgensen, T., Nohr, E. A., et al. (2008). Physical exercise during pregnancy and the risk of preterm birth: A study within the Danish National Birth Cohort. American Journal of Epidemiology, 167(7), 859–866.

    Article  PubMed  Google Scholar 

  40. Savitz, D. A., & Murnane, P. (2010). Behavioral influences on preterm birth: A review. Epidemiology, 21(3), 291–299.

    Article  PubMed  Google Scholar 

  41. Tobias, D. K., Zhang, C., van Dam, R. M., Bowers, K., & Hu, F. B. (2011). Physical activity before and during pregnancy and risk of gestational diabetes mellitus: A meta-analysis. Diabetes Care, 34(1), 223–229.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Fortner, R. T., Pekow, P. S., Whitcomb, B. W., Sievert, L. L., Markenson, G., & Chasan-Taber, L. (2011). Physical activity and hypertensive disorders of pregnancy among Hispanic women. Medicine and Science in Sports and Exercise, 43(4), 639–646.

    Article  PubMed  Google Scholar 

  43. Magnus, P., Trogstad, L., Owe, K. M., Olsen, S. F., & Nystad, W. (2008). Recreational physical activity and the risk of preeclampsia: A prospective cohort of Norwegian women. American Journal of Epidemiology, 168(8), 952–957.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Osterdal, M. L., Strom, M., Klemmensen, A. K., Knudsen, V. K., Juhl, M., Halldorsson, T. I., et al. (2009). Does leisure time physical activity in early pregnancy protect against pre-eclampsia? Prospective cohort in Danish women. British Journal of Obstetrics and Gynaecology, 116(1), 98–107.

    Article  PubMed  CAS  Google Scholar 

  45. Statistics Canada. (2013). Population by selected ethnic origins, by province and territory (2006 Census) (Nova Scotia). www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/demo26d-eng.htm. Accessed 11 Nov 2013.

  46. Althuizen, E., van Poppel, M. N., Seidell, J. C., & van Mechelen, W. (2009). Correlates of absolute and excessive weight gain during pregnancy. Journal of Women’s Health (Larchmt.), 18(10), 1559–1566.

    Article  Google Scholar 

  47. Hui, A., Back, L., Ludwig, S., Gardiner, P., Sevenhuysen, G., Dean, H., et al. (2012). Lifestyle intervention on diet and exercise reduced excessive gestational weight gain in pregnant women under a randomised controlled trial. British Journal of Obstetrics and Gynaeology, 119(1), 70–77.

    Article  CAS  Google Scholar 

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Acknowledgments

This study was funded, in part, by a grant from the Canadian Institutes for Health Research (CIHR). CW is supported by an Izaak Walton Killam Establishment Grant. We are grateful for the assistance of the study coordinators, Adelia Trenchard and Anne Spencer.

Conflict of interest

None of the authors have financial or other conflicts of interest.

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Authors and Affiliations

  1. Departments of Obstetrics and Gynaecology and Pediatrics, IWK Health Centre, Dalhousie University, 5980 University Ave., PO Box 9700, Halifax, NS, B3K 6R8, Canada

    Lisa M. Currie, Christy G. Woolcott & Linda Dodds

  2. Better Outcomes Registry and Network (BORN) Ontario, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada

    Deshayne B. Fell

  3. Department of Obstetrics & Gynaecology, Dalhousie University, Halifax, NS, Canada

    B. Anthony Armson

Authors
  1. Lisa M. Currie
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  2. Christy G. Woolcott
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  3. Deshayne B. Fell
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  4. B. Anthony Armson
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  5. Linda Dodds
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Correspondence to Christy G. Woolcott.

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Currie, L.M., Woolcott, C.G., Fell, D.B. et al. The Association Between Physical Activity and Maternal and Neonatal Outcomes: A Prospective Cohort. Matern Child Health J 18, 1823–1830 (2014). https://doi.org/10.1007/s10995-013-1426-3

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