Continuing regular exercise during pregnancy: Effect of exercise volume on fetoplacental growth

doi:10.1067/mob.2002.119109

American Journal of Obstetrics and Gynecology

Volume 186, Issue 1, January 2002, Pages 142-147

https://doi.org/10.1067/mob.2002.119109 Get rights and content

Abstract

Objective: The purpose of this study was to test the null hypothesis that the volume of exercise at different times during pregnancy has no effect on fetoplacental growth. Study Design: Seventy-five women who exercised regularly were evaluated before pregnancy and randomly assigned at 8 weeks' gestation to one of 3 exercise regimens for the remainder of pregnancy. Primary outcome variables included placental growth rate, birth weight, and placental volume at term. Results: The offspring of the women who were randomly assigned to a high volume of exercise in mid and late pregnancy were significantly lighter (3.39 kg vs 3.81 kg) and thinner (8.3% fat vs 12.1% fat) than those offspring born of women who were randomly assigned to reduce their exercise volume after the 20th week. Maternal weight gain, fresh placental volumes, and histomorphometric indices of placental function were greater in the high-low group. Conclusion: These data indicate that a high volume of moderate-intensity, weight-bearing exercise in mid and late pregnancy symmetrically reduces fetoplacental growth, whereas a reduction in exercise volume enhances fetoplacental growth with a proportionally greater increase in fat mass than in lean body mass. (Am J Obstet Gynecol 2002;186:142-7.)

Section snippets

General

The experimental protocol was approved by the hospital's Internal Review Board for Human Experimentation and used a prospective randomized design in which 80 healthy, regularly exercising (3 or more times each week), non–substance-abusing women were enrolled before pregnancy. At that time, they completed a demographic questionnaire and underwent a physical fitness assessment that included a fixed-rate, progressive incline treadmill evaluation of maximum aerobic capacity (VO_2max).¹⁰ No blood or

General

Seventy-five of the 80 women who were enrolled had an uncomplicated pregnancy and completed the protocol. One of the women in each group had a complication (1 woman had recurrent mid-trimester bleeding and intrauterine growth retardation; 2 women had premature labor), and 2 women were noncompliant. Of the 75 remaining women, 26 women had been randomized to the Lo-Hi group; 24 women had been randomized to the Mod-Mod group, and 25 women had been randomized to the Hi-Lo exercise group. Compliance

Comment

These data warrant several conclusions. First, continuing a regular regimen of weight-bearing exercise throughout pregnancy influences fetoplacental growth in both a time-dependant and exercise volume–dependant fashion. Women who either maintained the moderate volume of exercise throughout the pregnancy or increased their exercise volume in late pregnancy experienced a significantly slower fetoplacental growth rate than those women who maintained a high volume of exercise in early pregnancy and

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Maternal physical activity and sitting time and its association with placental morphology and blood flow during gestation: Findings from the Queensland Family Cohort study
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Antenatal exercise is associated with placental morphological alterations, however research in this area is limited. Given the emphasis on the beneficial effects of antenatal exercise, it is important to understand its effect on placental function and the relationship to foetal development. The aim of this study was to investigate the association between physical activity, sitting time, and placental outcomes measured during gestation.
Prospective cohort study.
Pregnant women in the Queensland Family Cohort study self-reported physical activity at 24 and 36 weeks of gestation (n = 203) and were categorised into physical activity volume groups of nil–low (0–<500 metabolic equivalent of task·minutes/week), moderate (500–<1000 metabolic equivalent of task·minutes/week), or high-volume activity (≥ 1000 metabolic equivalent of task·minutes/week). Participants reported average daily sitting time, whereby excessive sitting time was considered as ≥ 8 h/day. Placental stiffness, thickness, and uteroplacental blood flow resistance were measured by ultrasound imaging at each timepoint.
Physical activity volume was not associated with changes to placental morphometrics or uteroplacental blood flow resistance at 24 or 36 weeks of gestation. Excessive sitting time at 36 weeks was associated with greater placental stiffness (p = 0.046), and a lower umbilical artery pulsatility index (p = 0.001).
Placental tissue stiffness and umbilical artery resistance were altered in late gestation with higher maternal sitting time but not with physical activity volume. Overall, excessive sitting time may be a risk for suboptimal placental function and could be an important focus for antenatal care.
Sedentary lifestyle in pregnancy: Effects on the mother and the newborn
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Identificar el estado de sedentarismo durante el embarazo y los factores asociados a este comportamiento, los posibles factores, su situación de salud y del recién nacido.
Este estudio observacional transversal de 2 fases se desarrolló en el Hospital Universitario y Politécnico de La Fe, y participaron 228 mujeres embarazadas. Las características sociodemográficas maternas se obtuvieron mediante cuestionario estructurado e información de salud de la historia clínica electrónica, así como los resultados perinatales del recién nacido. Para evaluar el sedentarismo se valoró el ejercicio en el tiempo libre y el ejercicio en horario laboral, categorizándolos en función de la intensidad (sedentarismo, actividad leve, actividad moderada e intenso).
En total, la prevalencia de sedentarismo fue del 31,14%. El perfil de este grupo tiene menor nivel educativo y desempleo (p < 0,05), presentando una mayor prevalencia de problemas durante el parto, que requirió cesárea, así como problemas posparto en el recién nacido (p < 0,05).
La inactividad física es altamente prevalente entre las mujeres embarazadas. Debido a los beneficios (o no daños) atribuidos al ejercicio durante el embarazo. Se deben realizar mayores esfuerzos para superar las barreras para promover actividades entre las mujeres embarazadas que son más jóvenes, menos educadas y desempleadas, y aquellas con varios hijos y menores ingresos tienen menos probabilidades de participar en una cantidad adecuada de actividad física, conscientes de la importancia de hacerlo, resolviendo dudas y disipando temores que puedan surgir por una mala comprensión del mecanismo de su beneficio.
Identify the state of sedentary lifestyle during pregnancy and the factors associated with this behavior, the possible factors of your health situation and that of the newborn.
This two-phase, cross-sectional observational study was developed at the La Fe University and Polytechnic Hospital and 228 pregnant women participated. Maternal sociodemographic characteristics were obtained using structured questionnaire and health information from the electronic medical records, as well as perinatal results of the newborn. To assess sedentary lifestyle, exercise in free time and exercise during working hours were assessed, categorizing them based on intensity (sedentary lifestyle, light activity, moderate and intense activity).
In total, the prevalence of physical inactivity was 31.14%. The profile of this group has a lower level of education and unemployment (P<.05), presenting a higher prevalence of problems during childbirth, which required a caesarean section, as well as problems after birth in the newborn (P<.05).
Physical inactivity is highly prevalent among pregnant women. Due to the benefits (or non-harm) attributed to exercise during pregnancy. Further efforts should be taken to overcome the barriers to promote activities among pregnant women who are younger, less well educated, and unemployed and those with multiple children and a lower income are less likely to engage in an adequate amount of physical activity, aware of the importance of doing it, resolving doubts and allaying fears that may arise from a poor understanding of the mechanism of its benefit.
The placental role in developmental programming
2022, Reproductive and Developmental Toxicology
The principal placenta must protect the fetus from harmful substances while actively ensuring appropriate transfer of the nutrients essential for optimal fetal growth and development. Failure of the placenta to protect or nourish the fetus can have significant consequences for the offspring, both before birth and throughout its postnatal life. Poor fetal growth is associated with increased risk of many common noncommunicable disorders in adult life, including coronary heart disease, diabetes, and some forms of cancer. These long-term consequences are commonly referred to as “developmental programming.” The placenta is the interface between the mother and the fetus, influencing both the intrauterine environment and fetal growth, and placental function is therefore likely to be a major determinant of programming effects. Understanding the role of the placenta in developmental programming may provide new avenues for prevention and treatment in at-risk individuals.
The effects of exercise during pregnancy on placental composition: A systematic review and meta-analysis
2022, Placenta
Morphological changes to the placenta occur as the demands of the foetus increase throughout gestation. Physical activity during pregnancy is known to benefit both the mother and infant, however the impact of antenatal exercise training on placental development is less known. The aim of this systematic review and meta-analysis was to investigate the effects of exercise training during pregnancy on measures of placental composition.
Six electronic databases were searched from inception to June 2021 for studies comparing regular antenatal exercise with either usual maternal care or no exercise for its effect on measures of placental morphological composition. Meta-analyses were performed for placental weight and the placental weight to birthweight (PWBW) ratio.
Seven randomised controlled trials and two cohort studies were included in the systematic review and meta-analysis (n = 9). There was no significant difference in placental weight (mean difference (MD) = -9.07g, p = 0.42) or the PWBW ratio (MD = 0.00, p = 0.32) between exercise and control groups. Parenchymal tissue volume was higher, represented by an increase in villous tissue, and non-parenchymal volume was lower in women who exercised regularly compared to those that were not exercising during pregnancy.
Exercise training during pregnancy may not alter placental weight or the PWBW ratio. However, findings from this review indicate that antenatal exercise training can promote advantageous morphological changes to placental tissues.
Does exercise during pregnancy impact organs or structures of the maternal-fetal interface?
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Exercise during pregnancy has been shown to be associated with improved health outcomes both during and after pregnancy for mother and fetus across the lifespan. Increasing physical activity and reducing sedentary behaviour during pregnancy have been recommended by many researchers and clinicians-alike. It is thought that the placenta plays a central role in mediating any positive or negative pregnancy outcomes. The positive outcomes obtained through prenatal exercise are postulated to result from exercise-induced regulation of maternal physiology and placental development. Considerable research has been performed to understand the placenta's role in pregnancy-related diseases, such as preeclampsia, fetal growth restriction, and gestational diabetes mellitus. However, little research has examined the potential for healthy lifestyle and behavioural changes to improve placental growth, development, and function. While the placenta represents the critical maternal-fetal interface responsible for all gas, nutrient, and waste exchange between the mother and fetus, the impact of exercise during pregnancy on placental biology and function is not well known. This review will focus on prenatal exercise and its promising influence on the structures of the maternal-fetal interface, with particular emphasis on the placenta. Potential molecular mechanistic hypotheses are presented to aid future investigations of prenatal exercise and placental health.
Maternal physical activity affects yolk sac size and growth in early pregnancy, but girls and boys use different strategies
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^☆: Supported by grants HD21268, HD21109, and RR00080 from the National Institute of Child Health and Development and funds from MetroHealth Medical Center.

^☆☆: Reprint requests: James F. Clapp III, MD, Department of Obstetrics and Gynecology, MetroHealth Medical Center, 2500 MetroHealth Dr, Cleveland, OH 44109. E-mail: [email protected].

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Fetus-Placenta-NewbornContinuing regular exercise during pregnancy: Effect of exercise volume on fetoplacental growth☆,☆☆

Abstract

Section snippets

General

General

Comment

Am J Obstet Gynecol

Am J Obstet Gynecol

Clin Sports Med

Am J Obstet Gynecol

Am J Obstet Gynecol

Am J Obstet Gynecol

J Pediatr

Placenta

Placenta

Exercise during pregnancy

The effect of vigorous exercise during pregnancy on birth-weight

Aust NZ J Obstet Gynecol

Fetus-Placenta-Newborn
Continuing regular exercise during pregnancy: Effect of exercise volume on fetoplacental growth☆,☆☆