BMC Pregnancy and Childbirth (Mar 2023)

Effects of prenatal exercise on gestational weight gain, obstetric and neonatal outcomes: FitMum randomized controlled trial

  • Caroline B. Roland,
  • Signe dP. Knudsen,
  • Saud A. Alomairah,
  • Anne D. Jessen,
  • Ida K. B. Jensen,
  • Nina Brændstrup,
  • Stig Molsted,
  • Andreas K. Jensen,
  • Bente Stallknecht,
  • Jane M. Bendix,
  • Tine D. Clausen,
  • Ellen Løkkegaard

DOI
https://doi.org/10.1186/s12884-023-05507-7
Journal volume & issue
Vol. 23, no. 1
pp. 1 – 11

Abstract

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Abstract Background To investigate the effects of two different exercise interventions during pregnancy on gestational weight gain (GWG) and obstetric and neonatal outcomes compared to standard care. Additionally, we aimed to improve standardization of GWG measurements by developing a model to estimate GWG for a standardized pregnancy period of 40 weeks and 0 days accounting for individual differences in gestational age (GA) at delivery. Methods In a randomized controlled trial we compared the effects of structured supervised exercise training (EXE) three times per week throughout pregnancy versus motivational counselling on physical activity (MOT) seven times during pregnancy with standard care (CON) on GWG and obstetric and neonatal outcomes. Uniquely, to estimate GWG for a standardized pregnancy period, we developed a novel model to predict GWG based on longitudinally observed body weights during pregnancy and at admission for delivery. Observed weights were fitted to a mixed effects model that was used to predict maternal body weight and estimate GWG at different gestational ages. Obstetric and neonatal outcomes, among them gestational diabetes mellitus (GDM) and birth weight, were obtained after delivery. GWG and the investigated obstetric and neonatal outcomes are secondary outcomes of the randomized controlled trial, which might be underpowered to detect intervention effects on these outcomes. Results From 2018–2020, 219 healthy, inactive pregnant women with median pre-pregnancy BMI of 24.1 (21.8–28.7) kg/m2 were included at median GA 12.9 (9.4–13.9) weeks and randomized to EXE (n = 87), MOT (n = 87) or CON (n = 45). In total 178 (81%) completed the study. GWG at GA 40 weeks and 0 days did not differ between groups (CON: 14.9 kg [95% CI, 13.6;16.1]; EXE: 15.7 kg [14.7;16.7]; MOT: 15.0 kg [13.6;16.4], p = 0.538), neither did obstetric nor neonatal outcomes. For example, there were no differences between groups in the proportions of participants developing GDM (CON: 6%, EXE: 7%, MOT: 7%, p = 1.000) or in birth weight (CON: 3630 (3024–3899), EXE: 3768 (3410–4069), MOT: 3665 (3266–3880), p = 0.083). Conclusions Neither structured supervised exercise training nor motivational counselling on physical activity during pregnancy affected GWG or obstetric and neonatal outcomes compared to standard care. Trial registration ClinicalTrials.gov; NCT03679130; 20/09/2018.

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