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Protective Effect of Exercise in Pregnant Women Including Those Who Exceed Weight Gain Recommendations: A Randomized Controlled Trial

      Abstract

      Objective

      To investigate the effect of supervised moderate to vigorous exercise on gestational weight gain, its related risks (gestational diabetes [GD]), macrosomia, and type of delivery), and the preventive effects on women who exceed the weight gain recommendations.

      Patients and Methods

      We conducted a single-center, 2-armed, randomized controlled trial between October 1, 2009, and June 30, 2011, in which 678 women were assessed and 345 were randomized by a central computer system to an intervention group (N=115) or a standard care group (N=230). The intervention exercise program consisted of 70 to 78 sessions (24 weeks, 3 times per week, 60-65 minutes per session, moderate to vigorous intensity). The standard care group received usual care. Excessive gestational weight (EGW) gain was calculated on the basis of the 2009 Institute of Medicine (IOM) recommendations.

      Results

      Of the 345 women randomized for treatment, 44 were lost to follow-up, leaving 301 women for analysis (intervention, 100; standard care, 201). Fewer women in the intervention group exceeded IOM recommendations (22 [22.0%] vs 69 [34.3%]; P=.03), including overweight and obese women (15 of 35 [42.9%] vs 40 of 50 [80.0%]; P=.001). Analysis of women exceeding weight recommendations revealed that the 3 main related risks were directly related to EGW gain in the standard care group (GD, P=.003; macrosomia, P<.001; type of delivery, P<.001) but not in the intervention group (GD, P>.99; macrosomia, 0%; type of delivery, P=.46).

      Conclusion

      Supervised moderate to vigorous exercise performed throughout gestation was effective in the prevention of EGW gain even for women with a pregestational body mass index greater than 25 kg/m2. It also prevented its related risks (GD, macrosomia, and type of delivery) including for women exceeding the IOM recommendations, so we suggest that being active outweighs the effect of possible weight gain.

      Trial Registration

      ClinicalTrials.gov Identifier: NCT01477372

      Abbreviations and Acronyms:

      BMI (body mass index), IOM (Institute of Medicine), RCT (randomized controlled trial)
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      Linked Article

      • Rethinking Prenatal Exercise Trials: How Can We Improve Translation?
        Mayo Clinic ProceedingsVol. 94Issue 10
        • Preview
          Regular exercise is important to maintain health and reduce the risk of chronic disease in the general population. The greatest health benefits occur in sedentary individuals who incorporate small amounts of activity into their daily routine. Additional benefits of exercise for pregnant women include reduced rates of maternal and fetal complications, such as pre-eclampsia, gestational hypertension, gestational diabetes, Caesarean section, excessive gestational weight gain, and macrosomia.1 The trial of supervised moderate to vigorous prenatal exercise by Mireia Pelaez and colleagues,2 published in this issue of Mayo Clinic Proceedings, adds to this body of evidence.
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