Obesity, Physical Activity, Pregnancy
Conditions
Keywords
Pregnancy, Obesity, Physical activity, Cardiorespiratory fitness, Muscular Fitness, Weight gain, Fetal growth
Brief summary
In pregnancy, the adoption or pursuit of a sedentary lifestyle contributes to the development of co-morbid conditions such as hypertension, maternal and childhood obesity, gestational diabetes, pre-eclampsia, cesarean section and delivery of large-for-gestational-age infants (LGA). The aim of this study is to test the hypothesis that obese, pregnant women following a supervised moderate intensity physical conditioning program during the 2nd trimester of pregnancy will maintain a higher level of physical activity up to the end of pregnancy, as compared to women in the control group. We will also conduct a pilot study on the feasibility to examine the effects of the intervention on maternal fitness and neonatal anthropometry.
Detailed description
Looking at the multiple needs of pregnant women with obesity, physical conditioning may offer a great opportunity to improve fitness and to decrease cardio-metabolic disturbances, to prevent excessive weight gain, to improve general health status, and to reduce health care utilization. Furthermore, beneficial effects of fitness on adverse maternal health outcomes related to obesity might decrease the development of long-term obesity and metabolic repercussions in the offspring. The Society of Obstetricians and Gynaecologists of Canada (SOGC) recommends that all women without contraindication be encouraged to participate in aerobic and strength-conditioning exercises as part of a healthy lifestyle during pregnancy. Despite these recommendations, obese women are inactive during pregnancy and are currently still at high risk of poor physical fitness. Thus, although exercise clearly improves maternal health status and thus potentially prevents adverse perinatal outcomes, obese pregnant women poorly adhere to experts' recommendations about the need for exercise during pregnancy. Therefore, this situation justifies the need to develop adapted strategies aimed at increasing the implementation of guideline recommendations in this population.
Interventions
OTHERExercise intervention
Exercise group: 12 weeks of moderate intensity physical training under individual supervision in a specialised conditioning center, with a goal of 3 1h-sessions/week (from 16 wks to 28 wks of gestation). Including aerobic and muscular training.
OTHERStandard Care
Sponsors
Foundation of the Stars
CHU de Quebec-Universite Laval
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* pregnant women 18 years or older * single pregnancy * delivery at Centre Hospitalier Universitaire de Québec * pre-pregnancy BMI ≥30 kg/m2
Exclusion criteria
* multiple pregnancy * diabetes or chronic hypertension prior to pregnancy * uncontrolled thyroid problems * exercise contraindications
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Weekly time spent at physical activity of moderate intensity and above | At 36 weeks of gestation | Accelerometry data (minutes per week spent over selected cutpoints) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Muscular fitness | At 28 wks of gestation | Endurance and strength of lower and upper limbs as assessed by an isokinetic dynamometer. |
| Cardiorespiratory fitness | At 28 weeks of gestation | O2 consumption (ml\*kg-1\*min-1) at the anaerobic threshold. |
| Gestational weight gain | At 36 weeks of gestation | Weight in kg at 36 weeks - weight in kg at 14 weeks |
| Neonatal anthropometry | At delivery | Birth weight, length and skinfolds |
| Fetal growth | At 28 weeks of gestation | Ultrasound and doppler |
| Energy Expenditure | At 36 weeks of gestation | According to the Pregnancy Physical Activity Questionnaire (PPAQ) |
Countries
Canada
Outcome results
None listed