FitMum, pregnant woman running

FitMum: Effects of physical activity during pregnancy on health of mother and child

A physically active lifestyle during pregnancy has enormous potential to improve maternal and child health. This PhD project investigated how to implement physical activity in pregnant women´s everyday life, and whether physical activity affects health of the pregnant women and their offspring, by testing the efficacy of two very different exercise programs during pregnancy.

Effects of structured supervised exercise training versus motivational counseling supported by health technology on physical activity level and metabolic and clinical health parameters in healthy inactive pregnant women – a PhD project nested in the FitMum Study.

Background and research question

Physical activity during pregnancy is well-established as a safe and beneficial lifestyle component (1–3) and several mechanisms underlying the exercise-induced improvements of maternal and offspring health have been proposed. Danish (4) and international (1) recommendations prescribe physical activity at moderate intensity for 210 and 150 minutes per week, respectively, throughout pregnancy for all pregnant women with uncomplicated pregnancies. Nevertheless, high prevalence of insufficient physical activity during pregnancy, as well as in general, is a global health challenge (5–8) and the efficacy of different physical activity intervention strategies needs to be compared to clarify how to increase physical activity level among pregnant women and improve maternal and offspring health most efficiently.

The main objective of this PhD thesis was to investigate the effects of two different physical activity interventions during pregnancy; structured supervised exercise training versus motivational counselling on physical activity, on clinical health outcomes in healthy inactive pregnant women and their offspring compared to standard care, and to explore possible underlying mechanisms for optimized offspring health. Secondary outcomes data from the FitMum study formed the basis for the analyses in the thesis and papers. The focus of this thesis was on gestational weight gain and obstetric and neonatal outcomes during pregnancy and delivery as well as exercise-induced adaptations to breast milk as a possible underlying mechanism mediating improvements of offspring health.

Results and conclusion

This PhD project showed no effect of the two interventions on gestational weight gain and obstetric and neonatal outcomes compared to standard care. The interventions did not elicit major metabolite or lipid changes in human breast milk. There were distinct changes and positive correlations with physical activity for select metabolites and lipids, including 1,7-Dimethyluric acid, oxoglutarate and mainly
phospholipid species.

Collectively, this PhD project provides a greater insight into how different physical activity approaches during pregnancy affect maternal and offspring health, as well as into possible maternally exercise-induced adaptations involved in improvements in offspring health.

References

  1. Bull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Vol. 54, British Journal of Sports Medicine. BMJ Publishing Group; 2020. p. 1451–62.
  2. The American College of Obstetricians and Gynecologists. Physical Activity and Exercise During Pregnancy and the Postpartum Period. ACOG Committee Opinion No. 804. Obstet Gynecol. 2020;135:e178-88.

  3. Mottola MF, Davenport MH, Ruchat SM, Davies GA, Poitras VJ, Gray CE, et al. 2019 Canadian guideline for physical activity throughout pregnancy. Br J Sports Med. 2018;52(21):1339–

  4. The Danish Health Authorities. Recommendations for pregnant women [Internet]. 2021. Available from: https://www.sst.dk/da/viden/fysisk-aktivitet/anbefalinger-om-fysisk-aktivitet/gravide

  5. Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Glob Heal. 2018;(18):1–10.

  6. Santo EC, Forbes PW, Oken E, Belfort MB. Determinants of physical activity frequency and provider advice during pregnancy. BMC Pregnancy Childbirth. 2017;17(286):1–11.

  7. Richardsen KR, Falk RS, Jenum AK, Mørkrid K, Martinsen EW, Ommundsen Y, et al. Predicting who fails to meet the physical activity guideline in pregnancy: A prospective study of objectively recorded physical activity in a population-based multi-ethnic cohort. BMC Pregnancy Childbirth. 2016;16(186):1–11.

  8. Broberg L, Ersbøll AS, Backhausen MG, Damm P, Tabor A, Hegaard HK. Compliance with national recommendations for exercise during early pregnancy in a Danish cohort. BMC Pregnancy Childbirth. 2015;15:317. 

Thesis

Contact

Caroline Borup Roland
PhD student
Department of Biomedical Sciences

Contact

Bente Merete Stallknecht
Prorector, Professor
Department of Biomedical Sciences
+45 35 32 75 40
https://www.cachet.dk/research/finalized-phd-projects/fitmum
27 JANUARY 2023