Obesity can offset the cardiometabolic benefits of gestational exercise

Int J Obes (Lond). 2021 Feb;45(2):342-347. doi: 10.1038/s41366-020-00669-2. Epub 2020 Sep 4.

Abstract

Pregnancy exercise can prevent excessive gestational weight gain (EGWG), gestational diabetes mellitus (GDM) and hypertension (GH), but inter-individual variability has not been explored. We aimed to analyze the prevalence--and potential sociodemographic and medical predictors of--non-responsiveness to gestational exercise, and the association of non-responsiveness with adverse pregnancy outcomes. Among 688 women who completed a supervised light-to-moderate intensity exercise program (three ~1-h sessions/week including aerobic, resistance, and pelvic floor muscle training) until near-term, those who showed EGWG, GDM or GH were considered 'non-responders'. A low prevalence of non-responders was observed for GDM (3.6%) and GH (3.4%), but not for EGWG (24.2%). Pre-pregnancy obesity was the strongest predictor of non-responsiveness for GH (odds ratio 8.40 [95% confidence interval 3.10-22.78] and EGWG (5.37 [2.78-10.39]), whereas having a highest education level attenuated the risk of being non-responder for GDM (0.10 [0.02-0.49]). Non-responsiveness for EGWG was associated with a higher risk of prolonged labor length, instrumental/cesarean delivery, and macrosomia, and of lower Apgar scores. No association with negative delivery outcomes was found for GDM/GH. In summary, women with pre-pregnancy obesity might require from additional interventions beyond light-to-moderate intensity gestational exercise (e.g., diet and/or higher exercise loads) to ensure cardiometabolic benefits.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Mass Index
  • Diabetes, Gestational / prevention & control*
  • Exercise Therapy*
  • Exercise*
  • Female
  • Gestational Weight Gain / physiology
  • Humans
  • Hypertension, Pregnancy-Induced / prevention & control*
  • Obesity / complications*
  • Obesity / prevention & control*
  • Pregnancy
  • Pregnancy Outcome
  • Prenatal Care / methods
  • Randomized Controlled Trials as Topic
  • Risk Factors