A randomized controlled trial of exercise during pregnancy on maternal and neonatal outcomes: results from the PAMELA study

International Journal of Behavioral Nutrition and Physical Activity

Research

Kelly Evenson¹  Diego Bassani²  Bruna Gonçalves Cordeiro da Silva³  Andréa Dâmaso Bertoldi³  Carolina de Vargas Nunes Coll³  Pedro Curi Hallal³  Mariângela Freitas da Silveira³  Inácio Crochemore Mohnsam da Silva³  Shana Ginar da Silva⁴  Marlos Rodrigues Domingues⁵ 

[1] Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina – Chapel Hill, Chapel Hill, NC, USA;Department of Paediatrics, Faculty of Medicine, Centre for Global Child Health, University of Toronto; King’s College Circle, The Hospital for Sick Children, Toronto, Canada;Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul, Brazil;Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul, Brazil;Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina – Chapel Hill, Chapel Hill, NC, USA;Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil;

关键词: Exercise;    Randomized controlled trial;    Pregnant woman;    Maternal-child health;    Physical activity;    Intervention studies;   

DOI  :  10.1186/s12966-017-0632-6

 received in 2017-07-04, accepted in 2017-12-07,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundWomen are encouraged to be physically active during pregnancy. Despite available evidence supporting antenatal physical activity to bring health benefits for both the mother and child, the most effective way to prevent some maternal and fetal outcomes is still unclear. The purpose of this study was to evaluate the efficacy of an exercise intervention to prevent negative maternal and newborn health outcomes.MethodsA randomized controlled trial (RCT) nested into the 2015 Pelotas (Brazil) Birth Cohort Study was carried-out with 639 healthy pregnant women, 213 in the intervention group (IG) and 426 in the control (CG) group. An exercise-based intervention was conducted three times/week for 16 weeks from 16-20 to 32-36 weeks’ gestation. The main outcomes were preterm birth and pre-eclampsia. Gestational age was calculated based on several parameters, including routine ultrassounds and/or last menstrual period and categorized as < 37 weeks and ≥ 37 weeks for evaluation of preterm birth. Pre-eclampsia was self-reported. Secondary outcomes were gestational weight gain, gestational diabetes, birth weight, infant length, and head circumference. Analyses were performed by intention-to-treat (ITT) and per protocol (70% of the 48 planned exercise sessions). Odds ratio were derived using unconditional logistic regression.ResultsThe IG and CG did not differ at baseline regarding their mean age (27.2 years ± 5.3 vs. 27.1 years ± 5.7) and mean pre-pregnancy body mass index (25.1 ± 3.9 vs. 25.2 ± 4.1 kg/m2). The mean adherence to the exercise intervention was 27 ± 17.2 sessions (out of a potential 48) with 40.4% attending > = 70% of the recommended exercise sessions. A total of 594 participants (IG:198; CG: 396) were included in the ITT and 479 (IG: 83; CG: 396) were included in the per protocol analyses. There were no significant differences in the incidence of preterm birth and pre-eclampsia between groups in the ITT and per protocol analysis. There were also no differences between the two groups in mean gestational weight gain, gestational diabetes, birth weight, infant length, and head circumference.ConclusionsWhile the RCT did not support the benefits of exercise performed during pregnancy on preeclampsia and preterm birth, the exercise program also did not present adverse impacts on newborn health. Our findings may contribute to promote intervention strategies that motivate health providers to encourage pregnant women to be more physically active.Trial registrationClinicaltrials.gov identifier: NCT02148965, registered on 22 May 2014.

【 授权许可】

CC BY   
© The Author(s). 2017