Do changing levels of maternal exercise during pregnancy affect neonatal adiposity? Secondary analysis of the babies after SCOPE: evaluating the longitudinal impact using neurological and nutritional endpoints (BASELINE) birth cohort (Cork, Ireland)

Tom Norris, Fergus P McCarthy, Ali S Khashan, Deidre M Murray, Mairead Kiely, Jonathan O'B Hourihane, Philip N Baker, Louise C Kenny, SCOPE Ireland Cohort study and the Cork BASELINE Birth Cohort Study, Tom Norris, Fergus P McCarthy, Ali S Khashan, Deidre M Murray, Mairead Kiely, Jonathan O'B Hourihane, Philip N Baker, Louise C Kenny, SCOPE Ireland Cohort study and the Cork BASELINE Birth Cohort Study

Abstract

Objective: To investigate whether changing levels of exercise during pregnancy are related to altered neonatal adiposity.

Design: Secondary analysis of data from a prospective cohort study.

Setting: Cork, Ireland.

Participants: 1200 mother - infant pairs recruited as part of a prospective birth cohort, Babies After SCOPE: Evaluating the Longitudinal Impact Using Neurological and Nutritional Endpoints (BASELINE).

Main outcome measures: Neonatal adiposity was assessed within several days of birth using air displacement plethysmography (PEAPOD). Per cent body fat (BF%) as a continuous outcome and a pair of dichotomous variables; high or low adiposity, representing BF% >90th or <10th centile, respectively. Multivariable linear and logistic regression models were used to investigate the relationship between exercise and the respective outcomes.

Results: Crude analysis revealed no association between a changing level of exercise (since becoming pregnant) at 15 weeks' gestation and any of the outcomes (BF%, low adiposity and high adiposity). At 20 weeks' gestation, analyses revealed that relative to women who do not change their exercise level up to 20 weeks, those women who decreased their exercise level were more likely to give birth to a neonate with adiposity above the 90th centile (OR 1.62, 95% CI 1.07 to 2.46). This association was maintained after adjustment for putative confounders (OR 1.62, 95% CI 1.06 to 2.47).

Conclusions: We observed a possible critical period for the association between changing exercise levels and neonatal adiposity, with no association observed with exercise recall for the first 15 weeks of gestation, but an association with a decreasing level of exercise between 15 and 20 weeks. These results should be interpreted in line with the limitations of the study and further studies utilising objectively measured estimates of exercise are required in order to replicate these findings.

Trial registration number: NCT01498965.

Keywords: adiposity; exercise; peapod; pregnancy.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

References

    1. Royal College of Obstetricians and Gynaecologists. Exercise in Pregnancy. RCOG Statement, 2006;4.
    1. Hopkins SA, Cutfield WS. Exercise in pregnancy: weighing up the long-term impact on the next generation. Exerc Sport Sci Rev 2011;39:120–7. 10.1097/JES.0b013e31821a5527
    1. Pivarnik JM, Mauer MB, Ayres NA, et al. . Effects of chronic exercise on blood volume expansion and hematologic indices during pregnancy. Obstet Gynecol 1994;83:265–9.
    1. Russo LM, Nobles C, Ertel KA, et al. . Physical activity interventions in pregnancy and risk of gestational diabetes mellitus: a systematic review and meta-analysis. Obstet Gynecol 2015;125:576–82. 10.1097/AOG.0000000000000691
    1. Sanabria-Martínez G, García-Hermoso A, Poyatos-León R, et al. . Effectiveness of physical activity interventions on preventing gestational diabetes mellitus and excessive maternal weight gain: a meta-analysis. BJOG 2015;122:1167–74. 10.1111/1471-0528.13429
    1. Jackson MR, Gott P, Lye SJ, et al. . The effects of maternal aerobic exercise on human placental development: placental volumetric composition and surface areas. Placenta 1995;16:179–91. 10.1016/0143-4004(95)90007-1
    1. Clapp JF, Kim H, Burciu B, et al. . Continuing regular exercise during pregnancy: effect of exercise volume on fetoplacental growth. Am J Obstet Gynecol 2002;186:142–7. 10.1067/mob.2002.119109
    1. Clapp JF, Kim H, Burciu B, et al. . Beginning regular exercise in early pregnancy: effect on fetoplacental growth. Am J Obstet Gynecol 2000;183:1484–8. 10.1067/mob.2000.107096
    1. Clapp JF, Capeless EL. The changing glycemic response to exercise during pregnancy. Am J Obstet Gynecol 1991;165:1678–83. 10.1016/0002-9378(91)90014-I
    1. Hopkins SA, Baldi JC, Cutfield WS, et al. . Exercise training in pregnancy reduces offspring size without changes in maternal insulin sensitivity. J Clin Endocrinol Metab 2010;95:2080–8. 10.1210/jc.2009-2255
    1. Harrod CS, Chasan-Taber L, Reynolds RM, et al. . Physical activity in pregnancy and neonatal body composition: the Healthy Start study. Obstet Gynecol 2014;124:257–64. 10.1097/AOG.0000000000000373
    1. Barker DJP, Godfrey KM, Gluckman PD, et al. . Fetal nutrition and cardiovascular disease in adult life. The Lancet 1993;341:938–41. 10.1016/0140-6736(93)91224-A
    1. Barker DJ, Osmond C, Golding J, et al. . Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease. BMJ 1989;298:564–7. 10.1136/bmj.298.6673.564
    1. Martyn CN, Barker DJ, Osmond C. Mothers’ pelvic size, fetal growth, and death from stroke and coronary heart disease in men in the UK. Lancet 1996;348:1264–8. 10.1016/S0140-6736(96)04257-2
    1. Ravelli GP, Stein ZA, Susser MW. Obesity in young men after famine exposure in utero and early infancy. N Engl J Med 1976;295:349–53. 10.1056/NEJM197608122950701
    1. Hales CN, Barker DJ. Type 2 (non-insulin-dependent) diabetes mellitus: the thrifty phenotype hypothesis. Diabetologia 1992;35:595–601. 10.1007/BF00400248
    1. Phillips DI. Relation of fetal growth to adult muscle mass and glucose tolerance. Diabet Med 1995;12:686–90. 10.1111/j.1464-5491.1995.tb00570.x
    1. O’Donovan SM, Murray DM, Hourihane JO, et al. . Cohort profile: the cork BASELINE birth cohort study: babies after SCOPE: evaluating the longitudinal Impact on neurological and nutritional endpoints. Int J Epidemiol 2015;44:764–75. 10.1093/ije/dyu157
    1. North RA, McCowan LM, Dekker GA, et al. . Clinical risk prediction for pre-eclampsia in nulliparous women: development of model in international prospective cohort. BMJ 2011;342:d1875 10.1136/bmj.d1875
    1. McCarthy FP, Khashan AS, North RA, et al. . A prospective cohort study investigating associations between hyperemesis gravidarum and cognitive, behavioural and emotional well-being in pregnancy. PLoS One 2011;6:e27678 10.1371/journal.pone.0027678
    1. McCowan LM, Dekker GA, Chan E, et al. . Spontaneous preterm birth and small for gestational age infants in women who stop smoking early in pregnancy: prospective cohort study. BMJ 2009;338:b1081 10.1136/bmj.b1081
    1. Urlando A, Dempster P, Aitkens S. A new air displacement plethysmograph for the measurement of body composition in infants. Pediatr Res 2003;53:486–92. 10.1203/01.PDR.0000049669.74793.E3
    1. Ellis KJ, Yao M, Shypailo RJ, et al. . Body-composition assessment in infancy: air-displacement plethysmography compared with a reference 4-compartment model. Am J Clin Nutr 2007;85:5.
    1. Roggero P, Giannì ML, Amato O, et al. . Evaluation of air-displacement plethysmography for body composition assessment in preterm infants. Pediatr Res 2012;72:316–20. 10.1038/pr.2012.75
    1. Bell RJ, Palma SM, Lumley JM. The effect of vigorous exercise during pregnancy on birth-weight. Aust N Z J Obstet Gynaecol 1995;35:46–51. 10.1111/j.1479-828X.1995.tb01829.x
    1. Hawkes CP, Hourihane JO, Kenny LC, et al. . Gender- and gestational age-specific body fat percentage at birth. Pediatrics 2011;128:e645–e51. 10.1542/peds.2010-3856
    1. Textor J, Hardt J, Knüppel S. DAGitty: a graphical tool for analyzing causal diagrams. Epidemiology 2011;22:745 10.1097/EDE.0b013e318225c2be
    1. Moodie EE, Stephens DA. Using Directed Acyclic Graphs to detect limitations of traditional regression in longitudinal studies. Int J Public Health 2010;55:701–3. 10.1007/s00038-010-0184-x
    1. Bodnar LM, Davidian M, Siega-Riz AM, et al. . Marginal structural models for analyzing causal effects of time-dependent treatments: an application in perinatal epidemiology. Am J Epidemiol 2004;159:926–34. 10.1093/aje/kwh131
    1. Brotman RM, Klebanoff MA, Nansel TR, et al. . A longitudinal study of vaginal douching and bacterial vaginosis–a marginal structural modeling analysis. Am J Epidemiol 2008;168:188–96. 10.1093/aje/kwn103
    1. Greenland S, Pearl J, Robins JM. Causal diagrams for epidemiologic research. Epidemiology 1999;10:37–48. 10.1097/00001648-199901000-00008
    1. Ma G, Yao M, Liu Y, et al. . Validation of a new pediatric air-displacement plethysmograph for assessing body composition in infants. Am J Clin Nutr 2004;79:653–60.
    1. Yao M, Nommsen-Rivers L, Dewey K, et al. . Preliminary evaluation of a new pediatric air displacement plethysmograph for body composition assessment in infants. Acta Diabetol 2003;40:s55–8. 10.1007/s00592-003-0027-9
    1. International Atomic Energy Agency. Body composition assessment from birth to two years of age. Vienna: IAEA Human Health Series, 2013.
    1. DiNallo JM, Downs DS, Le Masurier G. Objectively assessing treadmill walking during the second and third pregnancy trimesters. J Phys Act Health 2012;9:21–8. 10.1123/jpah.9.1.21
    1. Connolly CP, Coe DP, Kendrick JM, et al. . Accuracy of physical activity monitors in pregnant women. Med Sci Sports Exerc 2011;43:1100–5. 10.1249/MSS.0b013e3182058883
    1. Evenson KR, Chasan-Taber L, Symons Downs D, et al. . Review of self-reported physical activity assessments for pregnancy: summary of the evidence for validity and reliability. Paediatr Perinat Epidemiol 2012;26:479–94. 10.1111/j.1365-3016.2012.01311.x
    1. Harrison CL, Thompson RG, Teede HJ, et al. . Measuring physical activity during pregnancy. Int J Behav Nutr Phys Act 2011;8:19 10.1186/1479-5868-8-19
    1. Evenson KR, Wen F. Measuring physical activity among pregnant women using a structured one-week recall questionnaire: evidence for validity and reliability. Int J Behav Nutr Phys Act 2010;7:21 10.1186/1479-5868-7-21
    1. Farrar D, Simmonds M, Bryant M, et al. . Hyperglycaemia and risk of adverse perinatal outcomes: systematic review and meta-analysis. BMJ 2016;354:i4694.
    1. Poston L. Gestational weight gain: influences on the long-term health of the child. Curr Opin Clin Nutr Metab Care 2012;15:252–7. 10.1097/MCO.0b013e3283527cf2
    1. Ireland Central Statistics Office. Census 2006 Volume 5- Ethnic or Cultural Background, 2007.
    1. Artal R, O’Toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br J Sports Med 2003;37:6–12. 10.1136/bjsm.37.1.6
    1. National Institute for Health and Care Excellence. NICE Clinical guidelines, no. 62: Antenatal care: Routine care for the healthy pregnant woman. London: RCOG Press, 2008.
    1. Clapp JF. Morphometric and neurodevelopmental outcome at age five years of the offspring of women who continued to exercise regularly throughout pregnancy. J Pediatr 1996;129:856–63. 10.1016/S0022-3476(96)70029-X

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe