Background
The prevalence of all pregnancies with some form of hypertension can be up to 10%,
with the rates of diagnosis varying according to the country and population studied
and the criteria used to establish the diagnosis. Prepregnancy obesity and excessive
gestational weight gain (GWG) of all body mass index (BMI) categories have been associated
with maternal hypertensive disorders and linked to macrosomia (>4000 g) and low birthweight
(<2500 g). No large randomized controlled trial with high adherence to an exercise
program has examined pregnancy-induced hypertension and these associated issues. We
investigated whether women adherent (≥80% attendance) to an exercise program initiated
early showed a reduction in pregnancy-induced hypertension and excessive GWG in all
prepregnancy BMI categories, and determined if maternal exercise protected against
macrosomia and low birthweight.
Objective
We sought to examine the impact of a program of supervised exercise throughout pregnancy
on the incidence of pregnancy-induced hypertension.
Study Design
A randomized controlled trial was used. Women were randomized into an exercise group
(N = 382) or a control group (N = 383) receiving standard care. The exercise group
trained 3 d/wk (50-55 min/session) from gestational weeks 9-11 until weeks 38-39.
The 85 training sessions involved aerobic exercise, muscular strength, and flexibility.
Results
High attendance to the exercise program regardless of BMI showed that pregnant women
who did not exercise are 3 times more likely to develop hypertension (odds ratio [OR],
2.96; 95% confidence interval [CI], 1.29–6.81, P = .01) and are 1.5 times more likely to gain excessive weight if they do not exercise
(OR, 1.47; 95% CI, 1.06–2.03, P = .02). Pregnant women who do not exercise are also 2.5 times more likely to give
birth to a macrosomic infant (OR, 2.53; 95% CI, 1.03–6.20, P = .04).
Conclusion
Maternal exercise may be a preventative tool for hypertension and excessive GWG, and
may control offspring size at birth while reducing comorbidities related to chronic
disease risk.
Key words
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Article info
Publication history
Published online: December 16, 2015
Accepted:
November 30,
2015
Received in revised form:
November 23,
2015
Received:
October 8,
2015
Footnotes
The authors report no conflict of interest.
Cite this article as: Barakat R, Pelaez M, Cordero Y, et al. Exercise during pregnancy protects against hypertension and macrosomia: randomized clinical trial. Am J Obstet Gynecol 2016;214:649.e1-8.
Identification
Copyright
© 2015 Elsevier Inc. All rights reserved.
