Journal of Pregnancy

Review Article

Preventing Long-Term Risk of Obesity for Two Generations: Prenatal Physical Activity Is Part of the Puzzle

Table 3

Effects of prenatal intervention studies including physical activity alone on gestational weight gain, maternal weight retention, and infant birth weight.

(a) Prenatal intervention studies using the 1990 IOM gestational weight gain recommendations


Reference, Sample characteristics	Treatment		Gestational weight gain (GWG) (kg)			Maternal weight retention postpartum (PP) (kg)			Infant birth weight (g)
Reference, Sample characteristics	Control	Intervention	Control	Intervention	P value	Control	Intervention	P value	Control	Intervention	P value

Yeo [71] Design RT Stretching (S) versus walking (W) N = 124 S = 60 W = 64 Country United States Ethnicity S = 82% Caucasians W = 87% Caucasians Age 31.0 ± 5.0 Parity NA SES S = 43% >75,000 (high) W = 61% >75,000 (high) Prepreg BMI S = 98% ≥26 kg/m²W = 97% ≥26 kg/m² Gestational age at recruitment <14 weeks Duration of study until end of pregnancy	—	Physical activity: Supervised and home-based exercise program Stretching: Frequency 5/week Intensity — Duration 40 min Type Videotape Walking: Frequency 5/week Intensity 55–69% of HR max Duration 40 min Delivered by exercise specialists	Stretchers At delivery 15.9 ± 6.8 Adherence to 1990 IOM 11% did not exceed	Walkers At delivery 15.4 ± 5.9 Adherence to 1990 IOM 0% did not exceed	NS NS	NA	NA	—	NA	NA	—

(b) Prenatal intervention studies using the 2009 IOM gestational weight gain recommendations


Reference, Sample characteristics	Treatment		Gestational weight gain (GWG) (kg)			Maternal weight retention postpartum (PP) (kg)			Infant birth weight (g)
Reference, Sample characteristics	Control	Intervention	Control	Intervention	P value	Control	Intervention	P value	Control	Intervention	P value

Cavalcante et al. [70] Design RCT N = 71 C = 37 I = 24 Country Brazil Ethnicity NA Age NA Parity NA SES Low SES Prepreg BMI C = 23.4 ± 3.8 I = 24.1 ± 4.5 Gestational age at recruitment 18–20 weeks Duration of study until end of pregnancy	Sedentary during pregnancy	Physical activity: Supervised exercise program Frequency 3/week Intensity 70% pred HR max Duration 50 min Type Water aerobic Delivered by trained instructors	At delivery 15.1 ± 1.6 Adherence to IOM NA	At delivery 14.3 ± 2.1 Adherence to IOM NA	0.38	NA	NA	—	3,313 ± 656 <2,500 g n = 2 (37%)	3,222 ± 563 <2,500 g n = 3 (33%)	0.54 0.44

Barakat et al. [69] Design RCT N = 160 C = 80 I = 80 Country Spain Ethnicity: NA Age: C = 29.5 ± 3.7 I = 30.4 ± 2.9 Parity C = 57% nulliparous I = 72% nulliparous SES C = 13% high school I = 26% high school Prepreg BMI: C = 23.4 ± 0.5 I = 24.3 ± 0.5 Gestational age at recruitment 12-13 weeks Duration of study until end of pregnancy	Continue usual daily activities	Physical activity: Supervised exercise program Frequency 3/week Intensity 60% HR max Duration 35–40 min Type Muscle strengthening and toning program	At delivery 12.4 ± 3.4 Adherence to 2009 IOM NA	At delivery 11.5 ± 3.7 Adherence to 2009 IOM NA	>0.1	NA	NA	—	3,307 ± 477 <2,500 g n = 4 (6%) >4,000 g n = 7 (10%)	3,165 ± 411 <2,500 g n = 4 (6%) >4,000 g n = 1 (1%)	>0.1 >0.1 >0.1

Barakat et al. [72] Design RCT N = 83 C = 43 I = 40 Country Spain Ethnicity NA Age C = 31 ± 3 I = 32 ± 4 Parity C = 49% nulliparous I = 65% nulliparous SES C = 14% >high school I = 83% >high school Prepreg BMI: C = 23.0 ± 2.9 I = 22.7 ± 2.8 Gestational age at recruitment 6–9 weeks Duration of study until end of pregnancy	Continue usual daily activities	Physical activity: Supervised exercise program Frequency 3/week Intensity ≤70% HR max Duration 35–45 min Type aerobic class (2/week) aquatic activities (1/week)	At delivery 13.8 ± 3.1 Adherence to 2009 IOM NA	At delivery 12.5 ± 3.2 Adherence to 2009 IOM NA	>0.05	NA	NA	—	3,465 ± 411	3,404 ± 465	>0.05

Haakstad and Bø [67] Design RCT N = 105 C = 53 I = 52 Country Norway Ethnicity NA Age C = 30.3 ± 4.4 I = 31.2 ± 3.7 Parity 100% nulliparous SES C = 85% college/university I = 85% college/university Prepreg BMI C = 23.9 ± 4.7 I = 23.8 ± 3.8 Gestational age at recruitment C = 18.0 ± 4.3 I = 17.3 ± 4.1 Duration of study 12 weeks	Continue usual daily activities	Physical activity: Supervised exercise program Frequency ≥2/week Intensity 12–14 RPE Duration 60 min Type Aerobic dance Women were asked to exercise 30 min/day on other days Delivered by certified aerobic instructors	At 36–38 weeks 13.8 ± 4.0 Adherence to 2009 IOM 62% did not exceed	At 36–38 weeks 13.0 ± 4.0 If attendance to all ex sessions (2/week, n = 24) 11.0 ± 2.0 Adherence to 2009 IOM 67% if ex 2/week 0% did not exceed	0.31 0.01 0.59 0.006	At 8.1 ± 1.5 w PP 3.3 ± 4.1	At 7.1 ± 1.6 we PP 3.3 ± 3.9 if ex sessions 2/week 0.8 ± 1.7	0.93 0.001	NA	NA	—

Nascimento et al. [68] Design RCT N = 82 C = 42 I= 40 Country Brazil Ethnicity NA Age C = 30.9 ± 5.9 I = 29.7 ± 6.8 Parity C = 24% nulliparous I = 30% nulliparous SES C = 38% >12 yr of school I = 43% >12 yr of school Prepreg BMI C = 36.4 ± 6.9 I = 34.8 ± 6.6 Gestational age at recruitment C = 17.8 ± 3.7 I = 17.6 ± 4.2 Duration of study until end of pregnancy	Standard prenatal care	Physical activity: Supervised exercise program Frequency 1/week Intensity HR < 140 Duration 40 min Type Aerobic dance Women were asked to exercise 5/week at home Other: women were counseled on recommended GWG Delivered by trained physical therapists	At final visit 11.5 ± 7.4 OB = 10.9 ± 7.6 OW =16.4 ± 3.9 Adherence to 2009 IOM 43% did not exceed	At final visit 10.3 ± 5.0 OB = 10.4 ± 5.6 OW = 10.0 ± 1.7 Adherence to 2009 IOM 52% did not exceed	0.54 0.76 0.001 0.43	NA	NA	—	3,228 ± 591 SGA n = 1 (3%) LGA n = 8 (24%)	3,267 ± 700 SGA n = 2 (6%) LGA n = 8 (24%)	0.79 NS NS

Abbreviations: RCT: randomized controlled trial; N: total number; C: control group; I: intervention group; SES: socioeconomic status; prepreg BMI: body mass index prior to pregnancy; IOM: Institute of Medicine; NA: non available; NS: non significant, NW: normal weight; OW: overweight; OB: obese.