Objective To assess whether antenatal exercise in overweight/obese women would improve maternal and perinatal outcomes.Design Two-arm parallel randomised controlled trial.Setting Home-based intervention in Auckland, New Zealand.Population and sample Pregnant women with body mass index ≥25 kg/m 2 .Methods Participants were randomised to a 16-week moderateintensity stationary cycling programme from 20 weeks of gestation, or to a control group with no exercise intervention.Main outcome measures Primary outcome was offspring birthweight. Perinatal and maternal outcomes were assessed, with the latter including weight gain, aerobic fitness, quality of life, pregnancy outcomes, and postnatal body composition. Exercise compliance was recorded with heart rate monitors.Results Seventy-five participants were randomised in the study (intervention 38, control 37). Offspring birthweight (adjusted mean difference 104 g; P = 0.35) and perinatal outcomes were similar between groups. Aerobic fitness improved in the intervention group compared with controls (48.0-second improvement in test time to target heart rate; P = 0.019). There was no difference in weight gain, quality of life, pregnancy outcomes or postnatal maternal body composition between groups. However, compliance with exercise protocol was poor, with an average of 33% of exercise sessions completed. Sensitivity analyses showed that greater compliance was associated with improved fitness (increased test time (P = 0.002), greater VO 2 peak (P = 0.015), and lower resting heart rate (P = 0.014)), reduced postnatal adiposity (reduced fat mass (P = 0.007) and body mass index (P = 0.035)) and better physical quality of life (P = 0.034).Conclusions Maternal non-weight-bearing moderate-intensity exercise in pregnancy improved fitness but did not affect birthweight or clinical outcomes.

Objectives To determine whether snoring, sleep position, and other sleep practices in pregnant women are associated with risk of late stillbirth.

WHAT'S KNOWN ON THIS SUBJECT: A serum 25-hydroxyvitamin D (25(OH)D) concentration of 20 ng/mL meets the requirements of at least 97.5% of the population older than 1 year. A recommended dietary intake to achieve this serum 25(OH)D concentration has not been established during infancy. WHAT THIS STUDY ADDS: METHODS:A randomized, double-blind, placebo-controlled trial in New Zealand. Pregnant mothers, from 27 weeks' gestation to birth, and then their infants, from birth to age 6 months, were randomly assigned to 1 of 3 mother/infant groups: placebo/placebo, vitamin D 3 1000/400 IU, or vitamin D 3 2000/800 IU. Serum 25(OH)D and calcium concentrations were measured at enrollment, 36 weeks' gestation, in cord blood, and in infants at 2, 4, and 6 months of age.RESULTS: Two-hundred-and-sixty pregnant women were randomized. At enrollment, the proportions with serum 25(OH)D $20 ng/mL for placebo, lower-dose, and higher-dose groups were 54%, 64%, and 55%, respectively. The proportion with 25(OH)D $20 ng/mL was larger in both intervention groups at 36 weeks' gestation (50%, 91%, 89%, P , .001). In comparison with placebo, the proportion of infants with 25(OH)D $20 ng/mL was larger in both intervention groups to age 4 months: cord blood (22%, 72%, 71%, P , .001), 2 months (50%, 82%, 92%, P , .001), and 4 months (66%, 87%, 87%, P = .004), but only in the higher-dose group at age 6 months (74%, 82%, 89%, P = .07; higher dose versus placebo P = .03, lower dose versus placebo P = .21).

Our study suggests that maternal perception of increasing fetal activity throughout the last 3 months of pregnancy is a sign of fetal well-being, whereas perception of reduced fetal movements is associated with increased risk of late stillbirth.