BackgroundDuring pregnancy, a sedentary lifestyle may have negative consequences on maternal and foetal health status. The main objective of this project is to assess the effects of an exercise intervention in overweight and grade I obese pregnant on maternal and foetal health markers.Methods/designThe present study aims to recruit 60 overweight and grade I obese women interested in participating in an exercise intervention program from the 17th gestational week until delivery. Women will be randomized to either an exercise (three 60-min sessions/week of combined aerobic and strength training and pelvic floor exercises), or usual care (control) group (30 women per group). The primary outcome measures are maternal weight gain, and maternal and neonatal glycaemic profile. Secondary outcome measures are: i) perinatal obstetric records; i) body composition; iii) dietary patterns; iv) physical fitness; v) low-back pain; vi) objectively measured physical activity and sedentary behaviour; vii) haematology and biochemical analyses; viii) oxidative stress; ix) pro- and anti-inflammatory markers; x) bone health biomarkers; xi) sleep quality; xii) mental health, quality of life and positive health.DiscussionThe findings of this project will help to identify strategies for primary prevention and health promotion based on this exercise-based intervention program among overweight and grade I obese pregnant women.Trial registration NCT02582567; Date of registration: 20/10/2015

The aim of the present study was to analyze the influence of a supervised concurrent exercise-training program, from the 17th gestational week until delivery, on cytokines in maternal (at 17th and 35th gestational week, and at delivery) and arterial and venous cord serum. Fifty-eight Caucasian pregnant women (age: 33.5 ± 4.7 years old, body mass index: 23.6 ± 4.1kg/m2) from the GESTAFIT Project (exercise (n = 37) and control (n = 21) groups) participated in this quasi-experimental study (per-protocol basis). The exercise group followed a 60-min 3 days/week concurrent (aerobic-resistance) exercise-training from the 17th gestational week to delivery. Maternal and arterial and venous cord serum cytokines (fractalkine, interleukin (IL)–1β, IL-6, IL-8, IL-10, interferon (IFN)–γ, and tumor necrosis factor (TNF)–α) were assessed using Luminex xMAP technology. In maternal serum (after adjusting for the baseline values of cytokines), the exercise group decreased TNF-α (from baseline to 35th week, p = 0.02), and increased less IL-1β (from baseline to delivery, p = 0.03) concentrations than controls. When adjusting for other potential confounders, these differences became non-significant. In cord blood, the exercise group showed reduced arterial IL-6 and venous TNF-α (p = 0.03 and p = 0.001, respectively) and higher concentrations of arterial IL-1β (p = 0.03) compared to controls. The application of concurrent exercise-training programs could be a strategy to modulate immune responses in pregnant women and their fetuses. However, future research is needed to better understand the origin and clearance of these cytokines, their role in the maternal-placental-fetus crosstalk, and the influence of exercise interventions on them.

AimTo analyse i) the association of physical fitness during early second trimester and late pregnancy with maternal and neonatal outcomes; and ii) to investigate whether physical fitness is associated with the type of birth (vaginal or caesarean section). MethodsPregnant women from the GESTAFIT Project (n = 159) participated in this longitudinal study. Maternal physical fitness including upper-and lower-body strength, cardiorespiratory fitness (CRF) and flexibility were measured through objective physical fitness tests at the 16 th and 34 th gestational weeks. Maternal and neonatal outcomes were collected from obstetric medical records. Umbilical arterial and venous blood gas pH and partial pressure of carbon dioxide (PCO 2 ) and oxygen (PO 2 ), were assessed. OPEN ACCESS Citation: Baena-García L, Coll-Risco I, Ocón-Hernández O, Romero-Gallardo L, Acosta-Manzano P, May L, et al. (2020) Association of objectively measured physical fitness during pregnancy with maternal and neonatal outcomes. The GESTAFIT Project. PLoS ONE 15(2): e0229079. https://doi.

Aim: (a) To analyse the association of objectively measured sedentary time (ST) and physical activity (PA) during early second trimester of pregnancy with maternal and neonatal birth outcomes; (b) to explore if ST and PA differ between women with vaginal or caesarean section deliveries. Methods: Ninety-four Caucasian pregnant women (32.9 ± 4.6 years old) participated in this prospective longitudinal study. Triaxial accelerometers were used to assess ST and PA intensity levels for seven consecutive days during second trimester of pregnancy. Birth data were collected from the obstetric medical records. Umbilical cord arterial and venous blood gas (pH, partial pressure of carbon dioxide and oxygen, and oxygen saturation) were analysed after birth. Results: After adjusting for potential confounders, greater ST was associated with higher arterial and venous cord blood partial pressure of carbon dioxide and more acidic arterial and venous pH (all, P < 0.01). Moderate PA, moderate-to-vigorous PA (MVPA), total PA and steps per day were positively associated with arterial cord blood oxygen saturation (all P < 0.05). Steps per day were inversely associated with gestational age at birth (P < 0.01), and duration of first stage of labor (P < 0.05).Total and light PA were associated with a more alkaline pH in umbilical vein (all, P < 0.01). Vigorous PA was inversely associated with the Apgar score (P < 0.01). No significant differences were observed in ST and PA levels between women with vaginal and women with caesarean section deliveries (all, P > 0.10). Conclusion: Increasing PA and decreasing ST during pregnancy might promote better maternal and neonatal birth markers. K E Y W O R D Saccelerometry, caesarean section, gestation, umbilical cord blood gas

Highlights Greater moderate-to-vigorous physical activity is modestly associated with decreased symptoms of depression in pregnancy. Higher levels of sedentary time were negatively associated with positive affect in pregnancy. Enhanced upper-body flexibility is modestly associated with better emotional regulation in pregnancy. Additional experimental research is warranted to confirm or refute these findings.

This study aimed (a) to examine the construct validity of the International Fitness Scale (IFIS) to discriminate between different objectively measured physical fitness levels in pregnant women and (b) to assess the extent to which IFIS is able to discriminate between pregnant women with different levels of health‐related quality of life (HRQoL). A total of 159 pregnant women were involved in the GESTAtion and FITness project: 106 pregnant women (mean age 32.7, SD 4.4 years) were included. Self‐reported physical fitness—that is, cardiorespiratory fitness, muscular strength, flexibility, and overall fitness—was assessed with the IFIS. Physical fitness was objectively measured using the Bruce test, the handgrip strength test and the back‐scratch test. The HRQoL was assessed with the 36‐item Short Form Health Survey (SF‐36). Higher self‐reported physical fitness measured with IFIS was associated with higher objectively measured physical fitness (P < .05). There was a linear association so that higher self‐reported physical fitness (ie, IFIS; regardless of the fitness component) was related to greater General Health dimension scores (P < .05). Moreover, higher self‐reported physical fitness (all components except muscular strength) was associated with better Physical Functioning, lower Bodily Pain and higher Vitality scores (ie, SF‐36 components). This linear trend was not seen for objectively measured physical fitness. The results of this study suggest that IFIS might be a useful tool for identifying pregnant women with low or very low physical fitness and with low quality of life health‐related. Further research should elucidate whether IFIS can identify women with pregnancy complications before it can be implemented in clinical practice.

Aims To explore the association of self‐reported physical fitness with bodily, lumbar and sciatic pain, and pain disability during pregnancy. Methods The present study sample comprised 159 pregnant women (32.9 ± 4.7 years old). Self‐reported physical fitness was assessed with the International Fitness Scale (IFIS), where higher scores indicate greater physical fitness. Bodily pain was assessed with the 36‐Item Short Form Health Survey (SF‐36), where higher scores indicate lower pain. Lumbar and sciatic pain were measured with a visual analogue scale (VAS). The Oswestry Disability Index (ODI) questionnaire was employed to assess the disability resulting from pain. Measures were assessed at 16th and 34th gestational weeks (g. w.). Results Pregnant women showed low‐moderate pain during pregnancy course. Most of them showed medium self‐reported overall physical fitness. At 16th g. w., greater self‐reported overall physical fitness and cardiorespiratory fitness were associated with less bodily and lumbar pain, and pain disability (all, P < 0.05). Greater muscular strength was associated with less bodily pain and pain disability (both, P < 0.05). Greater speed‐agility was associated with less bodily pain (P < 0.01) and less pain disability (P < 0.05). Self‐reported flexibility was not associated with any outcome (P > 0.05). At 34th g. w., greater overall physical fitness and its components were associated with less bodily and sciatic pain (all, P < 0.05). Conclusion Greater self‐reported overall physical fitness and its components are associated with less bodily, lumbar and sciatic pain, and reduced pain disability during pregnancy. Future studies are needed to explore whether increasing physical fitness before and during pregnancy could decrease pain in this relevant stage.

This concurrent exercise program promoted a less proinflammatory profile in human milk, especially in colostrum. Moreover, it might increase mature human milk fractalkine, which could induce a greater neurodevelopment and neuroprotection in the newborn. This trial was registered at ClinicalTrials.gov (NCT02582567) on October 20, 2015.