Associations of Pregnancy Physical Activity with Maternal Cardiometabolic Health, Neonatal Delivery Outcomes and Body Composition in a Biethnic Cohort of 7305 Mother–Child Pairs: The Born in Bradford Study

Abstract

Objective Physical activity is advocated for a range of benefits to the uncomplicated pregnancy. We investigated associations of mid-pregnancy physical activity with maternal and neonatal health in white British and Pakistani-origin women from a deprived urban setting. Methods The study was performed in 6921 pregnant women (53% Pakistani-origin) who contributed data for 7305 singleton births. At 26-28 weeks gestation, women were grouped into four activity levels (inactive/somewhat active/moderately active/ active) based on their self-reported physical activity. Linear regression with robust standard errors was used to calculate adjusted mean differences in health markers between the four groups of physical activity (reference group: inactive). Results Three-quarters (74%) of Pakistani-origin women and 39% of white British women were inactive. Trend-tests revealed that more active white British women tended to be less adipose, had lower fasting and postload glucose levels, lower triglyceride concentrations, and their babies were less adipose (smaller triceps and subscapular skinfolds) than less active white British women. Somewhat active Pakistani-origin women exhibited lower triglyceride concentrations and systolic blood pressure, higher high-density lipoprotein cholesterol levels, and their babies were less adipose (smaller mid-upper arm and abdominal circumferences; lower cord-blood leptin concentration) compared to inactive Pakistani-origin women. No associations were observed for gestational age or birth weight. Conclusions Physical activity performed mid-pregnancy was beneficially associated with maternal cardiometabolic health and neonatal adiposity, without influencing gestational age or birth weight. Associations were dose-dependent in white British women, and even a small amount of mid-pregnancy physical activity appeared to benefit some health markers in Pakistani-origin women.

Objectively-measured sedentary time and physical activity in a bi-ethnic sample of young children: variation by socio-demographic, temporal and perinatal factors

“…Maternal age at delivery was calculated as the time elapsed between the mother and child's dates of birth and was collapsed to three categories (< 25y, 25 to < 30y, ≥30y). Children who were part of the Born in Bradford birth cohort study were matched to birth weight using NHS patient identifiers [23]. Birth weight was categorised as low (< 2500 g), normal (2500 to 3500 g), or high (> 3500 g) [24].…”

Maternal Physical Activity and Neonatal Cord Blood pH: Findings from the Born in Bradford Pregnancy Cohort

“…Maternal physical activity was assessed at 26-28 weeks gestation using the General Practice Physical Activity Questionnaire (GPPAQ) which has been validated against accelerometry and exhibits face validity in the BiB pregnancy cohort (National Health Service, 2009;Collings et al, 2020aCollings et al, , 2020b. Mothers were grouped into one of four activity levels (inactive/somewhat active/moderately active/active) based on their self-reported occupational physical activity level, physical exercise and walking.…”

“…Women consented to the abstraction and use of their data from obstetric medical records and at recruitment completed an interviewer administered questionnaire. Full details of all covariables have previously been described (Collings et al, 2020a).…”

“…It is still good practice to avoid supine exercise, particularly late in pregnancy, but otherwise physical activity can enhance transportation of oxygenated blood to the developing fetus, via physiological adaptations such as increased placental surface area, and enhanced blood flow and perfusion balance between maternal and fetal circulations (Melzer et al, 2010;Ferraro, Gaudet and Adamo, 2012). Physical activity can also aid regulation of circulating blood glucose levels (Collings et al, 2020a) which could help to reduce the risk of placental dysfunction and fetal hyperinsulinemia, thereby impacting fetal metabolism, oxygen demand and lactate accumulation (Jarmuzek, Wielgos and Bomba-Opon, 2015). As well as acute neonatal stress, each of these factors can have implications for the cord blood pH, levels of which provide an objective marker of the neonate condition immediately prior to birth and closely relate to Apgar scores (Victory et al, 2004).…”

Developing a Physical Activity Intervention Strategy for Pregnant Women in Buffalo City Municipality, South Africa: A Study Protocol

“…Several studies have reported the benefits of PA participation during pregnancy. These include reduced risk of excessive gestational weight gain [ 14 , 15 , 16 , 17 ] and of developing conditions such as gestational diabetes mellitus (GDM) [ 15 , 18 , 19 , 20 ], pre-eclampsia [ 15 , 20 , 21 , 22 ], lower levels of maternal pregnancy triglycerides and a higher concentration of high-density lipoprotein cholesterol (HDL-c), [ 23 ] and neonatal cord blood HDL-c levels [ 24 ]. Lower rates of preterm birth [ 25 , 26 , 27 ], miscarriage [ 28 ], reduced length of labour, lowered risk of caesarean delivery and complications [ 21 , 25 , 27 , 29 , 30 ], reduced risk of macrosomia [ 28 , 31 ] and reduced risk of low birth weight [ 25 ] are also counted as benefits.…”