Effects of exercise training on maternal hormonal changes in pregnancy

Hopkins, Sarah; Baldi, James C.; Cutfield, Wayne S.; McCowan, Lesley; Hofman, Paul L.

doi:10.1111/j.1365-2265.2010.03964.x

Cited by 53 publications

(76 citation statements)

References 37 publications

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“…The most consistent reported change in maternal lipids in the acute response to exercise is an increase in triglycerides and free fatty acids compared with the resting state. A longer-term randomized trial of aerobic exercise in the second half of pregnancy in 84 healthy women showed a trend toward lower maternal free fatty acid levels with no change in maternal weight compared with control subjects (42). A trial of postprandial walking (for 20 min after each meal) in women with type 1 diabetes showed a reduction in fasting maternal triglycerides (43).…”

Section: Diet and Exercisementioning

confidence: 99%

Normalizing Metabolism in Diabetic Pregnancy: Is It Time to Target Lipids?

et al. 2014

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Outcomes in pregnancies complicated by preexisting diabetes (type 1 and type 2) and gestational diabetes mellitus have improved, but there is still excess morbidity compared with normal pregnancy. Management strategies appropriately focus on maternal glycemia, which demonstrably improves pregnancy outcomes for mother and infant. However, we may be reaching the boundaries of obtainable glycemic control for many women. It has been acknowledged that maternal lipids are important in pregnancies complicated by diabetes. Elevated maternal lipids are associated with preeclampsia, preterm delivery, and large-forgestational-age infants. Despite this understanding, assessment of management strategies targeting maternal lipids has been neglected to date. Consideration needs to be given to whether normalizing maternal lipids would further improve pregnancy outcomes. This review examines the dyslipidemia associated with pregnancy complicated by diabetes, reviews possible therapies, and considers whether it is time to start actively managing this aspect of maternal metabolism.Although rates of adverse outcomes in pregnancies complicated by preexisting diabetes (type 1 and type 2) and gestational diabetes mellitus (GDM) have improved, there is still excess maternal and fetal morbidity compared with normal pregnancy. Current management strategies focus on maternal glycemic control, which demonstrably improves pregnancy outcomes for mother and infant. Truly "normal" glucose levels in pregnancy appear lower than previously thought (1) and achieving currently recommended glucose targets in pregnancy carries a risk of hypoglycemia (2). The challenges in reaching glycemic targets before and after conception raise the question of whether other aspects of maternal metabolism could potentially be addressed to provide benefit to mother and infant.Multiple maternal metabolic, hormonal, and inflammatory factors other than maternal glucose are associated with maternal and fetal outcomes and are altered in pregnancies complicated by prepregnancy diabetes and GDM. These include maternal amino acids, glycerol, ketones, and lipids (3). Lipid management in diabetes is acknowledged as a key therapeutic target in the nonpregnant setting. However, it has not been accorded the same attention in pregnancy. Abnormal maternal lipids in pregnancy have been associated with preeclampsia (4,5), preterm delivery (6), and large-forgestational-age (LGA) infants (7). This review examines the dyslipidemia associated with pregnancy complicated by diabetes, reviews possible therapies, and considers whether there is sufficient evidence to start actively managing lipids in pregnancy. LIPID METABOLISM IN PREGNANCYMaternal metabolism is designed to provide adequate nutrition for fetal growth, in the form of glucose, ketones, lipids, and other fuels. In early pregnancy, maternal

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Section: Diet and Exercisementioning

confidence: 99%

Normalizing Metabolism in Diabetic Pregnancy: Is It Time to Target Lipids?

et al. 2014

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“…Results have varied regarding the effects of maternal exercise on birth weight, though differences may be reported the weights are still within normal birth weight range (Sternfeld et al 1995;Hopkins et al 2011). To begin with, some research shows no change in birth weight regardless of exposure or not to maternal exercise (Collings et al 1983;Carpenter et al 1988;Rose et al 1991;Hatch et al 1993;Sternfeld et al 1995;Horns et al 1996;Clapp et al 2000Clapp et al , 2002.…”

Section: Birth Weightmentioning

confidence: 94%

“…Though methodology has differed, there seems to be a dose-response relationship between maternal activity level (i.e., energy expenditure, intensity) and infant birth weight (Hatch et al 1993) unpublished data). A possible explanation for these findings is that the decrease in birth weight associated with maternal exercise might be a normalization of birth weight in light of the fact that newborn birth weights have increased across generations (Hopkins et al 2011).…”

Section: Birth Weightmentioning

confidence: 97%

Physiology of Prenatal Exercise and Fetal Development

May¹

2012

SpringerBriefs in Physiology

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“…A lack of effect of exercise on leptin levels during pregnancy has been shown previously: in a study of aerobic stationary cycling training during pregnancy from 20-to 35-week gestation, there was a significant decrease in birth weight but not body composition in the exercise intervention group with no differences in leptin levels between the exercise and the control arms. 30 Another exercise intervention study in women in the US military also reported an increase in leptin levels over the course of pregnancy but no effect of exercise. 34 The leptin levels reported in these studies were lower than in our study, but this likely due to the difference in mean BMI: around 25 versus 35.7 kg/m 2 in our cohort.…”

Section: Leptin Levelsmentioning

confidence: 96%