Skip to main content
SpringerLink
Log in

Clinical Research

Obesity can offset the cardiometabolic benefits of gestational exercise

  • Brief Communication
  • Published:
International Journal of Obesity Submit manuscript

Abstract

Pregnancy exercise can prevent excessive gestational weight gain (EGWG), gestational diabetes mellitus (GDM) and hypertension (GH), but inter-individual variability has not been explored. We aimed to analyze the prevalence––and potential sociodemographic and medical predictors of––non-responsiveness to gestational exercise, and the association of non-responsiveness with adverse pregnancy outcomes. Among 688 women who completed a supervised light-to-moderate intensity exercise program (three ~1-h sessions/week including aerobic, resistance, and pelvic floor muscle training) until near-term, those who showed EGWG, GDM or GH were considered ‘non-responders’. A low prevalence of non-responders was observed for GDM (3.6%) and GH (3.4%), but not for EGWG (24.2%). Pre-pregnancy obesity was the strongest predictor of non-responsiveness for GH (odds ratio 8.40 [95% confidence interval 3.10–22.78] and EGWG (5.37 [2.78–10.39]), whereas having a highest education level attenuated the risk of being non-responder for GDM (0.10 [0.02–0.49]). Non-responsiveness for EGWG was associated with a higher risk of prolonged labor length, instrumental/cesarean delivery, and macrosomia, and of lower Apgar scores. No association with negative delivery outcomes was found for GDM/GH. In summary, women with pre-pregnancy obesity might require from additional interventions beyond light-to-moderate intensity gestational exercise (e.g., diet and/or higher exercise loads) to ensure cardiometabolic benefits.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Deputy N, Sharma A, Kim S, Hinkle S. Prevalence and characteristics associated with gestational weight gain adequacy. Obstet Gynecol. 2016;125:773–781.

    Article  Google Scholar 

  2. Goldstein RF, Abell SK, Ranasinha S, Misso M, Boyle JA, Black MH, et al. Association of gestational weight gain with maternal and infant outcomes: a systematic review and meta-analysis. JAMA. 2017;317:2207–2225.

    Article  Google Scholar 

  3. Perales M, Artal R, Lucia A. Exercise during pregnancy. JAMA. 2017;317:1113–1114.

    Article  Google Scholar 

  4. Tobias DK, Stuart JJ, Li S, Chavarro J, Rimm EB, Rich-Edwards J, et al. Association of history of gestational diabetes with long-term cardiovascular disease risk in a large prospective cohort of US women. JAMA Intern Med. 2017;177:1735–1742.

    Article  Google Scholar 

  5. Behrens I, Basit S, Lykke JA, Ranthe MF, Wohlfahrt J, Bundgaard H, et al. Association between hypertensive disorders of pregnancy and later risk of cardiomyopathy. JAMA. 2016;315:1026–1033.

    Article  CAS  Google Scholar 

  6. Palinski W. Effect of maternal cardiovascular conditions and risk factors on offspring cardiovascular disease. Circulation. 2014;129:2066–2077.

    Article  Google Scholar 

  7. Mottola MF, Davenport MH, Ruchat SM, Davies GA, Poitras V, Gray C, et al. 2019 Canadian guideline for physical activity throughout pregnancy. Br J Sports Med. 2018;52:1339–1346.

    Article  Google Scholar 

  8. Perales M, Valenzuela PL, Barakat R, Cordero Y, Peláez M, López C, et al. Gestational exercise and maternal and child health: effects until delivery and at post-natal follow-up. J Clin Med. 2020;9:379.

    Article  CAS  Google Scholar 

  9. Álvarez C, Ramírez-Campillo R, Ramírez-Vélez R, Izquierdo M. Effects and prevalence of nonresponders after 12 weeks of high-intensity interval or resistance training in women with insulin resistance: a randomized trial. J Appl Physiol. 2017;122:985–996.

    Article  Google Scholar 

  10. Álvarez C, Ramírez-Campillo R, Cristi-Montero C, Ramírez-Vélez R, Izquierdo M. Prevalence of non-responders for blood pressure and cardiometabolic risk factors among prehypertensive women after long-term high-intensity interval training. Front Physiol. 2018;9:1–13.

    Article  Google Scholar 

  11. Ruiz JR, Perales M, Pelaez M, Lopez C, Lucia A, Barakat R. Supervised exercise-based intervention to prevent excessive gestational weight gain: a randomized controlled trial. Mayo Clin Proc. 2013;88:1388–1397.

    Article  Google Scholar 

  12. Borg G. Borg’s perceived exertion and pain scales. 7th ed. Champaign: Human Kinetics; 1998.

  13. Evenson KR, Barakat R, Brown WJ, Dargent-Molina P, Haruna M, Mikkelsen EM, et al. Guidelines for physical activity during pregnancy: comparisons from around the world. Am J Lifestyle Med. 2014;8:102–121.

    Article  Google Scholar 

  14. Institute of Medicine. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: National Academic Press; 2009.

  15. American Diabetes Association. Gestational diabetes mellitus. Diabetes Care. 2004;27:S88–90.

    Article  Google Scholar 

  16. Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. 2018 ESC/ESHGuidelines for themanagement of arterial hypertension. Eur Heart J. 2018;39:3021–3104.

    Article  Google Scholar 

  17. Heinze G, Dunkler D. Five myths about variable selection. Transpl Int. 2017;30:6–10.

    Article  Google Scholar 

  18. Amorim AR, Rössner S, Neovius M, Lourenço PM, Linné Y. Does excess pregnancy weight gain constitute a major risk for increasing long-term BMI? Obesity. 2007;15:1278–1286.

    Article  Google Scholar 

  19. Sava RI, March KL, Pepine CJ. Hypertension in pregnancy: taking cues from pathophysiology for clinical practice. Clin Cardiol. 2018;41:220–227.

    Article  Google Scholar 

  20. Melchiorre K, Thilaganathan B, Giorgione V, Ridder A, Memmo A, Khalil A. Hypertensive disorders of pregnancy and future cardiovascular health. Front Cardiovasc Med. 2020; 7. https://doi.org/10.3389/fcvm.2020.00059.

  21. Garnæs KK, Mørkved S, Salvesen Ø, Moholdt T. Exercise training and weight gain in obese pregnant women: a randomized controlled trial (ETIP Trial). PLoS Med. 2016;13:1–18.

    Article  Google Scholar 

  22. Yeo SA, Walker JS, Caughey MC, Ferraro AM, Asafu-Adjei JK. What characteristics of nutrition and physical activity interventions are key to effectively reducing weight gain in obese or overweight pregnant women? A systematic review and meta-analysis. Obes Rev. 2017;18:385–399.

    Article  Google Scholar 

  23. Suliga E, Rokita W, Adamczyk-Gruszka O, Pazera G, Cieśla E, Głuszek S. Factors associated with gestational weight gain: a cross-sectional survey. BMC Pregnancy Childbirth. 2018;18:1–11.

    Article  Google Scholar 

  24. Gante I, Ferreira AC, Pestana G, Pires D, Amaral N, Dores J, et al. Maternal educational level and the risk of persistent post-partum glucose metabolism disorders in women with gestational diabetes mellitus. Acta Diabetol. 2018;55:243–251.

    Article  Google Scholar 

  25. Bouthoorn SH, Silva LM, Murray SE, Steegers EAP, Jaddoe VWV, Moll H, et al. Low-educated women have an increased risk of gestational diabetes mellitus: the Generation R Study. Acta Diabetol. 2015;52:445–452.

    Article  Google Scholar 

Download references

Acknowledgements

The work of PLV is supported by University of Alcalá (FPI2016). The work of AL is supported by the Spanish Ministry of Economy and Competitiveness and Fondos FEDER (PI15/00558 and PI18/00139). We sincerely thank all participants for their collaboration in this study.

Author information

Author notes

  1. These authors contributed equally: María Perales, Pedro L. Valenzuela

Authors and Affiliations

  1. Research Institute of Hospital 12 de Octubre (‘i+12’), Madrid, Spain

    María Perales & Alejandro Lucia

  2. Faculty of Sport Science, Universidad Camilo José Cela, Madrid, Spain

    María Perales

  3. Department of System Biology, Universiy of Alcalá, Madrid, Spain

    Pedro L. Valenzuela

  4. Facultad de Ciencias de la Actividad Física y del Deporte, Universidad Politécnica de Madrid, Madrid, Spain

    Rubén Barakat

  5. Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain

    Lidia B. Alejo & Alejandro Lucia

  6. Universidad Complutense de Madrid, Madrid, Spain

    Yaiza Cordero

  7. Universidad Europea del Atlántico, Santander, Spain

    Mireia Peláez

Authors
  1. María Perales
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pedro L. Valenzuela
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rubén Barakat
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lidia B. Alejo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yaiza Cordero
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mireia Peláez
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alejandro Lucia
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alejandro Lucia.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Perales, M., Valenzuela, P.L., Barakat, R. et al. Obesity can offset the cardiometabolic benefits of gestational exercise. Int J Obes 45, 342–347 (2021). https://doi.org/10.1038/s41366-020-00669-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41366-020-00669-2

  • Springer Nature Limited

Search

Navigation