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Review of Impacts of Physical Activity on Maternal Metabolic Health During Pregnancy

  • Diabetes and Pregnancy (CJ Homko, Section Editor)
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Abstract

Our purpose was to review relations between physical activity during pregnancy, gestational diabetes, and other maternal metabolic markers (i.e., lipids, tumor necrosis factor alpha (TNFα), interleukin six (IL-6), leptin, and adiponectin). While observational studies indicate a protective effect of physical activity on gestational diabetes, interventions that promote recommended levels of physical activity during pregnancy (i.e., 150+ min/week) have failed to show significant effects. However, interventions have been often underpowered and with low protocol adherence. Maternal lipids, TNFα, IL-6, and leptin all increase and adiponectin decreases with a healthy pregnancy. Although the evidence base is small, preliminary results indicate a beneficial effect of physical activity on lowering triglycerides, TNFα, and leptin levels while increasing muscle-derived IL-6 levels during pregnancy. Future studies are needed to examine relationships among prospectively measured physical activity and metabolic markers throughout pregnancy, as well as theoretically based physical activity interventions to prevent gestational diabetes.

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References

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  1. Melzer K, Schutz Y, Soehnchen N, et al. Prepregnancy body mass index and resting metabolic rate during pregnancy. Ann Nutr Metab. 2010;57:221–7.

    Article  CAS  PubMed  Google Scholar 

  2. Lippi G, Albiero A, Montagnana M, et al. Lipid and lipoprotein profile in physiological pregnancy. Clin Lab. 2007;53:173–7.

    CAS  PubMed  Google Scholar 

  3. Catalano PM, Huston L, Amini SB, et al. Longitudinal changes in glucose metabolism during pregnancy in obese women with normal glucose tolerance and gestational diabetes mellitus. Am J Obstet Gynecol. 1999;180:903–16.

    Article  CAS  PubMed  Google Scholar 

  4. Atienza AA, Moser RP, Perna F, et al. Self-reported and objectively measured activity related to biomarkers using NHANES. Med Sci Sports Exerc. 2011;43:815–21.

    Article  CAS  PubMed  Google Scholar 

  5. Panagiotakos DB, Pitsavos C, Chrysohoou C, et al. The associations between leisure-time physical activity and inflammatory and coagulation markers related to cardiovascular disease: the Attica study. Prev Med. 2005;40:432–7.

    Article  PubMed  Google Scholar 

  6. Bouassida A, Zalleg D, Bouassida S, et al. Leptin, its implication in physical exercise and training: a short review. J Sports Sci Med. 2006;5:172–81.

    PubMed Central  PubMed  Google Scholar 

  7. Sternfeld B. Physical activity and pregnancy outcome. Review and recommendations. Sports Med. 1997;23:33–47.

    Article  CAS  PubMed  Google Scholar 

  8. American College of Obstetricians and Gynecologists. Exercise during pregnancy and the postpartum period. Committee Opinion Number 267. ACOG Int J Gynaecol Obstet. 2002;77:79–81.

    Article  Google Scholar 

  9. U.S. Department of Health and Human Services. U.S. physical activity guidelines for Americans. [cited 2014 Aug 6]. Available from: http://www.health.gov/paguidelines: ODPHP Publication No. U0036; 2008.

  10. Evenson K, Barakat R, Brown W, et al. Guidelines for physical activity during pregnancy: comparisons from around the world. Am J Lifestyle Med. 2014;8:102–21. This paper provides a summary of physical activity guidelines during pregnancy from 9 different countries.

  11. Evenson KR, Wen F. National trends in self-reported physical activity and sedentary behaviors among pregnant women: NHANES 1999-2006. Prev Med. 2010;50:123–8.

    Article  PubMed  Google Scholar 

  12. Bellamy L, Casas JP, Hingorani AD, et al. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373:1773–9.

    Article  CAS  PubMed  Google Scholar 

  13. Ehrenberg HM, Mercer BM, Catalano PM. The influence of obesity and diabetes on the prevalence of macrosomia. Am J Obstet Gynecol. 2004;191:964–8.

    Article  CAS  PubMed  Google Scholar 

  14. Oken E, Taveras EM, Kleinman KP, et al. Gestational weight gain and child adiposity at age 3 years. Am J Obstet Gynecol. 2007;196:322. e321-328.

    PubMed Central  PubMed  Google Scholar 

  15. Catalano PM, Ehrenberg HM. The short- and long-term implications of maternal obesity on the mother and her offspring. BJOG. 2006;113:1126–33.

    Article  CAS  PubMed  Google Scholar 

  16. Torloni MR, Betran AP, Horta BL, et al. Prepregnancy BMI and the risk of gestational diabetes: a systematic review of the literature with meta-analysis. Obes Rev. 2009;10:194–203.

    Article  CAS  PubMed  Google Scholar 

  17. Jiwani A, Marseille E, Lohse N, et al. Gestational diabetes mellitus: results from a survey of country prevalence and practices. J Matern Fetal Neonatal Med. 2012;25:600–10.

    Article  PubMed  Google Scholar 

  18. Wendland EM, Torloni MR, Falavigna M, et al. Gestational diabetes and pregnancy outcomes—a systematic review of the World Health Organization (WHO) and the International Association of Diabetes in Pregnancy Study Groups (IADPSG) diagnostic criteria. BMC Pregnancy Childbirth. 2012;12:23. This article provides an overview of current diagnostic criteria for gestational diabetes and their relation to birth outcomes.

    Article  PubMed Central  PubMed  Google Scholar 

  19. Tobias DK, Zhang C, van Dam RM, et al. Physical activity before and during pregnancy and risk of gestational diabetes mellitus: a meta-analysis. Diabetes Care. 2011;34:223–9.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Morkrid K, Jenum AK, Berntsen S, et al. Objectively recorded physical activity and the association with gestational diabetes. Scand J Med Sci Sports. 2014. doi:10.1111/sms.12183. This population-based prospective study examined the relation between objectively measured physical activity in early gestation (<20 weeks) and odds of gestational diabetes. This is a significant improvement over previous studies that have relied on self-reported measures of physical activity.

    Google Scholar 

  21. Yin YN, Li XL, Tao TJ, et al. Physical activity during pregnancy and the risk of gestational diabetes mellitus: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med. 2014;48:290–5.

    Article  PubMed  Google Scholar 

  22. Ruchat SM, Mottola MF. The important role of physical activity in the prevention and management of gestational diabetes mellitus. Diabetes Metab Res Rev. 2013;29:334–46. This review emphasizes low compliance as a reason why exercise intervention studies have failed to show a reduced risk of gestational diabetes.

    Article  PubMed  Google Scholar 

  23. Leppanen M, Aittasalo M, Raitanen J, et al. Physical activity during pregnancy: predictors of change, perceived support and barriers among women at increased risk of gestational diabetes. Matern Child Health J. 2014;18(9):2158–66.

    Article  PubMed  Google Scholar 

  24. Davenport MH, Mottola MF, McManus R, et al. A walking intervention improves capillary glucose control in women with gestational diabetes mellitus: a pilot study. Appl Physiol Nutr Metab. 2008;33:511–7.

    Article  CAS  PubMed  Google Scholar 

  25. Mudd LM, Owe KM, Mottola MF, et al. Health benefits of physical activity during pregnancy: an international perspective. Med Sci Sports Exerc. 2013;45:268–77.

    Article  PubMed  Google Scholar 

  26. Thangaratinam S, Rogozinska E, Jolly K, et al. Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ. 2012;344:e2088–103.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  27. Goodyear LJ, Kahn BB. Exercise, glucose transport, and insulin sensitivity. Annu Rev Med. 1998;49:235–61.

    Article  CAS  PubMed  Google Scholar 

  28. Golbidi S, Laher I. Potential mechanisms of exercise in gestational diabetes. J Nutr Metab. 2013;2013:285948. This article provides a good overview of maternal metabolic cytokines and hormones in relation to risk of gestational diabetes.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Chasan-Taber L. Gestational diabetes: is it preventable? Am J Life Med. 2012;6:395–406.

    Article  Google Scholar 

  30. Halperin IJ, Feig DS. The role of lifestyle interventions in the prevention of gestational diabetes. Curr Diab Rep. 2014;14:452.

    Article  PubMed  Google Scholar 

  31. Mudd LM, Holzman CB, Catov JM, et al. Maternal lipids at mid-pregnancy and the risk of preterm delivery. Acta Obstet Gynecol Scand. 2012;91:726–35.

    Article  PubMed  Google Scholar 

  32. Clausen T, Burski TK, Oyen N, et al. Maternal anthropometric and metabolic factors in the first half of pregnancy and risk of neonatal macrosomia in term pregnancies. A prospective study. Eur J Endocrinol. 2005;153:887–94.

    Article  CAS  PubMed  Google Scholar 

  33. Son GH, Kwon JY, Kim YH, et al. Maternal serum triglycerides as predictive factors for large-for-gestational age newborns in women with gestational diabetes mellitus. Acta Obstet Gynecol Scand. 2010;89:700–4.

    Article  CAS  PubMed  Google Scholar 

  34. Kulkarni SR, Kumaran K, Rao SR, et al. Maternal lipids are as important as glucose for fetal growth: findings from the PUNE maternal nutrition study. Diabetes Care. 2013;36:2706–13.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  35. Butler CL, Williams MA, Sorensen TK, et al. Relation between maternal recreational physical activity and plasma lipids in early pregnancy. Am J Epidemiol. 2004;160:350–9.

    Article  PubMed  Google Scholar 

  36. Schreuder YJ, Hutten BA, van Eijsden M, et al. Ethnic differences in maternal total cholesterol and triglyceride levels during pregnancy: the contribution of demographics, behavioural factors and clinical characteristics. Eur J Clin Nutr. 2011;65:580–9.

    Article  CAS  PubMed  Google Scholar 

  37. Loprinzi PD, Fitzgerald EM, Woekel E, et al. Association of physical activity and sedentary behavior with biological markers among U.S. Pregnant women. J Womens Health. 2013;22:953–8. This study utilizes data from NHANES to examine relations between physical activity during pregnancy and concurrently measured metabolic markers.

    Article  Google Scholar 

  38. van Poppel MN, Oostdam N, Eekhoff ME, et al. Longitudinal relationship of physical activity with insulin sensitivity in overweight and obese pregnant women. J Clin Endocrinol Metab. 2013;98:2929–35.

    Article  PubMed  Google Scholar 

  39. Bo S, Rosato R, Ciccone G, et al. Simple lifestyle recommendations and the outcomes of gestational diabetes. A 2x2 factorial randomized trial. Diabetes Obes Metab. 2014. doi:10.1111/dom.12289.

    PubMed  Google Scholar 

  40. Ko CW, Napolitano PG, Lee SP, et al. Physical activity, maternal metabolic measures, and the incidence of gallbladder sludge or stones during pregnancy: a randomized trial. Am J Perinatol. 2014;31:39–48.

    Article  PubMed  Google Scholar 

  41. Clapp 3rd JF, Kiess W. Effects of pregnancy and exercise on concentrations of the metabolic markers tumor necrosis factor alpha and leptin. Am J Obstet Gynecol. 2000;182:300–6.

    Article  CAS  PubMed  Google Scholar 

  42. van Poppel MN, Peinhaupt M, Eekhoff ME, et al. Physical activity in overweight and obese pregnant women is associated with higher levels of proinflammatory cytokines and with reduced insulin response through interleukin-6. Diabetes Care. 2014;37:1132–9.

    Article  PubMed  Google Scholar 

  43. Williams MA, Qiu C, Muy-Rivera M, et al. Plasma adiponectin concentrations in early pregnancy and subsequent risk of gestational diabetes mellitus. J Clin Endocrinol Metab. 2004;89:2306–11.

    Article  CAS  PubMed  Google Scholar 

  44. Ning Y, Williams MA, Butler CL, et al. Maternal recreational physical activity is associated with plasma leptin concentrations in early pregnancy. Hum Reprod. 2005;20:382–9.

    Article  CAS  PubMed  Google Scholar 

  45. Hopkins SA, Baldi JC, Cutfield WS, et al. Effects of exercise training on maternal hormonal changes in pregnancy. Clin Endocrinol. 2011;74:495–500.

    Article  Google Scholar 

  46. Briley AL, Barr S, Badger S, et al. A complex intervention to improve pregnancy outcome in obese women; the UPBEAT randomised controlled trial. BMC Pregnancy Childbirth. 2014;14:74–83. This article describes the methods of a behavioral intervention to reduce the incidence of gestational diabetes that is currently underway in the UK.

    Article  PubMed Central  PubMed  Google Scholar 

  47. Jelsma JG, van Poppel MN, Galjaard S, et al. DALI: vitamin D and lifestyle intervention for gestational diabetes mellitus (GDM) prevention: An European multicentre, randomised trial—study protocol. BMC Pregnancy Childbirth. 2013;13:142–56. This article describes the methods of a behavioral intervention to reduce the incidence of gestational diabetes that is currently underway in Europe.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  48. Rich-Edwards JW, Fraser A, Lawlor DA, et al. Pregnancy characteristics and women's future cardiovascular health: an underused opportunity to improve women's health? Epidemiol Rev. 2014;36:57–70.

    Article  PubMed Central  PubMed  Google Scholar 

  49. Mosca L, Benjamin EJ, Berra K, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women—2011 update: a guideline from the American Heart Association. Circulation. 2011;123:1243–62.

    Article  PubMed Central  PubMed  Google Scholar 

  50. Barouki R, Gluckman PD, Grandjean P, et al. Developmental origins of non-communicable disease: implications for research and public health. Environ Health. 2012;11:42.

    Article  PubMed Central  PubMed  Google Scholar 

  51. Rasmussen KM, Kjolhede CL. Maternal obesity: a problem for both mother and child. Obesity. 2008;16:929–31.

    Article  PubMed  Google Scholar 

  52. Hure AJ, Collins CE, Giles WB, et al. Protocol for the women and their children's health (WATCH) study: a cohort of pregnancy and beyond. J Epidemiol. 2012;22:267–75.

    Article  PubMed Central  PubMed  Google Scholar 

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Conflict of Interest

Lanay M. Mudd and Kelly R. Evenson declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Department of Kinesiology, Michigan State University, 308 West Circle Drive, IM Circle Rm 27s, East Lansing, MI, 48824, USA

    Lanay M. Mudd

  2. Gillings School of Global Public Health, Department of Epidemiology, University of North Carolina-Chapel Hill, 137 East Franklin Street, Suite 306, Campus Box 8050, Chapel Hill, NC, 27514, USA

    Kelly R. Evenson

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  1. Lanay M. Mudd
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  2. Kelly R. Evenson
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Correspondence to Lanay M. Mudd.

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This article is part of the Topical Collection on Diabetes and Pregnancy

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Mudd, L.M., Evenson, K.R. Review of Impacts of Physical Activity on Maternal Metabolic Health During Pregnancy. Curr Diab Rep 15, 6 (2015). https://doi.org/10.1007/s11892-014-0572-3

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  • DOI: https://doi.org/10.1007/s11892-014-0572-3

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