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Overview
abstract
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Within the US, maternal heart disease and obesity are an increasing problem that negatively impacts mother, pregnancy outcomes, and the future health of offspring. A potential safe intervention for alleviating or preventing obesity and co-morbid conditions during pregnancy is exercise. To begin to determine the influence of exercise during pregnancy on offspring development, a cohort study with women of healthy and overweight status was done. This pilot study found improved cardiac autonomic control in offspring in the 3rd trimester and after birth. Another cohort study found associations persisted between maternal activity during pregnancy and child heart measures up to 7 years of age. Clapp et al. found offspring of women who exercised during pregnancy had lower body fat at 5 years of age compared to offspring not exposed to maternal exercise in utero. Few studies have focused on the effects of exercise protocols for pregnant women and offspring health outcomes. Our study will begin to address this gap. Therefore, we hypothesize that maternal exercise during pregnancy, will improve cardiometabolic health in offspring. Aim 1: The first aim is designed to determine if regular maternal exercise is associated with increased coupling of fetal/neonatal measures (i.e. fetal body movement, fetal heart rate (HR) & heart rate variability (HRV), and cardiovascular measures) at 36 weeks gestational age, and one-month postnatal when exposed to regular maternal exercise compared to fetuses of women in the control group. We hypothesize there will be increased coupling in fetal movement and cardiovascular measures at 36 weeks gestational age, and one-month infants when exposed to regular maternal exercise compared to fetuses of women in the control group; Aim 2a: the second aim will determine if there are differences in maternal anxiety score and neurological maturation in neonates of exercising women compared to controls. This will be measured with a POMS2 scale (pregnant women) and standard neurological examination (neonates) and EKG (for HRV). We hypothesize that there will be increases in maternal scores and 1-month neurological examination scores of infants exposed to exercise in utero compared to controls. Aim 3: the third aim will determine if there are decreases in infant body composition measures (i.e. body fat) in one-month infants when exposed to maternal exercise compared to fetuses of women in the control group. Body morphometrics, skinfolds, and MRI will be used. We hypothesize that there will be differences decreases in infant body composition measures (i.e. body fat, bone density) in one-month infants when exposed to maternal exercise compared to fetuses of women in the control group. To accomplish these aims, pregnant women will be randomized into exercise or control groups. From 16 weeks until 36 weeks gestation, exercise women will be trained for 45 mintues, three times per week at moderate-to-vigorous intensity. We will assess cardiovascular health via ECG, ultrasound; level of adiposity via skinfold measures, body circumferences, MRI; will be measured in the offspring in the 3rd trimester and/or one-month after birth. This study will provide essential information regarding the influence maternal exercise has on the long-term cardiometabolic health of offspring. Heart disease and obesity are the leading causes of death in the US, therefore early assessment and focused intervention are necessary to attenuate and prevent the risk factors associated with cardiovascular disease, diabetes, and obesity. Gestation is the earliest time in which to target these deadly and preventable diseases and improve public health.
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