Key result
Supervised exercise fails to improve peak oxygen uptake in pregnant individuals with elevated BMI.
Why the study?
The study aimed to determine the effectiveness of exercise training during pregnancy on VO2 peak, cardiac function, and flow-mediated dilatation throughout pregnancy and post partum in individuals with prepregnancy BMI ≥28 kg/m2.
Does supervised exercise training improve peak oxygen uptake, cardiac function, or flow-mediated dilatation in pregnant individuals with a prepregnancy BMI ≥28 kg/m2?
RCT (n=91)
Parallel-group
Does supervised exercise training improve peak oxygen uptake, cardiac function, or flow-mediated dilatation in pregnant individuals with a prepregnancy BMI ≥28 kg/m2?
Effect estimate: Estimated effect 1.7 mL/min/kg (95% CI -0.4 to 3.7)
p-value: p=0.112
A supervised exercise intervention during pregnancy in individuals with a BMI ≥28 kg/m2 did not significantly improve cardiorespiratory fitness, cardiac function, or flow-mediated dilatation, though adherence to the intervention was low.
Supervised exercise does not improve late-pregnancy peak VO2 in BMI ≥28; challenges assumptions of benefit and highlights adherence barriers for future trials.
Objectives We aimed to determine the effectiveness of exercise training during pregnancy on peak oxygen uptake (V̇O 2 peak), cardiac function and flow-mediated dilatation (FMD) of the brachial artery throughout pregnancy and post partum in individuals with a prepregnancy body mass index (BMI) ≥28 kg/m 2 . Trial design Parallel-group randomised controlled trial (RCT). Methods The exercise group in the Exercise Training in Pregnancy (ETIP) RCT was offered 3 weekly supervised exercise sessions comprising 35 min of moderate-intensity treadmill walking followed by 25 min of strength exercises. The intervention started in gestational weeks 12–18 and continued throughout pregnancy. We measured V̇O 2 peak and FMD at baseline, in gestational weeks 34–37 and 3 months post partum and offered echocardiography in gestational weeks 14, 20, and 32, and 6–8 weeks postpartum. Results Of the 91 participants included in ETIP, 87 participants (age: 31.3±4.2 years, BMI: 34.6±4.3 kg/m 2 ) provided data on V̇O 2 peak, cardiac function and/or FMD. There was no statistically significant effect of exercise training on V̇O 2 peak in gestational weeks 34–37, with an estimated effect of 1.7 mL/min/kg (95% CI −0.4 to 3.7, p=0.112) or post partum (1.6 mL/min/kg, 95% CI −0.2 to 3.4, p=0.079), compared with the control group. There were no statistically significant between-group differences in either FMD or any of the echocardiographic outcomes. Only 50% of the participants in the exercise group fulfilled our prespecified adherence criteria. Conclusion Offering pregnant individuals with BMI ≥28 kg/m 2 , a supervised exercise intervention did not improve cardiorespiratory fitness, cardiac function or FMD. Trial registration number NCT01243554 .
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Moholdt et al. (2024) conducted an RCT in Pregnancy with high body mass index (BMI ≥28 kg/m2) (n=91). Supervised exercise training vs. Control group was evaluated on Peak oxygen uptake (V̇O2 peak) in gestational weeks 34-37 (Estimated effect 1.7 mL/min/kg, 95% CI -0.4 to 3.7, p=0.112). A supervised exercise intervention in pregnant individuals with BMI ≥28 kg/m2 did not significantly improve peak oxygen uptake in gestational weeks 34-37 (estimated effect 1.7 mL/min/kg; p=0.112).
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