Cardiac function in newborns of obese women and the effect of exercise during pregnancy. A randomized controlled trial

PLoS One. 2018 Jun 1;13(6):e0197334. doi: 10.1371/journal.pone.0197334. eCollection 2018.

Abstract

Background: The prevalence of maternal obesity is rising. Pre-pregnancy obesity is associated with later cardiovascular disease in the child and the underlying pathogenesis begins in early life. Therefore, pregnancy and infancy are key periods for potential intervention. The aim of this study was to study the cardiac function in newborns of obese women compared to newborns of normal-weight women, and to determine if exercise intervention during pregnancy could have an effect on cardiac function of newborns to obese women.

Material and methods: Fifty-five pregnant women, 51 obese (BMI ≥ 30 kg/m2) and four overweight (BMI 28-30 kg/m2), were randomized to an exercise training group (n = 27) or a control group (standard maternity care, n = 28). From gestational week 14 until delivery participants in the intervention group were offered supervised training sessions three times weekly. In addition, they were told to exercise at home once weekly. All newborns had an echocardiogram performed 1-3 days and 6-8 weeks after delivery. The results were compared with newborns of normal weight women (n = 20, standard maternity care).

Results: Newborns of obese women had an impaired systolic and diastolic cardiac function with reduced global strain, strain rate, tissue Doppler velocities and a thicker intraventricular septum at birth and after 6-8 weeks after delivery compared to newborns of normal weight women. Exercise had no statistically significant effect on either of the cardiac function parameters. The mean (± standard deviation) adherence to the exercise protocol was 1.3 ± 0.8 sessions per week for supervised training and 0.8 ± 0.7 sessions per week for home-based exercise training.

Conclusions: Newborns of obese women had reduced cardiac function and thicker intraventricular septum compared to newborns of normal weight women. Exercise training during pregnancy had no significant effect, potentially due to a low number of subjects and low adherence to the exercise protocol.

Trial registration: ClinicalTrials.gov NCT01243554.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / prevention & control*
  • Cardiovascular Diseases / therapy
  • Exercise Therapy*
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Obesity / complications
  • Obesity / physiopathology
  • Obesity / therapy*
  • Overweight / complications
  • Overweight / physiopathology
  • Pregnancy
  • Pregnancy Complications / therapy*
  • Pregnant People
  • Weight Gain / physiology

Associated data

  • ClinicalTrials.gov/NCT01243554

Grants and funding

Funding Sources list (registered electronically at first submission): The Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology. Award Number: 46056728. Recipient Kirsti Krohn Garnæs; The Liaison Committee between the Central Norway Regional Health Authority and the Norwegian University of Science and Technology. Award Number: 10364200. Recipient Charlotte Björk Ingul; The Norwegian Fund for Postgraduate Training and Physiotherapy, Award number: 47060000. Recipient Trine Moholdt. The first (SAN) and third (ØS) author had no specific funding for this work. The fourth author (AT) received salary from the Award number 10364200. The funders of the second (KKG), fifth (TM) and last author (CBI) had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Helse Midt-Norge RHF provided support in the form of salaries for the clinical work of the last author (CBI), but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific role of these authors are articulated in the ‘author contributions’ section.