Are physical activity and exercise associated with cardiometabolic health in early pregnancy?

Abstract

Background: Physical activity (PA) is an important component of a healthy pregnancy and has consistently been associated with improved weight management and a reduced risk of pregnancy complications. While the percentage of pregnant women meeting PA guidelines internationally is alarmingly low, no such data exists for the Canadian population. PA in pregnancy may also be a useful intervention for preventing and managing cardiometabolic dysfunction, but research in pregnancy is limited. Objectives: 1) To describe the PA and exercise habits of women in early pregnancy and assess the percentage of women meeting SOGC/CSEP guidelines for exercise in pregnancy; 2) To determine the association of PA with maternal cardiometabolic health in early pregnancy. Study Design: Maternal blood samples, and PA, dietary, and adiposity measures were collected from a subset of women in early pregnancy (12 – 17 wk gestation) upon enrollment in the Be Healthy in Pregnancy RCT. Fasted blood samples were analyzed for glucose, triglycerides, insulin, leptin, adiponectin and C-reactive protein (CRP). Self-reported and objectively measured PA were assessed using the PARmed-X for Pregnancy and an accelerometer. PA was quantified by three parameters: daily step count, energy expenditure (kcal/day) and meeting the SOGC/CSEP recommendations. Results: For the 198 participants of age 31 ± 4 years; BMI 25.4 ± 4.7kg/m2; at 13 ± 2 wk gestation (mean ± SD), 19.2% reported not exercising in early pregnancy. Approximately half of participants met the minimum SOGC/CSEP recommendation (15 min, 3x/wk), but only 14.2% met the preferred SOGC/CSEP recommendation (30 min, 4x/wk). Meeting the preferred recommendation was associated with lower CRP. Daily step count and energy expenditure (kcal/day) were not significantly associated with glucose, triglycerides, insulin, leptin, adiponectin or CRP. Percent body fat and a higher diet quality were associated with some of the cardiometabolic biomarkers. Conclusion: In a healthy pregnant cohort, while the majority had PA below recommendations, measured PA was not associated with most cardiometabolic biomarkers thus cardiometabolic risk in early pregnancy was low.