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Physical Activity in Pregnancy

Completed
Conditions
Pregnancy, Physical Activity
Registration Number
NCT03277807
Lead Sponsor
Medical University of Graz
Brief Summary

This prospective observational study assesses whether women who regularly exercise during pregnancy show reduced low grade Inflammation, compared to women who are not regularly exercising. Furthermore, the effects of regular physical activity in pregnancy on fetal and neonatal outcomes will be investigated. 3 groups of pregnant women will be formed (group 1: regularly physically active women; group 2: physically inactive women and group 3: women with a history of preeclampsia or positive history of metabolic conditions increasing the risk of hypertensive disorders in pregnancy).

Detailed Description

Pregnancy is a natural state of low grade inflammation in the mother and the feto-placental unit. The severity of this inflammation increases with higher pregravid Body Mass Index (BMI). This is reflected by an increase in pro-inflammatory cytokines in the maternal circulation and in the placenta. It has been proposed that the pro-inflammatory maternal and fetal environment plays a role in mediating pregnancy outcomes.

In non-pregnant individuals regular physical activity is associated with a reduced inflammatory state. The overall objective of the study is to investigate the interaction of maternal physical activity and pregnancy induced low-grade inflammation in the mother and feto-placental unit, and to assess th resulting effects on prenatal and postnatal development.

Specific research objective will be to study effects of maternal physical activity on:

1. low grade Inflammation in the mother an feto-placental unit;

2. maternal and fetal lipid profiles, including High Density Lipoprotein (HDL) proteome;

3. fetal growth and infant body composition;

4. transcriptomic and epigenetic profile in the placenta;

5. biomarkers of nutritive status;

6. psychological assessment: cardiac awareness; assessment of arterial stiffness; stress-coping questionaire

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
53
Inclusion Criteria
  • ongoing pregnancy no later than 14 weeks of gestation
  • giving informed consent
Exclusion Criteria
  • not wanting to give birth at the University Hospital
  • gestational age > 14 weeks of gestation
  • 3 or more consecutive miscarriages
  • increased risk to or above 1:200 after combined test (Minimum parameters: maternal age, fetal crown-rump length (CRL), nuchal translucency, nasal bone and maternal biochemistry)
  • fetal anomalies associated with possible growth or genetic anomalies
  • Smoking
  • diagnosed with Diabetes type 1 or 2 (T1D, T2D)
  • for groups 1 and 2: maternal metabolic risk factors (autoimmune conditions, increased risk for thromboembolic events needing anticoagulative therapy)
  • for groups 1 and 2: pre-pregnancy hypertension

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
low grade inflammation (in maternal and cord blood)1 year

clinical inflammation markers: C-reactive protein, cytokines and chemokine (IL1b, IL1a, IL-2, IL-5, IL-6,IL-12, TNFa, MCP-1, MIP1-a) measured by ELISA and multiplexing arrays

Secondary Outcome Measures
NameTimeMethod
psychological assessment1 year

assessment of arterial stiffness, stress coping questionnaire, cardiac awareness

maternal and newborn fat distribution1 year

subcutaneous adipose tissue thickness at 15 defined body sites, measured by a lipometer

maternal and fetal (cord blood) lipid profiles1 year

triglycerides, phospholipids, free fatty acids, HDL/LDL/total cholesterol

neonatal body composition (% body fat)1 year

measured by air displacement plethysmography (Peapod)

fetal growth1 year

measured by ultrasound scanner

transcriptome of the placenta2 years

measured by full genome arrays

epigenetic analysis of the placenta2 years

analysed by 450k methylation arrays

biomarkers of nutritional status2 years

measurement of blood levels of fatty acids (DHA, EPA, 15:0, 17:0), vitamin A, B1, B2, B6, D2/D3, C, E, homocysteine

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