American Journal of Epidemiology Vol. 137, No. 10: 1105-1114
Copyright © 1993 by The Johns Hopkins University School of Hygiene and Public Health
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Maternal Exercise during Pregnancy, Physical Fitness, and Fetal Growth
1Division of Epidemiology, Columbia University School of Public Health New York, NY
2Gertrude H. Sergievsky Center, Columbia University New York, NY
3Harlem Center for Health Promotion, Columbia University/Harlem Hospital Center New York, NY
4Division of Biostatistics, Columbia University School of Public Health New York, NY
5New York State Psychlatric Institute New York, NY
6Department of Obstetrics and Gynecology, Columbia Presbyterian Medical Center New York, NY
Reprint requests to Dr. Maureen Hatch, Division of Epidemiology, Columbia University School of Public Health, 600 West 168th Street, New York, NY 10032.
The value of exercise during pregnancy is controversial; both benefits and risks have been hypothesized. As empiric evidence is scant, the issue was investigated in a prospective study that assessed the impact on fetal growth of maternal exercise in each trimester of pregnancy. A cohort of over 800 prenatal patients was recruited from obstetric practices in Pennsylvania and New York between January 1987 and June 1989. Subjects were interviewed at entry Into care and recontacted at 28 and 36 weeks of gestation. In women with prior adverse outcomes or a lack of conditioning, the associations between maternal exercise and fetal growth were equivocal. In fit, low-risk, prenatal patients, exercise was positively associated with fetal growth. With low-moderate exercise levels, the adjusted mean birth weights were about 100 g higher than in nonexercisers (117 g; 95% confidence interval 17 to 217 g). With heavier exercise, larger birth weight Increments were seen, close to 300 g in those who exercised throughout pregnancy at levels of about 2,000 kcal/week in energy expenditure (276 g; 95% confidence interval 54 to 497 g). These results suggest that the guidelines issued by the American College of Obstetricians and Gynecologists may be too stringent for well-conditioned, low-risk, prenatal patients. Additional research to define safe limits more precisely seems warranted.
birth weight; energy expenditure; exercise; fetal growth retardation; physical fitness; pregnancy
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