Elsevier

The Journal of Pediatrics

Volume 129, Issue 6, December 1996, Pages 856-863
The Journal of Pediatrics

Morphometric and neurodevelopmental outcome at age five years of the offspring of women who continued to exercise regularly throughout pregnancy,☆☆,,★★

https://doi.org/10.1016/S0022-3476(96)70029-XGet rights and content

Abstract

OBJECTIVE: To test the hypothesis that continuing regular, vigorous, sustained exercise throughout pregnancy adversely affects morphometric and neurodevelopmental outcome in offspring at 5 years of age. STUDY DESIGN: The offspring of 20 women who exercised were compared with those of 20 physically active control subjects. The women and their offspring were matched for multiple prenatal and postnatal variables known to influence outcome. All women were enrolled before the index pregnancy, monitored throughout, and had clinically normal antenatal, intrapartum, and postnatal courses. Morphometric measures were obtained at birth and at 5 years of age by a single, trained observer. Neurodevelopment was assessed by developmental psychologists masked to maternal exercise status. Data were analyzed with an unpaired Student t test. RESULTS: At birth, head circumference and length were similar, but the offspring of the exercising women weighed less (3.40 ± 0.80 vs 3.64 ± 0.70 kg) and had less fat (10.5% ± 0.9% vs 15.1% ± 0.6%). At 5 years of age, head circumference and height were similar, but the offspring of the women who exercised weighed less (18.0 ± 0.5 vs 19.5 ± 0.6 kg) and had a lower sum (Σ) of five site skinfolds (37 ± 1 vs 44 ± 2 mm). Motor, integrative, and academic readiness skills were similar. However, the exercise offspring performed significantly better on the Wechsler scales (125 ± 2 vs 116 ± 3) and tests of oral language skills (119 ± 2 vs 109 ± 3). CONCLUSIONS: These data refute the hypothesis and suggest that exercise during pregnancy reduces the subcutaneous fat mass of the offspring. (J Pediatr 1996; 129:856-63)

Section snippets

Subject selection

A major design issue in studies of this type is to isolate the effect of the variable of interest (in this case exercise during pregnancy) from multiple other prenatal and postnatal confounders. The approach taken in this study was to obtain detailed data from a small number of offspring born of women without risk factors who were representative of those who continued to exercise throughout pregnancy and compare them to the offspring of individually matched control subjects born during the same

Maternal characteristics

By design, maternal characteristics in both groups were representative of the overall study populace3, 10 and were well matched for maternal characteristics known to affect size at birth and long-term outcome. The physical data dealing with age, height, weight, body fat, maximal aerobic capacity, pregnancy weight gain, change in weight at 5 years of age, and paternal weight and height are detailed in Table I. The only significant difference was that pregnancy weight gain was 21% less in the

DISCUSSION

These data negate the initial hypothesis. In terms of morphometric outcome, there is no evidence of growth restriction at age 5 years in the offspring of the exercising women. When compared with either national statistics33 or several other developmental cohorts,34, 35 both height and weight are at 50th percentile for age, and skinfold thicknesses and the subcutaneous fat area of the upper arm are between the 45th and 60th percentiles.18, 35, 36, 37, 38 Thus it is not that the offspring of the

References (44)

  • PVV Hamill et al.

    Physical growth: National Center for Health Statistics percentiles

    Am J Clin Nutr

    (1979)
  • SJ Fomon et al.

    Body composition of reference children from birth to age 10 years

    Am J Clin Nutr

    (1982)
  • KG Dewey et al.

    Breast-fed infants are leaner than formula-fed infants at 1 year of age: the DARLING Study

    Am J Clin Nutr

    (1993)
  • O Langer et al.

    Management of women with one abnormal oral glucose tolerance test value reduces adverse outcome in pregnancy

    Am J Obstet Gynecol

    (1989)
  • JF Clapp et al.

    The changing glycemic response to exercise during pregnancy

    Am J Obstet Gynecol

    (1991)
  • A Raben et al.

    Resistant starch: the effect on postprandial glycemia, hormonal response and satiety

    Am J Clin Nutr

    (1994)
  • JF Clapp

    Exercise and fetal health

    J Dev Physiol

    (1991)
  • JF Clapp et al.

    Endurance exercise and pregnancy outcome

    Med Sci Sports Exerc

    (1984)
  • JF Clapp

    Exercise in pregnancy: good, bad or indifferent

    Current Obstetric Medicine

    (1993)
  • JM Pivarnik et al.

    Effect of chronic exercise on blood volume expansion and hematologic indices during pregnancy

    Obstet Gynecol

    (1994)
  • HC Miller et al.

    Diagnosis of impaired fetal growth in newborn infants

    Pediatrics

    (1971)
  • VD Seefeldt et al.

    Infants, children, and youth

  • Cited by (0)

    From the Departments of Reproductive Biology and of Obstetrics and Gynecology, Case Western Reserve University at MetroHealth Medical Center, Cleveland, Ohio

    ☆☆

    Supported by grant HD21268 from the National Institute of Child Health and Human Development, the H. W. Chandler and G. F. Clapp Research Funds, and MetroHealth Medical Center.

    Reprint requests: James F. Clapp III, MD, Department of Obstetrics and Gynecology, MetroHealth Medical Center, 2500 MetroHealth Dr., Cleveland, OH 44109.

    ★★

    0022-3476/96/$5.00 + 0 9/21/76242

    View full text