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Cardiac function in newborns of obese women and the effect of exercise during pregnancy. A randomized controlled
Siri Ann Nyrnes1,2, Kirsti Krohn Garnæs1, Øyvind Salvesen3
1Department of Circulation and Medical Imaging, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
Insights
Maternal obesity in pregnancy is linked to impaired newborn cardiac function. Exercise interventions during pregnancy did not significantly improve cardiac parameters in newborns of obese mothers, possibly due to low adherence.
Area of Science:
- Cardiology
- Maternal-Fetal Medicine
- Pediatric Cardiology
Background:
- Rising prevalence of maternal obesity poses risks for offspring cardiovascular health.
- Pre-pregnancy obesity is associated with later childhood cardiovascular disease, with origins in early development.
- Pregnancy and infancy represent critical windows for intervention to mitigate these risks.
Purpose of the Study:
- To compare cardiac function in newborns of obese mothers versus normal-weight mothers.
- To evaluate the impact of a supervised exercise intervention during pregnancy on newborn cardiac function in obese mothers.
Main Methods:
- Randomized controlled trial involving 55 pregnant women (51 obese, 4 overweight) assigned to exercise or standard care.
- Exercise group received supervised and home-based training from gestational week 14 until delivery.
- Echocardiograms were performed on newborns at 1-3 days and 6-8 weeks postpartum.
Main Results:
- Newborns of obese mothers exhibited impaired systolic and diastolic cardiac function, reduced global strain, and thicker intraventricular septum compared to controls.
- Exercise intervention showed no statistically significant effect on measured cardiac function parameters.
- Adherence to the exercise protocol was low, averaging 1.3 supervised and 0.8 home-based sessions weekly.
Conclusions:
- Maternal obesity is associated with reduced cardiac function and increased intraventricular septum thickness in newborns.
- Antenatal exercise training did not significantly improve newborn cardiac function, likely due to insufficient adherence and sample size.
- Further research with improved adherence strategies is warranted.
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.
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