The Effect of a Supervised Exercise Program Throughout Pregnancy on Longitudinal Lipid Profile Changes: A Randomized...

To investigate whether a supervised exercise program during pregnancy induces modifications in the maternal lipid profile.

This unplanned secondary analysis of a multicenter randomized controlled trial (March 2021-June 2023) was conducted at Hospital Universitario de Torrejón, the only participating center with routine lipid profiling during all three trimesters and postpartum. Eligible women had a singleton pregnancy < 14⁺³ weeks without complications. Participants were randomized (1:1) to a supervised exercise program (three 55-60 min sessions/week, virtual or onsite) or control (usual activity). Exercise adherence was defined as ≥ 80% session attendance. Maternal characteristics, blood pressure, and weight were recorded at baseline and follow-up visits in the second and third trimesters and 6-12 months postpartum. Venous blood samples were collected for lipid profiling, including total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C). Between-group differences were tested with Wilcoxon signed-rank tests, and repeated measures were analyzed with generalized estimating equations including gestational age, intervention group, delivery status, and obesity interaction. Both intention-to-treat and per-protocol analyses were performed. Statistical significance was considered at P < 0.05.

A total of 202 pregnant women were enrolled, and 182 were included in the final analysis (90 in the control group and 92 in the intervention group). No significant between-group differences were observed in lipid profiles at the second trimester, third trimester, or postpartum. Longitudinal analysis showed higher HDL-C levels in the IG (+3.24 mg/dl; 95% confidence interval (CI): 0.13-6.35, P = 0.041), persisting postpartum, and a nonsignificant trend toward lower LDL-C (-6.02 mg/dl; 95% CI: -13.18 to 1.14, P = 0.099). These effects were not confirmed in the per-protocol analysis, and no interaction with obesity was observed.

A supervised exercise program throughout pregnancy may increase HDL-C levels and potentially reduce LDL-C, thereby improving the maternal lipid profile. Further studies are needed to confirm and expand upon these findings.

No. NCT04563065 (Randomized Controlled Clinical Trial).