title: Association between physical activity in obese pregnant women and pregnancy outcomes: the UPBEAT pilot study.
abstract: BACKGROUND
  Obesity in pregnancy is associated with fetal macrosomia, a raised neonatal fat mass and an increased risk of obesity and poor metabolic health in childhood which persists into adulthood. The offspring of obese women are more likely to be obese than the offspring of lean women when they become pregnant themselves, perpetuating a cycle of obesity and its associated negative metabolic consequences. Increasing physical activity during pregnancy could improve insulin sensitivity and reduce the risk of maternal and offspring adverse outcomes. The UK Pregnancy Better Eating and Activity Trial (UPBEAT) is a trial of a complex intervention designed to improve pregnancy outcomes through dietary changes and physical activity. Data from the pilot trial of 183 women were available for analysis. The relationship between the time spent at different physical activity levels and maternal and infant pregnancy outcomes was examined.
  
  
  CONCLUSIONS
  Strong evidence exists that physical activity improves insulin sensitivity in non-pregnant populations, and lifestyle interventions of proven effectiveness in non-pregnant populations have been developed. Women who are active in pregnancy demonstrate better glucose control and favourable pregnancy outcomes. There is a lack of effective interventions to support obese pregnant women to be physically active.
  
  
  CONCLUSIONS
  No difference was detected in objectively measured physical activity between women randomised to the intervention and control arms of the UPBEAT pilot trial. Light-intensity physical activity was lower in early pregnancy in women who delivered macrosomic infants. Maternal sedentary time at 35-36 weeks' gestation was positively associated and moderate-intensity physical activity was inversely associated with neonatal abdominal circumference. Maternal physical activity is associated with infant birth weight and abdominal circumference and is an appropriate target for intervention to improve infant outcomes. The challenge remains to develop an effective intervention to support obese pregnant women to be physically active.
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Hayes
authors.forename: Ruth
authors.initials: R
authors.lastname: Bell
authors.forename: Steve
authors.initials: S
authors.lastname: Robson
authors.forename: Lucilla
authors.initials: L
authors.lastname: Poston
mesh_terms: D001724:Birth Weight; D015992:Body Mass Index; D003131:Combined Modality Therapy; D016640:Diabetes, Gestational / Q000209:etiology / Q000517:prevention & control*; D003927:Diet, Diabetic; D005260:Female; D047109:Fetal Development; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D039382:Maternal Nutritional Physiological Phenomena; D009043:Motor Activity; D009765:Obesity / Q000178:diet therapy / Q000503:physiopathology / Q000628:therapy*; D010349:Patient Compliance; D010865:Pilot Projects; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology / Q000628:therapy*; D011256:Pregnancy Outcome; D006113:United Kingdom; D055105:Waist Circumference