title: The impact of an exercise intervention on C - reactive protein during pregnancy: a randomized controlled trial.
abstract: BACKGROUND
  C-reactive protein (CRP) during pregnancy has been associated with adverse maternal outcomes such as preeclampsia and gestational diabetes mellitus. Randomized trials suggest that exercise programs may be associated with reductions in CRP in non-pregnant populations; however, such studies have not been conducted among pregnant women. The purpose of this study was to evaluate the impact of an individually-tailored motivationally-matched exercise intervention on CRP in pregnant women.
  
  
  METHODS
  The Behaviors Affecting Baby and You study was a randomized controlled trial of prenatal physical activity to prevent the development of gestational diabetes mellitus in women at increased risk. Women were randomized to either a 12-week exercise intervention (n = 84) or a comparison health and wellness intervention (n = 87). High sensitivity CRP (mg/dL) was measured using a commercial immunoassay kit. Physical activity was measured using the Pregnancy Physical Activity Questionnaire. Mixed model analyses were used to evaluate the impact of the intervention on change in CRP using an intent-to-treat approach.
  
  
  RESULTS
  CRP decreased (-0.09 mg/dL, 95 % CI: -0.25, 0.07) from pre- to post-intervention in the exercise arm (p = 0.14) and increased (0.08 mg/dL, 95 % CI: -0.07, 0.24) (p = 0.64) in the health and wellness arm; however the between group difference was not statistically significant (p = 0.14). Findings did not differ according to ethnic group or pre-pregnancy body mass index. In a secondary analysis based on self-reported physical activity, women who decreased their time spent in sports/exercise experienced a mean increase in CRP (0.09 mg/dL, 95 % CI: -0.14, 0.33), whereas women who maintained or increased their sports/ exercise experienced a mean decrease in CRP (-0.08 mg/dL, 95 % CI: -0.23, 0.08) (p = 0.046).
  
  
  CONCLUSIONS
  Findings from this randomized trial in an ethnically and socio-economically diverse population of pregnant women were consistent with a positive impact of the exercise intervention on CRP levels, but not of statistical significance.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT00728377 . Registered 2 August 2008.
authors.affiliation: Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA. mshawkins@schoolph.umass.edu.
authors.forename: Marquis
authors.initials: M
authors.lastname: Hawkins
authors.affiliation: Department of Kinesiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA. Barry.Braun@colostate.edu.
authors.forename: Barry
authors.initials: B
authors.lastname: Braun
authors.affiliation: Department Family and Public Health, University of California San Diego School of Medicine, San Diego, CA, USA. bmarcus@ucsd.edu.
authors.forename: Bess H
authors.initials: BH
authors.lastname: Marcus
authors.affiliation: Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA. stanek@schoolph.umass.edu.
authors.forename: Edward
authors.initials: E
authors.lastname: Stanek
authors.affiliation: Baystate Medical Center, Springfield, MA, USA. Glenn.Markenson@baystatehealth.org.
authors.forename: Glenn
authors.initials: G
authors.lastname: Markenson
authors.affiliation: Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, Amherst, MA, USA. lct@schoolph.umass.edu.
authors.forename: Lisa
authors.initials: L
authors.lastname: Chasan-Taber
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D016640:Diabetes, Gestational / Q000517:prevention & control; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D009042:Motivation; D011247:Pregnancy; D011295:Prenatal Care / Q000379:methods*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein