title: What is the effect of regular group exercise on maternal psychological outcomes and common pregnancy complaints? An assessor blinded RCT.
abstract: OBJECTIVE
  to examine the effects of supervised group exercise on maternal psychological outcomes and commonly reported pregnancy complaints.
  
  
  METHODS
  an observer-blinded randomized controlled trial.
  
  
  METHODS
  Norwegian School of Sport Sciences, Oslo, Norway.
  
  
  METHODS
  105 sedentary, nulliparous pregnant women, mean age 30.7(± 4.0) years, pre-pregnancy BMI 23.8 (± 4.3), were assigned to either exercise (n=52) or control group (n= 53) at mean gestation week 17.7 (± 4.2).
  
  
  METHODS
  the exercise intervention followed ACOG guidelines and included a 60 minutes general fitness class, with 40 minutes of endurance training/aerobic and 20 minutes of strength training and stretching/relaxation, performed at least twice per week for a minimum of 12 weeks.
  
  
  METHODS
  outcome measures were assessed through standardized interviews pre- and post-intervention (gestation week 36.6, ± 0.9), and included psychological variables related to quality of life, well-being, body image and pregnancy depression, as well as assessment of 13 commonly reported pregnancy complaints.
  
  
  RESULTS
  post-intervention, using intention to treat (ITT) analysis, women randomized to exercise rated their health significantly better compared to women in the control group (p=0.02) and reported less fatigue related to everyday activities (p=0.04). Women with complete exercise adherence (≥ 24 sessions) had significantly better scores on measurements of feelings related to sadness, hopelessness and anxiety (p<0.01), compared to the control group. Contradictory, the control group reported higher life enjoyment (p<0.01). There were no significant group differences in body-image or pregnancy depression. With respect to analysing pregnancy complaints according to ITT, no differences between the groups were found. A comparison of the women who attended ≥ 19 (80%, n=21) or ≥ 24 (100%, n=14) exercise sessions with the control-participants, showed that fewer women in the exercise group reported nausea/vomiting and numbness/poor circulation in legs. KEY CONCLUSION AND IMPLICATION FOR PRACTISE: participation in regular group exercise during pregnancy contributed to improvements in some variables related to maternal well-being and quality of life. Women with high exercise adherence had significantly better results on several health variables reaping the highest benefits. A qualitative study exploring the barriers of women in achieving recommended amount of activity may be necessary to understand this population and developing better clinical practice educational tools.
authors.affiliation: Norwegian School of Sports Sciences, Department of Sports Medicine, Norway. Electronic address: lahaakstad@nih.no.
authors.forename: Lene A H
authors.initials: LA
authors.lastname: Haakstad
authors.affiliation: Norwegian School of Sports Sciences, Department of Sports Medicine, Norway. Electronic address: b.s.torset@nih.no.
authors.forename: Beate
authors.initials: B
authors.lastname: Torset
authors.affiliation: Norwegian School of Sports Sciences, Department of Sports Medicine, Norway. Electronic address: kari.bo@nih.no.
authors.forename: Kari
authors.initials: K
authors.lastname: Bø
mesh_terms: D000328:Adult; D015444:Exercise / Q000502:physiology / Q000523:psychology; D005260:Female; D006801:Humans; D017063:Outcome Assessment, Health Care; D011247:Pregnancy / Q000502:physiology / Q000523:psychology*; D011248:Pregnancy Complications / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D016037:Single-Blind Method
keywords: Exercise; Maternal well-being; Pregnancy complaint; Pregnancy depression; Quality of life