Exercise Training and Weight Gain in Obese Pregnant Women: A Randomized Controlled Trial (ETIP Trial)

Moholdt and colleagues show that exercise training in pregnancy reduces incidence of gestational diabetes and blood pressure, but not weight gain.

Vyšlo v časopise: Exercise Training and Weight Gain in Obese Pregnant Women: A Randomized Controlled Trial (ETIP Trial). PLoS Med 13(7): e32767. doi:10.1371/journal.pmed.1002079
Kategorie: Research Article
prolekare.web.journal.doi_sk: 10.1371/journal.pmed.1002079


Moholdt and colleagues show that exercise training in pregnancy reduces incidence of gestational diabetes and blood pressure, but not weight gain.


1. Brunner S, Stecher L, Ziebarth S, Nehring I, Rifas-Shiman SL, Sommer C, et al. Excessive gestational weight gain prior to glucose screening and the risk of gestational diabetes: a meta-analysis. Diabetologia. 2015;58:2229–2237. doi: 10.1007/s00125-015-3686-5 26141788

2. Baeten JM, Bukusi EA, Lambe M. Pregnancy complications and outcomes among overweight and obese nulliparous women. Am J Public Health. 2001;91:436–440. 11236410

3. Martin KE, Grivell RM, Yelland LN, Dodd JM. The influence of maternal BMI and gestational diabetes on pregnancy outcome. Diabetes Res Clin Pract. 2015;108:508–513. doi: 10.1016/j.diabres.2014.12.015 25796512

4. Athukorala C, Rumbold AR, Willson KJ, Crowther CA. The risk of adverse pregnancy outcomes in women who are overweight or obese. BMC Pregnancy Childbirth. 2010;10:56. doi: 10.1186/1471-2393-10-56 20849609

5. Oken E, Kleinman KP, Belfort MB, Hammitt JK, Gillman MW. Associations of gestational weight gain with short- and longer-term maternal and child health outcomes. Am J Epidemiol. 2009;170:173–180. doi: 10.1093/aje/kwp101 19439579

6. Crane JM, White J, Murphy P, Burrage L, Hutchens D. The effect of gestational weight gain by body mass index on maternal and neonatal outcomes. J Obstet Gynaecol Can. 2009;31:28–35. 19208280

7. Rasmussen KM, Abrams B, Bodnar LM, Butte NF, Catalano PM, Maria Siega-Riz A. Recommendations for weight gain during pregnancy in the context of the obesity epidemic. Obstet Gynecol. 2010;116:1191–1195. doi: 10.1097/AOG.0b013e3181f60da7 20966705

8. Cedergren M. Effects of gestational weight gain and body mass index on obstetric outcome in Sweden. Int J Gynaecol Obstet. 2006;93:269–274. doi: 10.1016/j.ijgo.2006.03.002 16626716

9. Guelinckx I, Devlieger R, Mullie P, Vansant G. Effect of lifestyle intervention on dietary habits, physical activity, and gestational weight gain in obese pregnant women: a randomized controlled trial. Am J Clin Nutr. 2010;91:373–380. doi: 10.3945/ajcn.2009.28166 19955397

10. Bogaerts AF, Devlieger R, Nuyts E, Witters I, Gyselaers W, Van den Bergh BR. Effects of lifestyle intervention in obese pregnant women on gestational weight gain and mental health: a randomized controlled trial. Int J Obes (Lond). 2013;37:814–821. doi: 10.1038/ijo.2012.162

11. Harrison CL, Lombard CB, Strauss BJ, Teede HJ. Optimizing healthy gestational weight gain in women at high risk of gestational diabetes: a randomized controlled trial. Obesity (Silver Spring). 2013;21:904–909. doi: 10.1002/oby.20163

12. Petrella E, Malavolti M, Bertarini V, Pignatti L, Neri I, Battistini NC, et al. Gestational weight gain in overweight and obese women enrolled in a healthy lifestyle and eating habits program. J Matern Fetal Neonatal Med. 2014;27:1348–1352. doi: 10.3109/14767058.2013.858318 24175912

13. Vinter CA, Jensen DM, Ovesen P, Beck-Nielsen H, Jorgensen JS. The LiP (Lifestyle in Pregnancy) study: a randomized controlled trial of lifestyle intervention in 360 obese pregnant women. Diabetes Care. 2011;34:2502–2507. doi: 10.2337/dc11-1150 21972411

14. Ong MJ, Guelfi KJ, Hunter T, Wallman KE, Fournier PA, Newnham JP. Supervised home-based exercise may attenuate the decline of glucose tolerance in obese pregnant women. Diabetes Metab. 2009;35:418–421. doi: 10.1016/j.diabet.2009.04.008 19747869

15. Choi J, Fukuoka Y, Lee JH. The effects of physical activity and physical activity plus diet interventions on body weight in overweight or obese women who are pregnant or in postpartum: a systematic review and meta-analysis of randomized controlled trials. Prev Med. 2013;56:351–364. doi: 10.1016/j.ypmed.2013.02.021 23480971

16. Seneviratne SN, Jiang Y, Derraik J, McCowan L, Parry GK, Biggs JB, et al. Effects of antenatal exercise in overweight and obese pregnant women on maternal and perinatal outcomes: a randomised controlled trial. BJOG. 2016;123:588–597. doi: 10.1111/1471-0528.13738 26542419

17. Simmons D, Jelsma JG, Galjaard S, Devlieger R, van Assche A, Jans G, et al. Results From a European multicenter randomized trial of physical activity and/or healthy eating to reduce the risk of gestational diabetes mellitus: the DALI Lifestyle Pilot. Diabetes Care. 2015;38:1650–1656. doi: 10.2337/dc15-0360 26112044

18. Barakat R, Pelaez M, Montejo R, Luaces M, Zakynthinaki M. Exercise during pregnancy improves maternal health perception: a randomized controlled trial. Am J Obstet Gynecol. 2011;204:402e1–7. doi: 10.1016/j.ajog.2011.01.043

19. Han S, Middleton P, Crowther CA. Exercise for pregnant women for preventing gestational diabetes mellitus. Cochrane Database Syst Rev. 2012;7:CD009021. doi: 10.1002/14651858.CD009021.pub2 22786521

20. Sui Z, Dodd JM. Exercise in obese pregnant women: positive impacts and current perceptions. Int J Womens Health. 2013;5:389–398. doi: 10.2147/IJWH.S34042 23861603

21. Callaway LK, Colditz PB, Byrne NM, Lingwood BE, Rowlands IJ, Foxcroft K, et al. Prevention of gestational diabetes: feasibility issues for an exercise intervention in obese pregnant women. Diabetes Care. 2010;33:1457–1459. doi: 10.2337/dc09-2336 20357374

22. Sanabria-Martinez G, Garcia-Hermoso A, Poyatos-Leon R, Alvarez-Bueno C, Sanchez-Lopez M, Martinez-Vizcaino V. Effectiveness of physical activity interventions on preventing gestational diabetes mellitus and excessive maternal weight gain: a meta-analysis. BJOG. 2015;122:1167–1174. doi: 10.1111/1471-0528.13429 26036300

23. Moholdt TT, Salvesen K, Ingul CB, Vik T, Oken E, Morkved S. Exercise Training in Pregnancy for Obese Women (ETIP): study protocol for a randomised controlled trial. Trials. 2011;12:154. doi: 10.1186/1745-6215-12-154 21682869

24. Artal R, O’Toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br J Sports Med. 2003;37:6–12. 12547738

25. Borg G. Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med. 1970;2:92–98. 5523831

26. Helsedirektoratet. Svangerskapsomsorgen: nasjonal faglig retningslinje for svangerskapsomsorgen. IS-1179. 2005 May 1 [cited 15 May 2016]. Available: https://helsedirektoratet.no/retningslinjer/nasjonal-faglig-retningslinje-for-svangerskapsomsorgen.

27. International Association of Diabetes and Pregnancy Study Groups Consensus Panel, Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, et al. International Association of Diabetes and Pregnancy Study Groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33:676–682. doi: 10.2337/dc09-1848 20190296

28. World Health Organization. Diagnostic criteria and classification of hyperglycaemia first detected in pregnancy. Geneva: World Health Organization; 2013.

29. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28:412–419. 3899825

30. Christiansen T, Paulsen SK, Bruun JM, Pedersen SB, Richelsen B. Exercise training versus diet-induced weight-loss on metabolic risk factors and inflammatory markers in obese subjects: a 12-week randomized intervention study. Am J Physiol Endocrinol Metab. 2010;298:E824–E831. doi: 10.1152/ajpendo.00574.2009 20086201

31. Wolff S, Legarth J, Vangsgaard K, Toubro S, Astrup A. A randomized trial of the effects of dietary counseling on gestational weight gain and glucose metabolism in obese pregnant women. Int J Obes (Lond). 2008;32:495–501. doi: 10.1038/sj.ijo.0803710

32. Agha M, Agha RA, Sandall J. Interventions to reduce and prevent obesity in pre-conceptual and pregnant women: a systematic review and meta-analysis. PLoS ONE. 2014;9:e95132. doi: 10.1371/journal.pone.0095132 24827704

33. Seneviratne SN, Jiang Y, Derraik J, McCowan L, Parry GK, Biggs JB, et al. Effects of antenatal exercise in overweight and obese pregnant women on maternal and perinatal outcomes: a randomised controlled trial. BJOG. 2015;123:588–597. doi: 10.1111/1471-0528.13738 26542419

34. Ruiz JR, Perales M, Pelaez M, Lopez C, Lucia A, Barakat R. Supervised exercise-based intervention to prevent excessive gestational weight gain: a randomized controlled trial. Mayo Clin Proc. 2013;88:1388–1397. doi: 10.1016/j.mayocp.2013.07.020 24290112

35. Barakat R, Pelaez M, Cordero Y, Perales M, Lopez C, Coteron J, et al. Exercise during pregnancy protects against hypertension and macrosomia: randomized clinical trial. Am J Obstet Gynecol. 2015;214:649.e1–8. doi: 10.1016/j.ajog.2015.11.039

36. Haakstad LA, Bø K. Effect of regular exercise on prevention of excessive weight gain in pregnancy: a randomised controlled trial. Eur J Contracept Reprod Health Care. 2011;16:116–125. doi: 10.3109/13625187.2011.560307 21417561

37. Thivel D, Aucouturier J, Metz L, Morio B, Duche P. Is there spontaneous energy expenditure compensation in response to intensive exercise in obese youth? Pediatr Obes. 2014;9:147–154. doi: 10.1111/j.2047-6310.2013.00148.x 23447495

38. Finlayson G, Bryant E, Blundell JE, King NA. Acute compensatory eating following exercise is associated with implicit hedonic wanting for food. Physiol Behav. 2009;97:62–67. doi: 10.1016/j.physbeh.2009.02.002 19419671

39. Muktabhant B, Lawrie TA, Lumbiganon P, Laopaiboon M. Diet or exercise, or both, for preventing excessive weight gain in pregnancy. Cochrane Database Syst Rev. 2015;6:CD007145. doi: 10.1002/14651858.CD007145.pub3 26068707

40. Oteng-Ntim E, Varma R, Croker H, Poston L, Doyle P. Lifestyle interventions for overweight and obese pregnant women to improve pregnancy outcome: systematic review and meta-analysis. BMC Med. 2012;10:47. doi: 10.1186/1741-7015-10-47 22574949

41. Bain E, Crane M, Tieu J, Han S, Crowther CA, Middleton P. Diet and exercise interventions for preventing gestational diabetes mellitus. Cochrane Database Syst Rev. 2015;4:CD010443. doi: 10.1002/14651858.CD010443.pub2 25864059

42. Nobles C, Marcus BH, Stanek EJ 3rd, Braun B, Whitcomb BW, Solomon CG, et al. Effect of an exercise intervention on gestational diabetes mellitus: a randomized controlled trial. Obstet Gynecol. 2015;125:1195–1204. doi: 10.1097/aog.0000000000000738 25932848

43. Simmons D. Prevention of gestational diabetes mellitus: where are we now? Diabetes Obes Metab. 2015;17:824–834. doi: 10.1111/dom.12495 25974384

44. HAPO Study Cooperative Research Group, Metzger BE, Lowe LP, Dyer AR, Trimble ER, Chaovarindr U, et al. Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008;358:1991–2002. doi: 10.1056/NEJMoa0707943 18463375

45. Sacks DA, Black MH, Li X, Montoro MN, Lawrence JM. Adverse pregnancy outcomes using the International Association of the Diabetes and Pregnancy Study Groups criteria: glycemic thresholds and associated risks. Obstet Gynecol. 2015;126:67–73. doi: 10.1097/aog.0000000000000865 26241258

46. Ruchat SM, Davenport MH, Giroux I, Hillier M, Batada A, Sopper MM, et al. Effect of exercise intensity and duration on capillary glucose responses in pregnant women at low and high risk for gestational diabetes. Diabetes Metab Res Rev. 2012;28:669–678. doi: 10.1002/dmrr.2324 22865627

47. Torloni MR, Betran AP, Horta BL, Nakamura MU, Atallah AN, Moron AF, et al. Prepregnancy BMI and the risk of gestational diabetes: a systematic review of the literature with meta-analysis. Obesity Rev. 2009;10:194–203. doi: 10.1111/j.1467-789X.2008.00541.x

48. Hernan MA, Hernandez-Diaz S. Beyond the intention-to-treat in comparative effectiveness research. Clin Trials. 2012;9:48–55. doi: 10.1177/1740774511420743 21948059

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