Effects of Structured Supervised Exercise Training or Motivational Counseling on Pregnant Women's Physical Activity Level: FitMum - Randomized Controlled Trial

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Background: Physical activity (PA) during pregnancy is an effective and safe way to improve maternal health in uncomplicated pregnancies. However, compliance with PA recommendations remains low among pregnant women. Objective: The purpose of this study was to evaluate the effects of offering structured supervised exercise training (EXE) or motivational counseling on PA (MOT) during pregnancy on moderate-to-vigorous intensity physical activity (MVPA) level. Additionally, complementary measures of PA using the Pregnancy Physical Activity Questionnaire (PPAQ) and gold standard doubly labeled water (DLW) technique were investigated. The hypotheses were that both EXE and MOT would increase MVPA in pregnancy compared with standard care (CON) and that EXE would be more effective than MOT. In addition, the association between MVPA and the number of sessions attended was explored. Methods: A randomized controlled trial included 220 healthy, inactive pregnant women with a median gestational age of 12.9 (IQR 9.4-13.9) weeks. A total of 219 women were randomized to CON (45/219), EXE (87/219), or MOT (87/219). The primary outcome was MVPA (minutes per week) from randomization to the 29th gestational week obtained by a wrist-worn commercial activity tracker (Vivosport, Garmin International). PA was measured by the activity tracker throughout pregnancy, PPAQ, and DLW. The primary outcome analysis was performed as an analysis of covariance model adjusting for baseline PA. Results: The average MVPA (minutes per week) from randomization to the 29th gestational week was 33 (95% CI 18 to 47) in CON, 50 (95% CI 39 to 60) in EXE, and 40 (95% CI 30 to 51) in MOT. When adjusted for baseline MVPA, participants in EXE performed 20 (95% CI 4 to 36) minutes per week more MVPA than participants in CON (P=.02). MOT was not more effective than CON; EXE and MOT also did not differ. MVPA was positively associated with the number of exercise sessions attended in EXE from randomization to delivery (P=.04). Attendance was higher for online (due to COVID-19 restrictions) compared with physical exercise training (P=.03). Adverse events and serious adverse events did not differ between groups. Conclusions: Offering EXE was more effective than CON to increase MVPA among pregnant women, whereas offering MOT was not. MVPA in the intervention groups did not reach the recommended level in pregnancy. Changing the intervention to online due to COVID-19 restrictions did not affect MVPA level but increased exercise participation.

TidsskriftJournal of Medical Internet Research
Udgave nummer7
Sider (fra-til)1-13
StatusUdgivet - 1 jul. 2022

Bibliografisk note

Funding Information:
The authors would like to acknowledge all the women who participated in FitMum. Our thanks go to students, research assistants, and staff at the Department of Gynecology and Obstetrics, Copenhagen University Hospital–North Zealand, who took part in performing interventions and collecting data. Additionally, we would like to thank the technical staff at the Clinical Research Unit, Department of Clinical Research, Copenhagen University Hospital–North Zealand, especially Susanne Månsson and Charlotte Pietraszek, who engaged themselves in planning practicalities and collecting data. FitMum was funded by grant 8020-00353B from the Independent Research Fund Denmark, grant 128509 from TrygFonden, grant 061017 from the Copenhagen Center for Health Technology, grant 17-2-0883 from Beckett-Fonden, grant 10-002052 from the Aase and Ejnar Danielsens Fond, and grant 2017-1142 from the Familien Hede Nielsens Fond. In addition, funding was provided by the University of Copenhagen and Copenhagen University Hospital–North Zealand.

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