Associations between maternal physical activity in early and late pregnancy and offspring birth size: remote federated individual level meta‐analysis from eight cohort studies

Objective Evidence on the impact of leisure time physical activity (LTPA) in pregnancy on birth size is inconsistent. We aimed to examine the association between LTPA during early and late pregnancy and newborn anthropometric outcomes. Design Individual level meta‐analysis, which reduces heterogenei...

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Published in:	BJOG : an international journal of obstetrics and gynaecology Vol. 126; no. 4; pp. 459 - 470
Main Authors:	Pastorino, S, Bishop, T, Crozier, SR, Granström, C, Kordas, K, Küpers, LK, O'Brien, EC, Polanska, K, Sauder, KA, Zafarmand, MH, Wilson, RC, Agyemang, C, Burton, PR, Cooper, C, Corpeleijn, E, Dabelea, D, Hanke, W, Inskip, HM, McAuliffe, FM, Olsen, SF, Vrijkotte, TG, Brage, S, Kennedy, A, O'Gorman, D, Scherer, P, Wijndaele, K, Wareham, NJ, Desoye, G, Ong, KK
Format:	Journal Article
Language:	English
Published:	England Wiley Subscription Services, Inc 01-03-2019 John Wiley and Sons Inc
Subjects:	Adipose Tissue Adult Age Alcoholic beverages Birth Weight Body fat Cohort analysis Cohort Studies Diabetes mellitus Diabetes, Gestational - epidemiology Energy expenditure Energy Metabolism Epidemiology Exercise Female Fetal Macrosomia - epidemiology Gestational age Gestational diabetes Health risk assessment Humans Infant, Newborn Infant, Small for Gestational Age large‐for‐gestational age Linear Models macrosomia Meta-analysis Minority & ethnic groups Obesity - epidemiology Overweight - epidemiology Physical activity Ponderal index Population studies Pregnancy Pregnancy Complications - epidemiology Pregnancy Trimester, First Pregnancy Trimester, Second Pregnancy Trimester, Third Protective Factors Risk Factors Small for gestational age Smoking Young Adult small-for-gestational age Birth weight large-for-gestational age macrosomia pregnancy physical activity
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Summary:	Objective Evidence on the impact of leisure time physical activity (LTPA) in pregnancy on birth size is inconsistent. We aimed to examine the association between LTPA during early and late pregnancy and newborn anthropometric outcomes. Design Individual level meta‐analysis, which reduces heterogeneity across studies. Setting A consortium of eight population‐based studies (seven European and one US) comprising 72 694 participants. Methods Generalised linear models with consistent inclusion of confounders (gestational age, sex, parity, maternal age, education, ethnicity, BMI, smoking, and alcohol intake) were used to test associations between self‐reported LTPA at either early (8–18 weeks gestation) or late pregnancy (30+ weeks) and the outcomes. Results were pooled using random effects meta‐analyses. Main outcome measures Birth weight, large‐for‐gestational age (LGA), macrosomia, small‐for‐gestational age (SGA), % body fat, and ponderal index at birth. Results Late, but not early, gestation maternal moderate to vigorous physical activity (MVPA), vigorous activity, and LTPA energy expenditure were modestly inversely associated with BW, LGA, macrosomia, and ponderal index, without heterogeneity (all: I2 = 0%). For each extra hour/week of MVPA, RR for LGA and macrosomia were 0.97 (95% CI: 0.96, 0.98) and 0.96 (95% CI: 0.94, 0.98), respectively. Associations were only modestly reduced after additional adjustments for maternal BMI and gestational diabetes. No measure of LTPA was associated with risk for SGA. Conclusions Physical activity in late, but not early, pregnancy is consistently associated with modestly lower risk of LGA and macrosomia, but not SGA. Tweetable In an individual participant meta‐analysis, late pregnancy moderate to vigorous physical activity modestly reduced birth size outcomes. Tweetable In an individual participant meta‐analysis, late pregnancy moderate to vigorous physical activity modestly reduced birth size outcomes.
Bibliography:	https://doi.org/10.1111/1471-0528.15542 Linked article This article is commented on by CA Venetis, p.471 in this issue. To view this mini commentary visit . The copyright line for this article was changed on 22 August 2019 after original online publication. Equal contributions. Linked article This article is commented on by CA Venetis, p.471 in this issue. To view this mini commentary visit https://doi.org/10.1111/1471-0528.15542.
ISSN:	1470-0328 1471-0528
DOI:	10.1111/1471-0528.15476