Influence of Maternal Exercise on Infant Skeletal Muscle and Metabolomics
Condition: Exercise
Study type: Interventional

Summary: 
      The American Heart Association suggests that heart disease prevention should target pregnancy
      and the first year of life; however, there is a fundamental gap in knowledge regarding the
      effects of prenatal exercise on the prevention of heart disease.[1, 2] Insulin resistance in
      skeletal muscle is believed to be a critical contributor to the metabolic syndrome which
      increases the risk for cardiovascular disease (CVD). Conversely, exercise improves insulin
      sensitivity and many other facets of skeletal muscle function and metabolism; however, it is
      unclear if this positive effect can be "imprinted" in the skeletal muscle of the fetus with
      maternal exercise and accordingly diminish CVD risk in offspring. Our previous studies found
      that exercise during pregnancy leads to improved heart measures and reduced adiposity.[3-6]
      These studies demonstrated the potential for maternal exercise to reduce risk for CVD, but
      the cellular mechanisms involved, however, are not clearly evident. The proposed project will
      fill this critical gap and assess the influence of maternal exercise intervention to
      "imprint" progenitor stem cells in the fetus (umbilical cord tissue) to develop into insulin
      sensitive skeletal muscle and also improve indices of infant morphometry and movement. Using
      a randomized design, 160 women will perform either exercise intervention (aerobic training,
      resistance training, or both) or usual care (controls). Infant cord tissue and blood will be
      sampled at birth while blood will be sampled at 1 month of age. Similarly, infant neuromotor
      and morphometric examinations will be performed at 1 month. and at 1-month of age via blood
      sample, neuromotor, and morphometric examinations. The rationale for the project is to
      elucidate the effects of maternal exercise on offspring health outcomes and determine
      specific metabolic targets predictive of offspring long-term disease risk. The investigators
      will test the central hypothesis that exercise during pregnancy alters skeletal muscle in a
      manner which decreases the risk of heart disease in offspring. To test this central
      hypothesis, the investigators will pursue two specific aims: Aim 1- Determine the ability of
      regular maternal exercise to imprint key myocellular metabolic (insulin sensitivity)
      properties of offspring mesenchymal stem cells (MSC), neuromotor function, and morphometry.
      Aim 2- Determine the distinct abilities of regular maternal exercise to imprint the
      metabolome of offspring MSC.
    

Detailed description: 
      Is offspring skeletal muscle function and metabolism imprinted by regular maternal exercise?
      What offspring metabolome markers are altered with regular maternal exercise? The
      investigators will use a randomized design of 160 women to either exercise intervention
      (aerobic training, resistance training, or both) or usual care (controls). Infant cord tissue
      and blood will be sampled at birth while blood will be sampled at 1 month of age. Similarly,
      infant neuromotor and morphometric examinations will be performed at 1 month. and at 1-month
      of age via blood sample, neuromotor, and morphometric examinations. The rationale for the
      project is to elucidate the effects of maternal exercise on offspring health outcomes and
      determine specific metabolic targets predictive of offspring long-term disease risk.
    

Intervention name(s): Types of Exercise
Intervention type(s): Behavioral
Intervention description(s): moderate intensity exercise
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: comparing 3 exercise interventions to a control (non-exercise) group
Masking: Double (Care Provider, Investigator)
Primary purpose: Prevention