## 4 Discussion  
### Effect of Pilates on Body Compositions and Lipid Profiles  
In general, as the number of weeks of pregnancy increases, most mothers have an imbalance in body fat and blood lipid metabolism, which can lead to hyperlipidemia and ischemic heart disease in the mother, so continuous management is required during pregnancy. In addition, sudden weight gain after pregnancy causes gestational hypertension and diabetes and negatively affects the microbial \begin{table}
\begin{tabular}{c c c c c c c c} \hline \hline  & \multicolumn{3}{c}{**Pilates (\(n=9\))**} & \multicolumn{3}{c}{**CON (\(u=7\))**} & \multicolumn{3}{c}{**Diff (Post – Pre)**} \\ \cline{2-7}  & **Pre** & **Post** & **Pre** & **Post** & **\(z\)** & **\(p\)** & **Cohen’s \(r\)** \\ \hline CK (U/L) & 34.78 \(\pm\) 8.66 & 42.22 \(\pm\) 13.15 & 39.57 \(\pm\) 16.06 & 59.43 \(\pm\) 27.72 ** & \(-\)1.700 & 0.089 & 0.425 \\ LDH (U/L) ** & 159.00 \(\pm\) 15.67 & 159.78 \(\pm\) 15.09 & 162.29 \(\pm\) 21.40 & 186.57 \(\pm\) 26.79 ** & \(-\)2.603 & 0.009 & 0.651 \\ AST (U/L) * & 20.22 \(\pm\) 6.32 & 17.78 \(\pm\) 5.02 & 14.71 \(\pm\) 4.11 & 16.29 \(\pm\) 4.03 * & \(-\)2.566 & 0.010 & 0.642 \\ CRF (mg/l) & 0.25 \(\pm\) 0.20 & 0.24 \(\pm\) 0.23 & 0.10 \(\pm\) 0.07 & 0.10 \(\pm\) 0.06 & \(-\)1.230 & 0.219 & 0.308 \\ \hline Values are means \(\pm\) SD. Main time effect: * \(p<0.05\) and ** \(p<0.01\) pre- versus post-Plates period in the between groups. CK: creatine kinase, LDH: lactate dehydrogenase, AST: aspartate aminotransferase, CRP: C-reactive protein. * \(p<0.05\) from pre and post. * \(p<0.05\), ** \(p<0.01\) change (post – pre) between groups. Diff (post – pre): difference change from pre to post between groups. Values are presented as mean \(\pm\) SD. & \\ \hline \hline \end{tabular}
\end{table} 
Table 4: Muscle damage and inflammation marker. Figure 2: Effect of Pilates exercise on cortisol hormone level, bars represent mean \(\pm\) SD (PE: n = 9, CON: 7, per group). * \(p<0.05\) from Pre to Post. PE: Pilates exercise group, CON: control group. environment in the intestine, leading to postpartum obesity [25; 37]. Gestational edema, another characteristic that pregnant women experience, not only causes discomfort and pain but also decreases the growth of the fetus in the uterus and is deeply related to gestational hypertension [38]. In general, body hydration increases as the number of gestational weeks increases, and in particular, an increase in ECW causes edema [39]. The ACOG [40] reported an increase in ECW during pregnancy and that ECW and the ECW/ICW ratio are significantly higher in pregnant women with pre-eclampsia. Similarly, in this study, both groups significantly increased post TBW, ICW, and ECW compared to the standard values, while the ECW/ICW ratio decreased significantly only in the PE group. Interestingly, the difference between TBW and ICW changes in the PE group was found to have increased over that in the CON group, while the ECW/ICW ratio was significantly reduced. These results may be thought to be partially mitigated by the increased rate of ECW that occurs during pregnancy and have shown some consistent results, with prior studies reporting a decrease in edema through Pilates exercise in cancer patients [41]. Moreover, the finding that Pilates exercise led to partial decreases in the ECW/ICW ratio, which increases in pre-eclampsia, suggests that Pilates exercise could be effective in relieving not only edema but also edema-induced gestational hypertension. On the other hand, since the increase in ICW shows a positive correlation with muscle mass [42], as a result of checking the SMM in this study, it was found that all groups significantly increased muscle mass after exercise compared to before (CON group: SMM: \(z=-2.371\), \(p=0.018\), PE group: SMM: \(z=-2.670\), \(p=0.008\); Table 2), which is thought to be due to the increase in SMM as part of the weight gain.