Physical Activity in Pregnancy

Study Overview
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Brief Summary
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This prospective observational study assesses whether women who regularly exercise during pregnancy show reduced low grade Inflammation, compared to women who are not regularly exercising. Furthermore, the effects of regular physical activity in pregnancy on fetal and neonatal outcomes will be investigated. 3 groups of pregnant women will be formed (group 1: regularly physically active women; group 2: physically inactive women and group 3: women with a history of preeclampsia or positive history of metabolic conditions increasing the risk of hypertensive disorders in pregnancy).

Detailed Description
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Pregnancy is a natural state of low grade inflammation in the mother and the feto-placental unit. The severity of this inflammation increases with higher pregravid Body Mass Index (BMI). This is reflected by an increase in pro-inflammatory cytokines in the maternal circulation and in the placenta. It has been proposed that the pro-inflammatory maternal and fetal environment plays a role in mediating pregnancy outcomes. In non-pregnant individuals regular physical activity is associated with a reduced inflammatory state. The overall objective of the study is to investigate the interaction of maternal physical activity and pregnancy induced low-grade inflammation in the mother and feto-placental unit, and to assess th resulting effects on prenatal and postnatal development. Specific research objective will be to study effects of maternal physical activity on: low grade Inflammation in the mother an feto-placental unit; maternal and fetal lipid profiles, including High Density Lipoprotein (HDL) proteome; fetal growth and infant body composition; transcriptomic and epigenetic profile in the placenta; biomarkers of nutritive status; psychological assessment: cardiac awareness; assessment of arterial stiffness; stress-coping questionaire

Official Title
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Effect of Physical Activity in Pregnancy on Low Grade Inflammation: a Pilot Study

Conditions
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Pregnancy, Physical Activity

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ongoing pregnancy no later than 14 weeks of gestation giving informed consent Exclusion Criteria: not wanting to give birth at the University Hospital gestational age > 14 weeks of gestation 3 or more consecutive miscarriages increased risk to or above 1:200 after combined test (Minimum parameters: maternal age, fetal crown-rump length (CRL), nuchal translucency, nasal bone and maternal biochemistry) fetal anomalies associated with possible growth or genetic anomalies Smoking diagnosed with Diabetes type 1 or 2 (T1D, T2D) for groups 1 and 2: maternal metabolic risk factors (autoimmune conditions, increased risk for thromboembolic events needing anticoagulative therapy) for groups 1 and 2: pre-pregnancy hypertension

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active<br>pregnant women who are physically active (spend a minimum of 150min/week with moderate to vigorous physical activity) | |
| Inactive<br>pregnant women who are physically inactive (spend less than 150min/week with moderate to vigorous physical activity) | |
| risk for hypertensive disorders<br>pregnant women with a history of preeclampsia or positive history for metabolic conditions increasing the risk of hypertensive disorders in pregnancy | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| low grade inflammation (in maternal and cord blood) | clinical inflammation markers: C-reactive protein, cytokines and chemokine (IL1b, IL1a, IL-2, IL-5, IL-6,IL-12, TNFa, MCP-1, MIP1-a) measured by ELISA and multiplexing arrays | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| maternal and fetal (cord blood) lipid profiles | triglycerides, phospholipids, free fatty acids, HDL/LDL/total cholesterol | 1 year | 
| neonatal body composition (% body fat) | measured by air displacement plethysmography (Peapod) | 1 year | 
| maternal and newborn fat distribution | subcutaneous adipose tissue thickness at 15 defined body sites, measured by a lipometer | 1 year | 
| fetal growth | measured by ultrasound scanner | 1 year | 
| transcriptome of the placenta | measured by full genome arrays | 2 years | 
| epigenetic analysis of the placenta | analysed by 450k methylation arrays | 2 years | 
| biomarkers of nutritional status | measurement of blood levels of fatty acids (DHA, EPA, 15:0, 17:0), vitamin A, B1, B2, B6, D2/D3, C, E, homocysteine | 2 years | 
| psychological assessment | assessment of arterial stiffness, stress coping questionnaire, cardiac awareness | 1 year |