Effects of maternal exercise type and metrics on maternal and infant body composition and blood biomarkers

Abstract

Obesity is a growing global health concern, particularly among reproductive-aged women, posing critical risks during pregnancy. Excess adiposity can lead to complications like gestational diabetes, hypertension, and preeclampsia, negatively impacting maternal and fetal health. Additionally, maternal obesity may have long-term consequences for both mother and child, highlighting the need for early intervention. A key metabolic concern in obese pregnancies is lipid and glucose dysregulation, which can affect fetal development. While cholesterol is essential for cellular functions, excess levels increase cardiovascular risks and oxidative stress. Elevated lactate levels suggest metabolic inflexibility, potentially leading to insulin resistance. During pregnancy, insulin resistance naturally progresses to support fetal glucose supply but is often amplified in obesity, increasing the risk of gestational diabetes. HOMA-IR assessments highlight these elevated risks. Body composition plays a crucial role in pregnancy outcomes, with greater muscle mass and lower fat levels enhancing insulin sensitivity and energy levels. Lifestyle interventions, particularly regular exercise, promote healthy body composition, optimize maternal health, and improve outcomes for mother and child. Exercise helps regulate lipid profiles, reduce lactate production, and enhance insulin sensitivity, mitigating obesity-related risks. Childhood obesity is closely linked to metabolic disorders like dyslipidemia and insulin resistance, increasing risks for cardiovascular disease and type 2 diabetes. These challenges often stem from early developmental influences, including maternal health and behaviors during pregnancy. Regular maternal exercise improves glucose regulation, reduces gestational diabetes risk, and supports healthier lipid profiles and insulin sensitivity in offspring. Exercise-induced metabolic improvements influence fetal epigenetics, shaping long-term resistance to obesity and cardiometabolic diseases. Emerging research highlights maternal exercise's role in reducing systemic inflammation and promoting optimal fetal growth, preventing early-life metabolic disorders. This research paper examines how maternal exercise during pregnancy influences infant body composition and metabolic biomarkers associated with obesity risk. Identifying early-life interventions is crucial given rising childhood obesity rates. This study explores how prenatal exercise affects infant adiposity and metabolic health, focusing on insulin sensitivity and lipid profiles. We hypothesize that prenatal exercise, particularly aerobic, will reduce infant adiposity and improve metabolic biomarkers compared to non-exercise-exposed infants. To address this gap, we recruited healthy females <16 weeks’ gestation, and randomized them to supervised moderate-intensity exercise (aerobic, resistance, or combination) or a control group, for the duration of their pregnancy. To investigate the impact of maternal exercise metrics on maternal and infant body composition we collected skinfold thicknesses, circumferences, and for maternal only, BodPod. To address the effects of maternal exercise metrics on maternal and infant blood biomarkers of obesity, we performed blood draw. In aim one of this dissertation, we show that various maternal FITT-V metrics were linked to specific maternal health outcomes. Higher weekly exercise volume correlated with lower body weight at 36 weeks, while longer exercise duration reduced adverse maternal blood biomarkers. Increased exercise frequency was associated with lower lactate levels and waist-to-hip ratio. These effects varied by exercise type, with aerobic exercise (AE) showing stronger associations than resistance exercise (RE) or combined aerobic and resistance exercise (AERE), particularly for lactate, insulin, and HOMA-IR. These findings emphasize the importance of individualized and structured exercise regimens during pregnancy, as specific combinations of frequency, intensity, and type of exercise can optimize maternal health outcomes. In aim two and three of the dissertation, we show that various maternal exercise metrics significantly influenced infant body composition and cholesterol levels, with aerobic and resistance exercises offering distinct benefits. These changes optimize the intrauterine environment, shaping fetal lipid metabolism and reducing the risk of high cholesterol and metabolic disorders. Aerobic exercise lowered non-HDL cholesterol and increased HDL cholesterol in 1-month-old infants, while resistance exercise reduced LDL cholesterol and had no change to HDL-cholesterol. Exercise frequency and duration were strongly associated with improved infant lipid profiles, mirroring adult studies linking consistent physical activity to better cardiovascular health. Higher exercise intensity correlated with lower infant BMI, while greater exercise volume was linked to increased infant length, suggesting prenatal exercise supports early growth and metabolic efficiency. Aerobic exercise showed the strongest associations with improved infant body composition and cholesterol levels, reinforcing its role in promoting long-term metabolic health. These results support the idea that maternal exercise FITT-V influences infant health in ways that mirror adult exercise research, emphasizing the importance of structured physical activity during pregnancy as a means of promoting optimal early-life health outcomes.