Efficacy of a controlled exercise program in the prevention of excessive gestational weight gain in pregnant women: a randomized, controlled, open-label clinical trial

Abstract

Background: Excessive weight gain during pregnancy is associated with short-term obstetric outcomes (gestational diabetes, pregnancy-induced hypertension, increased risk of cesarean delivery, preterm labor, increased postpartum weight retention) and short-term neonatal outcomes (macrosomic or large-for-gestational-age infants) but few adequately powered randomized controlled trials have evaluated the efficacy of a controlled exercise program during pregnancy in order to prevent that. Objective: This study examines whether a controlled exercise program during pregnancy could decrease the proportion of women who exceed the Institute of Medicine (IOM) recommendations for gestational weight gains and, therefore, the consequences arising from that, and increase the proportion of women who return to pregravid weights by 6 months post-partum compared to those that just attend to standard care and receive general counseling. Methods and study design: This study is a randomized, controlled, open-label clinical trial. A sample of 338 pregnant women will enter into the study through a non-probabilistic consecutive recruitment. Participants will be pregnant, normal-weight, overweight and obese women whose age will be between 18 and 40 years. Participants will be randomly assigned within the IOM weight category (normal-weight, overweight or obese) to standard care (n=169) or to the controlled exercise program (n=169) to prevent excessive gestational weight gain. The intervention includes 2 weekly sessions: one on land (gym hall) and one as an aquatic based activity (small pool tank). Apart from that, women can go for a fast walking on flat surface during 30 minutes the rest of the week that will have to be documented to the research team. The women’s weight will be measured at the 6th month after delivery