Objective To evaluate the association between physical exercise during pregnancy and maternal gestational weight gain and fetal cardiac function. Methods This was a randomized controlled trial of women with a singleton pregnancy managed from the first trimester at the Hospital de Torrejón, Madrid, between November 2014 and June 2015. Women were randomized to either follow a supervised physical conditioning program, consisting of a 60‐min session 3 days per week for the duration of pregnancy, or not attend any exercise program (controls). The primary outcome was maternal weight gain during pregnancy. Secondary outcomes included fetal cardiac function parameters evaluated at 20, 28 and 36 weeks' gestation, Cesarean section, preterm delivery, induction of labor and birth weight. A sample size of 45 in each group was planned to detect differences in maternal weight gain of at least 1 kg, with a power of > 80% and α of 0.05. Results During the study period, 120 women were randomized into the exercise (n = 75) and control (n = 45) groups. Following exclusions, the final cohort consisted of 42 women in the exercise group and 43 in the control group. Baseline characteristics (maternal age, prepregnancy body mass index, parity, conception by in‐vitro fertilization, Caucasian ethnicity, physical exercise prior to pregnancy and smoker) were similar between the two groups. No differences were found between the groups in maternal weight at 20, 28, 36 and 38 weeks' gestation or in weight gain at 38 weeks. However, the proportion of women with weight loss ≥ 9 kg at 6 weeks postpartum was higher in the exercise compared with the control group (68.2% vs 42.8%; relative risk 1.593; P = 0.02). The ductus arteriosus pulsatility index (DA‐PI) at 20 weeks (2.43 ± 0.40 vs 2.26 ± 0.33, P < 0.05) and the ejection fraction (EF) at 36 weeks (0.85 ± 0.13 vs 0.81 ± 0.11, P < 0.05) were higher in the exercise compared with the control group. All other evaluated fetal cardiac function parameters were similar between the two groups. Conclusions Performing exercise during pregnancy is not associated with a reduction in maternal weight gain but increases weight loss at 6 weeks postpartum. Physical exercise during pregnancy is associated with increased fetal DA‐PI at 20 weeks and EF at 36 weeks, which could reflect adaptive mechanisms. Copyright © 2018 ISUOG. Published by John Wiley & Sons Ltd.

Objective: to analyse maternal physiological changes in several areas (cardiovascular, metabolic, renal and hepatic) related to the regular practice of a supervised exercise program. Methods: This is an unplanned secondary analysis from a randomized controlled trial carried out in a single maternity unit in Madrid, Spain (NCT 02,756,143). From November 2014 to June 2015, 92 women were randomly assigned to perform a mild-moderate supervised exercise program during pregnancy (Intervention group, IG) or to continue with their routine pregnancy care (control group, CG). For the purpose of this study we collected clinical and analytical data (heart blood pressure, weight, blood glucose, AST, ALT, blood Creatinine and blood Uric acid) available from all obstetric visits and examined the differences between groups. Results: We did not find any differences in: pregnancy weight (IG: 11.4 ± 4.4 Kg vs. CG: 10.1 ± 5.3 Kg; p = 0.173); fasting glucose at 10 +0 -12 +6 weeks (IG: 78.48±8.34 vs. CG: 76±13.26, p = 0.305) or at 34 +0 -36 +4 weeks (IG: 73.25±10.27 vs CG: 73.45± 8.29,p = 0.920), and 50 gs glucose tolerance at 24 +4 -26 +6 weeks (IG: 116.23±35.07 vs CG: 116.36±25.98, p = 0.984); Aspartate-amino-transferase at 10 +0 -12 +6 weeks (IG: 15.38±4.17 vs CG: 17.33±7.05, p = 0.124) and at 34 +0 -36 +4 weeks (IG: 21.65±5.25 vs CG: 19.53±8.32, p = 0.165) or Alanine-amino-transferase at 10 +0 -12 +6 weeks (IG: 27.50±10.63 vs CG: 28.27±11.77, p = 0.746) or at 34 +0 -36 +4 weeks (IG: 22.93±9.23 vs CG: 20.84±13.49, p = 0.407); blood Creatinine concentrations at 34 +0 -36 +4 weeks (IG: 0.595±0.401 vs CG: 0.575±0.100, p = 0.757) and blood uric acid concentrations at 34 +0 -36 +4 weeks (IG: 3.526 ± 0.787 vs CG: 3.262±0.672, p = 0.218). Heart blood pressure was similar between groups except at 27 +0 -28 +6 weeks, where systolic blood pressure was significantly lower in the CG in comparison to the IG (116.31±10.8 mmHg vs. 120.22 ± 10.3 mmHg, p = 0.010). Conclusion: Regular supervised exercise during pregnancy does not alter normal maternal physiology.

and body mass index, previous prenatal depression (Center of Epidemiological Studies Depression scale), ethnicity, parity, in vitro fertilization pregnancy, smoking, level of studies and prepregnancy physical exercise.As shown in Table 1, the only factor that was predictive of compliance > 83% in both univariate and multivariate analyses was university studies (OR 3.0, 95% CI 1.0-9.2, P = .055).Our findings indicate that having university studies before pregnancy increases the likelihood of better compliance with a supervised exercise program during pregnancy.One study analyzing these factors in the general population, concluded that women with postsecondary education, no children, nonsmokers, and who were also engaged in regular recreational activity, were more likely to have a regular supervised exercise program during pregnancy. 5 All of these factors are associated with the mother's education level. Also, our study shows that maternal education is a predictive factor for compliance to the program, among highly motivated women participating in a randomized controlled trial. However, neither smoking nor practicing exercise previous to actual pregnancy predicted compliance.In conclusion, maternal education in a highly motivated population is crucial for a better compliance to an exercise program during pregnancy. Implementing strategies for improving compliance to an exercise program in a less educated pregnant population would improve exercising during pregnancy. Learning about compliance factors as well as improving healthcare staff knowledge on exercise during pregnancy, and facilitating exercise programs, could help to improve the health of the pregnant population.

suggest that the right dominance during fetal life is only due to higher blood volume shunted to the right cardiac side. Objectives: To assess the fetal cardiac function associated with exercise during pregnancy. Methods: A randomised controlled trial with sequential recruitment. Inclusion criteria: (I) (I) having no obstetric or medical complications (based on the American college of obstetricians and gynecologists guidelines (ACOG); (II) time of pregnancy <16 weeks; (III) not exercising regularly for more than 30 min (3 d per week−1); (IV) able to communicate in Spanish. Groups of study: Exercise Group (EG), attending to a regular supervised exercise program throughout the pregnancy, and Control Group (CG) advised not to attend to any exercise program during pregnancy. The EG trained 3 d/wk (50-55 min/session) from 11 to 38 weeks. Obstetric Ultrasound was performed at 20, 28 and 36 weeks, including a specific fetal echocardiography. The scans were performed by three blinded researchers. OP02.08Primary outcomes: MPI, TAPSE, MAPSE, Tricuspid and Mitral E/A ratios.Secondary outcomes: Aortic Artery Velocity, Pulmonary Artery Velocity, Ductus Arteriosus PI, Aortic Arch PI. Results: 121 women were recruited and randomised. Groups of study EG (N = 64) and CG (N = 49). Regarding parity, maternal age, pre pregnancy BMI, smoking, physical activity before pregnancy and gestational age at delivery, both groups were homogeneous.MPI at 20, 28 and 36 weeks of gestation were similar in both groups. However, when comparing Mitral E/A Ratio at 28 weeks, EG group showed lower Mitral E/A Ratios compared to CG (0.679 ± 0.092 vs. 0.691 ± 0.069, p = 0.047). Ductus Arteriosus PI was higher in the EG vs CG (2.40 ± 0.36 vs. 2.25 ± 0.33, p = 0.037). Conclusions: Practicing regular exercise during pregnancy, does not negatively affect the fetal cardiac function. However, there seem to be an adaptation in the Ductus Arteriosus (DA) tone, increasing the DA PI at 20 weeks.