Exercise in the prevention and treatment of maternal–fetal disease: a review of the literature

Weissgerber, Tracey L.; Wolfe, Larry A.; Davies, Gregory A.L.; Mottola, Michelle F.

doi:10.1139/h06-060

Cited by 165Gestational Diabetes Research and ManagementPhysical Activity and HealthPregnancy and preeclampsia studies

Exercise in the prevention and treatment of maternal–fetal disease: a review of the literature

Weissgerber, Tracey L., Wolfe, Larry A., Davies, Gregory A.L., Mottola, Michelle F.·2006·Applied Physiology, Nutrition, and Metabolism

DOI 10.1139/h06-060

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Abstract

Evidence-based guidelines indicate that regular prenatal exercise is an important component of a healthy pregnancy. In addition to maintaining physical fitness, exercise may be beneficial in preventing or treating maternal–fetal diseases. Women who are the most physically active have the lowest prevalence of gestational diabetes (GDM), and prevention of GDM may decrease the incidence of obesity and type 2 diabetes in both mother and offspring. However, few studies have investigated the effectiveness of exercise in delaying or preventing GDM in at-risk women, and exercise prescriptions that optimize outcomes for women with GDM are lacking. Physically active women are also less likely to develop pre-eclampsia, and we have proposed the following 4 mechanisms that may explain this protective effect: enhanced placental growth and vascularity, reduced oxidative stress, reduced inflammation, and correction of disease-related endothelial dysfunction. Exercise may also prevent reproductive complications associated with maternal obesity. Obesity increases the risk of infertility and miscarriage, and weight loss programs that incorporate diet and exercise are a cost-effective fertility treatment that may also reduce the probability of obesity-related complications during pregnancy. Regular exercise following conception may prevent excessive gestational weight gain and reduce post-partum weight retention.

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Regular leisure physical activity appears to protect against prematurity, low birthweight, gestational diabetes and preeclampsia.
“Regular leisure physical activity appears to protect against prematurity, low birthweight, gestational diabetes and preeclampsia [20–24].”
From Lack of evidence for prescription of antepartum bed rest (2011) · cites this paper as [24]

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RESPIRATORY INSUFFICIENCY AND THE MORTALITY OF SEVERE HEAD INJURIES
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Maternal metabolism and obesity: modifiable determinants of pregnancy outcome
Nelson, S. M., Matthews, P., & Poston, L. (2009) · Human Reproduction Update · doi:10.1093/humupd/dmp050 · Cited by 367 · see citing works
Physical exercise as an epigenetic modulator of brain plasticity and cognition
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Physical activity in pregnancy: a qualitative study of the beliefs of overweight and obese pregnant women
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Molecular pathways disrupted by gestational diabetes mellitus.
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Repeated measures of urinary oxidative stress biomarkers during pregnancy and preterm birth
Ferguson, K. K., McElrath, T. F., Chen, Y., Loch-Caruso, R. K., Mukherjee, B., & Meeker, J. D. (2014) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2014.08.007 · Cited by 116 · see citing works
The Inter- and Intragenerational Impact of Gestational Diabetes on the Epidemic of Type 2 Diabetes
Osgood, N. D., Dyck, R. F., & Grassmann, W. K. (2010) · American Journal of Public Health · doi:10.2105/ajph.2009.186890 · Cited by 117 · see citing works
The Role of Physical Activity in Preconception, Pregnancy and Postpartum Health
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The Potential Impact of Physical Activity During Pregnancy on Maternal and Neonatal Outcomes
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Physical Activity in Pregnancy: Women's Perceptions, Practices, and Influencing Factors
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First trimester fasting hyperglycemia as a predictor for the development of gestational diabetes mellitus
Riskin‐Mashiah, S., Damti, A., Younes, G., & Auslender, R. (2010) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2010.05.036 · Cited by 105 · see citing works
Impact of Exercise Training on Preeclampsia
Genest, D. S., Falcao, S., Gutkowska, J., & Lavoie, J. L. (2012) · Hypertension · doi:10.1161/hypertensionaha.112.194050 · Cited by 107 · see citing works
Exercise Prescription for Overweight and Obese Women: Pregnancy and Postpartum
Mottola, M. F. (2009) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/j.ogc.2009.03.005 · Cited by 98 · see citing works
Self-citation
Exercise and physical activity in the prevention of pre‐eclampsia: systematic review
Kasawara, K. T., do Nascimento, S. L., Costa, M. L., Surita, F. G., & Silva, J. L. P. E. (2012) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/j.1600-0412.2012.01483.x · Cited by 98 · see citing works
Maternal over-nutrition and offspring obesity predisposition: targets for preventative interventions
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Dietary advice in pregnancy for preventing gestational diabetes mellitus
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Exercise during pregnancy mitigates Alzheimer‐like pathology in mouse offspring
Herring, A., Donath, A., Yarmolenko, M., Uslar, E., Conzen, C., Kanakis, D. N., Bosma, C., Worm, K., Paulus, W., & Keyvani, K. (2011) · The FASEB Journal · doi:10.1096/fj.11-193193 · Cited by 92 · see citing works
Why do pregnant women stop exercising in the third trimester?
Haakstad, L. A. H., Voldner, N., Henriksen, T., & Bø, K. (2009) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.3109/00016340903284901 · Cited by 91 · see citing works
Physical activity and brain development
Gomes da Silva, S., & Arida, R. M. (2015) · Expert Review of Neurotherapeutics · doi:10.1586/14737175.2015.1077115 · Cited by 89 · see citing works
Development and validation of exercise target heart rate zones for overweight and obese pregnant women
Davenport, M. H., Charlesworth, S. A., Vanderspank, D., Sopper, M. M., & Mottola, M. F. (2008) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/h08-086 · Cited by 87 · see citing works
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The important role of physical activity in the prevention and management of gestational diabetes mellitus
Ruchat, S.-M., & Mottola, M. F. (2013) · Diabetes/Metabolism Research and Reviews · doi:10.1002/dmrr.2402 · Cited by 85 · see citing works
Self-citation
Exercise in pregnancies complicated by obesity: achieving benefits and overcoming barriers
Seneviratne, S. N., McCowan, L. M. E., Cutfield, W. S., Derraik, J. G. B., & Hofman, P. L. (2014) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2014.06.009 · Cited by 86 · see citing works
Maternal Exercise during Pregnancy Increases BDNF Levels and Cell Numbers in the Hippocampal Formation but Not in the Cerebral Cortex of Adult Rat Offspring
da Silva, S. G., de Almeida, A. A., Fernandes, J., Lopim, G. M., Cabral, F. R., Amado, D., de Oliveira-Pinto, A. V., Lent, R., & Arida, R. M. (2016) · PLoS ONE · doi:10.1371/journal.pone.0147200 · Cited by 83 · see citing works
The Childhood Obesity Epidemic as a Result of Nongenetic Evolution: The Maternal Resources Hypothesis
Archer, E. (2014) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2014.08.006 · Cited by 78 · see citing works
Leisure-Time Physical Activity Patterns and Correlates Among Pregnant Women in Ontario, Canada
Gaston, A., & Vamos, C. A. (2012) · Maternal and Child Health Journal · doi:10.1007/s10995-012-1021-z · Cited by 75 · see citing works
Factors associated with women's perceptions of physical activity safety during pregnancy
Mudd, L. M., Nechuta, S., Pivarnik, J. M., & Paneth, N. (2009) · Preventive Medicine · doi:10.1016/j.ypmed.2009.06.004 · Cited by 74 · see citing works
Using a combined protection motivation theory and health action process approach intervention to promote exercise during pregnancy
Gaston, A., & Prapavessis, H. (2014) · Journal of behavioral medicine · doi:10.1007/s10865-012-9477-2 · Cited by 77 · see citing works
Exercise for the treatment and management of overweight women with polycystic ovary syndrome: a review of the literature
Thomson, R. L., Buckley, J. D., & Brinkworth, G. D. (2011) · Obesity Reviews · doi:10.1111/j.1467-789x.2010.00758.x · Cited by 70 · see citing works
Impacts of Diet and Exercise on Maternal Gut Microbiota Are Transferred to Offspring
Srinivasan, S. P. B., Raipuria, M., Bahari, H., Kaakoush, N. O., & Morris, M. J. (2018) · Frontiers in Endocrinology · doi:10.3389/fendo.2018.00716 · Cited by 70 · see citing works
Antenatal depression: a rationale for studying exercise
Shivakumar, G., Brandon, A. R., Snell, P. G., Santiago-Munoz, P. C., Johnson, N. L., Trivedi, M. H., & Freeman, M. P. (2010) · Depression and Anxiety · doi:10.1002/da.20777 · Cited by 68 · see citing works
Strategies to Promote Physical Activity During Pregnancy
Pearce, E., Evenson, K. R., Downs, D. S., & Steckler, A. (2012) · American Journal of Lifestyle Medicine · doi:10.1177/1559827612446416 · Cited by 62 · see citing works
The Effects of Exercise Conditioning in Normal and Overweight Pregnant Women on Blood Pressure and Heart Rate Variability
Stutzman, S. S., Brown, C., Hains, S. M. J., Godwin, M. S., Smith, G. N., Parlow, J. L., & Kisilevsky, B. S. (2010) · Biological Research For Nursing · doi:10.1177/1099800410375979 · Cited by 62 · see citing works
Maternal Inactivity: 45-Year Trends in Mothers’ Use of Time
Archer, E., Lavie, C. J., McDonald, S. M., Thomas, D. M., Hébert, J. R., Ross, S. E. T., McIver, K. L., Malina, R. M., & Blair, S. N. (2013) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2013.09.009 · Cited by 62 · see citing works
Fetal and maternal metabolic responses to exercise during pregnancy
Mottola, M. F., & Artal, R. (2016) · Early Human Development · doi:10.1016/j.earlhumdev.2016.01.008 · Cited by 62 · see citing works
Self-citation
Modification of angiogenic factors by regular and acute exercise during pregnancy
Weissgerber, T. L., Davies, G., & Roberts, J. M. (2010) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00008.2010 · Cited by 61 · see citing works
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Physical Activity and Preterm Birth: A Literature Review
Domingues, M. R., Matijasevich, A., & Barros, A. J. D. (2009) · Sports Medicine · doi:10.2165/11317900-000000000-00000 · Cited by 56 · see citing works
Lack of evidence for prescription of antepartum bed rest
Maloni, J. A. (2011) · Expert Review of Obstetrics & Gynecology · doi:10.1586/eog.11.28 · Cited by 53 · see citing works
“Exercise may also reduce pregnancy complications linked with maternal obesity [24].”
Background
Stages of Change Model for Participation in Physical Activity during Pregnancy
Haakstad, L. A. H., Voldner, N., & Bø, K. (2013) · Journal of Pregnancy · doi:10.1155/2013/193170 · Cited by 50 · see citing works
Maternal-fetal disease information as a source of exercise motivation during pregnancy.
Gaston, A., & Harry Prapavessis, A. (2009) · Health Psychology · doi:10.1037/a0016702 · Cited by 47 · see citing works
Exercise training can attenuate preeclampsia-like features in an animal model
Falcao, S., Bisotto, S., Michel, C., Lacasse, A., Vaillancourt, C., Gutkowska, J., & Lavoie, J. L. (2010) · Journal of Hypertension · doi:10.1097/hjh.0b013e32833e97d0 · Cited by 47 · see citing works
DNA damage and health in pregnancy
Furness, D., Dekker, G., & Roberts, C. T. (2011) · Journal of Reproductive Immunology · doi:10.1016/j.jri.2011.02.004 · Cited by 46 · see citing works
Exercise for Preventing Childhood Obesity
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Impact of an Exercise Intervention on Physical Activity During Pregnancy: The Behaviors Affecting Baby and You Study
Hawkins, M., Chasan‐Taber, L., Marcus, B. H., Stanek, E. J., Braun, B., Ciccolo, J., & Markenson, G. R. (2014) · American Journal of Public Health · doi:10.2105/ajph.2014.302072 · Cited by 43 · see citing works
Maternal and Perinatal Outcomes of Exercise in Pregnant Women with Chronic Hypertension and/or Previous Preeclampsia: A Randomized Controlled Trial
Kasawara, K. T., Burgos, C. S. G., do Nascimento, S. L., Ferreira, N. O., Surita, F. G., & Silva, J. L. P. E. (2013) · ISRN Obstetrics and Gynecology · doi:10.1155/2013/857047 · Cited by 43 · see citing works
Weight loss before conception: A systematic literature review
Forsum, E., Brantsæter, A. L., Ólafsdóttir, A. S., Olsen, S. F., & Þórsdóttir, I. (2013) · Food & Nutrition Research · doi:10.3402/fnr.v57i0.20522 · Cited by 40 · see citing works
Trends in Health-Related Behavioral Risk Factors Among Pregnant Women in the United States: 2001–2009
Zhao, G., Ford, E. S., Tsai, J., Li, C., Ahluwalia, I. B., Pearson, W. S., Balluz, L. S., & Croft, J. B. (2012) · Journal of Women's Health · doi:10.1089/jwh.2011.2931 · Cited by 41 · see citing works
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Reece, E. A. (2008) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767050801929885 · Cited by 40 · see citing works
Walking Program of Low or Vigorous Intensity During Pregnancy Confers an Aerobic Benefit
Ruchat, S.-M., Davenport, M. H., Giroux, I., Hillier, M., Batada, A., Sopper, M. M., Hammond, J.-A., & Mottola, M. F. (2012) · International Journal of Sports Medicine · doi:10.1055/s-0032-1304635 · Cited by 39 · see citing works
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Is intensive counseling in maternity care feasible and effective in promoting physical activity among women at risk for gestational diabetes? Secondary analysis of a cluster randomized NELLI study in Finland
Aittasalo, M., Raitanen, J. A., Kinnunen, T. I., Ojala, K., Kolu, P., & Luoto, R. M. (2012) · International Journal of Behavioral Nutrition and Physical Activity · doi:10.1186/1479-5868-9-104 · Cited by 41 · see citing works
Agreement between pedometer and accelerometer in measuring physical activity in overweight and obese pregnant women
Kinnunen, T. I., Tennant, P. W. G., McParlin, C., Poston, L., Robson, S. C., & Bell, R. (2011) · BMC Public Health · doi:10.1186/1471-2458-11-501 · Cited by 38 · see citing works
Epidemiological studies in Poland on effect of physical activity of pregnant women on the health of offspring and future generations - adaptation of the hypothesis development origin of health and diseases.
Wojtyła, A., Kapka‐Skrzypczak, L., Paprzycki, P., Skrzypczak, M., & Biliński, P. (2012) · PubMed · Cited by 38 · see citing works
Physical activity among women at reproductive age and during pregnancy (Youth Behavioural Polish Survey - YBPS and Pregnancy-related Assessment Monitoring Survay - PrAMS) - epidemiological population studies in Poland during the period 2010-2011.
Wojtyła, A., Kapka‐Skrzypczak, L., Biliński, P., & Paprzycki, P. (2011) · PubMed · Cited by 38 · see citing works
Preventing Long-Term Risk of Obesity for Two Generations: Prenatal Physical Activity Is Part of the Puzzle
Ruchat, S.-M., & Mottola, M. F. (2012) · Journal of Pregnancy · doi:10.1155/2012/470247 · Cited by 37 · see citing works
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Maternal exercise during pregnancy ameliorates the postnatal neuronal impairments induced by prenatal restraint stress in mice
Bustamante, C., Henríquez, R., Medina, F., Reinoso, C., Vargas-Foitzick, R., & Pascual, R. (2013) · International Journal of Developmental Neuroscience · doi:10.1016/j.ijdevneu.2013.02.007 · Cited by 35 · see citing works
The Beneficial Role of Exercise on Treating Alzheimer’s Disease by Inhibiting β-Amyloid Peptide
Tan, Z., Dong, F., Wu, L., Feng, Y.-S., & Zhang, F. (2021) · Molecular Neurobiology · doi:10.1007/s12035-021-02514-7 · Cited by 36 · see citing works
Influence of prenatal physical activity on the course of labour and delivery according to the new Polish standard for perinatal care.
Szumilewicz, A., Wojtyła, A., Zarębska, A., Drobnik-Kozakiewicz, I., Sawczyn, M., & Kwitniewska, A. (2013) · PubMed · Cited by 34 · see citing works
‘Gaining the right amount for my baby’: Young pregnant women’s discursive constructions of health
Harper, E. A., & Rail, G. (2012) · Health Sociology Review · doi:10.5172/hesr.2012.21.1.69 · Cited by 33 · see citing works
Validity and Repeatability of a Short Pregnancy Leisure Time Physical Activity Questionnaire
Aittasalo, M., Pasanen, M. E., Fogelholm, M., & Ojala, K. (2010) · Journal of Physical Activity and Health · doi:10.1123/jpah.7.1.109 · Cited by 30 · see citing works
Gestational diabetes in IVF and spontaneous pregnancies.
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Association of sedentary time and physical activity levels with immunometabolic markers in early pregnancy: The GESTAFIT project
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Leisure-Time Physical Activity in Pregnancy and the Birth Weight Distribution: Where Is the Effect?
Mudd, L. M., Pivarnik, J., Holzman, C., Paneth, N., Pfeiffer, K. A., & Chung, H. (2012) · Journal of Physical Activity and Health · doi:10.1123/jpah.9.8.1168 · Cited by 28 · see citing works
The Effect of the More Active MuMs in Stirling Trial on Body Composition and Psychological Well-Being among Postnatal Women
Lee, A. S., McInnes, R. J., Hughes, A. R., Guthrie, W., & Jepson, R. G. (2016) · Journal of Pregnancy · doi:10.1155/2016/4183648 · Cited by 27 · see citing works
Exercise frequency and maternal mental health: Parallel process modelling across the perinatal period in an Australian pregnancy cohort
Watson, S., Lewis, A. J., Boyce, P. M., & Galbally, M. (2018) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2018.05.013 · Cited by 24 · see citing works
Influence of prenatal exercise on the relationship between maternal overweight and obesity and select delivery outcomes
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Health Behaviours during Pregnancy in Women with Very Severe Obesity
Shukri, N. A. M., Duncan, A., Denison, F. C., Forbes, S., Walker, B. R., Norman, J. E., & Reynolds, R. M. (2015) · Nutrients · doi:10.3390/nu7105403 · Cited by 22 · see citing works
Maternal Heart Rate Variability and Fetal Behavior in Hypertensive and Normotensive Pregnancies
Brown, C., Lee, C., Hains, S. M. J., & Kisilevsky, B. S. (2008) · Biological Research For Nursing · doi:10.1177/1099800408322942 · Cited by 22 · see citing works
Influence of a Concurrent Exercise Training Program During Pregnancy on Colostrum and Mature Human Milk Inflammatory Markers: Findings From the GESTAFIT Project
Aparicio, V. A., Ocón, O. M., Díaz‐Castro, J., Acosta‐Manzano, P., Coll‐Risco, I., Borges‐Cosic, M., Romero‐Gallardo, L., Moreno‐Fernández, J., & Ochoa, J. J. (2018) · Journal of Human Lactation · doi:10.1177/0890334418759261 · Cited by 22 · see citing works
Reducing the Adverse Maternal and Fetal Outcomes in IVF Women by Exercise Interventions During Pregnancy
Charkamyani, F., Hosseinkhani, A., Samani, L. N., & Khedmat, L. (2019) · Research Quarterly for Exercise and Sport · doi:10.1080/02701367.2019.1639601 · Cited by 22 · see citing works
International Fitness Scale—IFIS: Validity and association with health‐related quality of life in pregnant women
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An ensemble-based stage-prediction machine learning approach for classifying fetal disease
Dash, D., & Kumar, M. (2024) · Healthcare Analytics · doi:10.1016/j.health.2024.100322 · Cited by 21 · see citing works
Exercise epigenetics is fueled by cell bioenergetics: Supporting role on brain plasticity and cognition
Gómez‐Pinilla, F., & Thapak, P. (2024) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2024.04.237 · Cited by 21 · see citing works
Circulating small extracellular vesicles increase after an acute bout of moderate-intensity exercise in pregnant compared to non-pregnant women
Mohammad, S., Hutchinson, K. A., da Silva, D. F., Bhattacharjee, J., McInnis, K., Burger, D. E., & Adamo, K. B. (2021) · Scientific Reports · doi:10.1038/s41598-021-92180-5 · Cited by 21 · see citing works
Moderate Exercise Attenuates Lipopolysaccharide-Induced Inflammation and Associated Maternal and Fetal Morbidities in Pregnant Rats
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Authors: Weissgerber, T. L., Wolfe, L. A., Davies, G. A. L., & Mottola, M. F.
Affiliations: Western University (CA)
ORCID: Weissgerber, Tracey L.
Mottola, Michelle F.
Venue: Applied Physiology, Nutrition, and Metabolism
Publisher: Canadian Science Publishing
Published: 2006-12
Volume: 31
Issue: 6
Pages: 661-674
ISSN: 1715-5312 (ISSN-L)
1715-5320
DOI: 10.1139/h06-060
OpenAlex: W2070081338
Cited by: 165
References: 106
Citations by year: 2025: 1 · 2024: 4 · 2023: 7 · 2022: 6 · 2021: 5 · 2020: 3 · 2019: 8 · 2018: 7 · 2017: 5 · 2016: 13 · 2015: 5 · 2014: 14 · 2013: 12 · 2012: 22
FWCI: 1.54
Type: journal article
Language: en
Open access: closed
Licence: www.nrcresearchpress.com/page/about/CorporateTextAndDataMining (tdm)
Locations: Applied Physiology, Nutrition, and Metabolism (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
Health Sciences › Medicine › Physiology › Physical Activity and Health
Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
Keywords: exercise during pregnancy, gestational diabetes mellitus, preeclampsia, maternal obesity, type 2 diabetes prevention, exercise prescription, placental development, oxidative stress, inflammation, endothelial dysfunction, infertility, miscarriage, gestational weight gain, postpartum weight retention
MeSH terms: Algorithms, Female, Humans, Hypertension, Obesity, Pre-Eclampsia, Pregnancy, Prenatal Care, Exercise, Randomized Controlled Trials as Topic, Diabetes, Gestational

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Exercise in the prevention and treatment of maternal–fetal disease: a review of the literature

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