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Associations between maternal physical activity in early and late pregnancy and offspring birth size: remote federated individual level meta‐analysis from eight cohort studies

Lookup NU author(s): Dr Becca WilsonORCiD, Professor Paul BurtonORCiD



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Wiley, 2019.

For re-use rights please refer to the publisher's terms and conditions.


OBJECTIVE:Evidence on the impact of leisure time physical activity (LTPA) in pregnancy on birth size is inconsistent. We aimed to examine the association between LTPA during early and late pregnancy and newborn anthropometric outcomes.DESIGN:Individual level meta-analysis, which reduces heterogeneity across studies.SETTING:A consortium of eight population-based studies (seven European and one US) comprising 72,694 participants.METHODS:Generalised linear models with consistent inclusion of confounders (gestational age, sex, parity, maternal age, education, ethnicity, BMI, smoking and alcohol intake) were used to test associations between self-reported LTPA at either early (8-18 weeks gestation) or late pregnancy (30+ weeks) and the outcomes. Results were pooled using random effects meta-analyses.MAIN OUTCOME MEASURES:Birth weight, Large-for-gestational age (LGA), macrosomia, small-for-gestational age (SGA), %body fat and ponderal index at birth.RESULTS:Late, but not early, gestation maternal moderate-to-vigorous physical activity (MVPA), vigorous activity and LTPA energy expenditure were modestly inversely associated with BW, LGA, macrosomia and ponderal index, without heterogeneity (all: I-square=0%). For each extra hour/week of MVPA, RR for LGA and macrosomia were 0.97 (95% CI: 0.96, 0.98) and 0.96 (95%CI: 0.94, 0.98) respectively. Associations were only modestly reduced after additional adjustments for maternal BMI and gestational diabetes. No measure of LTPA was associated with risk for SGA.CONCLUSIONS:Physical activity in late, but not early, pregnancy is consistently associated with modestly lower risk of LGA and macrosomia, but not SGA.

Publication metadata

Author(s): Pastorino S, Bishop T, Crozier SR, Granström C, Kordas K, Küpers LK, O'Brien E, Polanska K, Sauder KA, Zafarmand MH, Wilson B, Agyemang C, Burton PR, Cooper C, Corpeleijn E, Dabelea D, Hanke W, Inskip HM, McAuliffe F, Olsen SF, Vrijkotte TG, Brage S, Kennedy A, O'Gorman D, Scherer P, Wijndaele K, Wareham NJ, Desoye G, Ong KK

Publication type: Article

Publication status: Published

Journal: BJOG: An International Journal of Obstetrics and Gynaecology

Year: 2019

Volume: 126

Issue: 4

Pages: 459-470

Print publication date: 01/03/2019

Online publication date: 19/09/2018

Acceptance date: 11/09/2018

Date deposited: 05/10/2018

ISSN (print): 1470-0328

ISSN (electronic): 1471-0528

Publisher: Wiley


DOI: 10.1111/1471-0528.15476

PubMed id: 30230190


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