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

S. Pastorino; T. Bishop; S. R. Crozier; C. Granström; K. Kordas; L. K. Küpers; E. C. O'Brien; K. Polanska; K. A. Sauder; M. H. Zafarmand; R. C. Wilson; C. Agyemang; P. R. Burton; C. Cooper; E. Corpeleijn; D. Dabelea; W. Hanke; H. M. Inskip; F. M. McAuliffe; S. F. Olsen; T. G. Vrijkotte; S. Brage; A. Kennedy; D. O'Gorman; P. Scherer; K. Wijndaele; N. J. Wareham; G. Desoye; K. K. Ong

doi:10.1111/1471-0528.15476

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

S. Pastorino^*, T. Bishop, S. R. Crozier, C. Granström, K. Kordas, L. K. Küpers, E. C. O'Brien, K. Polanska, K. A. Sauder, M. H. Zafarmand, R. C. Wilson, C. Agyemang, P. R. Burton, C. Cooper, E. Corpeleijn, D. Dabelea, W. Hanke, H. M. Inskip, F. M. McAuliffe, S. F. OlsenT. G. Vrijkotte, S. Brage, A. Kennedy, D. O'Gorman, P. Scherer, K. Wijndaele, N. J. Wareham, G. Desoye, K. K. Ong

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

62 Citationer (Scopus)

11 Downloads (Pure)

Abstract

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 ² = 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. Tweetable abstract: In an individual participant meta-analysis, late pregnancy moderate to vigorous physical activity modestly reduced birth size outcomes.

Originalsprog	Engelsk
Tidsskrift	BJOG: An International Journal of Obstetrics and Gynaecology
Vol/bind	126
Udgave nummer	4
Sider (fra-til)	459-470
Antal sider	12
ISSN	1470-0328
DOI	https://doi.org/10.1111/1471-0528.15476
Status	Udgivet - 2019
Udgivet eksternt	Ja

Bibliografisk note

Funding Information:
InterConnect: the research leading to these results received funding from the European Union Seventh Framework Programme (FP7/2007?2013) under grant agreement no. 602068. Amsterdam Born Children and their Development study (ABCD): the ABCD study was supported by grants from the Netherlands Organization for Health Research and Development (ZonMW) and The Netherlands Heart Foundation. Genotyping was funded by the BBMRI-NL grant CP2013-50. M.H. Zafarmand was supported by BBMRI-NL (CP2013-50). T.G.M. Vrijkotte was supported by ZonMW (TOP 40?00812?98?11010). Avon Longitudinal Study of Parents and Children (ALSPAC): we are grateful to all the families who took part in this study, the midwives for their help in recruiting them, and the Avon Longitudinal Study of Parents and Children (ALSPAC) team, including interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses. The UK Medical Research Council and Wellcome (grant ref: 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. Danish National Birth Cohort (DNBC, Denmark): the Danish National Research Foundation has established the Danish Epidemiology of Science Centre that initiated and created the DNBC. The cohort is furthermore a result of a major grant from this foundation. Additional support for the DNBC is obtained from the Pharmacy Foundation, the Egmont Foundation, the March of Dimes Birth Defect Foundation, the Augustinus Foundation, and the Health Foundation. Groningen Expert Center for Kids with Obesity (GECKO)-Drenthe: the GECKO Drenthe birth cohort was funded by an unrestricted grant of Hutchison Whampoa Ltd, Hong Kong, and supported by the University of Groningen, Well Baby Clinic Foundation Icare, Noordlease, and Youth Health Care Drenthe. Healthy Start Study (HSS) was funded by the following NIH funding sources: R01DK076645, UL1TR00108. Polish Mother and Child Cohort (REPRO_PL) is supported in part by funds from National Centre for Research and Development, Poland (grant no. PBZ-MEiN-/8/2/2006; contract no. K140/P01/2007/1.3.1.1) and grant PNRF-218-AI-1/07 from Norway through the Norwegian Financial Mechanism within the Polish?Norwegian Research Fund. ROLO study was funded by the Health Research Board of Ireland, with additional financial support from the National Maternity Hospital Medical Fund. Southampton Women's Survey (SWS) was supported by grants from the Medical Research Council, National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, and the European Union's Seventh Framework Programme (FP7/2007-2013), project EarlyNutrition (grant 289346). SB, KW, NW and KO are supported by the Medical Research Council (Unit Programme numbers: MC_UU_12015/1, MC_UU_12015/2 and MC_UU_12015/3).

Funding Information:
InterConnect: the research leading to these results received funding from the European Union Seventh Framework Programme (FP7/2007–2013) under grant agreement no. 602068. Amsterdam Born Children and their Development study (ABCD): the ABCD study was supported by grants from the Netherlands Organization for Health Research and Development (ZonMW) and The Netherlands Heart Foundation. Genotyping was funded by the BBMRI-NL grant CP2013-50. M.H. Zafarmand was supported by BBMRI-NL (CP2013-50). T.G.M. Vrijkotte was supported by ZonMW (TOP 40–00812–98–11010). Avon Longitudinal Study of Parents and Children (ALSPAC): we are grateful to all the families who took part in this study, the midwives for their help in recruiting them, and the Avon Longitudinal Study of Parents and Children (ALSPAC) team, including interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists, and nurses. The UK Medical Research Council and Wellcome (grant ref: 102215/2/13/2) and the University of Bristol provide core support for ALSPAC. Danish National Birth Cohort (DNBC, Denmark): the Danish National Research Foundation has established the Danish Epidemiology of Science Centre that initiated and created the DNBC. The cohort is furthermore a result of a major grant from this foundation. Additional support for the DNBC is obtained from the Pharmacy Foundation, the Egmont Foundation, the March of Dimes Birth Defect Foundation, the Augustinus Foundation, and the Health Foundation. Groningen Expert Center for Kids with Obesity (GECKO)-Drenthe: the GECKO Dren-the birth cohort was funded by an unrestricted grant of Hutchison Whampoa Ltd, Hong Kong, and supported by the University of Groningen, Well Baby Clinic Foundation Icare, Noordlease, and Youth Health Care Drenthe. Healthy Start Study (HSS) was funded by the following NIH funding sources: R01DK076645, UL1TR00108. Polish Mother and Child Cohort (REPRO_PL) is supported in part by funds from National Centre for Research and Development, Poland (grant no. PBZ-MEiN-/8/2/2006; contract no. K140/ P01/2007/1.3.1.1) and grant PNRF-218-AI-1/07 from Norway through the Norwegian Financial Mechanism within the Polish–Norwegian Research Fund. ROLO study was funded by the Health Research Board of Ireland, with additional financial support from the National Maternity Hospital Medical Fund. Southampton Women’s Survey (SWS) was supported by grants from the Medical Research Council, National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton National Health Service Foundation Trust, and the European Union’s Seventh Framework Programme (FP7/2007-2013), project EarlyNutrition (grant 289346). SB, KW, NW and KO are supported by the Medical Research Council (Unit Programme numbers: MC_UU_12015/1, MC_UU_12015/2 and MC_UU_12015/3).

Funding Information:
We included all live-born singleton full-term births and excluded mothers with pre-eclampsia and those with missing information for any of the covariates. The percentage of participants with any missing values across cohorts ranged between 10.2% and 34% for early pregnancy analyses, and between 12.7% and 43.5% for late pregnancy analyses. Funding for this study was received from the European Union Seventh Framework Programme (FP7/2007–2013) under grant agreement no. 602068. Core Outcome Set (COS), and patient involvement (PPI) is not relevant to this study and hence is not described here.

Publisher Copyright:
© 2018 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists

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Pastorino, S., Bishop, T., Crozier, S. R., Granström, C., Kordas, K., Küpers, L. K., O'Brien, E. C., Polanska, K., Sauder, K. A., Zafarmand, M. H., Wilson, R. C., Agyemang, C., Burton, P. R., Cooper, C., Corpeleijn, E., Dabelea, D., Hanke, W., Inskip, H. M., McAuliffe, F. M., ... Ong, K. K. (2019). Associations between maternal physical activity in early and late pregnancy and offspring birth size: remote federated individual level meta-analysis from eight cohort studies. BJOG: An International Journal of Obstetrics and Gynaecology, 126(4), 459-470. https://doi.org/10.1111/1471-0528.15476

Associations between maternal physical activity in early and late pregnancy and offspring birth size: remote federated individual level meta-analysis from eight cohort studies. / Pastorino, S.; Bishop, T.; Crozier, S. R. et al.
I: BJOG: An International Journal of Obstetrics and Gynaecology, Bind 126, Nr. 4, 2019, s. 459-470.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Pastorino, S, Bishop, T, Crozier, SR, Granström, C, Kordas, K, Küpers, LK, O'Brien, EC, Polanska, K, Sauder, KA, Zafarmand, MH, Wilson, RC, Agyemang, C, Burton, PR, Cooper, C, Corpeleijn, E, Dabelea, D, Hanke, W, Inskip, HM, McAuliffe, FM, Olsen, SF, Vrijkotte, TG, Brage, S, Kennedy, A, O'Gorman, D, Scherer, P, Wijndaele, K, Wareham, NJ, Desoye, G & Ong, KK 2019, 'Associations between maternal physical activity in early and late pregnancy and offspring birth size: remote federated individual level meta-analysis from eight cohort studies', BJOG: An International Journal of Obstetrics and Gynaecology, bind 126, nr. 4, s. 459-470. https://doi.org/10.1111/1471-0528.15476

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

abstract = " 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 2 = 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. Tweetable abstract: In an individual participant meta-analysis, late pregnancy moderate to vigorous physical activity modestly reduced birth size outcomes. ",

keywords = "Birth weight, large-for-gestational age, macrosomia, physical activity, pregnancy, small-for-gestational age",

author = "S. Pastorino and T. Bishop and Crozier, {S. R.} and C. Granstr{\"o}m and K. Kordas and K{\"u}pers, {L. K.} and O'Brien, {E. C.} and K. Polanska and Sauder, {K. A.} and Zafarmand, {M. H.} and Wilson, {R. C.} and C. Agyemang and Burton, {P. R.} and C. Cooper and E. Corpeleijn and D. Dabelea and W. Hanke and Inskip, {H. M.} and McAuliffe, {F. M.} and Olsen, {S. F.} and Vrijkotte, {T. G.} and S. Brage and A. Kennedy and D. O'Gorman and P. Scherer and K. Wijndaele and Wareham, {N. J.} and G. Desoye and Ong, {K. K.}",

note = "Publisher Copyright: {\textcopyright} 2018 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists",

year = "2019",

doi = "10.1111/1471-0528.15476",

language = "English",

volume = "126",

pages = "459--470",

journal = "BJOG: An International Journal of Obstetrics and Gynaecology",

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TY - JOUR

T1 - Associations between maternal physical activity in early and late pregnancy and offspring birth size

T2 - remote federated individual level meta-analysis from eight cohort studies

AU - Pastorino, S.

AU - Bishop, T.

AU - Crozier, S. R.

AU - Granström, C.

AU - Kordas, K.

AU - Küpers, L. K.

AU - O'Brien, E. C.

AU - Polanska, K.

AU - Sauder, K. A.

AU - Zafarmand, M. H.

AU - Wilson, R. C.

AU - Agyemang, C.

AU - Burton, P. R.

AU - Cooper, C.

AU - Corpeleijn, E.

AU - Dabelea, D.

AU - Hanke, W.

AU - Inskip, H. M.

AU - McAuliffe, F. M.

AU - Olsen, S. F.

AU - Vrijkotte, T. G.

AU - Brage, S.

AU - Kennedy, A.

AU - O'Gorman, D.

AU - Scherer, P.

AU - Wijndaele, K.

AU - Wareham, N. J.

AU - Desoye, G.

AU - Ong, K. K.

N1 - Publisher Copyright: © 2018 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists

PY - 2019

Y1 - 2019

N2 - 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 2 = 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. Tweetable abstract: In an individual participant meta-analysis, late pregnancy moderate to vigorous physical activity modestly reduced birth size outcomes.

AB - 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 2 = 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. Tweetable abstract: In an individual participant meta-analysis, late pregnancy moderate to vigorous physical activity modestly reduced birth size outcomes.

KW - Birth weight

KW - large-for-gestational age

KW - macrosomia

KW - physical activity

KW - pregnancy

KW - small-for-gestational age

U2 - 10.1111/1471-0528.15476

DO - 10.1111/1471-0528.15476

M3 - Journal article

C2 - 30230190

AN - SCOPUS:85055281217

SN - 1470-0328

VL - 126

SP - 459

EP - 470

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

IS - 4

ER -