Obesity Clinical Trial
Official title:
Effects of Physical Activity on Maternal Lipid Metabolism, Oxidative Stress, and Neonatal Outcomes in Obese Pregnancy
Regular maternal physical activity leads to the delivery of lighter, leaner infants. Higher birth weights and childhood obesity are both strong predictors for adult obesity, suggesting that the impact of maternal physical activity on the future health of a child is substantial. However, the mechanisms underlying the relationships between maternal physical activity and improved infant outcomes are unclear. Thus, the purpose of this project is to measure two potential contributing factors: maternal fat metabolism and maternal oxidative stress profiles. The investigators believe that maternal physical activity leads to beneficial alterations in maternal fat metabolism and oxidative stress profiles. Further, the investigators believe that both maternal fat metabolism and oxidative stress levels are related to infant outcomes such as obesity and insulin resistance. Therefore, exercise will improve maternal metabolic factors that can lead to improvements in infant outcomes. The investigators will compare these factors between obese inactive pregnant women and obese active pregnant women. This study design will allow us not only to determine the effect of physical activity on maternal and neonatal pregnancy outcomes, but also to establish whether obesity or physical inactivity should be a primary area of focus when prescribing pregnancy interventions in clinical practice.
Status | Recruiting |
Enrollment | 30 |
Est. completion date | December 2015 |
Est. primary completion date | December 2015 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 18 Years to 44 Years |
Eligibility |
Inclusion Criteria: - . Age 18-44 2. Confirmed singleton viable pregnancy with no fetal abnormalities at routine 18-22 ultrasonography 3. Obese: Pre-pregnancy BMI between 30 and 45 kg/m2 4. Receipt of prenatal care and plans to deliver at Barnes-Jewish Hospital 5. Inactive: < 30min of low intensity activity (>1.5 METS) all or most days of the week Physically Active: >150 minutes/week of moderate to high intensity activity 6. Completion of a normal routine, standard of care 1 hour 50 gram gestational diabetes screen Exclusion Criteria: 1. Multiple gestation pregnancy 2. Inability to provide voluntary informed consent 3. Current use of illegal drugs (cocaine, methamphetamine, opiates, etc…) 4. Current smoker who does not consent to cessation 5. Current usage of daily medications by class: corticosteroids, anti-psychotics (known to alter insulin resistance and metabolic profiles) 6. History of gestational diabetes, pre-pregnancy diabetes or prior macrosomic (>4500g) infant (each elevate the risk for gestational diabetes in the current pregnancy, or undiagnosed gestational diabetes) 7. History of heart disease. |
Observational Model: Case Control, Time Perspective: Cross-Sectional
Country | Name | City | State |
---|---|---|---|
United States | Washington University in St. Louis | St. Louis | Missouri |
Lead Sponsor | Collaborator |
---|---|
Washington University School of Medicine |
United States,
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* Note: There are 36 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Neonatal adiposity | Within 48 hours of delivery, neonatal body composition (fat and lean mass) will be measured by skin fold thickness measurement and by air displacement plethysmography (Pea Pod, Life Measurement, Inc., Concord, CA) in the CRU at WUSM. | 24-48 hr after delivery | No |
Primary | Neonatal insulin sensitivity | Infant HOMA-IR will be determined by measuring umbilical cord plasma glucose and insulin concentrations at parturition vis cord blood collection. Cord blood will be collected within 30 min of delivery, centrifuged for 10 min at 3000rpm to remove plasma, and stored at -80. | Immediately after delivery | No |
Secondary | Maternal Lipid Oxidation | The investigators will measure maternal lipid oxidation rate using indirect calorimetry (True One 2400, Parvo Medics, Sandy, UT) before, during, and after acute exercise. This will involve placing a hoodlike device over the subject's head as they lay supine (rest). For exercise measurements, they will have a mouthpiece and nose clips to obtain these measurements. Using both techniques, The investigators will be able to calculate lipid oxidation rates from the volumes of CO2 produced and volumes of O2 used. | 32-37 weeks gestation | No |
Secondary | Maternal Oxidative Stress profiles | The investigators will measure maternal plasma reactive oxygen species through F2- isoprostanes by mass spectrometry. The investigators will also measure total antioxidant capacity using the Total Antioxidant Capacity (TAC) ELISA assay. These two measurements will allow us to determine maternal levels of oxidative stress and the ability to buffer ROS. | 32-37 weeks gestation | No |
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