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Pregnancy RelatedNCT06572943

The Effect of Long-Term Moderate Intensity Exercise During Pregnancy on Maternal and Fetal Cardiovascular System

A study testing Moderate intensity physical activity in people with Pregnancy Related, run by George Makrydimas at 1 site in Greece.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The investigators aim to evaluate the effect of long-term moderate intensity physical activity during pregnancy in maternal and fetal cardiovascular system. A randomized clinical trial was designed with two groups (Study group and Control Group). Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Pregnancy Related
What is being tested?
Moderate intensity physical activity
Could I receive a placebo?
No, everyone receives an active treatment
How many people
40 participants
Where
1 siteGreece
Study dates
26 Aug 2024to 1 Sep 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Pregnant women during 1st trimester, who had the routine dating scan at 11-13+6 gestational weeks [also known as Nuchal translucency (NT) scan] and the uterine arteries (UtA) PI assessment

Who cannot join

  • Diabetes Mellitus (Type I or II)
  • Maternal age < 18 years old
  • Body Mass Index (BMI) > 40
  • Contraindications for PA: Multiple Pregnancies, Vaginal Bleeding, Hypertension or Gestational Hypertension, Uncontrolled Thyroid Diseases, Cardiovascular Diseases (e.g. valvular diseases, congenital heart diseases, cardiomyopathies, atrial fibrillation, coronary heart disease) or respiratory system diseases (asthma, chronic obstructive pulmonary disease) or systemic disease (cancer, autoimmune diseases) or several other diseases considered to be barriers for PA during pregnancy.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

George Makrydimas, Professor contact

+306944542420

grmak@otenet.gr

Greece1 site, 1 recruiting
  • Department of Obstetrics and Gynecology, University Hospital of Ioannina

    Ioannina, 45500

    George Makrydimas, Professor, +30 6944542420, gmakrydi@uoi.gr

    Recruiting

Other trials in Greece

About this study

The investigators aim to evaluate the effect of long-term moderate intensity physical activity during pregnancy in maternal and fetal cardiovascular system. A randomized clinical trial was designed with two groups (Study group and Control Group).

Read the detailed description

Physical activity (PA) enhances not only physical but also mental health.PA contributes to the prevention of a variety of diseases in general population including hypertension, diabetes mellitus, stress, and depression. Nevertheless, pregnancy is a time period that various changes take place in a woman's body. Those alterations might be either facilitators or barriers for conducting PA during pregnancy.

When it comes to pregnancy several benefits have been associated with PA for both mother and fetus; such as low gestational weight gain, lower incidence of gestational diabetes mellitus (GDM), better management of Pre-eclampsia and post-partum weight retention. Moreover, PA improves mental health in pregnant women, while recent studies have revealed that physical exercise during pregnancy can improve oxidative stress, inflammation and endothelial function. The vast majority of Obstetricians \& Gynecologists recommend that pregnant women should be urged to start or continue doing physical activity in the absence of contraindications. To be more specific, pregnant women should do at least 150 minutes of moderate intensity PA weekly. However, several studies support that pregnant women all over the world does not meet those recommendations. Relevant evidence of published literature are scarce regarding the alterations on maternal and fetal cardiovascular system due to chronic exercise .

Thus, investigators aim to evaluate the effect of long-term moderate intensity PA in maternal and fetal cardiovascular system. Thus, a randomized clinical trial with two groups (study group-control group) was designed. The study group includes pregnant women during the 1st trimester that will undergo moderate intensity PA, while the control group includes pregnant women that will receive the routine antenatal care. Participants will be followed up until 6 months postpartum.

To be more specific, all participants will receive a pedometer to record their daily steps from the first trimester until the postpartum period. The intervention group will additional receive detailed recommendations for 30 minutes of moderate intensity exercise at least 4-5 times per week (if not daily) and brochures with relevant information will be administrated as well. Moreover, brochures with dietary recommendations during pregnancy will be given to all participants.

Three routine antenatal ultrasound scans at 11-13+6 , 20-24, and 32-36 gestational weeks will be performed. Maternal Uterine Dopplers will be assessed at every scan, while fetal Dopplers will be done at 2nd and 3rd trimester. Maternal cardiovascular assessment will take place at 1st trimester, 3rd trimester and postpartum with transthoracic echocardiography, ophthalmic artery Doppler, Flow Mediated Dilatation and Arterial Stiffness . Fetal heart function will be assessed at 2nd and 3rd trimester. Evaluation of the infants' heart will also be performed at 6 months postpartum. A questionnaire evaluating mental health known as Depression-Anxiety and Stress Scale 21 (DASS-21) in pregnant women will be administered during the 1st and 3rd trimester. Maternal body fat measurements will take place at each trimester and postpartum. In addition fat composition of both the fetus will be evaluated by ultrasound before the delivery and the newborn within 48 hours following birth. Maternal blood sample will be collected during 1st trimester, 3rd trimester and postpartum and blood sample from the umbilical cord during labour, to assess several parameters.

All participants will be fully informed about the purpose of the study and will be included only after signing the Informed Consent Form. All data collected will be confidential and only accessible to members of the research team. These data will be coded according to GDPR. The clinical implementation of this study will be according to the International Code of Medical Ethics of the World Medical Association (Declaration of Helsinki), and all participants submitted a written informed consent since a detailed description of all aspects and the objectives of the study are explained and fully understood. The ethical committee of the University Hospital of Ioannina approved this study (decision number: 3/30-01-2024; date of approval; 30 January 2024).

Being tested
Moderate intensity physical activity
Keywords
pregnancy, physical activity, exercise, Maternal cardiovascular system, Fetal cardiovascular system
Medical subject headings
Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Moderate intensity physical activityOther

    Moderate intensity exercise of 30 minutes for at least 4-5 times per week (if not daily).

Study groups in NCT06572943
Study groupRoleWhat they receive
ControlNo interventionRoutine Antenatal Care. Brochures with dietary recommendations will be given.
ExperimentalExperimentalDetailed recommendations and brochures regarding physical activity will be given.Moreover brochures with dietary recommendations will be administrated.
Receives: Other: Moderate intensity physical activity

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Uterine Arteries Pulsatility Index at each trimester

    Uterine Arteries Pulsatility Index will be measured with Ultrasound Doppler by the same operator, at each trimester

    Measured: 11-13+6, 20-24, and 32-36 gestational weeks

Secondary outcomes (14)
  1. Umbilical artery Pulsatility Index during the 2nd and 3rd trimester

    Measured with Ultrasound Doppler by the same operator

    Measured: 20-24, and 32-36 gestational weeks

  2. Middle Cerebral Artery Pulsatility Index during the 2nd and 3rd trimester

    Measured with Ultrasound Doppler by the same operator

    Measured: 20-24, and 32-36 gestational weeks

  3. Incidence of Gestational Diabetes

    Diagnosis will be made based on oral glucose tolerance test with ingestion of 75g of glucose. Abnormal is considered either of the following: fasting glucose >92mg/dl, glucose >180mg/dl one hour after, glucose >153mg/dL two hours after.

    Measured: 26-29 weeks gestation

  4. Incidence Pre-eclampsia

    New onset of hypertension and proteinuria or the new onset of hypertension plus significant end-organ dysfunction with or without proteinuria

    Measured: >20 weeks until 4-6 weeks postpartum

  5. Maternal body fat measurements

    Measured with calibrated body fat scale

    Measured: 11-13+6., 20-24, and 32-36 gestational weeks, 8-12 weeks postpartum

  6. Gestational weight Change

    Comparison of maternal weight at the time of inclusion in the study and at the final ultrasound examination.

    Measured: Between 36-40 weeks gestation

  7. Gestational age at labor

    Gestational weeks

    Measured: Delivery

  8. Maternal mental health

    Depression-Anxiety and Stress Scale 21. This scale is a 21 item self report questionnaire designed to measure the severity of a range of symptoms common ot both Depression and Anxiety. Each item is scored from 0 (did not apply to me) to 3(applied to me very much or most of the time). The scale ot which each item belongs is indicated by the letters D(Depression), A(Anxiety) and S (Stress). For each scale (D, A\&S) sum the scores for identified items. The higher scores indicate more severe conditions.

    Measured: 11-13+6. and 32-36 gestational weeks

  9. Maternal cardiovascular adaptations during pregnancy and postpartum

    Transthoracic echocardiography will be performed by specialist cardiologist and will assess the following parameters: PWV, cSBP, cPP, LVEF, LVEDd, LVM, GLS, EDV, ESV, LAV, LAVI, MPI, LVMI, IVS, VTI, TR, PWT, RWT, E wave velοcity, A wave velocity, Deceleration time E/A ratio, Lateral e' velocity, Septal e' velocity

    Measured: 11-13+6, 32-36 gestational weeks and 8-12 weeks postpartum

  10. Arterial stiffness and FMD adaptations thorough pregnancy

    : Arterial Stiffness will be evaluated using the Mobil-O-Graph tool as assessed by the Pulse wave Velocity (PWV). FMD represents a non-invasive method to determine the endothelial dysfunction in the brachial artery in response to reactive hyperaemia.

    Measured: 11-13+6. and 32-36 gestational weeks and 8-12 weeks postpartum

  11. Maternal Blood Samples' findings

    : Maternal blood samples will be analyzed by certified laboratories and the findings will be evaluated. Comparisons between the two groups will take place.

    Measured: 11-13+6, 32-36 gestational weeks and 8-12 weeks postpartum

  12. Umbilical cord blood samples; findings

    Umbilical cord blood samples will be analyzed by certified laboratories and the findings will be evaluated. Comparisons between the two groups will take place

    Measured: Delivery

  13. Fetus and Neonatal Fat Composition

    Fat composition of the neonate will be measured with ultrasound at the level of femur, humerus abdomen and scapula. Comparisons between the two groups will take place

    Measured: Before delivery and within 48 hours following delivery

  14. Fetal heart adaptations and cardiovascular changes of the infant

    The following parameters were obtained via fetal echocardiography during ultrasound examinations at 20-24 and 32-36 gestational weeks as well as transthoracic echocardiography of the infant at 5-7 months old: MAPSE, TAPSE, LVCO, LVEF, E/A ratio, AoI PI, DA PI, Aorta peak velocity, Pulmonary Artery peak Velocity. A comparison between the two groups (study group-control group) will be conducted, as well.

    Measured: 20-24, 32-36 gestational weeks and 5-7 months postpartum.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Aug 2024
  2. Study start26 Aug 2024
  3. Primary completion1 Jul 2026 (estimated)
  4. Study completion1 Sep 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06572943
Sponsor's protocol ID
3/30-01-2024 (θ. 6)
Status last verified
Dec 2024
First submitted
20 Aug 2024
Last updated
11 Dec 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Martland R, Mondelli V, Gaughran F, Stubbs B. Can high-intensity interval training improve physical and mental health outcomes? A meta-review of 33 systematic reviews across the lifespan. J Sports Sci. 2020 Feb;38(4):430-469. doi: 10.1080/02640414.2019.1706829. Epub 2019 Dec 31.

    PubMed 31889469
  • Zschucke E, Gaudlitz K, Strohle A. Exercise and physical activity in mental disorders: clinical and experimental evidence. J Prev Med Public Health. 2013 Jan;46 Suppl 1(Suppl 1):S12-21. doi: 10.3961/jpmph.2013.46.S.S12. Epub 2013 Jan 30.

    PubMed 23412549
  • Davies G, Artal R. It's time to treat exercise in pregnancy as therapy. Br J Sports Med. 2019 Jan;53(2):81. doi: 10.1136/bjsports-2018-100360. Epub 2018 Dec 15. No abstract available.

    PubMed 30554145
  • Michalek IM, Comte C, Desseauve D. Impact of maternal physical activity during an uncomplicated pregnancy on fetal and neonatal well-being parameters: a systematic review of the literature. Eur J Obstet Gynecol Reprod Biol. 2020 Sep;252:265-272. doi: 10.1016/j.ejogrb.2020.06.061. Epub 2020 Jun 29.

    PubMed 32634674
  • Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstet Gynecol. 2020 Apr;135(4):e178-e188. doi: 10.1097/AOG.0000000000003772.

    PubMed 32217980
  • Mottola MF, Davenport MH, Ruchat SM, Davies GA, Poitras VJ, Gray CE, Jaramillo Garcia A, Barrowman N, Adamo KB, Duggan M, Barakat R, Chilibeck P, Fleming K, Forte M, Korolnek J, Nagpal T, Slater LG, Stirling D, Zehr L. 2019 Canadian guideline for physical activity throughout pregnancy. Br J Sports Med. 2018 Nov;52(21):1339-1346. doi: 10.1136/bjsports-2018-100056.

    PubMed 30337460
  • Evenson KR, Wen F. Prevalence and correlates of objectively measured physical activity and sedentary behavior among US pregnant women. Prev Med. 2011 Jul-Aug;53(1-2):39-43. doi: 10.1016/j.ypmed.2011.04.014. Epub 2011 May 4.

    PubMed 21575654
  • Hesketh KR, Evenson KR. Prevalence of U.S. Pregnant Women Meeting 2015 ACOG Physical Activity Guidelines. Am J Prev Med. 2016 Sep;51(3):e87-9. doi: 10.1016/j.amepre.2016.05.023. No abstract available.

    PubMed 27544437
  • Fernandez-Buhigas I, Martin Arias A, Vargas-Terrones M, Brik M, Rolle V, Barakat R, Munoz-Gonzalez MD, Refoyo I, Gil MM, Santacruz B. Fetal and maternal Doppler adaptation to maternal exercise during pregnancy: a randomized controlled trial. J Matern Fetal Neonatal Med. 2023 Dec;36(1):2183759. doi: 10.1080/14767058.2023.2183759.

    PubMed 36889747
  • Chatzakis C, Sotiriadis A, Fatouros IG, Jamurtas AZ, Deli CK, Papagianni M, Dinas K, Mastorakos G. The Effect of Physical Exercise on Oxidation Capacity and Utero-Placental Circulation in Pregnancies with Gestational Diabetes Mellitus and Uncomplicated Pregnancies, a Pilot Study. Diagnostics (Basel). 2022 Jul 16;12(7):1732. doi: 10.3390/diagnostics12071732.

    PubMed 35885635

Questions about this trial

What is this clinical trial studying?

A study testing Moderate intensity physical activity in people with Pregnancy Related, run by George Makrydimas at 1 site in Greece.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 11 Dec 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Greece. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact George Makrydimas, Professor (+306944542420, grmak@otenet.gr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Uterine Arteries Pulsatility Index at each trimester (time frame: 11-13+6, 20-24, and 32-36 gestational weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06572943, which also lists 10 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Dec 2024.

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