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 “The study suggests that a prenatal exercise-based intervention
leads to both decreased costs and improved outcomes in obese women,”
said Leah Savitsky, a medical student at Oregon Health and Science
University in Portland who led the study.
As reported at the 37th annual meeting of the Society for
Maternal-Fetal Medicine in San Diego, California, Savitsky and her
team analyzed previously published research on the effect of
exercise on pregnant women with a body mass index (BMI) of at least
30.
The normal range for BMI - a ratio of weight to height - is 18.5 to
24.9; a BMI of 30 or more indicates obesity. (A BMI calculator is
here, on the website of the U.S. Centers for Disease Control and
Prevention: http://bit.ly/2bLiujh.)
Based on their analyses of those earlier studies, the researchers
estimated the benefit of exercise for women who are obese at the
start of their pregnancy.
They calculated that for every one million such women, there would
be 38,176 cases of a dangerous pregnancy-related blood pressure
problem known as preeclampsia among those who exercised, compared to
113,000 cases among those who didn’t exercise.
Exercise would also be linked to a decrease in so-called gestational
diabetes, with a rate of 195,520 per million among exercisers
compared to 305,500 among non-exercisers, according to their
calculations.
Likewise, they estimated, for every million obese pregnant women the
preterm birth rate would drop from 105,059 to 90,923 with exercise,
the maternal death rate would fall from 90 to 70 and the neonatal
death rate would drop from 1,932 to 1,795.
Based on a cost-effectiveness threshold of $100,000 per
quality-adjusted life year, an exercise intervention could save
money as long as expenses are held to just under $3,000.
The effects of exercise may be even more beneficial than the study
suggests, Savitsky said.
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“This study did not consider additional downstream benefits on
control of weight beyond pregnancy as well as the downstream
potential benefits on hypertension and diabetes,” she told Reuters
Health by email.
Women who are not obese may benefit as well. The researchers applied
their model to women with a normal BMI of 18.5 – 24.9 and found
similar improvements in outcomes among those who exercise, although
the cost-effectiveness thresholds were lower.
One trial that the study drew from looked at 765 women randomized to
an exercise group or a control group (http://bit.ly/1QNoQzN). “We
showed that women who do not exercise are three times more likely to
develop (high blood pressure), 1.5 times more likely to gain
excessive weight and 2.5 times more likely to give birth to a large
infant,” said Michelle Mottola of Western University in London,
Ontario, Canada, who was involved in the randomized trial.
“With the obesity epidemic looming in our society, perhaps we should
be turning our attention to prevention of disease. It does not seem
to be too late even for obese pregnant women to engage in lifestyle
change that may substantially reduce health care costs,” Mottola
told Reuters Health by email.
The current study was not designed to develop specific exercise
guidelines for obese pregnant women; these women should consult
their obstetricians for guidance. In the meantime, the American
College of Obstetricians and Gynecologists advises obese pregnant
women to “start with low-intensity, short periods of exercise and
gradually increase as able.”
SOURCE: http://bit.ly/2l0OKUo Society for Maternal-Fetal Medicine
37th Annual Pregnancy Meeting, January 23, 2017
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