Emilie Mass Dalhaug

Objectives: To investigate the effects of a prenatal exercise intervention on offspring body weight, body mass index (BMI), and lifestyle variables at 7 years of age. Methods: Out of 105 physically inactive participants initially randomized to either a physical activity intervention or control group, 80 women and their children (76.2%) participated in this follow‐up study. The intervention consisted of intensive physical activity counseling and supervised, group‐based moderate‐intensity exercise sessions during the second and third trimesters of pregnancy, while the control group received standard prenatal care only. Data were collected via a standardized telephone interview with the mother and included the offspring’s body weight and height, physical activity level, sports participation, and adherence to general health recommendations regarding screen time and diet. Differences between groups were examined using two‐sided independent sample t ‐tests or chi‐squared tests as appropriate. Results: Mean BMI was similar in both groups (intervention group: n = 40; control group: n = 40), but the intervention group had fewer children with overweight/obesity (1 vs. 4) and underweight (3 vs. 6) than the control group. There was a nonsignificant trend toward increased physical activity among the offspring of the intervention group compared with the control group. This was reflected in a higher number following guidelines (≥ 60 min of daily moderate‐to‐vigorous physical activity [MVPA] according to WHO recommendations) (97.5% vs. 87.5%), number of bouts of MVPA per week (6.4 ± 3.8 vs. 5.8 ± 2.3), and daily hours of MVPA in both summer and winter seasons (2.4 ± 1.3 vs. 2.2 ± 1.3 and 1.6 ± 1.0 vs. 1.4 ± 1.0). The intervention group also reported higher rates of active school transportation than the control group (72.5% vs. 57.5%). No differences were observed in sedentary screen time and diet between the groups. Conclusions: Our results suggest that the intervention may have positively influenced the BMI status and physical activity levels of the offspring.

Objectives: To explore the acute effects of a heavy-load resistance protocol and exercise in the supine position on fetal heart rate (FHR) and uteroplacental blood flow. Method: In this experimental laboratory study, 48 healthy pregnant athletes (elite: n=7; recreational: n=41) completed 3×8 repetitions with one repetition in reserve in sumo deadlift, bench press and incline bench press. FHR and umbilical and uterine artery pulsatility index (PI) were assessed before and after exercise. Symptoms of vena cava syndrome were recorded following the supine exercise. Results: Pre- and post-exercise FHR remained within the normal range (110–160 bpm), but there were statistically significant increases after sumo deadlifts (p=0.002) and incline bench press (p=0.008), with no significant change after bench press (p=0.122). Umbilical artery PI did not change, while uterine artery PI significantly decreased after the sumo deadlift (p=0.005), bench press (p180 bpm). One recreational athlete experienced symptoms of vena cava syndrome after the supine exercise, coinciding with a slight decrease in umbilical artery PI, but with stable FHR. Conclusion: The results indicate that highly active women, especially those with resistance training experience, can safely engage in a heavy-load resistance protocol, including supine exercise, without jeopardising fetal well-being.

Elite athletes routinely undertake strenuous training routines, which often involve high-intensity sessions. However, there are knowledge gaps in how they experience training during pregnancy and subsequent return to sport. Combined with inadequate financial and contractual safety, female athletes may jeopardise their careers when starting families. This study aimed to describe female athletes' experiences and perspectives related to pregnancy and motherhood within the context of elite sports in Norway. We interviewed five world-class athletes between October 2022 and April 2023, using a descriptive qualitative approach. Full interview transcripts were analysed based on a reflexive thematic analysis model. Five overarching themes were identified: (1) uncertainty, (2) lack of supportive networks, (3) physical capacity, (4) the impact of postpartum return to sports on maternal health, and (5) combining motherhood and elite sports. Our findings emphasise the challenges that Norwegian pregnant and postpartum athletes face in balancing motherhood with successful careers, highlighting the importance of providing adequate support systems to ensure their health and the well-being of their child.

Objectives: To explore the acute effects of high-intensity interval training on fetal heart rate (FHR) and uteroplacental blood flow. Method: Elite (n=10) and recreational athletes (n=50) participated in an experimental laboratory study involving 5×5 min intervals of high-intensity exercise on both a treadmill and cycle ergometer, with a 4 min pause between intervals for measurement of FHR and uteroplacental blood flow. Target intensity was 17 on Borg’s rating of perceived exertion (RPE) scale and 90% of estimated maximal maternal heart rate (MHR_max). Results: Mean exercise intensity was 16.4 (SD 1.0) RPE and 89.4 (SD 3.8) % of MHR_max during running and 16.0 (SD 1.0) RPE and 84.6 (SD 5.0) % of MHR_max during cycling. Mean FHR was 140.9 (SD 27.4) beats per minute (bpm) during pauses between running bouts and 148.9 (SD 16.0) bpm during pauses between cycling bouts. Six cases of prolonged fetal bradycardia (3 min) occurred during running, leading to the termination of exercise. The mothers exercised at 17–18 on Borg’s RPE scale and 86.4%–92.6% of MHR_max in these cases. All cases were normalised within 8 min of ending the protocol. There were no cases of prolonged fetal bradycardia during cycling. Exercise was terminated for three women during running and two women during cycling due to fetal tachycardia (≥180 bpm for >4 min during rest). Conclusion: Despite cases of fetal bradycardia and tachycardia, our results indicate that highly active women can engage in multiple intervals of high-intensity interval training without apparent harm to fetal well-being.

Background: Exercise during pregnancy is associated with numerous health benefits. However, guidelines for elite and recreational athletes, who often exceed general recommendations regarding intensity, duration, and frequency are lacking, and potential risks remain unclear. The aim of the study was to describe exercise levels, pregnancy, and maternal and neonatal health outcomes in elite and recreational athletes. Method: This study was part of the Strong Mama research project, which was carried out in Oslo, Norway, between October 2022 and February 2024. Sixty athletes (10 elite and 50 recreational) participated in the study. They completed an online survey during late pregnancy and participated in a structured telephone interview six weeks postpartum. The survey and interview collected data on exercise habits, pregnancy experiences, and maternal and neonatal health outcomes. Results: The athletes maintained high exercise levels during pregnancy, with elite athletes exercising an average of 11.6 h per week (SD 3.2) and recreational athletes exercising 7.0 h per week (SD 2.4). Most athletes resumed exercising within six weeks postpartum. Almost all pregnancies were planned, including six which involved fertility treatment. Most women (76.7%) had spontaneous onset of labor and vaginal deliveries to term (between 36 and 42 weeks). The mean birthweight was 3487 (SD 519.4, range 2600–4775) grams. Two of the elite athletes were diagnosed with gestational diabetes mellitus and two with hypertension during pregnancy. None of the 50 recreational athletes reported any pregnancy complications. Conclusion: High levels of exercise during pregnancy did not seem to negatively impact maternal or neonatal health in this descriptive sample of Norwegian elite and recreational athletes. However, more research is needed to confirm these findings.

Objective During pregnancy, international guidelines recommend ≥150 min of moderate-intensity aerobic physical activity per week, with an intensity perceived as fairly light to somewhat hard on the Borg Rating of Perceived Exertion (RPE) scale (ranging from 6 ‘no exertion’ to 20 ‘maximal exertion’, corresponding to 60% to 80% of maximum heart rate). However, the determination and monitoring of exercise intensity seem to be a particular source of confusion, and the most effective method to monitor exercise intensity remains uncertain. This study aimed to examine existing research on the correlation between the Borg RPE scale and maternal heart rate (MHR) for monitoring exercise intensity during pregnancy. Design Scoping review using the mixed methods appraisal tool (MMAT) and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Data sources PubMed, Web of Science and SPORTDiscus were searched from 16–17 April 2023, with a subsequent search on 1 November 2023. Eligibility criteria We included studies investigating the correlation between perceived intensity on the Borg RPE scale (6–20) and MHR during exercise in pregnant individuals and written in English/Scandinavian language. There were no restrictions on publication year or study design. Data extraction and synthesis Two independent reviewers screened the articles based on title and Selected articles were read in full text and reference lists of screened articles were also checked. Out of 120 studies screened, six articles met the inclusion criteria after removing one duplicate. The results were qualitatively summarised to provide an overview of common themes and variations between studies. MMAT and GRADE assessed the risk of bias and the certainty of the evidence. Results The six studies involved a total of 260 healthy pregnant individuals (gestational week: from 16 to 38), with various exercise protocols (cycling, walking, running and resistance exercise) and intensities (from light to moderate). Three studies supported the Borg RPE scale to estimate exercise intensity during pregnancy, while three found no correlation between this scale and MHR. The certainty of the evidence was graded as low to moderate, with a potential risk of bias due to small sample sizes, incomplete outcome data and inconsistencies across studies. Conclusion The mixed results highlight the complexity of monitoring exercise intensity during pregnancy. Using both the Borg RPE scale and MHR might be better than using them separately for monitoring exercise intensity during pregnancy. Due to limited and inconsistent research, more extensive studies are needed.

Background: Pregnancy-related lumbopelvic pain is a frequently reported musculoskeletal disorder, but few studies have compared data between countries. Objectives: Examine prevalence, severity, and sick leave and explore potential risk factors associated with pregnancy-related lumbopelvic pain in Italian women and compare the results to a similar study in Norway, utilizing the same questionnaire. Design: Cross-sectional Methods: Italian ( n = 481) and Norwegian women ( n = 435) were allocated from two public hospitals in Rome (Fatebenefratelli San Giovanni Calibita-Isola Tiberina) and Oslo (Oslo University Hospital), as well as four antenatal clinics in Modena (Italy). The questionnaire was completed between gestation weeks 32 and 36, addressing women’s experiences of pregnancy-related lumbopelvic pain and sick leave in current week, and retrospectively for prepregnancy, first and second trimesters. Results: In Italy and Norway, 39% and 57% of pregnant women reported pregnancy-related lumbopelvic pain, respectively, with 11% and 25% experiencing severe pregnancy-related lumbopelvic pain. Pregnancy-related lumbopelvic pain was associated with sick leave in Norway ( p < 0.01), but not in Italy ( p = 0.66) at late gestation. In both countries, women with pregnancy-related lumbopelvic pain versus those with no pregnancy-related lumbopelvic pain were more likely to be multiparous (Italy: 40% versus 31%, p = 0.06 and Norway: 53% versus 38%, p < 0.01), and have gestational weight gain above guidelines (Italy: 21% versus 13%, p = 0.02% and Norway: 27% versus 14%, p < 0.01) and previous experience of pregnancy-related lumbopelvic pain (Italy: 15% versus 2%, p < 0.01 and Norway: 31% versus 4%, p < 0.01). Maternal exercise (⩾2 times weekly) was associated with less pregnancy-related lumbopelvic pain (Italy: odds ratio = 0.33, 95% confidence interval = 0.11–1.0, p = 0.05 and Norway: odds ratio = 0.55, 95% confidence interval = 0.29–1.0, p = 0.06). Conclusion: We observed high rates of pregnancy-related lumbopelvic pain in Italy and Norway, with Norwegian women reporting the highest prevalence and severity level. While both countries had similar rates of sick leave in late gestation, an association between pregnancy-related lumbopelvic pain and sick leave was observed among Norwegian women only. Health care providers should be proactive in addressing pregnancy-related lumbopelvic pain through open communication and seeking input from pregnant individuals. However, it is essential to acknowledge that the current evidence on effective treatments remains limited and inconclusive, highlighting the need for further research in this field.

Few studies have explored the associations between body satisfaction and physical activity and weight gain during pregnancy, and none have been conducted in Scandinavia. Hence, the aim of the present study was to evaluate changes in body satisfaction from pre-pregnancy to late pregnancy and investigate whether this differed according to parity. We also wanted to explore the association between body satisfaction and physical activity and weight gain among pregnant women in Norway. This cross-sectional survey used an electronic questionnaire to assess physical activity level, weight gain and women’s satisfaction with body weight and size. In total, 150 pregnant women answered the questionnaire. Related-samples Wilcoxon signed rank tests, Mann–Whitney U tests and chi-square tests were used to answer our research questions. The proportion of women who were dissatisfied with their body weight and shape increased from pre-pregnancy to late gestation (body weight p = 0.030 and body shape p = 0.040). Body dissatisfaction before and during pregnancy was linked to weight gain above recommendations. Characterising oneself as physically active prior to pregnancy was associated with satisfaction with body shape pre-pregnancy. Given that mothers strongly influence how a child will judge their body later in life, the results of this study underline the importance of addressing these issues during pregnancy.