Physical fitness (PF) is a cornerstone of metabolic health. However, its role in maternal–fetal metabolism during pregnancy is poorly understood. The present work investigates: (i) the association of PF with maternal and fetal cardiometabolic markers, and with clustered cardiometabolic risk during pregnancy, and (ii) whether being fit counteracts cardiometabolic abnormalities associated with overweight/obesity. Several PF components (flexibility, lower and upper body strength, and cardiorespiratory fitness [CRF]) were objectively assessed in 151 pregnant women at gestational weeks 16 and 33, and an overall PF cluster score calculated. At the same times, maternal glycemic and lipid markers, cortisol, and C-reactive protein were assessed with standard biochemical methods, along with blood pressure and a proxy for insulin resistance, and a cardiometabolic risk cluster score determined. These analytes were also measured in maternal and umbilical cord arterial and venous blood collected at delivery. PF was found to be associated with several maternal and a small number of fetal cardiometabolic markers (p < .05). Lower and upper body muscle strength, CRF, overall PF (week 16), and CRF changes (weeks 16–33) were inversely associated with clustered cardiometabolic risk (p < .05). Normal weight fit women had lower values for insulin level, insulin resistance, triglycerides, low-density lipoprotein cholesterol, C-reactive protein, and diastolic blood pressure than did overweight/obese unfit women at week 16 (p < .05). In conclusion, greater PF, especially muscle strength and CRF in early–middle pregnancy, appears to be associated with a better metabolic phenotype, and may protect against maternal cardiometabolic risk. “Keep yourself fit and normal weight before and during early pregnancy” should be a key public health message.

体能 (PF) 是代谢健康的基石。然而，人们对其在妊娠期母胎代谢中的作用知之甚少。目前的工作调查：(i) PF 与母体和胎儿心脏代谢标志物的关联，以及与怀孕期间聚集的心脏代谢风险的关系，以及 (ii) 健康是否能抵消与超重/肥胖相关的心脏代谢异常。在妊娠第 16 周和第 33 周时，对 151 名孕妇的几个 PF 成分（柔韧性、下肢和上肢力量以及心肺健康 [CRF]）进行了客观评估，并计算了总体 PF 集群评分。同时，使用标准生化方法评估母体血糖和脂质标志物、皮质醇和 C 反应蛋白，以及血压和胰岛素抵抗的替代指标，并确定心脏代谢风险集群评分。这些分析物也在分娩时采集的母体和脐带动脉和静脉血中进行了测量。发现 PF 与几种母体和少数胎儿心脏代谢标志物有关。p  < .05)。下肢和上肢肌肉力量、CRF、总体 PF（第 16 周）和 CRF 变化（第 16-33 周）与聚集性心脏代谢风险呈负相关（p  < .05）。体重正常的女性在第 16 周的胰岛素水平、胰岛素抵抗、甘油三酯、低密度脂蛋白胆固醇、C 反应蛋白和舒张压的值低于超重/肥胖的不健康女性（p  < .05）。总之，更大的 PF，尤其是早中期妊娠的肌肉力量和 CRF，似乎与更好的代谢表型相关，并且可以防止母体心脏代谢风险。“在怀孕前和怀孕初期保持健康和正常体重”应该是一个重要的公共卫生信息。