This study examines (a) the influence of exercise, lifestyle behavior components (sedentary time, physical activity, and sleep and dietary patterns), and physical fitness on maternal weight gain, postpartum weight retention, and excessive gestational weight gain and (b) whether exercise protects against the adverse effects of impaired metabolism and nonoptimal body composition related to excessive gestational weight gain. Subjects were assigned to either a supervised concurrent (aerobic + resistance) exercise program followed 3 days/week (n = 47) or a control group (n = 54). Sedentary time, physical activity, sleep and dietary patterns (assessed by accelerometry and questionnaires), muscle strength (handgrip test), and cardiorespiratory fitness (Bruce test) were determined at gestational Weeks 16 and 33 (early-middle and late pregnancy, respectively), and at 6 weeks postpartum. Weight gain and weight retention were calculated using recorded weights at prepregnancy, early-middle, and late pregnancy, and at 6 weeks postpartum. Birth complications, maternal postpartum body composition, cardiometabolic, and inflammatory markers in maternal and umbilical cord arterial and venous blood, and in colostrum, and mature milk were also recorded. The exercise intervention reduced late weight gain (B = −2.7, SE = 0.83, p = .003) and weight retention (B = −2.85, SE = 1.3, p = .03), independent of any lifestyle behavior component or physical fitness, but did not prevent excessive weight gain. Increasing cardiorespiratory fitness, muscle strength, and sleep duration were associated with a smaller mean weight gain and lower excessive weight gain values (p < .05). Among the participants who experienced excessive weight gain, those who were exercisers had a lower body mass index and systemic tumor necrosis factor-alpha concentration, lower umbilical cord venous tumor necrosis factor-alpha and arterial interferon gamma levels, higher cord arterial interleukin-10 levels, and improved placental function compared with controls (p < .05). In summary, exercise may help optimize gestational weight gain and weight retention, and may attenuate the impaired phenotype related to excessive weight gain. Increasing cardiorespiratory fitness, muscle strength, and sleep duration might help to prevent excessive weight gain during pregnancy.

本研究检查 (a) 运动、生活方式行为组成部分（久坐时间、身体活动、睡眠和饮食模式）以及身体健康对产妇体重增加、产后体重保持和妊娠期体重过度增加的影响，以及 (b) 是否运动可以防止新陈代谢受损和与妊娠期体重过度增加相关的非最佳身体成分的不利影响。受试者被分配到每周 3 天（n  = 47）或对照组（n = 54)。久坐时间、体力活动、睡眠和饮食模式（通过加速度计和问卷评估）、肌肉力量（握力测试）和心肺健康（布鲁斯测试）在妊娠第 16 周和第 33 周（分别为早中期和妊娠晚期）测定，以及产后 6 周。使用记录的孕前、中期和晚期以及产后 6 周的体重计算体重增加和体重保持。还记录了产妇和脐带动脉和静脉血以及初乳和成熟乳中的出生并发症、产妇产后身体成分、心脏代谢和炎症标志物。运动干预减少了后期体重增加（B  = -2.7，SE  = 0.83，p = .003）和体重保持（B  = -2.85，SE  = 1.3，p  = .03），独立于任何生活方式行为成分或身体健康，但不能防止体重过度增加。增加心肺健康、肌肉力量和睡眠时间与较小的平均体重增加和较低的过度体重增加值相关 ( p  < .05)。在体重过度增加的参与者中，锻炼者的体重指数和全身肿瘤坏死因子-α浓度较低，脐带静脉肿瘤坏死因子-α和动脉干扰素γ水平较低，脐动脉白细胞介素10水平较高，并且与对照组相比改善了胎盘功能（p < .05)。总之，运动可能有助于优化妊娠期体重增加和体重保持，并可能减轻与体重过度增加相关的受损表型。增加心肺健康、肌肉力量和睡眠时间可能有助于防止怀孕期间体重过度增加。