{"id":{"repo_id":"cadiz","oai_identifier":"oai:rodin.uca.es:10498/39656"},"canonical_url":"https://search.dev.ndltd.org/etd/cadiz/oai:rodin.uca.es:10498/39656","repository":{"repo_id":"cadiz","name":"Universidad de Cadiz","base_url":"https://rodin.uca.es/oai/request"},"display":{"title":"Influence of a physical exercise program, physical activity, sedentarism, body composition and physical fitness during pregnancy on body composition, physical fitness and neurocognition of the offspring: the gestafitos project","abstract":"In the absence of contraindications, current Guidelines encourage women to perform combined aerobic and resistance exercise (i.e., concurrent exercise) during pregnancy to improve maternal and offspring health outcomes, as it has been shown to contribute positively to a better metabolic intrauterine environment. Body composition is a strong determinant of birth complications and future diseases. Exercise during pregnancy has been shown to contribute positively to a better body composition of both the mother and offspring, as it has been associated with reduced risk of excessive gestational weight gain and a better control of offspring birth weight in healthy ranges. Additionally, the increased prevalence of maternal obesity in recent decades has occurred in parallel with the rise of macrosomia (defined as body weight at birth > 4000 grams) and childhood obesity, suggesting an association between maternal body composition and offspring body composition. Physical fitness is a powerful marker of health in general populations (i.e., childhood, adulthood and elderly) and specific populations (including pregnant women), as higher levels of physical fitness have been related to a better self-rated health, bone and psychological health, cardiovascular or metabolic profile, lower levels of total and abdominal adiposity, higher academic performance and all-cause mortality. Neurocognition evolves from conception to after birth, setting the foundation for lifelong neurodevelopment. Several studies have shown that regular maternal exercise induces benefits for the fetal brain development. Understanding the influence of exercise and maternal body composition during pregnancy on offspring body composition, as well as knowing whether exercise and physical fitness during pregnancy may improve all or some components of offspring physical fitness and their neurocognition might be of great importance for a better design of public health interventions, as it reflects prenatal conditions that can influence future development and may offer a preventive strategy against future disorders. Despite this, physical exercise interventions during pregnancy are often not based on programs specifically tailored to this stage. Moreover, most are designed at very low intensity or focused on aerobic or resistance exercise uniquely, even though current Guidelines recommend concurrent exercise to achieve greater health benefits. Therefore, the general aim of this International Doctoral Thesis was to evaluate the influence of a concurrent physical exercise program during pregnancy on offspring body composition, physical fitness, and neurocognition. Likewise, the specific aims were: (i) to analyze the influence of prenatal exercise on Apgar score and childhood health-related physical fitness and to identify possible differences based on maternal age and pre-pregnancy body mass index (BMI) (study I); (ii) to conduct a post-hoc analysis to examine the effect of a supervised-concurrent exercise training program from the 16th gestational week until delivery on 1-month infant neuromotor skills based on maternal pre-pregnancy BMI (study II); (iii) to compare the effect of different exercise interventions on offspring body weight and adequate values of body weight at birth, 6 and 12 months of age (study III); (iv) to systematically explore the influence of prenatal exercise, maternal physical activity, and physical fitness during pregnancy on offspring neurodevelopment up to 5 years of age (study IV); (v) to investigate the effects of a supervised concurrent exercise training program during pregnancy on children’s intelligence at 4-5 years of age (study V); (vi) to assess the association of maternal sedentary time and physical activity during pregnancy on children’s intelligence at 4-5 years of age, and to explore potential sex-related differences (study VI); and (vii) to assess the influence of maternal morphometrics in late pregnancy on offspring morphometrics at birth, 6, and 12 months of age, and examine variation by infant sex and pre-pregnancy BMI (study VII). The main results showed that: (i) exercise during pregnancy improves Apgar score at 1 and 5 minutes and reduces body weight at birth within normal values; there is limited evidence about the influence of exercise during pregnancy on offspring health-related physical fitness (study I). (ii) Concurrent exercise during pregnancy improves neuromotor skills in infants at 1 month of age in women with normal body weight; we observed limited evidence about the influence of concurrent exercise during pregnancy on infants whose mothers have overweight or obesity, and the potential mechanism behind the role of maternal BMI in the development of infant neuromotor skills (study II). (iii) Aerobic exercise with a meal plan resulted in the most favorable outcomes regarding adequate offspring body weight from birth to 12 months of age, whereas stretching showed the least favorable results (study III). (iv) Maternal exercise and physical activity during pregnancy improve offspring neurodevelopment; no studies were found that assessed the association of maternal physical fitness during pregnancy with offspring neurodevelopment (study IV). (v) A supervised concurrent exercise program during pregnancy had a positive effect on verbal and composite intelligence of children at 4-5 years; concurrent exercise during pregnancy seemed especially effective in verbal intelligence for male and female children, and composite intelligence mainly for males (study V). (vi) Moderate and moderate-to-vigorous physical activity during pregnancy were associated with greater non-verbal and composite intelligence in children at 4-5 years of age, while sedentary time and light physical activity showed no significant associations (study VI). (vii) Maternal weight, BMI, and gestational weight gain in late pregnancy were positively associated with offspring morphometrics at birth, but only gestational weight gain remained associated at 6 and 12 months of age (study VII). This International Doctoral Thesis provides evidence on the positive influence of concurrent exercise during pregnancy on body composition, neuromotor skills (i.e., motor fitness) and neurocognition of the offspring. However, there is limited evidence regarding the influence of concurrent exercise during pregnancy on offspring cardiorespiratory fitness and musculoskeletal fitness. Additionally, maternal morphometrics during pregnancy were directly associated with offspring morphometrics at birth, 6, and 12 months of age, and moderate and moderate-to-vigorous physical activity during pregnancy were associated with greater non-verbal and composite intelligence in children at 4-5 years of age. However, future studies are still necessary to know the influence of maternal physical fitness during pregnancy on neurocognition of the offspring.","abstract_html":"In the absence of contraindications, current Guidelines encourage women to perform combined aerobic and resistance exercise (i.e., concurrent exercise) during pregnancy to improve maternal and offspring health outcomes, as it has been shown to contribute positively to a better metabolic intrauterine environment. Body composition is a strong determinant of birth complications and future diseases. Exercise during pregnancy has been shown to contribute positively to a better body composition of both the mother and offspring, as it has been associated with reduced risk of excessive gestational weight gain and a better control of offspring birth weight in healthy ranges. Additionally, the increased prevalence of maternal obesity in recent decades has occurred in parallel with the rise of macrosomia (defined as body weight at birth > 4000 grams) and childhood obesity, suggesting an association between maternal body composition and offspring body composition. Physical fitness is a powerful marker of health in general populations (i.e., childhood, adulthood and elderly) and specific populations (including pregnant women), as higher levels of physical fitness have been related to a better self-rated health, bone and psychological health, cardiovascular or metabolic profile, lower levels of total and abdominal adiposity, higher academic performance and all-cause mortality. Neurocognition evolves from conception to after birth, setting the foundation for lifelong neurodevelopment. Several studies have shown that regular maternal exercise induces benefits for the fetal brain development. Understanding the influence of exercise and maternal body composition during pregnancy on offspring body composition, as well as knowing whether exercise and physical fitness during pregnancy may improve all or some components of offspring physical fitness and their neurocognition might be of great importance for a better design of public health interventions, as it reflects prenatal conditions that can influence future development and may offer a preventive strategy against future disorders. Despite this, physical exercise interventions during pregnancy are often not based on programs specifically tailored to this stage. Moreover, most are designed at very low intensity or focused on aerobic or resistance exercise uniquely, even though current Guidelines recommend concurrent exercise to achieve greater health benefits. Therefore, the general aim of this International Doctoral Thesis was to evaluate the influence of a concurrent physical exercise program during pregnancy on offspring body composition, physical fitness, and neurocognition. Likewise, the specific aims were: (i) to analyze the influence of prenatal exercise on Apgar score and childhood health-related physical fitness and to identify possible differences based on maternal age and pre-pregnancy body mass index (BMI) (study I); (ii) to conduct a post-hoc analysis to examine the effect of a supervised-concurrent exercise training program from the 16th gestational week until delivery on 1-month infant neuromotor skills based on maternal pre-pregnancy BMI (study II); (iii) to compare the effect of different exercise interventions on offspring body weight and adequate values of body weight at birth, 6 and 12 months of age (study III); (iv) to systematically explore the influence of prenatal exercise, maternal physical activity, and physical fitness during pregnancy on offspring neurodevelopment up to 5 years of age (study IV); (v) to investigate the effects of a supervised concurrent exercise training program during pregnancy on children’s intelligence at 4-5 years of age (study V); (vi) to assess the association of maternal sedentary time and physical activity during pregnancy on children’s intelligence at 4-5 years of age, and to explore potential sex-related differences (study VI); and (vii) to assess the influence of maternal morphometrics in late pregnancy on offspring morphometrics at birth, 6, and 12 months of age, and examine variation by infant sex and pre-pregnancy BMI (study VII). The main results showed that: (i) exercise during pregnancy improves Apgar score at 1 and 5 minutes and reduces body weight at birth within normal values; there is limited evidence about the influence of exercise during pregnancy on offspring health-related physical fitness (study I). (ii) Concurrent exercise during pregnancy improves neuromotor skills in infants at 1 month of age in women with normal body weight; we observed limited evidence about the influence of concurrent exercise during pregnancy on infants whose mothers have overweight or obesity, and the potential mechanism behind the role of maternal BMI in the development of infant neuromotor skills (study II). (iii) Aerobic exercise with a meal plan resulted in the most favorable outcomes regarding adequate offspring body weight from birth to 12 months of age, whereas stretching showed the least favorable results (study III). (iv) Maternal exercise and physical activity during pregnancy improve offspring neurodevelopment; no studies were found that assessed the association of maternal physical fitness during pregnancy with offspring neurodevelopment (study IV). (v) A supervised concurrent exercise program during pregnancy had a positive effect on verbal and composite intelligence of children at 4-5 years; concurrent exercise during pregnancy seemed especially effective in verbal intelligence for male and female children, and composite intelligence mainly for males (study V). (vi) Moderate and moderate-to-vigorous physical activity during pregnancy were associated with greater non-verbal and composite intelligence in children at 4-5 years of age, while sedentary time and light physical activity showed no significant associations (study VI). (vii) Maternal weight, BMI, and gestational weight gain in late pregnancy were positively associated with offspring morphometrics at birth, but only gestational weight gain remained associated at 6 and 12 months of age (study VII). This International Doctoral Thesis provides evidence on the positive influence of concurrent exercise during pregnancy on body composition, neuromotor skills (i.e., motor fitness) and neurocognition of the offspring. However, there is limited evidence regarding the influence of concurrent exercise during pregnancy on offspring cardiorespiratory fitness and musculoskeletal fitness. Additionally, maternal morphometrics during pregnancy were directly associated with offspring morphometrics at birth, 6, and 12 months of age, and moderate and moderate-to-vigorous physical activity during pregnancy were associated with greater non-verbal and composite intelligence in children at 4-5 years of age. However, future studies are still necessary to know the influence of maternal physical fitness during pregnancy on neurocognition of the offspring.","abstract_has_math":false,"creators":["Sánchez Parente, Sandra"],"institution":null,"degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Castro Piñero, José","Aparicio García Molina, Virginia"],"committee_chairs":[],"committee_members":[],"year":2026,"date_issued":"2026","date_published":"2026","updated_at":"2026-07-24T01:29:31Z","subjects":[],"languages":["eng"],"rights":["Attribution-NonCommercial-NoDerivatives 4.0 Internacional"],"rights_urls":["http://creativecommons.org/licenses/by-nc-nd/4.0/"],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/10498/39656","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Castro Piñero, José","Aparicio García Molina, Virginia"]},{"key":"dc:contributor.other","label":"Dc Contributor Other","values":["Didáctica de la Educación Física, Plástica y Musical"]},{"key":"dc:creator","label":"Author","values":["Sánchez Parente, Sandra"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2026-05-26T09:44:40Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2026-05-26T09:44:40Z"]},{"key":"dc:date.issued","label":"Date","values":["2026"]},{"key":"dc:type","label":"Dc Type","values":["doctoral thesis"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["eng"]},{"key":"dc:rights","label":"Dc Rights","values":["Attribution-NonCommercial-NoDerivatives 4.0 Internacional"]},{"key":"dc:rights.uri","label":"Rights URI","values":["http://creativecommons.org/licenses/by-nc-nd/4.0/"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/10498/39656"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["In the absence of contraindications, current Guidelines encourage women to perform combined aerobic and resistance exercise (i.e., concurrent exercise) during pregnancy to improve maternal and offspring health outcomes, as it has been shown to contribute positively to a better metabolic intrauterine environment. Body composition is a strong determinant of birth complications and future diseases. Exercise during pregnancy has been shown to contribute positively to a better body composition of both the mother and offspring, as it has been associated with reduced risk of excessive gestational weight gain and a better control of offspring birth weight in healthy ranges. Additionally, the increased prevalence of maternal obesity in recent decades has occurred in parallel with the rise of macrosomia (defined as body weight at birth > 4000 grams) and childhood obesity, suggesting an association between maternal body composition and offspring body composition. Physical fitness is a powerful marker of health in general populations (i.e., childhood, adulthood and elderly) and specific populations (including pregnant women), as higher levels of physical fitness have been related to a better self-rated health, bone and psychological health, cardiovascular or metabolic profile, lower levels of total and abdominal adiposity, higher academic performance and all-cause mortality. Neurocognition evolves from conception to after birth, setting the foundation for lifelong neurodevelopment. Several studies have shown that regular maternal exercise induces benefits for the fetal brain development. Understanding the influence of exercise and maternal body composition during pregnancy on offspring body composition, as well as knowing whether exercise and physical fitness during pregnancy may improve all or some components of offspring physical fitness and their neurocognition might be of great importance for a better design of public health interventions, as it reflects prenatal conditions that can influence future development and may offer a preventive strategy against future disorders. Despite this, physical exercise interventions during pregnancy are often not based on programs specifically tailored to this stage. Moreover, most are designed at very low intensity or focused on aerobic or resistance exercise uniquely, even though current Guidelines recommend concurrent exercise to achieve greater health benefits. Therefore, the general aim of this International Doctoral Thesis was to evaluate the influence of a concurrent physical exercise program during pregnancy on offspring body composition, physical fitness, and neurocognition. Likewise, the specific aims were: (i) to analyze the influence of prenatal exercise on Apgar score and childhood health-related physical fitness and to identify possible differences based on maternal age and pre-pregnancy body mass index (BMI) (study I); (ii) to conduct a post-hoc analysis to examine the effect of a supervised-concurrent exercise training program from the 16th gestational week until delivery on 1-month infant neuromotor skills based on maternal pre-pregnancy BMI (study II); (iii) to compare the effect of different exercise interventions on offspring body weight and adequate values of body weight at birth, 6 and 12 months of age (study III); (iv) to systematically explore the influence of prenatal exercise, maternal physical activity, and physical fitness during pregnancy on offspring neurodevelopment up to 5 years of age (study IV); (v) to investigate the effects of a supervised concurrent exercise training program during pregnancy on children’s intelligence at 4-5 years of age (study V); (vi) to assess the association of maternal sedentary time and physical activity during pregnancy on children’s intelligence at 4-5 years of age, and to explore potential sex-related differences (study VI); and (vii) to assess the influence of maternal morphometrics in late pregnancy on offspring morphometrics at birth, 6, and 12 months of age, and examine variation by infant sex and pre-pregnancy BMI (study VII). The main results showed that: (i) exercise during pregnancy improves Apgar score at 1 and 5 minutes and reduces body weight at birth within normal values; there is limited evidence about the influence of exercise during pregnancy on offspring health-related physical fitness (study I). (ii) Concurrent exercise during pregnancy improves neuromotor skills in infants at 1 month of age in women with normal body weight; we observed limited evidence about the influence of concurrent exercise during pregnancy on infants whose mothers have overweight or obesity, and the potential mechanism behind the role of maternal BMI in the development of infant neuromotor skills (study II). (iii) Aerobic exercise with a meal plan resulted in the most favorable outcomes regarding adequate offspring body weight from birth to 12 months of age, whereas stretching showed the least favorable results (study III). (iv) Maternal exercise and physical activity during pregnancy improve offspring neurodevelopment; no studies were found that assessed the association of maternal physical fitness during pregnancy with offspring neurodevelopment (study IV). (v) A supervised concurrent exercise program during pregnancy had a positive effect on verbal and composite intelligence of children at 4-5 years; concurrent exercise during pregnancy seemed especially effective in verbal intelligence for male and female children, and composite intelligence mainly for males (study V). (vi) Moderate and moderate-to-vigorous physical activity during pregnancy were associated with greater non-verbal and composite intelligence in children at 4-5 years of age, while sedentary time and light physical activity showed no significant associations (study VI). (vii) Maternal weight, BMI, and gestational weight gain in late pregnancy were positively associated with offspring morphometrics at birth, but only gestational weight gain remained associated at 6 and 12 months of age (study VII). This International Doctoral Thesis provides evidence on the positive influence of concurrent exercise during pregnancy on body composition, neuromotor skills (i.e., motor fitness) and neurocognition of the offspring. However, there is limited evidence regarding the influence of concurrent exercise during pregnancy on offspring cardiorespiratory fitness and musculoskeletal fitness. Additionally, maternal morphometrics during pregnancy were directly associated with offspring morphometrics at birth, 6, and 12 months of age, and moderate and moderate-to-vigorous physical activity during pregnancy were associated with greater non-verbal and composite intelligence in children at 4-5 years of age. However, future studies are still necessary to know the influence of maternal physical fitness during pregnancy on neurocognition of the offspring.","En ausencia de contraindicaciones, las guías actuales recomiendan a las mujeres realizar ejercicio combinado aeróbico y de fuerza (p. ej., ejercicio concurrente) durante el embarazo para mejorar los resultados de salud materna y de la descendencia, ya que se ha demostrado que contribuye positivamente a un mejor entorno metabólico intrauterino. La composición corporal es un fuerte determinante de complicaciones en el parto y enfermedades futuras. Se ha demostrado que el ejercicio durante el embarazo se ha asociado con un menor riesgo de ganancia excesiva de peso gestacional y un mejor control del peso al nacer dentro de rangos saludables. Además, el aumento de la prevalencia de obesidad materna en las últimas décadas ha ocurrido en paralelo con el aumento de la macrosomía (definida como peso corporal al nacer > 4000 gramos) y de la obesidad infantil, sugiriendo una asociación entre la composición corporal materna y la de la descendencia. La condición física es un potente marcador de salud en poblaciones generales (es decir, infancia, adultez y vejez) y poblaciones específicas (incluidas las mujeres embarazadas), ya que mayores niveles de condición física se han relacionado con una mejor salud auto percibida, salud ósea y psicológica, perfil cardiovascular o metabólico, menores niveles de adiposidad total y abdominal, mayor rendimiento académico y menor mortalidad por todas las causas. La neurocognición evoluciona desde la concepción hasta después del nacimiento, estableciendo la base para el desarrollo neurológico durante toda la vida. Varios estudios han demostrado que el ejercicio materno regular induce beneficios en el desarrollo cerebral fetal. Comprender la influencia del ejercicio y de la composición corporal materna durante el embarazo sobre la composición corporal de la descendencia, así como saber si el ejercicio y la condición física durante el embarazo puede mejorar todos o algunos componentes de la condición física de la descendencia y su neurocognición, podría ser de gran importancia para un mejor diseño de intervenciones de salud pública, ya que refleja condiciones prenatales que pueden influir en el desarrollo futuro y ofrecer una estrategia preventiva frente a trastornos futuros. A pesar de ello, las intervenciones en ejercicio físico durante el embarazo frecuentemente no se basan en programas específicamente adaptados a esta etapa. Además, la mayoría están diseñadas con una intensidad muy baja o se enfocan únicamente en el ejercicio aeróbico o de fuerza, a pesar de que las guías actuales recomiendan el ejercicio concurrente para lograr mayores beneficios en salud. Por lo tanto, el objetivo principal de esta Tesis Doctoral Internacional fue evaluar la influencia de un programa de ejercicio físico concurrente durante el embarazo sobre la composición corporal, condición física y neurocognición de la descendencia. Asimismo, los objetivos específicos fueron: (i) analizar la influencia del ejercicio prenatal en la puntuación de Apgar y la condición física relacionada con la salud en la infancia, así como identificar posibles diferencias según la edad materna y el índice de masa corporal previo al embarazo (estudio I); (ii) realizar un análisis post-hoc para examinar el efecto de un programa de entrenamiento supervisado de ejercicio concurrente desde la semana 16 de gestación hasta el parto, sobre las habilidades motrices de la descendencia al mes de vida, en función del índice de masa corporal materno previo al embarazo (estudio II); (iii) comparar el efecto de diferentes intervenciones de ejercicio durante el embarazo sobre el peso corporal de la descendencia y los valores adecuados de peso corporal al nacer, a los 6 y 12 meses de edad (estudio III); (iv) explorar sistemáticamente la influencia del ejercicio prenatal, la actividad física materna y la condición física durante el embarazo en el neurodesarrollo de la descendencia hasta los 5 años de edad (estudio IV); (v) investigar los efectos de un programa de ejercicio concurrente supervisado durante el embarazo en la inteligencia de la descendencia a los 4-5 años de edad (estudio V); (vi) evaluar la asociación entre el tiempo sedentario y la actividad física materna durante el embarazo con la inteligencia de la descendencia a los 4-5 años de edad, así como explorar posibles diferencias según el sexo de la descendencia (estudio VI); y (vii) evaluar la influencia de las medidas morfométricas maternas al final del embarazo sobre las medidas morfométricas de la descendencia al nacer, a los 6 y 12 meses de edad, y examinar la variación según el sexo de la descendencia y el índice de masa corporal previo al embarazo (estudio VII). Los principales resultados mostraron que: (i) el ejercicio durante el embarazo mejora el Apgar al minuto y 5 minutos y reduce el peso corporal al nacer dentro de valores normales; existe evidencia limitada sobre la influencia del ejercicio durante el embarazo en la condición física relacionada con la salud de la descendencia (estudio I). (ii) El ejercicio concurrente durante el embarazo mejora las habilidades motrices al mes de edad en bebés cuyas madres presentaban peso corporal normal; observamos evidencia limitada sobre la influencia del ejercicio concurrente en bebés cuyas madres presentaban sobrepeso u obesidad, así como sobre el posible mecanismo detrás del papel del índice de masa corporal materno en el desarrollo neuromotor infantil (estudio II). (iii) El ejercicio aeróbico combinado con un plan de alimentación resultó en los resultados más favorables respecto al peso corporal adecuado del lactante desde el nacimiento hasta los 12 meses; mientras que el ejercicio de estiramiento mostró los resultados menos favorables (estudio III). (iv) El ejercicio y la actividad física materna durante el embarazo mejoran el neurodesarrollo infantil; no se encontraron estudios que evaluaran la asociación entre la condición física materna durante el embarazo y el neurodesarrollo de la descendencia (estudio IV). (v) Un programa de ejercicio físico concurrente supervisado durante el embarazo tuvo un efecto positivo sobre la inteligencia verbal y compuesta de los niños a los 4-5 años; el ejercicio concurrente durante el embarazo pareció especialmente efectivo en la inteligencia verbal tanto en niños como niñas, y en la inteligencia compuesta principalmente en varones (estudio V). (vi) La actividad física moderada y la moderadavigorosa durante el embarazo se asociaron con mayor inteligencia no verbal y compuesta en niños a los 4-5 años, mientras que el tiempo sedentario y la actividad física ligera no mostraron asociaciones significativas (estudio VI). (vii) El peso materno, el índice de masa corporal y la ganancia de peso gestacional en etapas avanzadas del embarazo se asociaron positivamente con las medidas morfométricas del lactante al nacer, pero solo la ganancia de peso gestacional se mantuvo asociada a los 6 y 12 meses (estudio VII). Esta Tesis Doctoral Internacional aporta evidencia sobre la influencia positiva del ejercicio concurrente durante el embarazo en la composición corporal, las habilidades motrices (capacidad motora) y la neurocognición de la descendencia. Sin embargo, existe evidencia limitada sobre la influencia del ejercicio concurrente durante el embarazo en la capacidad cardiorrespiratoria y la condición musculoesquelética de la descendencia. Además, las medidas morfométricas maternas durante el embarazo se asociaron directamente con las medidas morfométricas de la descendencia al nacer, a los 6 y 12 meses, y la actividad física moderada y moderada-vigorosa durante el embarazo se asociaron con una mayor inteligencia no verbal y compuesta en niños a los 4-5 años. Sin embargo, aún son necesarios estudios futuros para conocer la influencia de la condición física materna durante el embarazo sobre la neurocognición de la descendencia."]},{"key":"dc:format","label":"Dc Format","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["Influence of a physical exercise program, physical activity, sedentarism, body composition and physical fitness during pregnancy on body composition, physical fitness and neurocognition of the offspring: the gestafitos project"]}]}],"canonical_facts":{"dc:contributor.advisor":["Castro Piñero, José","Aparicio García Molina, Virginia"],"dc:contributor.other":["Didáctica de la Educación Física, Plástica y Musical"],"dc:creator":["Sánchez Parente, Sandra"],"dc:date.accessioned":["2026-05-26T09:44:40Z"],"dc:date.available":["2026-05-26T09:44:40Z"],"dc:date.issued":["2026"],"dc:description.abstract":["In the absence of contraindications, current Guidelines encourage women to perform combined aerobic and resistance exercise (i.e., concurrent exercise) during pregnancy to improve maternal and offspring health outcomes, as it has been shown to contribute positively to a better metabolic intrauterine environment. Body composition is a strong determinant of birth complications and future diseases. Exercise during pregnancy has been shown to contribute positively to a better body composition of both the mother and offspring, as it has been associated with reduced risk of excessive gestational weight gain and a better control of offspring birth weight in healthy ranges. Additionally, the increased prevalence of maternal obesity in recent decades has occurred in parallel with the rise of macrosomia (defined as body weight at birth > 4000 grams) and childhood obesity, suggesting an association between maternal body composition and offspring body composition. Physical fitness is a powerful marker of health in general populations (i.e., childhood, adulthood and elderly) and specific populations (including pregnant women), as higher levels of physical fitness have been related to a better self-rated health, bone and psychological health, cardiovascular or metabolic profile, lower levels of total and abdominal adiposity, higher academic performance and all-cause mortality. Neurocognition evolves from conception to after birth, setting the foundation for lifelong neurodevelopment. Several studies have shown that regular maternal exercise induces benefits for the fetal brain development. Understanding the influence of exercise and maternal body composition during pregnancy on offspring body composition, as well as knowing whether exercise and physical fitness during pregnancy may improve all or some components of offspring physical fitness and their neurocognition might be of great importance for a better design of public health interventions, as it reflects prenatal conditions that can influence future development and may offer a preventive strategy against future disorders. Despite this, physical exercise interventions during pregnancy are often not based on programs specifically tailored to this stage. Moreover, most are designed at very low intensity or focused on aerobic or resistance exercise uniquely, even though current Guidelines recommend concurrent exercise to achieve greater health benefits. Therefore, the general aim of this International Doctoral Thesis was to evaluate the influence of a concurrent physical exercise program during pregnancy on offspring body composition, physical fitness, and neurocognition. Likewise, the specific aims were: (i) to analyze the influence of prenatal exercise on Apgar score and childhood health-related physical fitness and to identify possible differences based on maternal age and pre-pregnancy body mass index (BMI) (study I); (ii) to conduct a post-hoc analysis to examine the effect of a supervised-concurrent exercise training program from the 16th gestational week until delivery on 1-month infant neuromotor skills based on maternal pre-pregnancy BMI (study II); (iii) to compare the effect of different exercise interventions on offspring body weight and adequate values of body weight at birth, 6 and 12 months of age (study III); (iv) to systematically explore the influence of prenatal exercise, maternal physical activity, and physical fitness during pregnancy on offspring neurodevelopment up to 5 years of age (study IV); (v) to investigate the effects of a supervised concurrent exercise training program during pregnancy on children’s intelligence at 4-5 years of age (study V); (vi) to assess the association of maternal sedentary time and physical activity during pregnancy on children’s intelligence at 4-5 years of age, and to explore potential sex-related differences (study VI); and (vii) to assess the influence of maternal morphometrics in late pregnancy on offspring morphometrics at birth, 6, and 12 months of age, and examine variation by infant sex and pre-pregnancy BMI (study VII). The main results showed that: (i) exercise during pregnancy improves Apgar score at 1 and 5 minutes and reduces body weight at birth within normal values; there is limited evidence about the influence of exercise during pregnancy on offspring health-related physical fitness (study I). (ii) Concurrent exercise during pregnancy improves neuromotor skills in infants at 1 month of age in women with normal body weight; we observed limited evidence about the influence of concurrent exercise during pregnancy on infants whose mothers have overweight or obesity, and the potential mechanism behind the role of maternal BMI in the development of infant neuromotor skills (study II). (iii) Aerobic exercise with a meal plan resulted in the most favorable outcomes regarding adequate offspring body weight from birth to 12 months of age, whereas stretching showed the least favorable results (study III). (iv) Maternal exercise and physical activity during pregnancy improve offspring neurodevelopment; no studies were found that assessed the association of maternal physical fitness during pregnancy with offspring neurodevelopment (study IV). (v) A supervised concurrent exercise program during pregnancy had a positive effect on verbal and composite intelligence of children at 4-5 years; concurrent exercise during pregnancy seemed especially effective in verbal intelligence for male and female children, and composite intelligence mainly for males (study V). (vi) Moderate and moderate-to-vigorous physical activity during pregnancy were associated with greater non-verbal and composite intelligence in children at 4-5 years of age, while sedentary time and light physical activity showed no significant associations (study VI). (vii) Maternal weight, BMI, and gestational weight gain in late pregnancy were positively associated with offspring morphometrics at birth, but only gestational weight gain remained associated at 6 and 12 months of age (study VII). This International Doctoral Thesis provides evidence on the positive influence of concurrent exercise during pregnancy on body composition, neuromotor skills (i.e., motor fitness) and neurocognition of the offspring. However, there is limited evidence regarding the influence of concurrent exercise during pregnancy on offspring cardiorespiratory fitness and musculoskeletal fitness. Additionally, maternal morphometrics during pregnancy were directly associated with offspring morphometrics at birth, 6, and 12 months of age, and moderate and moderate-to-vigorous physical activity during pregnancy were associated with greater non-verbal and composite intelligence in children at 4-5 years of age. However, future studies are still necessary to know the influence of maternal physical fitness during pregnancy on neurocognition of the offspring.","En ausencia de contraindicaciones, las guías actuales recomiendan a las mujeres realizar ejercicio combinado aeróbico y de fuerza (p. ej., ejercicio concurrente) durante el embarazo para mejorar los resultados de salud materna y de la descendencia, ya que se ha demostrado que contribuye positivamente a un mejor entorno metabólico intrauterino. La composición corporal es un fuerte determinante de complicaciones en el parto y enfermedades futuras. Se ha demostrado que el ejercicio durante el embarazo se ha asociado con un menor riesgo de ganancia excesiva de peso gestacional y un mejor control del peso al nacer dentro de rangos saludables. Además, el aumento de la prevalencia de obesidad materna en las últimas décadas ha ocurrido en paralelo con el aumento de la macrosomía (definida como peso corporal al nacer > 4000 gramos) y de la obesidad infantil, sugiriendo una asociación entre la composición corporal materna y la de la descendencia. La condición física es un potente marcador de salud en poblaciones generales (es decir, infancia, adultez y vejez) y poblaciones específicas (incluidas las mujeres embarazadas), ya que mayores niveles de condición física se han relacionado con una mejor salud auto percibida, salud ósea y psicológica, perfil cardiovascular o metabólico, menores niveles de adiposidad total y abdominal, mayor rendimiento académico y menor mortalidad por todas las causas. La neurocognición evoluciona desde la concepción hasta después del nacimiento, estableciendo la base para el desarrollo neurológico durante toda la vida. Varios estudios han demostrado que el ejercicio materno regular induce beneficios en el desarrollo cerebral fetal. Comprender la influencia del ejercicio y de la composición corporal materna durante el embarazo sobre la composición corporal de la descendencia, así como saber si el ejercicio y la condición física durante el embarazo puede mejorar todos o algunos componentes de la condición física de la descendencia y su neurocognición, podría ser de gran importancia para un mejor diseño de intervenciones de salud pública, ya que refleja condiciones prenatales que pueden influir en el desarrollo futuro y ofrecer una estrategia preventiva frente a trastornos futuros. A pesar de ello, las intervenciones en ejercicio físico durante el embarazo frecuentemente no se basan en programas específicamente adaptados a esta etapa. Además, la mayoría están diseñadas con una intensidad muy baja o se enfocan únicamente en el ejercicio aeróbico o de fuerza, a pesar de que las guías actuales recomiendan el ejercicio concurrente para lograr mayores beneficios en salud. Por lo tanto, el objetivo principal de esta Tesis Doctoral Internacional fue evaluar la influencia de un programa de ejercicio físico concurrente durante el embarazo sobre la composición corporal, condición física y neurocognición de la descendencia. Asimismo, los objetivos específicos fueron: (i) analizar la influencia del ejercicio prenatal en la puntuación de Apgar y la condición física relacionada con la salud en la infancia, así como identificar posibles diferencias según la edad materna y el índice de masa corporal previo al embarazo (estudio I); (ii) realizar un análisis post-hoc para examinar el efecto de un programa de entrenamiento supervisado de ejercicio concurrente desde la semana 16 de gestación hasta el parto, sobre las habilidades motrices de la descendencia al mes de vida, en función del índice de masa corporal materno previo al embarazo (estudio II); (iii) comparar el efecto de diferentes intervenciones de ejercicio durante el embarazo sobre el peso corporal de la descendencia y los valores adecuados de peso corporal al nacer, a los 6 y 12 meses de edad (estudio III); (iv) explorar sistemáticamente la influencia del ejercicio prenatal, la actividad física materna y la condición física durante el embarazo en el neurodesarrollo de la descendencia hasta los 5 años de edad (estudio IV); (v) investigar los efectos de un programa de ejercicio concurrente supervisado durante el embarazo en la inteligencia de la descendencia a los 4-5 años de edad (estudio V); (vi) evaluar la asociación entre el tiempo sedentario y la actividad física materna durante el embarazo con la inteligencia de la descendencia a los 4-5 años de edad, así como explorar posibles diferencias según el sexo de la descendencia (estudio VI); y (vii) evaluar la influencia de las medidas morfométricas maternas al final del embarazo sobre las medidas morfométricas de la descendencia al nacer, a los 6 y 12 meses de edad, y examinar la variación según el sexo de la descendencia y el índice de masa corporal previo al embarazo (estudio VII). Los principales resultados mostraron que: (i) el ejercicio durante el embarazo mejora el Apgar al minuto y 5 minutos y reduce el peso corporal al nacer dentro de valores normales; existe evidencia limitada sobre la influencia del ejercicio durante el embarazo en la condición física relacionada con la salud de la descendencia (estudio I). (ii) El ejercicio concurrente durante el embarazo mejora las habilidades motrices al mes de edad en bebés cuyas madres presentaban peso corporal normal; observamos evidencia limitada sobre la influencia del ejercicio concurrente en bebés cuyas madres presentaban sobrepeso u obesidad, así como sobre el posible mecanismo detrás del papel del índice de masa corporal materno en el desarrollo neuromotor infantil (estudio II). (iii) El ejercicio aeróbico combinado con un plan de alimentación resultó en los resultados más favorables respecto al peso corporal adecuado del lactante desde el nacimiento hasta los 12 meses; mientras que el ejercicio de estiramiento mostró los resultados menos favorables (estudio III). (iv) El ejercicio y la actividad física materna durante el embarazo mejoran el neurodesarrollo infantil; no se encontraron estudios que evaluaran la asociación entre la condición física materna durante el embarazo y el neurodesarrollo de la descendencia (estudio IV). (v) Un programa de ejercicio físico concurrente supervisado durante el embarazo tuvo un efecto positivo sobre la inteligencia verbal y compuesta de los niños a los 4-5 años; el ejercicio concurrente durante el embarazo pareció especialmente efectivo en la inteligencia verbal tanto en niños como niñas, y en la inteligencia compuesta principalmente en varones (estudio V). (vi) La actividad física moderada y la moderadavigorosa durante el embarazo se asociaron con mayor inteligencia no verbal y compuesta en niños a los 4-5 años, mientras que el tiempo sedentario y la actividad física ligera no mostraron asociaciones significativas (estudio VI). (vii) El peso materno, el índice de masa corporal y la ganancia de peso gestacional en etapas avanzadas del embarazo se asociaron positivamente con las medidas morfométricas del lactante al nacer, pero solo la ganancia de peso gestacional se mantuvo asociada a los 6 y 12 meses (estudio VII). Esta Tesis Doctoral Internacional aporta evidencia sobre la influencia positiva del ejercicio concurrente durante el embarazo en la composición corporal, las habilidades motrices (capacidad motora) y la neurocognición de la descendencia. Sin embargo, existe evidencia limitada sobre la influencia del ejercicio concurrente durante el embarazo en la capacidad cardiorrespiratoria y la condición musculoesquelética de la descendencia. Además, las medidas morfométricas maternas durante el embarazo se asociaron directamente con las medidas morfométricas de la descendencia al nacer, a los 6 y 12 meses, y la actividad física moderada y moderada-vigorosa durante el embarazo se asociaron con una mayor inteligencia no verbal y compuesta en niños a los 4-5 años. Sin embargo, aún son necesarios estudios futuros para conocer la influencia de la condición física materna durante el embarazo sobre la neurocognición de la descendencia."],"dc:format":["application/pdf"],"dc:identifier.uri":["http://hdl.handle.net/10498/39656"],"dc:language.iso":["eng"],"dc:rights":["Attribution-NonCommercial-NoDerivatives 4.0 Internacional"],"dc:rights.uri":["http://creativecommons.org/licenses/by-nc-nd/4.0/"],"dc:title":["Influence of a physical exercise program, physical activity, sedentarism, body composition and physical fitness during pregnancy on body composition, physical fitness and neurocognition of the offspring: the gestafitos project"],"dc:type":["doctoral thesis"]},"updated_at":"2026-07-24T01:29:31Z"}