Prenatal exercise decreases offspring adiposity, but it is uncertain whether this relationship is present in offspring exposed to obesity in utero. We aimed to determine whether exercise during pregnancy reduces infant cellular and whole-body adiposity in offspring born to women with obesity. This is a sub-analysis of a randomized controlled trial, where women were randomized to supervised exercise or control for ~24 weeks during pregnancy. Exercise FITT-V metrics (frequency, intensity, time, type, and volume) were collected. Infant mesenchymal stem cells (MSCs) (healthy weight [n = 16], obesity [n = 21]) were adipogenically differentiated and stained for lipid content. Infant body composition was measured at 1 month of age via skinfold. Among women randomized to control, maternal BMI influenced infant adiposity; infants exposed to obesity had higher body fat percentage (p = 0.02). Birthweight was negatively correlated with infant body fat; offspring with lower birthweight had higher body fat (R2 = 0.38, p = 0.03). Maternal weekly exercise volume trended toward negative association with infant body fat (R2 = 0.33, p = 0.06) and lipid content (R2 = 0.21, p = 0.06). For infants born to women with obesity, exercise during pregnancy helps reduce adiposity.

Modifiable health behaviors such as exercise regulate adiposity in adults, but the effects of exercise during pregnancy on infant adiposity remain understudied. This report analyzed the relationship between prenatal exercise frequency, intensity, time, type, and volume (FITT-V) and infant adiposity, to better guide prenatal exercise prescription. Female participants [body mass index = 29.0 kg/m2, 30.5 yr of age, with gravida = 1 and parity = 0, peak oxygen consumption (V̇o2peak) = 21.9 mL/kg/min, and pregnant for 39.6 wk] were randomized to supervised exercise (aerobic, resistance, combination) or attention control for ∼24 wk during pregnancy. FITT-V metrics were analyzed from session records. Infant mesenchymal stem cells (MSCs), a model of infant adiposity, were collected from umbilical cord at delivery, adipogenically differentiated, and stained for lipids. Infant body fat percentage was estimated from skinfolds measured at 1 mo of age. Higher weekly exercise volume correlated with lower infant body fat (R2 = 0.12, P = 0.03) and MSC lipids (R2 = 0.13, P = 0.01). Weekly exercise frequency (R2 = 0.06, P = 0.10) and total volume (R2 = 0.19, P = 0.002) influenced adiposity. Subscapular skinfolds were notably affected by exercise (R2 = 0.27, P < 0.001). We conclude that in utero exposure to exercise beyond minimum recommendations is associated with reduced infant adiposity. Specifically, our findings suggest that exercising below 450 metabolic equivalent (MET)·min/wk, e.g., exercising at an average of 3 METs for 150 min/wk or 5 METs for 90 min/wk, excludes individuals from these offspring health benefits.NEW & NOTEWORTHY This study was the first to test how specific prenatal exercise dose, i.e., the FITT-V (frequency, intensity, time, type, volume) metrics, could influence the storage of triglycerides in infant adipogenic mesenchymal stem cells (MSCs). Prenatal exercise led to a reduction in infant whole body fat percentage (BF%), which was reflected by lower lipid storage in infant MSCs. Changes in lipid content were observed in offspring born to participants exercising beyond the minimum recommended weekly volume, 450 metabolic equivalent (MET)·min/wk.

Background: Sleep disturbances are common in pregnancy and have negative implications for the health of the mother and offspring. We aimed to test the effect of prenatal exercise on sleep quantity and quality. Methods: This study was a retrospective, secondary analysis of pooled data from 2 blinded, prospective, randomized controlled trials (control n = 15; exercise n = 71). Sleep quality and quantity were assessed via self-report at 16 (baseline) and 36 weeks’ gestation in women assigned to exercise (aerobic, resistance, or combination) or an attention-control group. Sleep metrics were compared between exercise and control groups using independent-samples t tests. Tests for exercise mode and sleep characteristics were completed using mixed models, and the influence of exercise dose on sleep was assessed via Pearson correlations and independent-samples t tests. Results: Women exercised for an average of 21.8 weeks during pregnancy (range = 13–28 weeks). Exercising women slept 15–30 min longer per night than controls at 16 weeks’ ( P = 0.049) but not 36 weeks’ gestation (control 7.27 h, exercise 7.52 h; P = 0.26). Whereas the aerobic and resistance exercise groups showed an increased probability of reporting good sleep quality at 36 weeks ( P < .05), combination exercisers had no decrease in sleep quantity compared with decreases in the other groups ( P = 0.19). Conclusion: Whereas exercise benefits sleep quantity during pregnancy, our results show an exercise mode–dependent influence on sleep quantity and quality at 36 weeks’ gestation.

This article highlights the broad and significant changes that occur in the placental proteome in response to different types of maternal exercise. Our findings further reveal that the overall volume of maternal exercise was associated with alterations in nearly 25% of the identified placental proteins, suggesting that both the type and amount of maternal physical activity may play important roles in shaping placental function and possibly contributing to fetal development.

OBJECTIVE:To conduct interdisciplinary fetal monitoring education focused on communication strategies to improve attitudes toward collaboration among members of the perinatal team. DESIGN:Participants received interdisciplinary fetal monitoring education from the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) and were surveyed preclass, at the immediate conclusion of the in-person interdisciplinary class, and within 60 days postclass using the Jefferson Survey of Attitudes Toward Physician-Nurse Collaboration (JSAPNC). Scores were calculated and analyzed by applying the scale provided by the JSAPNC's author. SETTING:An academic medical center providing level IV maternal care located in the southeast region of the United States. PARTICIPANTS:Physicians, registered nurses, and certified nurse-midwives attending AWHONN's Intermediate Fetal Heart Monitoring (FHM) Course from January 2024 through March 2024. INTERVENTION/MEASUREMENTS:The reliable and validated JSAPNC tool was used to survey participants. Survey scores were compared for the total scores and four identified constructs (shared education and collaborative relationships, caring versus curing, nurse's autonomy, and physician's authority) to better understand collaboration and interdisciplinary education. RESULTS:Attitudes toward collaboration demonstrated statistically significant improvement among the perinatal team after participation in an interdisciplinary AWHONN Intermediate FHM Course. CONCLUSION:The findings establish that interdisciplinary education is associated with improved attitudes around collaboration.

The aim of this study was to show the effects of different maternal exercise modes on infant cord blood proteome. We used infant cord blood from two randomized controlled trials where women with a wide range of BMI and free of pregnancy complications participated in controlled and supervised aerobic, resistance, or combination (aerobic+resistance) exercise from <16 weeks of gestation until delivery. Results of this study showed that infant cord blood proteome is altered in a maternal exercise mode specific manner. Additionally, results showed 61 downregulated proteins common to all exercise modes, which correspond to gas transport, cellular stress response, reactive oxygen species metabolism, and other biological processes. Collectively, these data demonstrate the differential effect of maternal exercise modes on infant cord blood proteome.

This is a post-hoc secondary analysis of a randomized controlled trial whose purpose was to analyze the effect of a supervised-combined aerobic and resistance exercise (concurrent exercise) training program during pregnancy on 1-month infant neuromotor skills based on maternal pre-pregnancy body mass index (BMI). Ninety-four pregnant women participated in this study, which was conducted at East Carolina University (Greenville, North Carolina, USA) between 2015 and 2018, and were allocated into concurrent exercise (n = 42) or stretching and breathing group (n = 52). The exercise group followed a 50-min 3 days/week moderate intensity concurrent exercise training program from the 16th gestational week until birth. Infant neuromotor skills were assessed with the Peabody Developmental Motor Scales, 2nd edition (PDMS-2). Per protocol analyses showed that infants from the exercise group and whose mothers were normal-weight, had higher PDMS-2 Stationary, Locomotion (borderline) and Gross Motor Quotient (GMQ) percentiles than infants of stretching and breathing participants (p = 0.022, ηp2 = 0.20; p = 0.054, ηp2 = 0.15; p = 0.022, ηp2 = 0.20, respectively). No differences between groups were found in infants whose mothers were normal-weight in reflexes percentiles in the adjusted model, or those infants whose mothers were overweight/obese in any of the outcomes (all p ≥ 0.05). Concurrent exercise training during pregnancy improves neuromotor skills in infants at 1 month of age in normal-weight women. Further studies are needed to understand the influence of concurrent exercise training during pregnancy on infants whose mothers are overweight or obese, and the potential mechanism behind the role of maternal BMI in the development of infant neuromotor skills. ClinicalTrials.gov Identifier: NCT03838146. Infants from normal-weight (but not overweight/obese) women who performed concurrent exercise during pregnancy presented better neuromotor skills than infants of stretching and breathing participants. The results of this study encourage the implementation of strategies to keep pregnant women active throughout pregnancy, to improve the neuromotor skills of future generations. Further studies are needed to understand the influence of concurrent exercise training during pregnancy on infants whose mothers are overweight or obese, which provides future lines of research necessary for society.

BACKGROUND:Despite decades of research documenting health benefits from exercise during pregnancy, it remains unknown how prenatal exercise affects infant neuromotor skill development. OBJECTIVES:To examine the effects of exercise modes, and maternal exercise metrics; frequency, intensity, time, type, and volume (FITT-V) during pregnancy on infant gross motor skills. We hypothesized that 1 month old infants of mothers who exercised during pregnancy would exhibit more developed gross motor skills compared to infants of mothers who did not exercise during pregnancy. Further, we hypothesized that infant gross motor skills will be directly associated with maternal exercise frequency, volume, and duration. MATERIALS & METHODS:Healthy pregnant women between 18 and 40 years were randomized to one of four groups: aerobic, resistance, combination exercise, or no exercise. Infant neuromotor skills (n = 162) were measured at 1 month of age using the Peabody Developmental Motor Scales, 2nd Edition (PDMS-2). RESULTS:Locomotion subtest percentile for infants born to exercising mothers trended higher than infants of controls (p = .09), while exercise group allocation did not affect outcomes. Infants born to women who averaged > 4 METs (n = 35) exercise intensity during each session showed a higher overall Gross Motor Quotient (GMQ) percentile score (p = .02). CONCLUSION:While we found no relationship for maternal exercise frequency, volume or duration during pregnancy, exercise intensity shows an intensity-dependent association with increased locomotor skills in 1 month old infants.

Excessive inflammation during pregnancy can be influenced by maternal factors (e.g., pre-pregnancy obesity, excessive gestational weight gain) and is associated with adverse pregnancy outcomes. Pro-inflammatory biomarkers such as tumor necrosis factor-alpha (TNF-α), interleukin 6 (IL-6), interleukin 1 beta (IL-1ß), interleukin-8 (IL-8), and c-reactive protein (CRP) are increased in individuals with gestational diabetes, preeclampsia, intrauterine growth restriction, and preterm birth. Maternal-fetal interface pathologies, such as recurrent spontaneous miscarriages, are also associated with increased pro-inflammatory biomarkers. Prolonged excessive inflammation can also increase fetal exposure to a pro-inflammatory environment in utero, thereby elevating the risk of cardiometabolic conditions later in life. Exercise is an effective method for reducing pro-inflammatory and increasing anti-inflammatory biomarkers in non-gravid adults and has differing effects depending on exercise mode. Exercise during pregnancy is associated with reduced risk for adverse pregnancy outcomes (APOs), enhanced placental function and structure, lower neonatal adiposity, and improved maternal and offspring cardiovascular measures. Although there are other methods for reducing inflammation during pregnancy (e.g., medications, dietary interventions), there is evidence to support that exercise during pregnancy may have a lasting effect on infant health, potentially improving the risk for chronic disease later in life. Recent research suggests that exercise during pregnancy reduces pro-inflammatory biomarkers, however, research is limited, and remains unclear whether there is an exercise mode effect similar to non-gravid adults. This review outlines the effects of excessive inflammation during pregnancy and explores how different exercise modes may influence maternal, placental, and fetal inflammation.

Background: Hypertensive disorders of pregnancy (HDP) hold negative health implications for mothers and offspring. While the beneficial influence of prenatal exercise on reducing HDP risk has been previously shown, there is a lack of specific information on the effect on birth outcomes in at-risk women, and in-depth analysis of appropriate exercise dose is lacking. Objective: We aimed to elucidate the effects of exercise training FITT-V (frequency, intensity, type, time, volume) on hypertension and birth outcomes in pregnant women. Study Design: This study is a retrospective, secondary analysis of pooled data from three blinded, prospective, randomized controlled trials. Women at risk of HDP (11 control, 27 exercise) were identified from the population and monitored in supervised exercise sessions throughout pregnancy. Upon delivery, birth measures were obtained. Pearson correlations and stepwise regressions determined associations. Tests for outcomes between exercise types were completed using one-way ANOVA. Results: Women at risk of HDP with higher total exercise volume trended lower systolic blood pressure during pregnancy (P=.07). In at-risk women, total and weekly exercise volume were then associated with gestational age at birth (R=0.42, P=.03; R=0.46, P=.02) and increased birthweight (R=0.43, P=.03). Weekly exercise duration predicted birthweight (P=.02) independent of gestational age at birth. Conclusion: The current findings add to a body of literature showing the beneficial influence of exercise during pregnancy on HDP risk, and importantly the effect on exposed offspring. Prenatal exercise improved birth outcomes in women with higher HDP risk in a dose-dependent manner, whereby higher exercise volume and duration are associated with improvements in birth outcomes.

Hypertensive disorders of pregnancy (HDP) hold negative health implications for mothers and offspring. While the beneficial influence of prenatal exercise on reducing HDP risk has been previously shown, there is a lack of specific information on the effect on birth outcomes in at-risk women, and in-depth analysis of appropriate exercise dose is lacking. We aimed to elucidate the effects of exercise training FITT-V (frequency, intensity, type, time, volume) on hypertension and birth outcomes in pregnant women. This study is a retrospective, secondary analysis of pooled data from three blinded, prospective, randomized controlled trials. Women at risk of HDP (11 control, 27 exercise) were identified from the population and monitored in supervised exercise sessions throughout pregnancy. Upon delivery, birth measures were obtained. Pearson correlations and stepwise regressions determined associations. Tests for outcomes between exercise types were completed using one-way ANOVA. Women at risk of HDP with higher total exercise volume trended lower systolic blood pressure during pregnancy (P=.07). In at-risk women, total and weekly exercise volume were then associated with gestational age at birth (R=0.42, P=.03; R=0.46, P=.02) and increased birthweight (R=0.43, P=.03). Weekly exercise duration predicted birthweight (P=.02) independent of gestational age at birth. The current findings add to a body of literature showing the beneficial influence of exercise during pregnancy on HDP risk, and importantly the effect on exposed offspring. Prenatal exercise improved birth outcomes in women with higher HDP risk in a dose-dependent manner, whereby higher exercise volume and duration are associated with improvements in birth outcomes.

Resting lactate concentration in venous blood is a commonly used indicator of metabolic disease risk. Regular exercise during pregnancy improves maternal metabolic health; however, it is unknown if maternal exercise regulates resting lactate concentration. We aimed to elucidate the effects of three different modalities of exercise during pregnancy on blood lactate in pregnant women. This is a secondary analysis of data from three blinded, prospective, randomized controlled trials. Pregnant women were randomized to control or exercise. Exercisers underwent ~24 weeks of supervised aerobic, resistance, or combination exercise between 12–16 and 37–40 weeks gestation. Fasted resting maternal blood lactate was collected at 16 and 36 weeks of gestation. Although lactate increased 0.5 mmol/L in controls across gestation, this rise was blunted in exercisers ( p = 0.01). Pre‐pregnancy BMI was correlated with blood lactate in controls ( p < 0.05, R 2 = 0.20) but not in exercisers ( p > 0.05, R 2 = 0.01). Exercisers with overweight or obesity had lower 36‐week lactate ( p = 0.001), particularly in aerobic and combination ( p = 0.03; p = 0.006, respectively). These findings show that exercise helps control the BMI‐associated rise in maternal lactate seen in gestation and highlights the importance of exercise in women with overweight or obesity.

BACKGROUND:Offspring body mass index is often higher in parents with overweight or obesity, thereby increasing the risk of obesity later in life. As data has shown that exercise during pregnancy reduces gestational weight gain and offspring adiposity, we believe the intergenerational risk of obesity could be reduced. OBJECTIVE:This study aimed to test the influence of paternal and maternal overweight or obesity on neonatal body mass index and other birth measures, and whether exercise during pregnancy would improve outcomes. METHODS:Prenatal exercise (aerobic, resistance, or combination) was provided as a supervised exercise intervention throughout pregnancy. Pre-pregnancy body mass index was reported by mothers and fathers at enrollment. Gestational age (GA), neonatal resting heart rate (rHR), morphometrics (body circumferences, weight-to-length, body mass index), Apgar, and reflex scores were obtained at birth. Independent samples t-tests assessed the effect of exercise, while one-way ANOVA was used to detect group differences. Pearson product-moment correlations tested the intergenerational relationship of body mass index. RESULTS:Birth outcomes were obtained for 220 women (CON: 62, AE: 68, RE: 39, AERE: 51). Women participated in exercise for an average of 17 weeks during pregnancy. Birth weight tended to be higher in offspring born to 1 or 2 parents with overweight or obesity (p = .07), thereby increasing birth weight-length ratio (p = .05). BMI was reduced for neonates born to exercising mothers (p = .08) and fathers with OB. CONCLUSION:These data suggest exercise during pregnancy could prevent the intergenerational cycle of obesity from parent to offspring.

Objective Rates of pediatric obesity are continuously rising and are likely to translate into a high incidence of metabolic disease later in life. Maternal exercise (ME) has been established as a useful non-pharmacological intervention to improve infant metabolic health; however, mechanistic insight behind these adaptations remains mostly confined to animal models. Infant mesenchymal stem cells (MSCs) give rise to infant tissues (e.g., skeletal muscle), and remain involved in mature tissue maintenance. Importantly, these cells maintain metabolic characteristics of an offspring donor and provide a model for the investigation of mechanisms behind infant metabolic health improvements.Methods We used undifferentiated MSC to investigate if ME affects infant MSC mitochondrial function and insulin action, and if these adaptations are associated with lower infant adiposity.Results We found that infants from exercising mothers have improvements in MSC insulin signaling are related to higher MSC respiration and fat oxidation, and expression and activation of energy-sensing and redox-sensitive proteins. Further, we found that infants exposed to exercise in utero were seemingly leaner at 1-month of age, with a significant inverse correlation between infant MSC respiration and infant adiposity at 6-months of age.Conclusion These data suggest that infants from exercising mothers are relatively leaner and this is associated with higher infant MSC mitochondrial respiration, fat use, and insulin action.### Competing Interest StatementThe authors have declared no competing interest.### Clinical TrialNCT03838146### Funding StatementThis project was supported by the American Heart Association (18IPA34150006 to L.E.M.)### Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:Approval for this study and all experiments was obtained from the East Carolina University Review Board (IRB#: 12-002524).I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as [ClinicalTrials.gov][1]. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.Yes [1]: http://ClinicalTrials.gov

BACKGROUND:Preterm delivery typically increases health risk for neonates and is associated with longer infant hospital stay and financial burden. Prenatal exercise dose (frequency, intensity, type, time, volume) have been shown to influence birth outcomes. Increased prenatal exercise dose could therefore provide a critical reduction in health risk and financial burden in preterm neonates. OBJECTIVE:It was our aim to explore the effects of prenatal exercise dose from a supervised exercise intervention in pregnant women on the occurrence of preterm (<37 weeks gestation) births, and the impact on health outcomes in preterm neonates. STUDY DESIGN:This study is a retrospective, secondary analysis of pooled data from three blinded, prospective, randomized controlled trials. Prenatal exercise dose were assessed in supervised aerobic, resistance, and combination sessions throughout pregnancy. In addition to gestational age, birth weight, resting heart rate, neonatal morphometrics (body circumferences, ponderal index), and health status (Apgar-1 and -5) metrics were obtained for 21 women at birth. One-way analysis of variance tests were used to assess the differences between dose grouped as tertiles, while Pearson correlations determined the association between dose and birth outcomes. RESULTS:Women exercised for an average of 19.6 wks (range: 6 - 21 wks) during pregnancy. Exercise during pregnancy tended to result in later preterm deliveries (p = 0.08). Greater prenatal exercise volume and duration were associated with reduced infant hospital stay post-delivery (p = 0.02). Weekly exercise volume was associated with increased Apgar scores (p = 0.01). CONCLUSION:Increased prenatal exercise volume and duration is associated with improved birth outcomes in preterm neonates.

Maternal exercise (ME) has been established as a useful non-pharmacological intervention to improve infant metabolic health; however, mechanistic insight behind these adaptations remains mostly confined to animal models. Infant mesenchymal stem cells (MSCs) give rise to infant tissues (e.g., skeletal muscle), and remain involved in mature tissue maintenance. Importantly, these cells maintain metabolic characteristics of an offspring donor and provide a model for the investigation of mechanisms behind infant metabolic health improvements. We used undifferentiated MSC to investigate if ME affects infant MSC mitochondrial function and insulin action, and if these adaptations are associated with lower infant adiposity. We found that infants from exercising mothers have improvements in MSC insulin signaling related to higher MSC respiration and fat oxidation, and expression and activation of energy-sensing and redox-sensitive proteins. Further, we found that infants exposed to exercise in utero were leaner at 1 month of age, with a significant inverse correlation between infant MSC respiration and infant adiposity at 6 months of age. These data suggest that infants from exercising mothers are relatively leaner, and this is associated with higher infant MSC mitochondrial respiration, fat use, and insulin action.

BACKGROUND Exercise is linked to health-conscious behaviors, such as healthy eating, through psychophysiological pathways that include improvements in executive functioning. The influence of exercise while pregnant on healthy eating is currently unknown. PURPOSE To determine if there are differences in food choices of women who exercised (EX) or not (CON) during pregnancy, and if this differed by pre-pregnancy body mass index (BMI; normal weight, NW; overweight/obese, OWOB). METHODS This study was a secondary analysis to examine the food frequency questionnaires (FFQs) of pregnant women randomized to 150min/wk of EX (n=72) or CON (n=16). Maternal descriptors and pre-pregnancy BMI were collected at enrollment (≤16 weeks gestation). At enrollment and at 36 weeks gestation, women reported the frequency of specific food consumption across a range of food groups based on a Likert-scale ranging from 1-rarely or never eat the food to 5- eat the food more than once/day. RESULTS OWOB EX increased consumption of nutrient-dense foods from enrollment to 36 weeks pregnancy and these results were not seen in OWOB CON and NW CON groups. Since FFQ is self-reported and captures a broad scope of habitual diet, it is important for future research in this area. CONCLUSION Overall, data in our study suggests that OWOB women who start exercising during pregnancy also improve their diet. Thus, future research should investigate how exercise may influence changes in nutrient intake during pregnancy.

Maternal obesity decreases infant energy expenditure, subsequently predisposing infants to greater adiposity and weight gain. Conversely, some findings suggest that maternal exercise may increase infant energy expenditure; however, the impact of maternal exercise mode (i.e., aerobic or resistance exercise) on infant energy expenditure is not known. The purpose of this study was to investigate whether supervised maternal exercise [aerobic, resistance, and combination (aerobic + resistance)] affects infant energy expenditure. When weight-adjusted resting energy expenditure was determined at 1 mo of age, infants exposed to resistance exercise in utero had >35% higher energy expenditure compared with infants exposed to aerobic exercise or no exercise. In addition, infant energy expenditure and lean mass were associated with maternal blood lipids independent of exercise mode. The increase in infant resting energy expenditure with the addition of any resistance exercise during gestation resulted in a discrepancy between measured and estimated energy expenditure using common estimation equations. These results implicate maternal metabolic health in determining infant metabolic rate, and maternal resistance exercise during pregnancy as a lifestyle intervention to increase infant energy expenditure potentially decreasing the subsequent infant adiposity gain. ClinicalTrials.gov Identifier: NCT03838146 and NCT04805502. NEW & NOTEWORTHY Maternal resistance exercise increases infant energy expenditure. This increase creates a gap between the measured and estimated energy expenditure when using standard estimation equations. These findings suggest that maternal resistance exercise can serve as a nonpharmacological method to enhance an infant's daily caloric expenditure.