human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To evaluate the influence of exercise on maternal and perinatal outcome in a low‐risk healthy obstetric population . METHODS We conducted a prospect i ve observational study of low‐risk healthy women exercising during their pregnancy . An extensive question naire collected antepartum , intrapartum , and postpartum patient information on 750 women . The women were divided into four groups based on exercise level during pregnancy . RESULTS There were no differences among groups for maternal demographic characteristics , antenatal illnesses , stress , social support , or smoking . Heavily exercising women were older ( P = .042 ) , had higher incomes ( P = .001 ) , and were exercising more at conception ( P = .001 ) . Women who did more exercise were more likely to need an induction of labor ( P = .033 , relative risk 1.84 , 95 % confidence interval 1.05 , 3.20 ) , induction or augmentation with oxytocin ( P = .015 , relative risk 1.53 , 95 % confidence interval 1.19 , 1.97 ) , and had longer first‐stage labors ( P = .032 ) result ing in longer total labors ( P = .011 ) . The difference in the length of first‐stage labor was even greater if the no‐exercise group was compared with the strongly exercising group ( P = .009 , relative risk 1.38 , 95 % confidence interval 0.16 , 2.60 ) . Fewer umbilical cord abnormalities ( P = .034 ) were observed with exercise , but exercising women had more colds and flu ( P = .008 ) . Heavily exercising women had smaller infants ( mean difference 86.5 g ) compared with sedentary women . CONCLUSION Exercise  in working women is associated with smaller babies , increased number of inductions and augmentations of labor , and longer labors . Colds and flu are more frequent in exercising women PURPOSE The present study examined the effects of exercise on physical and psychological variables in sedentary primigravidae ( PRA ) . METHODS A total of nine women r and omly assigned to an exercise ( E ) ( mean age = 31.3 + /- 3.1 yr ) and six subjects r and omly assigned to a control ( C ) group ( mean age = 27.8 + /- 3.1 yr ) fulfilled all requirements for the study . Exercise included a variety of exercise activities performed to a target heart rate of 150 - 156 beats x min(-1 ) , three times per week for 15 wk . RESULTS Results showed no significant differences between E and C groups in physical characteristics initially . A repeated measures ANOVA showed a significant group effect ( P < 0.05 ) and a significant group by time interaction ( P = 0.001 ) with the E group showing a significantly longer amount of time on the PWC150 test than the C group . There was no significant group , time , or group by time interaction for lactate accumulation . This occurred , despite the fact that the E group spent 56 % longer on the PWC150 test and the C group spent 30 % less time on the same test at the conclusion of the study . Finally , the E group in comparison to the C group showed more favorable improvements in several items related to health and well-being on the Body Cathexis Scale . There were no significant differences between E and C groups in any pregnancy outcome measures . All babies were delivered healthy  at term . CONCLUSIONS These data suggest that a vigorous exercise program can lead to significant improvements in aerobic fitness at similar lactate concentrations compared to a control group and can be well tolerated by low risk sedentary PRA without any deleterious effects occurring to herself or unborn child Does strenuous antenatal exercise reduce birth‐weight ? Does reducing maternal exercise increase birthweight ? What to advise about exercise during pregnancy A group of 62 healthy primigravidae aged 20–26 years participated in an investigation concerning physical work capacity and cardiovascular dynamics during pregnancy and the effect of physical training beginning in the 10th or 14th week of pregnancy and lasting until term . The training group consisted of 31 women who were examined every 4 weeks throughout pregnancy , the last examination occurring in the 38th week . The r and omly selected control group consisted of 31 women who were examined in the 10th or 14th , in the 26th , and in the 38th week of pregnancy . During the examination the  pulse rate and blood pressure were measured in the left lateral position after rest , in the sitting position , and at nearly maximal exertion . The  pulse-conducted triangular ECG test  was used for determination of physical work capacity . All forms of voluntary exercise were allowed and recommended to the training group , emphasizing strenuous physical exertion . The physical work capacity in the control group spontaneously rose 10 % OBJECTIVE To investigate if water-gymnastics during pregnancy may reduce the intensity of back/low back pain and the number of days on sick-leave . METHODS A prospect i ve , r and omized study . One hundred and twenty-nine women were r and omized to participate in water-gymnastics once a week during the second half of pregnancy and 129 were r and omized to a control group . The women in both groups filled in question naires in gestational weeks 18 , 34 and within the first postpartum week . Every day from week 18 to labor they assessed the intensity of back/low back pain . RESULTS Back pain intensity increased during pregnancy . No excess risk for the pregnancy associated with water-gymnastics was observed . The women participating in water-gymnastics recorded a lower intensity of back/low back pain . The total number of days on sick-leave because of back/low back pain was 982 in the water-gymnastics group ( 124 women ) compared with 1484 in the control group ( 120 women ) . After weeks 32 33 , seven women in the water-gymnastics group compared with 17 in the control group were on sickleave because of back/ low back pain ( p=0.031 ) . CONCLUSIONS Intensity of back/low back pain increased with advancing pregnancy . There was no excess risk for urinary or vaginal infections associated with water-gymnastics . Water-gymnastics during the second half of pregnancy significantly reduced the intensity of back/ low back pain .  Water-gymnastics decreased the number of women on sick-leave because of back/low back pain .  Water-gymnastics during pregnancy can be recommended as a method to relieve back pain and may reduce the need for sick-leave The effect on fetal and maternal outcome in gestational exercise in a recreational athlete was investigated in a 2 1/2-year prospect i ve study . A training effect in a pregnant subject engaged in aerobic exercise was also determined . One hundred forty-one low-risk pregnant subjects had their aerobic capacity tested during the first trimester , during the third trimester , and post partum . Predicted maximum oxygen consumption values were determined by using st and ard Bruce treadmill protocol during the first and third tests and the Astr and protocol for submaximal testing on a bicycle ergometer during the third trimester . Exercise prescriptions were given . The primiparous and multiparous subjects were r and omized into control and exercise groups , differing only in the frequency of aerobic exercise . The results showed that exercise had no associated increase in neonatal morbidity and obstetric complications . All subjects improved or maintained their level of aerobic fitness . The exercisers showed a significant training effect . The disparity in the second test 's results may suggest that the physiologic characteristics of pregnancy masked the aerobic improvement BACKGROUND : The Institute of Medicine ( IOM ) recommends that normal‐weight women ( BMI ( body mass index ) of 19.8–26.0 ) gain 25–35 lb ( 11.4–15.9 kg ) during pregnancy , and that overweight women ( BMI of 26.1–29.0 ) gain 15–25 lbs ( 6.8–11.4 kg ) . A significant number of normal‐weight women and an even greater proportion of overweight women exceed these guidelines , which increases postpartum weight retention and may contribute to the development of obesity . OBJECTIVE : To determine whether a stepped care , behavioral intervention will decrease the percentage of women who gain more than the IOM recommendation . DESIGN : R and omized controlled trial comparing a stepped-care behavioral intervention with usual care .  Women ( n=120 ) who had a BMI > 19.8 , age>18 and < 20 weeks gestation were recruited from a hospital-based clinic serving low-income women and r and omized by race and BMI category to the intervention or control group . The intervention group received education about weight gain , healthy eating , and exercise and individual graphs of their weight gain . Those exceeding weight gain goals were given more intensive intervention . Women were followed through pregnancy to their first postpartum clinic visit . The main outcome measure was weight gain during pregnancy categorized as above the IOM recommendations vs below or within the IOM recommendations . RESULTS : The intervention significantly decreased the percentage of normal-weight women who exceeded the IOM recommendations ( 33 vs 58 % , P<0.05 ) . There was a non-significant ( P=0.09 ) effect in the opposite direction among overweight women ( 59 % of intervention and 32 % of control gained more than recommended ) . Postpartum weight retention was strongly related to weight gain during pregnancy ( r=0.89 ) . CONCLUSIONS : The intervention reduced excessive weight gain during pregnancy among normal weight women OBJECTIVE Our purpose was to test the null hypothesis that beginning regular , moderate-intensity exercise in early pregnancy has no effect on fetoplacental growth . STUDY DESIGN Forty-six women who did not exercise regularly were r and omly assigned at 8 weeks either to no exercise ( n = 24 ) or to weight-bearing exercise ( n = 22 ) 3 to 5 times a week for the remainder of pregnancy . Outcome variables included antenatal placental growth rate and neonatal and placental morphometric measurements . RESULTS The offspring of the exercising women were significantly heavier ( corrected birth weight : 3.75 + /- 0.08 kg vs 3.49 + /- 0.07 kg ) and longer ( 51.8 + /- 0.3 cm vs 50.6 + /- 0.3 cm ) than those born to control women . The difference in birth weight was the result of an increase in both lean body mass and fat mass . In addition , midtrimester placental growth rate was faster ( 26 + /- 2 cm(3)/wk vs 21 + /- 1 cm(3)/wk ) and morphometric indexes of placental function were greater in the exercise group . There were no significant differences in neonatal percentage body fat , head circumference , ponderal index , or maternal weight gain . CONCLUSIONS These data indicate that beginning a moderate regimen of weight-bearing exercise in early pregnancy enhances fetoplacental growth In order to determine if moderate maternal exercise increased uterine activity , a prospect i ve study was done during the last 8 weeks of pregnancy in 17 women . Two forms of exercise were chosen , weight-bearing ( running ) and non-weight-bearing ( stationary bicycle ) , to study this hypothesis . The results show that with these types of exercise no increase in uterine activity was noted . This is useful information to convey to pregnant patients ready to engage in a physical fitness program BACKGROUND The role of walking , as compared with vigorous exercise , in the prevention of coronary heart disease remains controversial , and data for women on this topic are sparse . METHODS We prospect ively examined the associations between the score for total physical activity , walking , and vigorous exercise and the incidence of coronary events among 72,488 female nurses who were 40 to 65 years old in 1986 . Participants were free of diagnosed cardiovascular disease or cancer at the time of entry and completed serial detailed question naires about physical activity . During eight years of follow-up , we documented 645 incident coronary events ( nonfatal myocardial infa rct ion or death from coronary disease ) . RESULTS There was a strong , grade d inverse association between physical activity and the risk of coronary events . As compared with women in the lowest quintile group for energy expenditure ( expressed as the metabolic-equivalent [ MET ] score ) , women in increasing quintile groups had age-adjusted relative risks of 0.77 , 0.65 , 0.54 , and 0.46 for coronary events ( P for trend < 0.001 ) . In multivariate analyses , the inverse gradient remained strong ( relative risks , 0.88 , 0.81 , 0.74 , and 0.66 for women in increasing quintile groups as compared with those in the lowest quintile group ; P for trend=0.002 ) . Walking was inversely associated with the risk of coronary events ; women in the highest quintile group for walking , who walked the equivalent of three or more hours per week at a brisk pace , had a multivariate relative risk of 0.65 ( 95 percent confidence interval , 0.47 to 0.91 ) as compared with women who walked infrequently . Regular vigorous exercise ( > or = 6 MET ) was associated with similar risk reductions ( 30 to 40 percent ) . Sedentary women who became active in middle adulthood or later had a lower risk of coronary events than their counterparts who remained sedentary . CONCLUSIONS These prospect i ve data indicate that brisk walking and vigorous exercise are associated with substantial and similar reductions in the incidence of coronary events among women This study examined the questions of whether pregnancy decreases physical fitness , as measured by maximal oxygen consumption , between the second and third trimesters , and whether maintaining a regular exercise program during the second half of pregnancy affects fitness . At the 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To evaluate the influence of exercise on maternal and perinatal outcome in a low‐risk healthy obstetric population . METHODS We conducted a prospect i ve observational study of low‐risk healthy women exercising during their pregnancy . An extensive question naire collected antepartum , intrapartum , and postpartum patient information on 750 women . The women were divided into four groups based on exercise level during pregnancy . RESULTS There were no differences among groups for maternal demographic characteristics , antenatal illnesses , stress , social support , or smoking . Heavily exercising women were older ( P = .042 ) , had higher incomes ( P = .001 ) , and were exercising more at conception ( P = .001 ) . Women who did more exercise were more likely to need an induction of labor ( P = .033 , relative risk 1.84 , 95 % confidence interval 1.05 , 3.20 ) , induction or augmentation with oxytocin ( P = .015 , relative risk 1.53 , 95 % confidence interval 1.19 , 1.97 ) , and had longer first‐stage labors ( P = .032 ) result ing in longer total labors ( P = .011 ) . The difference in the length of first‐stage labor was even greater if the no‐exercise group was compared with the strongly exercising group ( P = .009 , relative risk 1.38 , 95 % confidence interval 0.16 , 2.60 ) . Fewer umbilical cord abnormalities ( P = .034 ) were observed with exercise , but exercising women had more colds and flu ( P = .008 ) . Heavily exercising women had smaller infants ( mean difference 86.5 g ) compared with sedentary women . CONCLUSION Exercise  in working women is associated with smaller babies , increased number of inductions and augmentations of labor , and longer labors . Colds and flu are more frequent in exercising women PURPOSE The present study examined the effects of exercise on physical and psychological variables in sedentary primigravidae ( PRA ) . METHODS A total of nine women r and omly assigned to an exercise ( E ) ( mean age = 31.3 + /- 3.1 yr ) and six subjects r and omly assigned to a control ( C ) group ( mean age = 27.8 + /- 3.1 yr ) fulfilled all requirements for the study . Exercise included a variety of exercise activities performed to a target heart rate of 150 - 156 beats x min(-1 ) , three times per week for 15 wk . RESULTS Results showed no significant differences between E and C groups in physical characteristics initially . A repeated measures ANOVA showed a significant group effect ( P < 0.05 ) and a significant group by time interaction ( P = 0.001 ) with the E group showing a significantly longer amount of time on the PWC150 test than the C group . There was no significant group , time , or group by time interaction for lactate accumulation . This occurred , despite the fact that the E group spent 56 % longer on the PWC150 test and the C group spent 30 % less time on the same test at the conclusion of the study . Finally , the E group in comparison to the C group showed more favorable improvements in several items related to health and well-being on the Body Cathexis Scale . There were no significant differences between E and C groups in any pregnancy outcome measures . All babies were delivered healthy  at term . CONCLUSIONS These data suggest that a vigorous exercise program can lead to significant improvements in aerobic fitness at similar lactate concentrations compared to a control group and can be well tolerated by low risk sedentary PRA without any deleterious effects occurring to herself or unborn child Does strenuous antenatal exercise reduce birth‐weight ? Does reducing maternal exercise increase birthweight ? What to advise about exercise during pregnancy A group of 62 healthy primigravidae aged 20–26 years participated in an investigation concerning physical work capacity and cardiovascular dynamics during pregnancy and the effect of physical training beginning in the 10th or 14th week of pregnancy and lasting until term . The training group consisted of 31 women who were examined every 4 weeks throughout pregnancy , the last examination occurring in the 38th week . The r and omly selected control group consisted of 31 women who were examined in the 10th or 14th , in the 26th , and in the 38th week of pregnancy . During the examination the  pulse rate and blood pressure were measured in the left lateral position after rest , in the sitting position , and at nearly maximal exertion . The  pulse-conducted triangular ECG test  was used for determination of physical work capacity . All forms of voluntary exercise were allowed and recommended to the training group , emphasizing strenuous physical exertion . The physical work capacity in the control group spontaneously rose 10 % OBJECTIVE To investigate if water-gymnastics during pregnancy may reduce the intensity of back/low back pain and the number of days on sick-leave . METHODS A prospect i ve , r and omized study . One hundred and twenty-nine women were r and omized to participate in water-gymnastics once a week during the second half of pregnancy and 129 were r and omized to a control group . The women in both groups filled in question naires in gestational weeks 18 , 34 and within the first postpartum week . Every day from week 18 to labor they assessed the intensity of back/low back pain . RESULTS Back pain intensity increased during pregnancy . No excess risk for the pregnancy associated with water-gymnastics was observed . The women participating in water-gymnastics recorded a lower intensity of back/low back pain . The total number of days on sick-leave because of back/low back pain was 982 in the water-gymnastics group ( 124 women ) compared with 1484 in the control group ( 120 women ) . After weeks 32 33 , seven women in the water-gymnastics group compared with 17 in the control group were on sickleave because of back/ low back pain ( p=0.031 ) . CONCLUSIONS Intensity of back/low back pain increased with advancing pregnancy . There was no excess risk for urinary or vaginal infections associated with water-gymnastics . Water-gymnastics during the second half of pregnancy significantly reduced the intensity of back/ low back pain .  Water-gymnastics decreased the number of women on sick-leave because of back/low back pain .  Water-gymnastics during pregnancy can be recommended as a method to relieve back pain and may reduce the need for sick-leave The effect on fetal and maternal outcome in gestational exercise in a recreational athlete was investigated in a 2 1/2-year prospect i ve study . A training effect in a pregnant subject engaged in aerobic exercise was also determined . One hundred forty-one low-risk pregnant subjects had their aerobic capacity tested during the first trimester , during the third trimester , and post partum . Predicted maximum oxygen consumption values were determined by using st and ard Bruce treadmill protocol during the first and third tests and the Astr and protocol for submaximal testing on a bicycle ergometer during the third trimester . Exercise prescriptions were given . The primiparous and multiparous subjects were r and omized into control and exercise groups , differing only in the frequency of aerobic exercise . The results showed that exercise had no associated increase in neonatal morbidity and obstetric complications . All subjects improved or maintained their level of aerobic fitness . The exercisers showed a significant training effect . The disparity in the second test 's results may suggest that the physiologic characteristics of pregnancy masked the aerobic improvement BACKGROUND : The Institute of Medicine ( IOM ) recommends that normal‐weight women ( BMI ( body mass index ) of 19.8–26.0 ) gain 25–35 lb ( 11.4–15.9 kg ) during pregnancy , and that overweight women ( BMI of 26.1–29.0 ) gain 15–25 lbs ( 6.8–11.4 kg ) . A significant number of normal‐weight women and an even greater proportion of overweight women exceed these guidelines , which increases postpartum weight retention and may contribute to the development of obesity . OBJECTIVE : To determine whether a stepped care , behavioral intervention will decrease the percentage of women who gain more than the IOM recommendation . DESIGN : R and omized controlled trial comparing a stepped-care behavioral intervention with usual care .  Women ( n=120 ) who had a BMI > 19.8 , age>18 and < 20 weeks gestation were recruited from a hospital-based clinic serving low-income women and r and omized by race and BMI category to the intervention or control group . The intervention group received education about weight gain , healthy eating , and exercise and individual graphs of their weight gain . Those exceeding weight gain goals were given more intensive intervention . Women were followed through pregnancy to their first postpartum clinic visit . The main outcome measure was weight gain during pregnancy categorized as above the IOM recommendations vs below or within the IOM recommendations . RESULTS : The intervention significantly decreased the percentage of normal-weight women who exceeded the IOM recommendations ( 33 vs 58 % , P<0.05 ) . There was a non-significant ( P=0.09 ) effect in the opposite direction among overweight women ( 59 % of intervention and 32 % of control gained more than recommended ) . Postpartum weight retention was strongly related to weight gain during pregnancy ( r=0.89 ) . CONCLUSIONS : The intervention reduced excessive weight gain during pregnancy among normal weight women OBJECTIVE Our purpose was to test the null hypothesis that beginning regular , moderate-intensity exercise in early pregnancy has no effect on fetoplacental growth . STUDY DESIGN Forty-six women who did not exercise regularly were r and omly assigned at 8 weeks either to no exercise ( n = 24 ) or to weight-bearing exercise ( n = 22 ) 3 to 5 times a week for the remainder of pregnancy . Outcome variables included antenatal placental growth rate and neonatal and placental morphometric measurements . RESULTS The offspring of the exercising women were significantly heavier ( corrected birth weight : 3.75 + /- 0.08 kg vs 3.49 + /- 0.07 kg ) and longer ( 51.8 + /- 0.3 cm vs 50.6 + /- 0.3 cm ) than those born to control women . The difference in birth weight was the result of an increase in both lean body mass and fat mass . In addition , midtrimester placental growth rate was faster ( 26 + /- 2 cm(3)/wk vs 21 + /- 1 cm(3)/wk ) and morphometric indexes of placental function were greater in the exercise group . There were no significant differences in neonatal percentage body fat , head circumference , ponderal index , or maternal weight gain . CONCLUSIONS These data indicate that beginning a moderate regimen of weight-bearing exercise in early pregnancy enhances fetoplacental growth In order to determine if moderate maternal exercise increased uterine activity , a prospect i ve study was done during the last 8 weeks of pregnancy in 17 women . Two forms of exercise were chosen , weight-bearing ( running ) and non-weight-bearing ( stationary bicycle ) , to study this hypothesis . The results show that with these types of exercise no increase in uterine activity was noted . This is useful information to convey to pregnant patients ready to engage in a physical fitness program BACKGROUND The role of walking , as compared with vigorous exercise , in the prevention of coronary heart disease remains controversial , and data for women on this topic are sparse . METHODS We prospect ively examined the associations between the score for total physical activity , walking , and vigorous exercise and the incidence of coronary events among 72,488 female nurses who were 40 to 65 years old in 1986 . Participants were free of diagnosed cardiovascular disease or cancer at the time of entry and completed serial detailed question naires about physical activity . During eight years of follow-up , we documented 645 incident coronary events ( nonfatal myocardial infa rct ion or death from coronary disease ) . RESULTS There was a strong , grade d inverse association between physical activity and the risk of coronary events . As compared with women in the lowest quintile group for energy expenditure ( expressed as the metabolic-equivalent [ MET ] score ) , women in increasing quintile groups had age-adjusted relative risks of 0.77 , 0.65 , 0.54 , and 0.46 for coronary events ( P for trend < 0.001 ) . In multivariate analyses , the inverse gradient remained strong ( relative risks , 0.88 , 0.81 , 0.74 , and 0.66 for women in increasing quintile groups as compared with those in the lowest quintile group ; P for trend=0.002 ) . Walking was inversely associated with the risk of coronary events ; women in the highest quintile group for walking , who walked the equivalent of three or more hours per week at a brisk pace , had a multivariate relative risk of 0.65 ( 95 percent confidence interval , 0.47 to 0.91 ) as compared with women who walked infrequently . Regular vigorous exercise ( > or = 6 MET ) was associated with similar risk reductions ( 30 to 40 percent ) . Sedentary women who became active in middle adulthood or later had a lower risk of coronary events than their counterparts who remained sedentary . CONCLUSIONS These prospect i ve data indicate that brisk walking and vigorous exercise are associated with substantial and similar reductions in the incidence of coronary events among women This study examined the questions of whether pregnancy decreases physical fitness , as measured by maximal oxygen consumption , between the second and third trimesters , and whether maintaining a regular exercise program during the second half of pregnancy affects fitness . At the 
    Output:
    