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 investigate the effect of a supervised home-based exercise program on the recurrence and severity of gestational diabetes mellitus ( GDM )  together with other aspects of maternal health and obstetric and neonatal outcomes . METHODS : This r and omized controlled trial allocated women with a history of GDM to an  exercise intervention ( 14-week supervised home-based stationary cycling program ) or to a control group ( st and ard care ) at 13±1 weeks of gestation . The primary outcome was a diagnosis of GDM . Secondary outcomes included maternal fitness , psychological well-being , and obstetric and neonatal outcomes . A sample size of 180 ( 90 in each group ) was required to attain 80 % power to detect a 40 % reduction in the incidence of GDM . RESULTS : Between June 2011 and July 2014 , 205 women provided written consent and completed baseline assessment s. Of these , 33 ( 16 % ) were subsequently excluded as a result of an elevated baseline oral glucose tolerance test ( OGTT ) , leaving 172 r and omized to exercise ( n=85 ) or control ( n=87 ) . Three women miscarried before the assessment of outcome measures ( control=2 ; exercise=1 ) . All remaining women completed the postintervention OGTT . The recurrence rate of GDM was similar between groups ( control 40 % [ n=34 ] ; exercise 40.5 % [ n=34 ] ; P=.95 ) and the severity of GDM at diagnosis was unaffected by the exercise program with similar glucose and insulin responses to the OGTT ( glucose 2 hours post-OGTT 7.7±1.5 compared with 7.6±1.6 mmol/L ; P>.05 ) . Maternal fitness was improved by the exercise program ( P<.01 ) and psychological distress was reduced ( P=.02 ) . There were no differences in obstetric and neonatal outcomes between groups ( P>.05 ) . CONCLUSION : Supervised home-based exercise started at 14 weeks of gestation did not prevent the recurrence of GDM ; however , it was associated with important benefits for maternal fitness and psychological well-being . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , https:// clinical trials.gov , NCT01283854 Background To evaluate the effectiveness and safety of water aerobics during pregnancy . Methods A r and omized controlled trial carried out in 71 low-risk sedentary pregnant women , r and omly allocated to water aerobics or no physical exercise .  Maternal body composition and perinatal outcomes were evaluated . For statistical analysis Chi-square , Fisher 's or Student 's t-tests were applied . Risk ratios and their 95 % CI were estimated for main outcomes . Body composition was evaluated across time using MANOVA or Friedman multiple analysis . Results There were no significant differences between the groups regarding maternal weight gain , BMI or percentage of body fat during pregnancy . Incidence of preterm births ( RR = 0.84 ; 95%CI:0.28–2.53 ) , vaginal births ( RR = 1.24 ; 95%CI:0.73–2.09 ) , low birthweight ( RR = 1.30 ; 95%CI:0.61–2.79 ) and adequate weight for gestational age ( RR = 1.50 ; 95%CI:0.65–3.48 ) were also not significantly different between groups . There were no significant differences in systolic and diastolic blood pressure and heart rate between before and immediately after the water aerobics session . Conclusion Water aerobics for sedentary pregnant women proved to be safe and was not associated with any alteration in maternal body composition , type of delivery , preterm birth rate , neonatal well-being or weight INTRODUCTION Walking may be a strategy for increasing moderate-intensity physical activity ( MPA )  during pregnancy . PURPOSE This study aim ed to promote MPA among overweight and obese pregnant women , via walking , and to evaluate the effect of the intervention on maternal and birth outcomes . METHODS Thirty-seven overweight or obese pregnant women were r and omly assigned to a walking intervention or control group . Anthropometric and objective PA ( StepWatch ™ Activity Monitor ) data were collected for four 1-wk periods : weeks 10 - 14 ( V1 ) , weeks 17 - 19 ( V2 ) , weeks 27 - 29 ( V3 ) , and weeks 34 - 36 ( V4 ) of gestation . Participants provided information about maternal and birth outcomes . A cadence of ≥ 80 steps per minute was defined as MPA , and " meaningful walking " was defined as moderate walking in ≥ 8-min bouts . ANOVA was used to determine the differences in walking amount and meaningful walks , the Kolmogorov-Smirnov test was used for walking intensity distribution analysis , and Fisher 's exact test was used for maternal and infant outcomes analyses . Pearson correlation was used to examine the association between prepregnancy body mass index and gestational weight gain ( GWG ) . RESULTS There was significantly more MPA among women in the intervention group compared with those in the control group at V2 ( overweight , P < 0.0001 ; obese , P < 0.025 ) , V3 ( overweight , P < 0.0001 ) , and V4 ( overweight , P < 0.0001 ; obese , P < 0.025 ) . Women in the intervention group significantly increased their meaningful walks at V2 ( P = 0.054 ) , V3 ( P = 0.01 ) , and V4 ( P = 0.014 ) . There were trends for intervention group women to have more favorable maternal and birth outcomes compared with the control group . Rates of GWG at measurement points during pregnancy were significantly associated with preceding rates of GWG . CONCLUSION The pilot , unsupervised walking intervention increased the MPA of overweight and obese women during pregnancy Few studies have investigated the impact of lifestyle interventions during pregnancy on post-partum weight retention and infant growth .  Thirty seven previously non-exercising , overweight or obese pregnant women were r and omly assigned to a walking intervention or non-intervention control . For the follow-up study , weight of the mother and weight , length and body composition of the infant were collected at 1 month post-partum ( n=37 ) and 6 months post-partum ( n=33 ) . Analysis of variance and linear regression were conducted to determine the differences and association in maternal post-partum weight retention and child outcomes . At 6 months post-partum , weight retention of obese women in the intervention group ( Int-OB ) was -0.10±8.11 kg ; while , obese women in the control group ( Con-OB ) was 6.35±7.47 kg . A significantly higher percentage of Con-OB women retained more than 5 kg at 6 months post-partum ( P=0.046 ) . Even though statistically non-significant between the groups , the growth trend observed among offspring of obese women in the control group was consistently higher than the offspring of obese women in the intervention group from birth to 6-months . Third trimester gestational weight gain rate significantly predicted 6-m weight-for-length z-score after controlling for birth weight , treatment group and pre-pregnancy body mass index ( r 2=0.31 , β=1.75 , P=0.03 ) . The reduced post-partum weight retention observed among the obese women in the intervention group may be explained in part by the lifestyle modification during pregnancy ABSTRACT Accumulating research indicates that the regular practice of physical exercise is beneficial to the human brain . From the improvement of academic achievement in children to the prevention of Alzheimer ’s disease in the elderly , exercise appears beneficial across the developmental spectrum . Recent work from animal studies also indicates that a pregnant mother can transfer the benefits of exercise during gestation to her offspring ’s brain . Exercising pregnant rats give birth to pups that have better memory and spatial learning as well as increased synaptic density . To investigate whether this transfer from the pregnant mother to her child also occurs in humans , we conducted a r and omized controlled trial ( n = 18 ) and measured the impact of exercise during pregnancy on the neuroelectric response of the neonatal brain with electroencephalography ( EEG ) . Here we show that , compared to the newborns of mothers who were inactive during their pregnancy , the children of exercising pregnant women are born with more mature brains . This was measured with the infant slow positive mismatch response ( SPMMR ) , an electroencephalographic potential known to decrease in amplitude with age . The SPMMR reflects processes associated with brain maturation via its response to sound discrimination and auditory memory . In this study , the children of the mothers who exercised throughout their pregnancy  have a smaller SPMMR than the children of mothers who remained sedentary ( p = .019 ) . Our results demonstrate the impact regular exercise during pregnancy can have on the development of the human fetal brain 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 AIM The effect of exercise training during the course of pregnancy on the newborn 's birth weight is unclear . This study examines the effect of aerobic and strength conditioning exercise performed during the second and the third trimester of pregnancy in nulliparous , previously inactive women on the newborn 's outcome . METHODS Sixty-three nulliparous , previously sedentary , were r and omly assigned to either an exercise ( N.=30 ) or a control ( N.=33 ) group . The subjects participated in the exercise group ( EG ) focused on aerobic and strength-conditioning exercise in three sessions for about 20 weeks . We registered the birth weight , birth length , gestational age at time of delivery , Apgar score and head circumference of the newborn . RESULTS There were no statistically significant differences between the two groups in mean birth weight , length , head circumference , and length of gestation . There was a significant difference between two groups in Apgar scores at 1 min ( P=0.036 ) and 5 min ( P=0.015 ) with newborns of the EG scoring higher than the CG . CONCLUSION Supervised , aerobic and strength conditioning exercise performed over the second and third trimester of pregnancy does not have a negative impact on the newborn 's body size and health 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 
    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 investigate the effect of a supervised home-based exercise program on the recurrence and severity of gestational diabetes mellitus ( GDM )  together with other aspects of maternal health and obstetric and neonatal outcomes . METHODS : This r and omized controlled trial allocated women with a history of GDM to an  exercise intervention ( 14-week supervised home-based stationary cycling program ) or to a control group ( st and ard care ) at 13±1 weeks of gestation . The primary outcome was a diagnosis of GDM . Secondary outcomes included maternal fitness , psychological well-being , and obstetric and neonatal outcomes . A sample size of 180 ( 90 in each group ) was required to attain 80 % power to detect a 40 % reduction in the incidence of GDM . RESULTS : Between June 2011 and July 2014 , 205 women provided written consent and completed baseline assessment s. Of these , 33 ( 16 % ) were subsequently excluded as a result of an elevated baseline oral glucose tolerance test ( OGTT ) , leaving 172 r and omized to exercise ( n=85 ) or control ( n=87 ) . Three women miscarried before the assessment of outcome measures ( control=2 ; exercise=1 ) . All remaining women completed the postintervention OGTT . The recurrence rate of GDM was similar between groups ( control 40 % [ n=34 ] ; exercise 40.5 % [ n=34 ] ; P=.95 ) and the severity of GDM at diagnosis was unaffected by the exercise program with similar glucose and insulin responses to the OGTT ( glucose 2 hours post-OGTT 7.7±1.5 compared with 7.6±1.6 mmol/L ; P>.05 ) . Maternal fitness was improved by the exercise program ( P<.01 ) and psychological distress was reduced ( P=.02 ) . There were no differences in obstetric and neonatal outcomes between groups ( P>.05 ) . CONCLUSION : Supervised home-based exercise started at 14 weeks of gestation did not prevent the recurrence of GDM ; however , it was associated with important benefits for maternal fitness and psychological well-being . CLINICAL TRIAL REGISTRATION : Clinical Trials.gov , https:// clinical trials.gov , NCT01283854 Background To evaluate the effectiveness and safety of water aerobics during pregnancy . Methods A r and omized controlled trial carried out in 71 low-risk sedentary pregnant women , r and omly allocated to water aerobics or no physical exercise .  Maternal body composition and perinatal outcomes were evaluated . For statistical analysis Chi-square , Fisher 's or Student 's t-tests were applied . Risk ratios and their 95 % CI were estimated for main outcomes . Body composition was evaluated across time using MANOVA or Friedman multiple analysis . Results There were no significant differences between the groups regarding maternal weight gain , BMI or percentage of body fat during pregnancy . Incidence of preterm births ( RR = 0.84 ; 95%CI:0.28–2.53 ) , vaginal births ( RR = 1.24 ; 95%CI:0.73–2.09 ) , low birthweight ( RR = 1.30 ; 95%CI:0.61–2.79 ) and adequate weight for gestational age ( RR = 1.50 ; 95%CI:0.65–3.48 ) were also not significantly different between groups . There were no significant differences in systolic and diastolic blood pressure and heart rate between before and immediately after the water aerobics session . Conclusion Water aerobics for sedentary pregnant women proved to be safe and was not associated with any alteration in maternal body composition , type of delivery , preterm birth rate , neonatal well-being or weight INTRODUCTION Walking may be a strategy for increasing moderate-intensity physical activity ( MPA )  during pregnancy . PURPOSE This study aim ed to promote MPA among overweight and obese pregnant women , via walking , and to evaluate the effect of the intervention on maternal and birth outcomes . METHODS Thirty-seven overweight or obese pregnant women were r and omly assigned to a walking intervention or control group . Anthropometric and objective PA ( StepWatch ™ Activity Monitor ) data were collected for four 1-wk periods : weeks 10 - 14 ( V1 ) , weeks 17 - 19 ( V2 ) , weeks 27 - 29 ( V3 ) , and weeks 34 - 36 ( V4 ) of gestation . Participants provided information about maternal and birth outcomes . A cadence of ≥ 80 steps per minute was defined as MPA , and " meaningful walking " was defined as moderate walking in ≥ 8-min bouts . ANOVA was used to determine the differences in walking amount and meaningful walks , the Kolmogorov-Smirnov test was used for walking intensity distribution analysis , and Fisher 's exact test was used for maternal and infant outcomes analyses . Pearson correlation was used to examine the association between prepregnancy body mass index and gestational weight gain ( GWG ) . RESULTS There was significantly more MPA among women in the intervention group compared with those in the control group at V2 ( overweight , P < 0.0001 ; obese , P < 0.025 ) , V3 ( overweight , P < 0.0001 ) , and V4 ( overweight , P < 0.0001 ; obese , P < 0.025 ) . Women in the intervention group significantly increased their meaningful walks at V2 ( P = 0.054 ) , V3 ( P = 0.01 ) , and V4 ( P = 0.014 ) . There were trends for intervention group women to have more favorable maternal and birth outcomes compared with the control group . Rates of GWG at measurement points during pregnancy were significantly associated with preceding rates of GWG . CONCLUSION The pilot , unsupervised walking intervention increased the MPA of overweight and obese women during pregnancy Few studies have investigated the impact of lifestyle interventions during pregnancy on post-partum weight retention and infant growth .  Thirty seven previously non-exercising , overweight or obese pregnant women were r and omly assigned to a walking intervention or non-intervention control . For the follow-up study , weight of the mother and weight , length and body composition of the infant were collected at 1 month post-partum ( n=37 ) and 6 months post-partum ( n=33 ) . Analysis of variance and linear regression were conducted to determine the differences and association in maternal post-partum weight retention and child outcomes . At 6 months post-partum , weight retention of obese women in the intervention group ( Int-OB ) was -0.10±8.11 kg ; while , obese women in the control group ( Con-OB ) was 6.35±7.47 kg . A significantly higher percentage of Con-OB women retained more than 5 kg at 6 months post-partum ( P=0.046 ) . Even though statistically non-significant between the groups , the growth trend observed among offspring of obese women in the control group was consistently higher than the offspring of obese women in the intervention group from birth to 6-months . Third trimester gestational weight gain rate significantly predicted 6-m weight-for-length z-score after controlling for birth weight , treatment group and pre-pregnancy body mass index ( r 2=0.31 , β=1.75 , P=0.03 ) . The reduced post-partum weight retention observed among the obese women in the intervention group may be explained in part by the lifestyle modification during pregnancy ABSTRACT Accumulating research indicates that the regular practice of physical exercise is beneficial to the human brain . From the improvement of academic achievement in children to the prevention of Alzheimer ’s disease in the elderly , exercise appears beneficial across the developmental spectrum . Recent work from animal studies also indicates that a pregnant mother can transfer the benefits of exercise during gestation to her offspring ’s brain . Exercising pregnant rats give birth to pups that have better memory and spatial learning as well as increased synaptic density . To investigate whether this transfer from the pregnant mother to her child also occurs in humans , we conducted a r and omized controlled trial ( n = 18 ) and measured the impact of exercise during pregnancy on the neuroelectric response of the neonatal brain with electroencephalography ( EEG ) . Here we show that , compared to the newborns of mothers who were inactive during their pregnancy , the children of exercising pregnant women are born with more mature brains . This was measured with the infant slow positive mismatch response ( SPMMR ) , an electroencephalographic potential known to decrease in amplitude with age . The SPMMR reflects processes associated with brain maturation via its response to sound discrimination and auditory memory . In this study , the children of the mothers who exercised throughout their pregnancy  have a smaller SPMMR than the children of mothers who remained sedentary ( p = .019 ) . Our results demonstrate the impact regular exercise during pregnancy can have on the development of the human fetal brain 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 AIM The effect of exercise training during the course of pregnancy on the newborn 's birth weight is unclear . This study examines the effect of aerobic and strength conditioning exercise performed during the second and the third trimester of pregnancy in nulliparous , previously inactive women on the newborn 's outcome . METHODS Sixty-three nulliparous , previously sedentary , were r and omly assigned to either an exercise ( N.=30 ) or a control ( N.=33 ) group . The subjects participated in the exercise group ( EG ) focused on aerobic and strength-conditioning exercise in three sessions for about 20 weeks . We registered the birth weight , birth length , gestational age at time of delivery , Apgar score and head circumference of the newborn . RESULTS There were no statistically significant differences between the two groups in mean birth weight , length , head circumference , and length of gestation . There was a significant difference between two groups in Apgar scores at 1 min ( P=0.036 ) and 5 min ( P=0.015 ) with newborns of the EG scoring higher than the CG . CONCLUSION Supervised , aerobic and strength conditioning exercise performed over the second and third trimester of pregnancy does not have a negative impact on the newborn 's body size and health 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 
    Output:
    