The goal of this observational study is to learn how a physically active lifestyle during pregnancy affects placental development and function. The main question it aims to answer is:

Does regular physical activity during pregnancy improve placental function and support healthy fetal growth?

Pregnant participants will provide biological samples and health information during pregnancy and at delivery. The study will use these samples to examine how activity levels relate to placental energy production and overall health.

This observational study aims to examine how a physically active lifestyle during pregnancy affects placental function and fetal development. We will enroll pregnant participants and collect biological samples, including blood and placental tissue after delivery. The study will measure markers of placental energy production and other indicators of placental health to understand the mechanisms by which maternal physical activity may influence fetal growth.

Data collected will also include health information, lifestyle questionnaires, and activity assessments during pregnancy. Participants will not need to change their normal exercise habits. The results of this study may help identify how maternal physical activity supports placental and fetal health, which could inform future recommendations for healthy pregnancies.

Inclusion Criteria:

• Pregnant female and their newborn infant(s)
• Aged 18-45 (pregnant female), age 0-60 days of life (newborn infant)
• English speaking
• Screened for gestational diabetes with standard glucose tolerance test between 24w - 41w gestation
• Delivered at gestational age 34week-41weeks
• Delivered via non-emergent Cesarean section during weekday hours
• No known infectious disease (ex: HIV, HepC)

Exclusion Criteria:

• Women <18yo or >45yo
• Non-English speaking
• Pre-existing diabetes or diagnosed with diabetes prior to 24weeks
• Required complex diets/supplements not related to the pregnancy (i.e. malnutrition)
• Known severe fetal anomalies or genetic disorder
• Placenta accreta spectrum
• Emergent cesarean delivery performed due to fetal distress
• Known infectious disease (ex: HIV, HepC)

The study population consists of pregnant individuals receiving prenatal care and/or delivering at affiliated clinical sites of the University of Maryland, Baltimore and surrounding community healthcare settings. Participants will be recruited from local obstetric clinics and hospital-based prenatal care programs. The study represents a community-based sample of pregnant individuals with varying levels of physical activity during pregnancy.

Results of our study will not be shared with the subjects. We plan on publishing our results in a peer reviewed journal. We also plan to present the results as a thesis dissertation for Dr. Esteves. We also hope the results will generate evidence for benefits of physical activity during pregnancy, which will lead to seeking extramural NIH grants for cohort study of pregnant women with exercise programs.