REF-1780 · Guo et al., 2026 · Advances in Therapy, · Paper · PubMed

Women with overweight or obesity who had been randomised to moderate exercise in pregnancy had, 8-10 years later, a lower BMI (27.15 vs 29.45 kg/m²), less body fat and visceral fat and lower glucose and insulin than controls, and their children were less often overweight or obese (37.93% vs 48.07%), in a follow-up of 118 mothers and 110 children from a randomised trial; the original trial size and retention are not reported, so the follow-up may no longer be a randomised comparison

Main caveat: Abstract only: the original trial's size, the arms' sizes at follow-up, the reasons for loss to follow-up and baseline comparability at follow-up are not…
limited evidenceMeasured on non-athletes and recreational peopleRead from the abstract only

Guo and colleagues went back to a randomised trial that had tested exercise in pregnancy for preventing gestational diabetes in women with overweight or obesity, and examined mothers and children 8-10 years after the intervention.

They measured weight, skinfolds, body composition, blood pressure, a glucose tolerance test with insulin release, and blood lipids. 118 mothers and 110 children took part.

Mothers from the exercise group had lower fasting and 2-h glucose, lower fasting and 2-h insulin and lower HOMA-IR, as well as a lower BMI, body-fat percentage, visceral fat area and waist and hip circumferences.

Their children were less often overweight or obese; the children's BMI Z-score, fasting glucose and waist and hip circumferences were lower without reaching significance. The authors conclude that moderate exercise in pregnancy gives lasting metabolic benefits to mothers with overweight or obesity and may benefit their children.

Participants

118 mothers and 110 children at 8-10 years; the split by arm, the original number randomised, the loss to follow-up, the mothers' ages and the children's ages and sexes are not in the abstract.
Mothers had overweight or obesity at the time of the original trial (BMI criteria not in the abstract).

Protocol

Original trial: exercise in pregnancy (described as moderate intensity) against controls, to prevent gestational diabetes; exercise type, frequency, duration, supervision and adherence are not in the abstract.
Follow-up: anthropometry (weight, skinfold thickness, body composition), blood pressure, oral glucose tolerance test, insulin release test, lipid profile, in mothers and children.
Analysis: adjusted comparisons (covariates not in the abstract); results reported as median (interquartile range) or mean ± SD.

Key Results

Mothers, exercise vs control:

OutcomeExerciseControlP
Fasting glucose, mmol/L, median (IQR)5.00 (4.61, 5.23)5.08 (4.89, 5.52)adj. <0.001
2-h glucose, mmol/L6.54 (5.64, 8.10)7.17 (6.28, 9.59)adj. <0.001
Fasting insulin, mU/L9.14 (6.38, 14.40)12.5 (9.52, 16.10)adj. <0.001
2-h insulin, mU/L52.85 (40.60, 105.50)100.85 (66.90, 146.00)adj. <0.001
HOMA-IR1.96 (1.47, 3.29)3.00 (2.10, 3.94)0.008 (not labelled adjusted)
BMI, kg/m², mean ± SD27.15 ± 3.2529.45 ± 4.24adj. 0.001
Body fat, %36.31 ± 5.2139.07 ± 5.21adj. 0.006
Visceral fat area, cm²128.79 ± 40.21151.62 ± 38.54adj. 0.003
Waist (abdominal) circumference, cm91.68 ± 9.3496.92 ± 9.40adj. 0.004
Hip circumference, cm104.16 ± 7.37108.88 ± 8.65adj. 0.002

Children, exercise vs control:

OutcomeResult
Overweight or obesity37.93% vs 48.07%, adj. P = 0.002
BMI Z-score, fasting glucose, waist and hip circumferencelower in the exercise group, not significant (values not in the abstract)
Blood pressure and lipid results: not in the abstract. No confidence intervals are given.

Practical Application

In women with overweight or obesity, a randomised programme of moderate exercise in pregnancy went with a lower BMI, less body and visceral fat and better glucose control 8-10 years later, and with fewer overweight children (37.93% vs 48.07%) — in the women who returned, from the abstract only. It supports SYNTH-95's "keep training in pregnancy" for this population and adds nothing that contradicts it.
What it adds to the guide: REF-1710 and REF-1712 show exercise in pregnancy lowering gestational diabetes at the time; this follow-up suggests the difference in the mother's body composition and glucose regulation may persist for years, which the base had no entry on.
Inference, not tested here: for a woman who already trains, this says little — the sample is women with overweight or obesity in a diabetes-prevention trial, and nothing is reported on what the exercise group did after the pregnancy, which could also explain the gap.
Not treatment advice: exercise in pregnancy, and any metabolic follow-up, is planned with the obstetric provider or physician.

Limitations

Abstract only: the original trial's size, the arms' sizes at follow-up, the reasons for loss to follow-up and baseline comparability at follow-up are not reported, so selective return could explain the differences.
No confidence intervals; many outcomes tested with adjusted P values, covariates not named; HOMA-IR's P is not labelled adjusted.
The children's percentages cannot be turned back into counts because the group sizes are not given.
What the mothers did in the 8-10 years since (activity, later pregnancies, diet) is not in the abstract.
The exercise intervention (type, dose, supervision, adherence) is not described in the abstract.
The registration number (NCT07435857) is not dated in the abstract and may belong to the follow-up rather than the original trial.
Glucose, insulin and HOMA-IR are markers; BMI, fat and circumferences are body composition.
Women with overweight or obesity in a single trial; no athletes. Funding not stated in the abstract.
How this entry was checked and changed
Why this level

capped at B+ as a trial read from the abstract only, and one step lower because the abstract gives neither the original trial size nor how many returned in each arm, so the 118 mothers are best read as a small cohort of those who came back; the glucose and insulin claims are also markers