Investigation of the Relationship between Physical Activity Levels, Maternal Weight (before delivery) and Serum Cortisol Level (during labor) in Nulliparous Women

Document Type : Original Article


1 MSc of physiology, Department of Educational office Region Bastam, Bastam, Iran.

2 Associate Professor, Department of Exercise Physiology, Physical Education and Sport Sciences Faculty, Ferdowsi University of Mashhad, Mashhad, Iran.

3 Gynecologist, Shahrood, Iran.


Introduction: Many studies confirm the health benefits of exercise during pregnancy both for mother and fetus. Given the possibility of poor pregnancy outcomes as well as adverse economic, physical and psychological consequences, the main purpose of the present study was to investigate the relationship between physical activity levels, maternal weight (before delivery) and serum cortisol levels (during labor) in nulliparous women.
Methods: The participants of this cross-sectional study were women admitted to Imam Hussein hospital for delivery in Shahrood, Iran, 2013. Overall, 76 women were chosen randomly as the sample. The physical activity level was determined via PPAQ questionnaire and maternal weight and serum cortisol level were measured using a scale and ELISA kit, respectively. The validity of all the data gathering tools was approved by a number of experts in the field and the reliability of the questionnaire was measured (α=0.81). The data was analyzed using SPSS software version 18. Kolmogorov-Smironov, Pearson correlation and Spearman correlation were performed (P-value less than 0.05 was considered significant). 
Results: Our findings proposed that there is a significant inverse relationship between physical activity Level of pregnant women and maternal weight before delivery (p<0.05); however, no significant relationship was found between physical activity level of pregnant women and maternal serum cortisol level while in labor (p>0.05).
Conclusion: Delivery, considered as the most physically and mentally stressful event for pregnant women, is completely independent of pregnancy. Therefore, serum cortisol levels during labor is not affected by physical activity during pregnancy, however, the weight gain during pregnancy can be controlled through physical activity.
Keywords: Delivery, Physical Activity, Cortisol, Weight

  1. Cuningham FG, Gant NF, Levero Kj, Gilstrap LC, Hauth JC, Wenstrom KD. Williams Obstetrics. 21th ed. NewYork: McGraw- Hill; 2001. P.567,609,613,1209-16,1253-54, 1340-44, 1367-68, 1371-74, 1385-8.
  2. U.S. Department of Health and Human Services. Healthy People, 2010.Conference Edition (Two Volumes). Washington DC: Centers for Disease Control and Prevention; 2000.
  3. Zhang J, Savitz DA. Exercise during pregnancy among US women. Ann Epidemiol 1996;6(1):53-9.
  4. Monk C, Fifer WP, Myers MM, Sloan RP, Trien L, Hurtado A. . .Maternal stress responses and anxiety during pregnancy: Effects on fetal heart rate. Dev Psychobiol 2000; 36(1): 67-77.
  5. ACSM's Guidelines for Graded Exercise Testing and Prescription. 1999.2ndEd. Philadelphia: Lea & Febiger.
  6. Polley BA, Wing RR, Sims CJ. Randomized control trial to prevent excessive weight gain in pregnant women. Int J Obes Relat Metab Disord 2002; 26(11): 1494-502.
  7. American College of Obstetricians and Gynecologists, Exercise during pregnancy and the postpartum period 2002. (ACOG Committee Opinion No. 267). Obstetrics and Gynecology.; 99: 171-173
  8. Wolf LA, Weissgerber TL. Clinical physiology of exercise in pregnancy: a literature review. J Obstet Gynecol Can 2003; 25(6): 473-83
  9. Field T. Prenatal exercise research .Infant Behav Dev 2012; 35(3): 397-407
  10. Bruce RA. Exercise, functional aerobic capacity, and aging--another viewpoint. Med Sci Sports Exerc 1994; 16(1): 8-13.
  11.   Magann EF, Evans SF, Newnham JP. Employment, exertion, and pregnancy outcome: assessment by kilocalories expended each day. Am J Obstet Gynecol 1996; 175(1): 182-7
  12. Lee AM, Lam SK, Sze Mun Lau SM, Chong CS, Chui HW, Fong DY. Prevalence. course. and risk factors for antenatal anxiety and depression. Obstet Gynecol 2007; 110(5): 1102-12.
  13. O'Connor TG, Caprariello P, Blackmore ER, Gregory AM, Glover V, Fleming P; ALSPAC Study Team. Prenatal mood disturbance predicts sleep problems in infancy and toddlerhood. Early Hum Dev 2007; 83(7): 451-8.
  14.  Boudarene M, Legros JJ, Timsit – Berthier M. Study of the stress response: role of anxiety. cortisol and DHEAs. Encephale 2002; 28(2): 139-46.
  15. Clapp JF 3rd, Dickstein S. Endurance exercise and pregnancy outcome. Med Sci Sports Exerc 1984; 5(1): 556-62
  16.  Van den Bergh BR, Mulder EJ, Mennes M, Glover V. Antenatal. maternal anxiety and stress and the neurobehavioural development of the fetus and child: links and possible mechanisms. A review. Neurosci Biobehav Rev 2005; 29(2): 237-58.
  17. Mancuso RA, Schetter CD, Rini CM, Roesch SC, Hobel CJ. Maternal prenatal anxiety and corticotropin-releasing hormone associated with timing of delivery. Psychosom Med 2004; 66(5): 762-9.
  18. Kammerer M, Adams D, Castelberg Bv, Glover V. Pregnant women become insensitive to cold stress. BMC Pregnancy Childbirth 2002; 2(1): 8.
  19. Rahman A, Creed F. Outcome of prenatal depression and risk factors associated with persistence in the first postnatal year: prospective study from Rawalpindi, Pakistan. J Affect Disord 2007; 100(1-3): 115-21.
  20. Borjesson B, Paperin C, Lindell M. Maternal support during the first year of infancy. J Adv Nurs 2004; 45(6): 588-94
  21. -Cohen TR, Koski KG. Limiting  excess weight gain in healthy pregnant women: importance of energy intakes, physical activity, and adherence to gestational weight gain guidelines.  J Pregnancy 2013; 2013: 787032.
  22. Khaledan A, Mirdar Sh, Motahari Tabari NS, Ahmad Shirvani M. Effect of an aerobic exercise program on fetal growth in pregnant women . Hayat 2010; 16 (1): 55-64. [Persian]
  23. Chasan-Taber L, Schmidt MD, Roberts DE, Hosmer D, Markenson G, Freedson PS. Development and validation of pregnancy physical activity questionnaire. Med Sci Sports Exerc 2004; 36(10): 1750-60.
  24.  Mehran N, Abbaszadeh F, Bagheri A, Noroozi M. Relation between Home Work and Preterm Labor. hayat 2012; 18(5): 46-54.[Persian]
  25.  Kazemi A, Ahmadi P. Relationship between physical activity during the first 20 weeks of gestation and hypertension in pregnancy. J Shahrekord Univ Med Sci. 2007; 9 (2) :20-27.[Persian]
  26.  Manar LK, Escott SV. Food nutrition & diet theraphy. 11th ed. Philadelphia: RA Chelk-Johnson;2004. p: 21
  27. Salari P, Alavian F, Habibi Rad A, Tara F. The Relationship between Stress, Anxiety and Pain with Salivary Cortisol Levels in First Stage of Labor in Primiparous Women.  The Iranian Journal of Obstetrics, Gynecology and Infertility. 2013 ;16(55). 14-21.[Persian]
  28. Gorzi, Ali. The effect of 10 weeks endurance, strength and concurrent (combined endurance and strength) training on serum TNF-a and cortisol in untrained men. M.A.Thesis, , TarbiatModares niversity ;2007 .[Persian]
  29. Smilios I, Pilianidis T, Karamouzis M,Tokmakidis SP. Hormonal. responses after various resistance exercise protocols. Med Sci Sports Exerc 2003; 35(4): 644-54.
  30. Abaassi Daluee A, Ghanbari Niaki A, Fathi R, Hedayati M. The Effect of a Single Session Aerobic Exercise on Plasma Ghrelin, GH, Insulin and Cortisol in Non-Athlete University Male Students. Iranian Journal of Endocrinology and Metabolism. 2011; 13 (2) :197-201. [Persian]
  31.  Nordhagen IH, Sundgot-Borgen J. “Physical activity among pregnant women in relation to pregnancy-related complaints and symptoms of depression”. Tidsskr Nor Laegeforen. 2002;  122 (5): 470-4.
  32. Hatch, M, C, and Stein, Z. Work and exercise during pregnancy: Epidemiological  Studies. In: exercise in pregnancy. (Eds): Artal, Mittlemark, R. Wiswell, R. and Drinkwater Baltimore: Williams &Wilkins. 1990: 279-286.
  33. Magann EF, Evans SF, Weitz B, Newnham J. Antepartum, Intrapartum, and neonatal significance of exercise on healthy low-risk pregnant working women. Obstet Gynecol 2002; 99(3): 466-72.
  34. Galtier-Dereure f ,Boulot P. Obstetrical complications of maternal overweight. contracept Fertil sex 1994;  22(2): 113-16.
  35. Zand S, Zamani AThe effect of simple exercise maneuvers and proper performance of daily activity on outcome of pregnancyIranian Journal of Obstetrics, Gynecology and Infertility 2009;12(3):51-7.[Persian]