{
  "abstract": "ObjectiveTo evaluate moderate-intensity exercise effects on glucoregulatory and inflammatory markers in pregnant women with obesity.\n\nMethodsSecondary analysis of the Expecting Study (NCT02125149) included 263 sedentary pregnant women with pre-pregnancy BMI [≥]30kg/m2 randomized to exercise (EX, n=157) or standard-of-care (SoC, n=106). Fasting biomarkers were assessed at 12.14{+/-}0.50, 24.19{+/-}0.68, and 36.03{+/-}0.58 weeks gestation. Linear mixed-effects models evaluated intervention and gestational effects at 24-36 weeks. Exploratory repeated-measures continuous glucose monitoring (CGM) included 18 participants (SoC=6, EX=12), evaluating 24-h/temporal glycemia and exploring inflammatory marker associations.\n\nResultsInsulin, C-peptide, HOMA2-IR, HOMA2-%B, IL-6, and TNF- increased with gestation, while HOMA2-%S and CRP decreased (all p<0.001). Exercise did not affect fasting glucose or inflammatory markers. CGM-wear yielded 12-15 days/trimester with >95% valid wear time; glycemia remained normoglycemic. By 36-weeks, SoC-metrics declined in 24-h and nocturnal glucose and time-in-range (TIR), with increased time-below-range (all p<0.022). TIR was inversely associated with IL-6 at 24-weeks (-0.23 [95%CI: -0.43,-0.02] p=0.035), and mean amplitude of glycemic excursion positively with TNF- at 36-weeks (0.02 [95%CI: 0.00,0.04] p=0.033).\n\nConclusionExercise did not modify mid-to late-gestation fasting glucoregulatory or inflammatory profiles. High CGM-adherence and preliminary indications of distinct longitudinal glycemic patterns support further CGM evaluation in antepartum behavioral interventions.\n\nWhat is already known about this subject?O_LIPregnancy and obesity increase insulin resistance and metabolic stress; exercise may improve maternal metabolic health. C_LIO_LIContinuous Glucose Monitoring (CGM) can detect glycemic patterns not captured by fasting measures but is understudied in pregnancies with obesity without diabetes. C_LI\n\nWhat are the new findings in your manuscript?O_LIExercise did not alter fasting glucoregulatory or inflammatory trajectories despite substantial gestational metabolic adaptation. C_LIO_LIExploratory CGM showed declining late-gestation glycemic metrics in the standard of care group, whereas these metrics remained stable in the exercise group. C_LI\n\nHow might your results change the direction of research or the focus of clinical practice?O_LIFasting biomarkers alone may not capture metabolic responses to antepartum exercise. C_LIO_LILarger trials should evaluate CGM-derived glycemic patterns and clinically meaningful targets in pregnancies with obesity. C_LI",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "name": "Lisa T. Jansen",
      "orcid": "0000-0002-6447-5537"
    },
    {
      "name": "Simon Chung",
      "orcid": "0000-0003-2349-3779"
    },
    {
      "name": "Aaron R. Caldwell",
      "orcid": "0000-0002-4541-6283"
    },
    {
      "name": "Andrew W. Brown",
      "orcid": "0000-0002-1758-8205"
    },
    {
      "name": "Brittany N. Burgener"
    },
    {
      "name": "Audrey Martinez"
    },
    {
      "name": "Elisabet Børsheim",
      "orcid": "0000-0002-7842-0625"
    },
    {
      "name": "Aline Andres",
      "orcid": "0000-0003-2611-2193"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bqyxaq8pcv8vw.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.21.26366153",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.21.26366153v1.full",
  "id": "bqyxaq8pcv8vw",
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  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.21.26366153v1",
  "language": "en",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
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      "Article"
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      "medrxiv",
      "endocrinology"
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    [
      "openalex",
      "2729|Gestational Diabetes Research and Management"
    ]
  ],
  "openalex": "W7223464559",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.21.26366153v1.full.pdf",
  "pmcid": "PMC13738881",
  "pmid": "42996297",
  "published": "2026-10-21",
  "publisher": "Cold Spring Harbor Laboratory Preprints",
  "ris": "https://research.draconitic.com/paper/bqyxaq8pcv8vw.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:40Z",
      "native_id": "10.64898/2026.10.21.26366153",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.21.26366153v1"
    },
    {
      "first_seen": "2026-11-09T12:23:47Z",
      "native_id": "PMC13738881",
      "source": "pmc",
      "url": "https://doi.org/10.64898/2026.10.21.26366153"
    }
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  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:endocrinology",
      "subfield": "endocrinology-metabolism"
    }
  ],
  "title": "Glucoregulatory and Inflammatory Trajectories in Pregnancy with Obesity: Secondary Analysis of a Randomized Exercise Trial",
  "title_text": "Glucoregulatory and Inflammatory Trajectories in Pregnancy with Obesity: Secondary Analysis of a Randomized Exercise Trial",
  "type": "preprint",
  "updated_at": "2026-11-09T12:23:47Z",
  "url": "https://research.draconitic.com/paper/bqyxaq8pcv8vw",
  "venue": "medRxiv",
  "versions": []
}