Is aerobic exercises effective in improving stress level, sleep quality and cardiovascular fitness among pregnant women compared to routine maternal care?

Study setting- Medical Officer of health (MOH) ,Ragama

Randomization- Simple random sampling:

The pregnant mothers registered under MOH-Ragama for their antenatal clinic who consent to participate in the study and satisfy inclusion criteria will be identified and prepare a list according to the alphabetic order. Of these mothers, 70 number of subjects will be selected by random sampling by randomization on SPSS. The selected participants(70) will be randomly allocated either to the control group(35) and to the treatment group(35) using a computer-based random number generation randomization procedure.

The intervention group will be receiving a 8 weeks Aerobic exercise program and routine antenatal care at MOH Ragama.

The control group will be receiving only routine antenatal care for 8 weeks at MOH Ragama. Blinding- Single blinded, Only outcome assessors are blinded.

The intervention group of pregnant women will be given a home aerobic exercise programme. Exercise programme was designed strictly adhered to ACSM guidelines for pregnant women. On the 1st day participants will be asked to come with their husband or family member. Full aerobic exercise steps including 5 minutes warm up, 30 minutes aerobic exercise, 5 minutes cool down will be demonstrated and taught properly for each participant. The exercise programme will be demonstrated by the researcher and the participants will be requested to perform the exercises steps and any deviations will be corrected. They will be instructed to carry out the moderate intensity exercise programme for 8 weeks with a frequency of 4 days per week. Intensity of the exercises will be assessed using Borg scale. In addition, a detailed instruction sheet including clear images of the exercise procedures, instructions and warning signs will be provided to the participants. (Available in English, Sinhala and Tamil). The compliance of the participants will be monitored by regular video call sessions with each subject and if that facility is not accessible by them, regular voice calls will be made. Subjects will be advised to maintain an exercise diary and bring it to their monthly MOH clinic. Principle investigator will review the exercises at monthly MOH clinic. Adherence to the exercise program will be encouraged by the principal investigator who supervises the exercise sessions.

Pregnant women age between 18 to 35 years Pregnant women in their first pregnancy. Pregnant women in their second trimester. Those who are willing to comply with all study procedures and be available for the duration of the study.

History of high blood pressure, restrictive lung disease, chronic medical illnesses, (cancer, renal, endocrine, neurologic, infectious, or cardiovascular diseases) Previously diagnosed sleep disorders, stress disorders, panic attacks or psychiatric disorders currently on treatment. Known cases of severe cognitive, physical, visual and communication impairments Persistent vaginal bleeding after 12 weeks History of miscarriage within last 12 months Multiple gestation at risk for premature labour Diseases related to the reproductive system such as placenta previa Participants of a structured exercise programme within last 6 months Extreme obesity or underweight ( 12>BMI>30 )