Acute maternal exercise during the third trimester of pregnancy, influence on foetal heart rate. (Ejercicio físico durante el tercer trimestre de embarazo, influencia en la frecuencia cardiaca fetal).

ObjectiveTo perform a systematic review and meta-analysis examining the influence of acute and chronic prenatal exercise on fetal heart rate (FHR) and umbilical and uterine blood flow metrics.DesignSystematic review with random-effects meta-analysis and meta-regression.Data sourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were included (except case studies) if published in English, Spanish or French, and contained information on the population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone [“exercise-only”] or in combination with other intervention components [eg, dietary; “exercise + co-intervention”]), comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and outcomes (FHR, beats per minute (bpm); uterine and umbilical blood flow metrics (systolic:diastolic (S/D) ratio; Pulsatility Index (PI); Resistance Index (RI); blood flow, mL/min; and blood velocity, cm/s)).Results‘Very low’ to ‘moderate’ quality evidence from 91 unique studies (n=4641 women) were included. Overall, FHR increased during (mean difference (MD)=6.35bpm; 95% CI 2.30 to 10.41, I2=95%, p=0.002) and following acute exercise (MD=4.05; 95% CI 2.98 to 5.12, I2=83%, p<0.00001). The incidence of fetal bradycardia was low at rest and unchanged with acute exercise. There were no significant changes in umbilical or uterine S/D, PI, RI, blood flow or blood velocity during or following acute exercise sessions. Chronic exercise decreased resting FHR and the umbilical artery S/D, PI and RI at rest.ConclusionAcute and chronic prenatal exercise do not adversely impact FHR or uteroplacental blood flow metrics.

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Low-intensity physical activity may protect pregnant women against spontaneous preterm labour: a prospective case-control study

Steckle

Shynlova

Lye

et al. 2021

Appl. Physiol. Nutr. Metab.

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The innate immune system plays a significant role in onset of parturition. Maternal antenatal physical activity can influence immune function and timing of labor. We examined physical activity patterns and concentration of 19 cytokines at 16 and 27 weeks gestational age (GA), in peripheral plasma of 28 asymptomatic women who later had spontaneous preterm labor (SPTL, <37 weeks GA) and 52 women who later delivered at term (TL; ≥37 weeks GA). This nested case-control study used data from the Ontario Birth Study cohort. Exercise was assessed using the International Physical Activity Questionnaire, and cytokines were analyzed using Luminex assays. There was no significant difference in exercise patterns between SPTL and TL subjects. Plasma concentration of interleukin(IL)-10) was significantly higher in SPTL women at 16 and 27 weeks; while TNFα, IL-8, and MCP1 concentrations were increased at 27 weeks GA (p<0.05). Concentration of IL-10 was negatively correlated with the amount of reported walking (ρ=-0.264, p=0.03). Women should be encouraged to partake in low-intensity exercise throughout pregnancy, as it may confer a protective effect against SPTL through IL10-mediated pathways. Additionally, plasma cytokine analysis at 27 weeks GA may be useful for predicting SPTL in asymptomatic women. Novelty bullets: 1. In women that delivered preterm, plasma levels of anti-inflammatory cytokine IL-10 were significantly elevated at 16 and 27 weeks of gestation,; 2. Plasma levels of IL-10 was negatively correlated with the amount of reported walking; 3. Concentration of IL-8, MCP-1 and TNFa were increased in plasma of asymptomatic women that subsequently deliver preterm.

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Acute maternal exercise during the third trimester of pregnancy, influence on foetal heart rate. (Ejercicio físico durante el tercer trimestre de embarazo, influencia en la frecuencia cardiaca fetal).

Cited by 5 publications

References 16 publications

Summary and synthesis of current knowledge

Summary and synthesis of current knowledge

Effects of prenatal exercise on fetal heart rate, umbilical and uterine blood flow: a systematic review and meta-analysis

Low-intensity physical activity may protect pregnant women against spontaneous preterm labour: a prospective case-control study

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