Effects of Exercise During Pregnancy on Maternal Heart Rate and Heart Rate Variability

May, Linda E.; Knowlton, Jennifer; Hanson, Jessica; Suminski, Richard R.; Paynter, Christopher A.; Fang, Xiangming; Gustafson, Kathleen M.

doi:10.1016/j.pmrj.2015.11.006

Cited by 40 publications

(56 citation statements)

References 66 publications

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“…Information on the practicality, importance and limitations of physical exercise and sport should therefore form an integral part of antenatal counselling. Positive effects have been described for cardiovascular function, weight gain during pregnancy, musculoskeletal symptoms, muscle cramps and oedema, the development of postpartum incontinence and psycho-emotional problems [5][6][7]. Shortened labour and a lower rate of operative/instrumental delivery appear to be secondary positive effects [5,8,9].…”

Section: Introductionmentioning

confidence: 99%

Physical Exercise During Pregnancy – How Active Are Pregnant Women in Germany and How Well Informed?

Schmidt

Heilmann

Savelsberg

et al. 2017

Geburtshilfe Frauenheilkd

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ABSTR AC TIntroduction There is sufficient evidence showing the positive effects of physical exercise on various aspects of pregnancy. This study evaluates knowledge and status of physical exercise among pregnant women. MethodsThe standardised paper-pencil questionnaire "Pregnancy Physical Activity Questionnaire" (PPAQ) as well as general demographic questions were used to assess the exercise behaviour of study participants. 83 questionnaires completed by women presenting to the Kiel University Hospital for antenatal assessment were included in the analysis.Results At the time of questionnaire completion 10 women were in the first trimester of pregnancy, 64 in the second, and 9 in the third. Just less than 90 % of participants felt they had been informed "sufficiently" on the topic physical exercise during pregnancy, over 50 % felt they were "well" or "very well" informed. Just less than half of participants received their information from a doctor (either their gynaecologist or general practitioner) and none of these felt "insufficiently" informed. Almost 80 % of participants reported still doing no sport or less exercise than before falling pregnant. The maximum proportional energy expenditure for recreational activity -just under 20 % -was in the third trimester. Women who felt they had been well counselled tended to have higher activity levels.Conclusion Study participants demonstrated a clear decline in physical exercise during pregnancy despite clear evidence of the benefits of regular exercise for pregnant women, and despite participants feeling they were well informed. Detailed information on the recommendations for physical exertion in pregnancy should form an integral part of antenatal counselling. ZUSAMMENFASSUNGEinleitung Die positiven Effekte einer körperlichen Aktivität

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Section: Introductionmentioning

confidence: 99%

Physical Exercise During Pregnancy – How Active Are Pregnant Women in Germany and How Well Informed?

Schmidt

Heilmann

Savelsberg

et al. 2017

Geburtshilfe Frauenheilkd

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“…To assess self-reported maternal exercise, the authors used the ‘Modifiable Physical Activity Questionnaire’ (MPAQ). Finally, the remaining six articles [37–39, 41, 42, 47] were post-hoc analyses of subsets of the before mentioned longitudinal study of May et al [40]. Four of these post-hoc analyses referred to maternal or fetal HRV measurements performed in gestational week 36, one to maternal HRV measurements performed at 28, 32, and 36 weeks of gestation, and one to infant HRV measurements at one month of age.…”

Section: Resultsmentioning

confidence: 99%

“…Of these, 108 articles were excluded due to not passing all of the a priori formulated criteria. Finally, full texts of 13 articles were screened [34, 36–47]. Of these, 4 were excluded for specific reasons (Fig.…”

Section: Methodsmentioning

confidence: 99%

The influence of physical activity during pregnancy on maternal, fetal or infant heart rate variability: a systematic review

Dietz

Watson

Sattler

et al. 2016

BMC Pregnancy Childbirth

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BackgroundPhysical activity (PA) during pregnancy has been shown to be associated with several positive effects for mother, fetus, and offspring. Heart rate variability (HRV) is a noninvasive and surrogate marker to determine fetal overall health and the development of fetal autonomic nervous system. In addition, it has been shown to be significantly influenced by maternal behavior. However, the influence of maternal PA on HRV has not yet been systematically reviewed. Therefore, the aim of this systematic review was to assess the influence of regular maternal PA on maternal, fetal or infant HRV.MethodsA systematic literature search following a priori formulated criteria of studies that examined the influence of regular maternal PA (assessed for a minimum period of 6 weeks) on maternal, fetal or infant HRV was performed in the databases Pubmed and SPORTDiscus. Quality of each study was assessed using the standardized Quality Assessment Tool for Quantitative Studies (QATQS).ResultsNine articles were included into the present systematic review: two intervention studies, one prospective longitudinal study, and six post-hoc analysis of subsets of the longitudinal study. Of these articles four referred to maternal HRV, five to fetal HRV, and one to infant HRV. The overall global rating for the standardized quality assessment of the articles was moderate to weak. The articles regarding the influence of maternal PA on maternal HRV indicated contrary results. Five of five articles regarding the influence of maternal PA on fetal HRV showed increases of fetal HRV on most parameters depending on maternal PA. The article referring to infant HRV (measured one month postnatal) showed an increased HRV.ConclusionsBased on the current evidence available, our overall conclusion is that the hypothesis that maternal PA influences maternal HRV cannot be supported, but there is a trend that maternal PA might increase fetal and infant HRV (clinical conclusion). Therefore, we recommend that further, high quality studies addressing the influence of maternal PA on HRV should be performed (methodological conclusion).

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“…Estes achados podem ser explicados, uma vez que o sistema nervoso autônomo atua constantemente para modular o funcionamento de vários sistemas orgânicos [5]. Assim, este sistema é o principal responsável pelo aumento da frequência cardíaca, que é mais elevada em mulheres no período gestacional a fim de suprir as alterações anatômicas e fisiológicas e garantir adequado aporte sanguíneo para o feto [1][2][3][16][17][18].…”

Section: Discussionunclassified

“…Ainda, May et al [16] mostraram que exercícios associados à respiração promoveram melhora do controle autonômico em mulheres grávidas. No presente estudo, observamos valores indicativos da integridade do sistema nervoso autônomo avaliado pela mASR para ambos os grupos, embora tais respostas sejam atenuadas nas gestantes, indicando uma capacidade de ajuste rápido do sistema nervoso autônomo mais eficiente no grupo de não gestantes.…”

Section: /7unclassified

Respiração lenta e profunda aumenta a modulação vagal em gestantes

Farche

Jürgensen

Rossi

et al. 2017

Sci Med

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Este artigo está licenciado sob forma de uma licença Creative Commons Atribuição 4.0 Internacional, que permite uso irrestrito, distribuição e reprodução em qualquer meio, desde que a publicação original seja corretamente citada. RESUMOOBJETIVOS: Comparar a resposta da modulação autonômica da frequência cardíaca de gestantes e mulheres não gestantes, antes e após a manobra de acentuação da arritmia sinusal respiratória. MÉTODOS: Foi realizado um estudo transversal com amostra de 24 mulheres, divididas em dois grupos: grupo gestantes (independente da idade gestacional) e grupo controle (não gestantes). A avaliação consistiu em registro dos intervalos RR por um cardiofrequencímetro, para análise de índices lineares e não lineares da variabilidade da frequência cardíaca. As avaliações foram feitas no repouso em decúbito lateral esquerdo, antes e após a manobra de acentuação da arritmia sinusal respiratória, que consiste em respirações lentas de cinco a seis ciclos por minuto. A razão expiração/inspiração e a diferença entre a inspiração e a expiração foram avaliadas durante a manobra. Foram comparados os resultados obtidos entre os dois grupos (gestantes e não gestantes), assim como os obtidos em cada grupo, antes e após a manobra. Para a análise estatística o nível de significância considerado foi p<0,05. RESULTADOS: Os índices lineares mostraram valores iniciais da modulação simpática (banda de baixa frequência) aumentados nas gestantes quando comparadas às mulheres não gestantes (gestantes: 68,9±28,1; controles: 49,3±11,7; p=0,002). Após a manobra respiratória, o índice obtido pela raiz quadrada da média do quadrado das diferenças entre os intervalos RR normais adjacentes aumentou no grupo gestantes (pré-manobra: 34,5±5,7; pós-manobra: 38,9±5,8; p=0,027), indicando aumento da atuação parassimpática para essa população após a aplicação da manobra. Além disso, houve aumento dos valores de complexidade, sugeridos pela entropia de Shanon após a manobra, para ambos os grupos, sendo o aumento maior nas gestantes. Em relação aos índices avaliados durante a manobra, ambos os grupos apresentaram valores da razão expiração/inspiração maiores que 1, o que sugere integridade do sistema nervoso autônomo. CONCLUSÕES: Houve melhora da regulação do sistema nervoso autônomo ao final da manobra respiratória para as gestantes, sugerindo que o padrão de respiração lenta e profunda possa aumentar a modulação vagal e conferir efeito cardioprotetor, além de ocasionar relaxamento e sensação de bem-estar.DESCRITORES: gravidez; respiração; sistema cardiovascular; frequência cardíaca; arritmia sinusal respiratória; sistema nervoso autônomo. ABSTRACTAIMS: To compare the responses of the heart rate autonomic modulation in pregnant and non-pregnant women before and after the respiratory sinus arrhythmia maneuver. METHODS: A cross-sectional study was conducted with a sample of 24 women, divided into two groups: pregnant group (independent of gestational age) and control group (non-pregnant). The evaluation consisted of recording the RR inter...

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Effects of Exercise During Pregnancy on Maternal Heart Rate and Heart Rate Variability

Cited by 40 publications

References 66 publications

Physical Exercise During Pregnancy – How Active Are Pregnant Women in Germany and How Well Informed?

Physical Exercise During Pregnancy – How Active Are Pregnant Women in Germany and How Well Informed?

The influence of physical activity during pregnancy on maternal, fetal or infant heart rate variability: a systematic review

Respiração lenta e profunda aumenta a modulação vagal em gestantes

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