Pregnant women maintain body temperatures within safe limits during moderate-intensity aqua-aerobic classes conducted in pools heated up to 33 degrees Celsius: an observational study

Brearley, Amanda; Sherburn, Margaret; Galea, Mary P.; Clarke, Sandy

doi:10.1016/j.jphys.2015.08.004

Cited by 10 publications

(7 citation statements)

References 18 publications

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“…The highest mean core temperature for pregnant women with warm water (30°C) immersion cycling was 37.5°C (95% CI 37.3°C to 37.7°C38). Aqua-aerobic exercise in water temperatures ranging from 28.8°C to 33.4°C resulted in a mean core temperature of 36.7°C (95% CI 36.6°C to 36.8°C45). Studies assessing pregnant women during passive heating via sauna or a 40°C water immersion reported mean maternal core temperatures peaking at 37.6°C (95% CI 37.5°C to 37.7°C34) and 36.9°C (95% CI 36.8°C to 37.0°C41), respectively.…”

Section: Resultsmentioning

confidence: 99%

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Heat stress and fetal risk. Environmental limits for exercise and passive heat stress during pregnancy: a systematic review with best evidence synthesis

Ravanelli

Casasola²,

English

et al. 2018

Br J Sports Med

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ObjectivePregnant women are advised to avoid heat stress (eg, excessive exercise and/or heat exposure) due to the risk of teratogenicity associated with maternal hyperthermia; defined as a core temperature (Tcore) ≥39.0°C. However, guidelines are ambiguous in terms of critical combinations of climate and activity to avoid and may therefore unnecessarily discourage physical activity during pregnancy. Thus, the primary aim was to assess Tcore elevations with different characteristics defining exercise and passive heat stress (intensity, mode, ambient conditions, duration) during pregnancy relative to the critical maternal Tcore of ≥39.0°C.DesignSystematic review with best evidence synthesis.Data sourcesEMBASE, MEDLINE, SCOPUS, CINAHL and Web of Science were searched from inception to 12 July 2017.Study eligibility criteriaStudies reporting the Tcore response of pregnant women, at any period of gestation, to exercise or passive heat stress, were included.Results12 studies satisfied our inclusion criteria (n=347). No woman exceeded a Tcore of 39.0°C. The highest Tcore was 38.9°C, reported during land-based exercise. The highest mean end-trial Tcore was 38.3°C (95% CI 37.7°C to 38.9°C) for land-based exercise, 37.5°C (95% CI 37.3°C to 37.7°C) for water immersion exercise, 36.9°C (95% CI 36.8°C to 37.0°C) for hot water bathing and 37.6°C (95% CI 37.5°C to 37.7°C) for sauna exposure.ConclusionThe highest individual core temperature reported was 38.9°C. Immediately after exercise (either land based or water immersion), the highest mean core temperature was 38.3°C; 0.7°C below the proposed teratogenic threshold. Pregnant women can safely engage in: (1) exercise for up to 35 min at 80%–90% of their maximum heart rate in 25°C and 45% relative humidity (RH); (2) water immersion (≤33.4°C) exercise for up to 45 min; and (3) sitting in hot baths (40°C) or hot/dry saunas (70°C; 15% RH) for up to 20 min, irrespective of pregnancy stage, without reaching a core temperature exceeding the teratogenic threshold.

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Section: Resultsmentioning

confidence: 99%

“…Using our modified Cochrane ROB V.2.0 tool, six studies (out of 12) had some concerns about (n=5) or were at high risk (n=1) of selection bias,39 detection bias45 and intervention bias 25 26 40 42…”

Section: Resultsmentioning

confidence: 99%

Heat stress and fetal risk. Environmental limits for exercise and passive heat stress during pregnancy: a systematic review with best evidence synthesis

Ravanelli

Casasola²,

English

et al. 2018

Br J Sports Med

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“…Recommendations in the prenatal literature as described by Brearley et al (2015) indicate ‘that the safe upper limit for maternal core temperature is 38.9 or 1.5 °C above resting core temperature,’ to prevent possible harm to the foetus (Brearley et al, 2015; Hartgill, Bergersen & Pirhonen, 2011; Lindqvist et al, 2003). During this study, the participants remained below this threshold in 99.7% of instances (883 instances) where body temperature was measured while the compression shorts were worn, with only two (0.3%) reports of single measurements of body temperature reaching 39.0 °C which were monitored as per normal practice in prenatal care with their maternity care provider.…”

Section: Discussionmentioning

confidence: 99%

“…A concern for the use of compression garments during pregnancy is the increase in skin temperature and apprehension that it will raise core body temperature. According to 2016 guidelines from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) (2016) a rise in core temperature of less than 1.5 °C is widely accepted as safe during pregnancy and these and other experts routinely advise pregnant women to avoid overheating to prevent possible harm to the foetus (Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), 2016; Brearley et al, 2015; Lindqvist et al, 2003). Previous empirical evidence suggested male and female athletes, aged 19–33, that the thermoregulatory response to wearing compression garments at recreational and high levels of training and competition did result in increased skin temperatures (Doan et al, 2003); however, the associated increases in core temperature were not great enough to have detrimental effects in ambient and temperate environments with relative humidity between 46% and 64% (Houghton, Dawson & Maloney, 2009; MacRae et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Compression shorts reduce prenatal pelvic and low back pain: a prospective quasi-experimental controlled study

Szkwara

Hing

Pope

et al. 2019

PeerJ

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Background Common prenatal ailments negatively impact performance of activities of daily living and it has been proposed that the use of dynamic elastomeric fabric orthoses, more commonly referred to as compression garments, during pregnancy might aid in the reduction of pain from these ailments, allowing for improved functional capacity. However, the effectiveness of such garments in this context has not been established. This study aims to determine whether compression shorts are effective and thermally safe in the prevention and management of prenatal pelvic and low back pain (LBP). Method A prospective quasi-experimental controlled study using parallel groups without random allocation was conducted, involving 55 childbearing women (gestational weeks 16–31) recruited from hospital and community-based maternity care providers. The compression shorts group (SG) wore SRC Pregnancy Shorts in addition to receiving usual care. The comparison group (CG) received usual care alone. Primary outcome measures—Numeric Pain Rating Scale (NPRS) and Roland Morris Disability Questionnaire (RMDQ) and secondary measures Pelvic Floor Impact Questionnaire - 7 (PFIQ-7) and SF-36 Short Form Health Survey—were assessed fortnightly over 6-weeks for both groups. The compression SG self-assessed daily their body temperatures to monitor thermal impact. Data analysis involved descriptive analyses of the primary and secondary outcome measures scores by group and time-point, and multivariable linear regressions to assess between-group differences in change scores at 6-weeks from baseline while controlling for baseline factors. Results After controlling for baseline scores, gestational weeks and parity, statistically significant differences in NPRS and RMDQ change scores between groups were in favour of the compression SG. At 6-weeks, mean (SD) NPRS change scores in the compression SG and CG were significantly different, at −0.38 (2.21) and 2.82 (2.68), respectively, p = 0.003. Mean (SD) RMDQ change scores in the compression SG and CG were also significantly different, at 0.46 (3.05) and 3.64 (3.32), respectively, p = 0.009. A total of 883 (99.7%) of the reported daily self-assessed body temperatures ranged between 35.4 and 38.0 °C when wearing the compression shorts. At 6-weeks, mean (SD) PFIQ-7 and SF-36 change scores in the compression SG and CG were not significantly different. Conclusion Compression shorts are effective and thermally safe for prenatal management of pelvic and LBP. Registration Trial registration was not required (Australian Government Department of Health Therapeutic Goods Administration (TGA), 2018).

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“…6 Many forms of exercise modalities are presented in intervention studies with a wide variety of designs and variations. Although most studies are based on land exercises, some studies have used a "swimming" intervention, 16,17 "aquatic activities" or "water aerobics," [18][19][20][21][22][23][24] and an "immersion" exercise session. [25][26][27] Kamioka et al 28 reviewed the effects of aquatic exercise and concluded that there is insufficient evidence to report benefits for aquatic exercise due to poor methodological and reporting quality and heterogeneity of nonrandomized clinical trials.…”

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confidence: 99%

Aquatic Activities During Pregnancy Prevent Excessive Maternal Weight Gain and Preserve Birth Weight: A Randomized Clinical Trial

et al. 2017

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Pregnant women maintain body temperatures within safe limits during moderate-intensity aqua-aerobic classes conducted in pools heated up to 33 degrees Celsius: an observational study

Abstract: Healthy pregnant women maintain body temperatures within safe limits during moderate-intensity aqua-aerobic exercise conducted in pools heated up to 33 degrees Celsius. The study provides evidence to inform guidelines for safe water temperatures for aqua-aerobic exercise during pregnancy.

Cited by 10 publications

References 18 publications

Heat stress and fetal risk. Environmental limits for exercise and passive heat stress during pregnancy: a systematic review with best evidence synthesis

Heat stress and fetal risk. Environmental limits for exercise and passive heat stress during pregnancy: a systematic review with best evidence synthesis

Compression shorts reduce prenatal pelvic and low back pain: a prospective quasi-experimental controlled study

Aquatic Activities During Pregnancy Prevent Excessive Maternal Weight Gain and Preserve Birth Weight: A Randomized Clinical Trial

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