Does Exercise Alter Blood Flow to the Uterus During Pregnancy?
BACKGROUND AND PURPOSE:
Despite recommendations, women tend to exercise less during pregnancy
May be related to safety concerns
Szymanski et al. (Obstetrics & Gynecology 2018) sought to determine the effect of typical exercise sessions on uterine artery blood flow
Current study was part of a prospective cross-sectional study of uterine artery Doppler velocimetry in healthy pregnant women after exercise
‘Exercisers’ or ‘nonexercisers’ based on self-reported physical activity
Regular physical activity: >20 minutes per session for ≥3 times per week during the 6 months prior to pregnancy or during pregnancy
Exercisers: Minimum regular physical activity
Nonexercisers: Did not meet requirements for minimal physical activity
Moderate-intensity exercise on treadmill (all participants)
40–59% of heart rate reserve
Vigorous-intensity exercise on treadmill (only exercisers)
60–84% of heart rate reserve
Uterine artery Doppler measures were obtained
After a 20-minute fetal heart tracing prior to the exercise session
Immediately after the exercise session
30 regular exercisers | 15 nonexercisers
Approximately 31+ weeks gestation
For moderate-intensity session
Mean uterine artery Doppler indices (pulsatility index, resistance index, systolic/diastolic ratio) did not significantly change with exercise
For vigorous-intensity session
Average maternal heart rate: 140 bpm (ranging from 123 to 156 bpm); dropped to 85±12 bpm post exercise
All mean uterine artery Doppler indices showed reductions postexercise
Pulsatility index: Decreased from 0.63 to 0.58 (P=.037)
Resistance index: Decreased from 0.47 to 0.44 (P=.028)
SD ratio: Decreased from 1.94 to 1.84 (P=.042)
Exercise according to current professional guidelines did not reduce uterine artery blood flow
Slight decreases in uterine artery Doppler indices
The authors state
Obstetric care providers have a unique opportunity to positively affect women’s health by encouraging regular physical activity because pregnancy is a time when women are more likely to focus on optimizing their own health and is thus an ideal time for both initiation and continuation of exercise.
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