Effect of Gestational Age and Position on Peak Expiratory Flow Rate: A Longitudinal Study

Harirah, Hassan; Donia, Sahar E.; Nasrallah, Fayez K.; Saade, George R.; Belfort, Michael A.

doi:10.1097/01.aog.0000152303.80103.69

Cited by 30 publications

(16 citation statements)

References 15 publications

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“…Inadequate nutrition due to morning sickness and altered eating habits may also result in muscular weakness, leading to decreased PEFR. Similar findings were reported by Singhal and Saxena [9] and Harirah et al [10] A descending trend in PEFR at different trimesters was observed by Chaitra and Maitri. [11] The decrease in the mean PEFR may be attributed to lesser force of contraction of expiratory muscles (i.e., anterior abdominal muscles) or to mechanical effect of enlarging gravid uterus, decreasing the vertical diameter by restricting the diaphragmatic movement.…”

Section: Discussionsupporting

confidence: 90%

Study of effect of exercise on PEFR in pregnant women

Anitha¹,

Johncy²,

Bondade³

2015

Natl J Physiol Pharm Pharmacol

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Background: Many physiological adaptations occur during pregnancy. One such is changes in the respiratory functions and response to exercise. Many studies have been conducted on changes in peak expiratory flow rate (PEFR) in pregnancy, but there are only few studies reporting the effect of exercise on PEFR in pregnant women. Aims and Objectives:To study the effect of exercise on PEFR in pregnant women. Materials and Methods: PEFR was measured in 50 pregnant women in their second trimester of pregnancy in comparison with nonpregnant women (controls). PEFR was measured twice. The first reading was taken at rest and the second after moderate exercise, in the form of walking on a treadmill for 6 min at 12% slope. It was measured using RMS Medspiror. Results: The mean age of the pregnant women was 23.1 ± 2.7 years and that of the controls was 24.3 ± 2.4 years. The mean height was 1.51 ± 0.05 m in pregnant women and 1.51 ± 0.04 m in controls. In pregnant women, PEFR at rest was lower than that in nonpregnant women. The difference was found to be statistically significant. After exercise, the PEFR decreased in both pregnant and nonpregnant women. The percentage of decrease did not change significantly between the two groups. Conclusion: We conclude that although resting PEFR in pregnant women is less, there is not much difference in the response to exercise between the two groups. Thus, pregnant women can be encouraged to exercise regularly.

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Section: Discussionsupporting

confidence: 90%

Study of effect of exercise on PEFR in pregnant women

Anitha¹,

Johncy²,

Bondade³

2015

Natl J Physiol Pharm Pharmacol

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“…3,7,12 Other trials have a longitudinal design, some of which have non-pregnant women serving as controls, 2 and others in which an early postpartum value is taken as the non-pregnant reference. [4][5][6]8,10,11 Importantly, the chosen statistical methods and tests in previously published trials may have limited the ability to acknowledge significant changes in forced spirometry during pregnancy, because the correlation between measurements of the same subjects is not accounted for within the statistical method. The regression-based statistical methods with analysis of variance in repeated measures (mixed model) take into account the greater agreement between the data obtained from repeated measures of the same subject than measures from different subjects at the same time, providing new evidence for the natural development of various conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Two studies have found PEF to decline during pregnancy. 10,11 Using a portable flow meter Harirah et al 10 found PEF to decline with advancing gestational age. They explain their findings on a mechanical basis, pointing out the effect of the uterine enlargement and maternal weight gain.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] The values obtained by forced spirometry, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and peak expiratory flow (PEF) have largely been found to remain unchanged during pregnancy. 2,3,[5][6][7][8][9] In other studies, PEF is found to decrease with advancing gestational age and to be affected by maternal positioning, 10,11 and by living at high altitude. 12 Earlier studies addressing changes in pulmonary function during pregnancy have various methodological weaknesses, such as small sample size, 8 cross-sectional study design, 3,7,12 or insufficient statistical methods, 4,5,8 which may have limited the validity of their conclusions.…”

Section: Introductionmentioning

confidence: 99%

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Changes in pulmonary function during pregnancy: a longitudinal cohort study

Grindheim

Toska

et al. 2011

BJOG

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Objective To record any physiological changes in lung function during healthy pregnancies, and evaluate the influence of parity, pregestational overweight, and excessive weight gain.Design Longitudinal cohort study.Setting Antenatal clinic at Oslo University Hospital.Population One hundred healthy white women with singleton pregnancies.Methods The women were studied with repeated measures of lung function using spirometry at a gestational age of 14-16, 22-24, 30-32, and 36 weeks, and at 6 months postpartum.Main outcome measures Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and peak expiratory flow (PEF), also expressed as a percentage of predicted values according to age and height: i.e. FVC%, FEV1%, and PEF%.Results Both FVC and FVC% increased significantly after 14-16 weeks of gestation (P = 0.001), as was the case for both PEF and PEF% (P < 0.001). FVC, FVC%, PEF, and PEF% in early and mid-pregnancy were significantly lower compared with the postpartum value (all P < 0.05). Nulliparous women had an overall 4.4% lower value of FVC% than parous women (P = 0.039). There were no differences in FVC, FEV1, or PEF dependent upon pregestational overweight or excessive weight gain.Conclusions Forced vital capacity (FVC) increases significantly after 14-16 weeks of gestation. The FVC% is significantly higher in parous compared with primigravida women, suggesting that the changes in FVC occurring during pregnancy persist postpartum. PEF increases significantly during healthy pregnancies, and should be interpreted cautiously in pregnant women with impaired lung function.

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“…15 These include: increase in tidal volume (30-40%), increase in inspiratory capacity (5-10%), increase in minute ventilation (30-50%), decrease in functional residual capacity (20%), decrease in expiratory reserve volume (20-30%), decrease in residual volume (20%), and a slight decrease in total lung capacity (5%), all of which may potentially affect airborne exposures. 7,15,[17][18][19] The increase in progesterone levels during pregnancy results in a decrease in intestinal tone and motility. 15 The decrease in intestinal motility leads to an increase in the absorption of nutrients such as calcium and iron, as well as other substances.…”

Section: Physiological and Behavioral Changes During Pregnancy And Lamentioning

confidence: 99%

A review of physiological and behavioral changes during pregnancy and lactation: Potential exposure factors and data gaps

Moya

Phillips

Sanford

et al. 2014

J Expo Sci Environ Epidemiol

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Exposures to environmental contaminants can pose risks to pregnant women's health, their developing fetuses, children, and adults later in their lives. Assessing risks to this potentially susceptible population requires a sound understanding of the physiological and behavioral changes that occur during pregnancy and lactation. Many physiological and anatomical changes occur in a woman's organ systems during the course of pregnancy and lactation. For example, blood volume and cardiac output increase during pregnancy, and other metabolic functions are altered to provide for the demands of the fetus. During lactation, nutritional demands are greater than during pregnancy. There are also changes in behavior during both pregnancy and lactation. For example, water consumption during pregnancy and lactation increases. These behavioral and physiological changes can lead to different environmental exposures than these women might otherwise experience in the absence of pregnancy or lactation. This paper provides a summary of information from the published literature related to behavioral and physiological changes in pregnant and lactating women that may affect their exposure or susceptibility to environmental contaminants, provides potentially useful exposure factor data for this population of women, and highlights data gaps.

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Effect of Gestational Age and Position on Peak Expiratory Flow Rate: A Longitudinal Study

Abstract: III.

Cited by 30 publications

References 15 publications

Study of effect of exercise on PEFR in pregnant women

Study of effect of exercise on PEFR in pregnant women

Changes in pulmonary function during pregnancy: a longitudinal cohort study

A review of physiological and behavioral changes during pregnancy and lactation: Potential exposure factors and data gaps

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