Fetal wellbeing may be compromised during strenuous exercise among pregnant elite athletes

Salvesen, Kjell Å.; Hem, Erlend; Sundgot‐Borgen, Jorunn

doi:10.1136/bjsm.2010.080259

Cited by 101 publications

(121 citation statements)

References 26 publications

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“…This is in line with a previous study reporting that an exercise intensity >90% of maximal maternal heart rate may reduce the blood flow to the uterus and result in fetal bradycardia (Salvesen et al, 2012). In contrast, MIT was performed throughout the entire pregnancy, and with higher amounts than pre-pregnancy during the second trimester.…”

Section: Discussionsupporting

confidence: 93%

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Training Characteristics During Pregnancy and Postpartum in the World’s Most Successful Cross Country Skier

Solli

Sandbakk

2018

Front. Physiol.

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This case-study investigated the training characteristics, physiological capacity, and body composition of the world’s most successful cross country skier during the 40-week pregnancy, and the 61-week postpartum. Training data was systemized by training form (endurance, strength, and speed), intensity [low- (LIT), moderate- (MIT), and high-intensity training (HIT)], and mode (running, cycling, and skiing/roller skiing). The training volume [mean ± standard deviation (median)] during pregnancy was 12.9 ± 7.3(10.0) h/week in the first- (weeks 1–12), 18.3 ± 2.9(18.0) h/week in the second- (weeks 13–28), and 8.8 ± 4.4(9.6) h/week in the third trimester (weeks 29–40). Endurance training time was distributed into 10.9 ± 6.2(9.9), 15.2 ± 2.3(15.6), and 7.6 ± 3.8(7.9) LIT and 0.4 ± 0.5(0.0), 1.3 ± 0.4(1.4), and 0.7 ± 0.6(0.8) h/week MIT during the three trimesters. Only 2.2 h of HIT was performed during the entire pregnancy. During the first two trimesters, the distribution of exercise modes were approximately the same as pre-pregnancy, but the amount of running was reduced during the third trimester. Training volume during the postpartum periods 1–4 was 6.6 ± 3.8(7.1) (PP1; weeks 1–6), 14.1 ± 3.4(14.3) (PP2; weeks 7–12), 10.6 ± 3.8(10.4) (PP3; weeks 13–18), and 13.6 ± 4.1(14.5) h/week (PP4; weeks 19–24), respectively. Training during PP3 and PP4 was interfered with two fractions in the sacrum, leading to decreased amount of running and MIT/HIT, compensated by increased amounts of cycling. Thereafter, training volume progressively approached the pre-pregnancy values, being 18.0 ± 3.9(18.7) h/week during the general preparation- (weeks 25–44), 17.6 ± 4.4(17.3) h/week during the specific preparation- (weeks 45–53), and 16.9 ± 3.5(17.2) h/week during the competition period (CP; weeks 54–61) leading up to the subsequent world championship. The oxygen uptake at the estimated lactate threshold (LT) decreased to 90% of pre-pregnancy values in the second trimester, but remained to ∼100% in PP3. Body weight and fat-% was higher, while lean body mass and bone mineral density was lower after delivery compared to pre-pregnancy. These measurements gradually changed and were back to ∼pre-pregnancy values during CP. This study indicates that high-level cross country skiers can tolerate high training loads during pregnancy. Although the participant had some postpartum setbacks in her training due to fractures in the sacrum, reduced overall training load, followed by a slower progression and utilization of alternative exercise modes, led to a successful return to competitions.

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Section: Discussionsupporting

confidence: 93%

“…Intensive exercise >90% of maternal heart rate, especially during hot and humid conditions, could lead to a hypoxic situation for the fetus (Salvesen et al, 2012; Bo et al, 2016). This is also the case for intensive training at altitudes >1500–2000 m due to decreased fetal arterial oxygen saturation (Entin and Coffin, 2004).…”

Section: Introductionmentioning

confidence: 99%

Training Characteristics During Pregnancy and Postpartum in the World’s Most Successful Cross Country Skier

Solli

Sandbakk

2018

Front. Physiol.

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“…Even though some authors have recommended the intensity of the training to be decreased to avoid the foetus´s vascular compromise (Salvesen et al, 2012 A c c e p t e d M a n u s c r i p t 20 with additional check-ups (Salvesen et al, 2012;Barakat et al, 2014;Price et al, 2012).…”

Section: Fears and Doubtsmentioning

confidence: 97%

Pregnancy in Spanish elite sportswomen: A qualitative study

Martínez-Pascual

Alvarez-Harris

Fernández‐de‐las‐Peñas

et al. 2016

Women & Health

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Pregnancy and motherhood have been historically considered as reasons why elite sportswomen may end their sport careers. During pregnancy, the safety of both mother and baby has been identified as a key reason for ceasing sport participation. Recent "official" statistics on how many elite athletes are mothers suggest that pregnancy, motherhood, and sport could be no longer mutually exclusive. The aim of this qualitative phenomenological study was to describe the lived pregnancy of Spanish elite sportswomen. Spanish elite sportswomen (n = 20) aged between 18 and 65 years that had been pregnant during their sporting professional career and after the end of their pregnancy had taken up again their professional sporting career for at least one year were included. Data were collected from May 2010 to April 2012 using in-depth personal interviews, investigator's field notes, and extracts from the participants' personal letters. Identified themes included: (1) choosing the right moment; (2) fears and doubts; and (3) justifying physical exercise. By giving voice to these elite Spanish sportswomen, their pregnancy experiences are made visible, which might help to gain a better understanding into their expectations and develop policies and practices focused on elite sportswomen during and after pregnancy.

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“…Although the recent study published in BJSM by Salvesen et al 2 is timely with respect to the fetal response to extreme levels of maternal exertion in competitive Olympic hopefuls, it has limited applicability to the maternal population at large who are mostly inactive 3. The latter may benefit the most from a physically active, healthful pregnancy.…”

mentioning

confidence: 99%

“…The latter may benefit the most from a physically active, healthful pregnancy. In their study examining fetal response and utero-placental blood flow during strenuous treadmill running in the second trimester, Salvesen et al 2 note that fetal HR was within the normal range as long as maternal exertion was below 90% maternal HRmax; an exercise intensity that few women would routinely work at, nor would be encouraged in a typical maternal population. If maternal HR exceeded 90% of maximum value and uterine artery blood flow was simultaneously less than 50% the initial value, fetal bradycardia occurred.…”

mentioning

confidence: 99%

An active pregnancy for fetal well-being? The value of active living for most women and their babies

2012

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Fetal wellbeing may be compromised during strenuous exercise among pregnant elite athletes

Abstract: Exercise at intensity above 90% of maximal MHR in pregnant elite athletes may compromise fetal wellbeing.

Cited by 101 publications

References 26 publications

Training Characteristics During Pregnancy and Postpartum in the World’s Most Successful Cross Country Skier

Training Characteristics During Pregnancy and Postpartum in the World’s Most Successful Cross Country Skier

Pregnancy in Spanish elite sportswomen: A qualitative study

An active pregnancy for fetal well-being? The value of active living for most women and their babies

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