Maternal hemodynamic responses to two different types of moderate physical exercise during pregnancy: a randomized clinical trial

Abstract

Background/Aim: Maternal hemodynamic responses (heart rate, systolic and diastolic blood pressure) were compared during two types of moderate-intensity physical exercise. Methods:A randomized clinical trial compared 120 pregnant women performing physical exercise on a treadmill (n=64) or stationary bicycle (n=56). In 44 of these women (n=23 treadmill; n=21 bicycle), blood pressure was monitored for 24 hours following exercise. Repeated-measures analysis compared maternal heart rate, systolic and diastolic blood pressure before, during and in the 24 hours following exercise in both groups.Results: Maternal heart rate increased significantly (p<0.001) with both types of exercise (from 84 at rest to 112 bpm on the treadmill and from 87 at rest to 107 bpm on the bicycle), without exceeding the limit of 140 bpm. Systolic pressure increased from 110 at rest to 118 mmHg on the bicycle (p=0.06) and from 112 at rest to 120 mmHg on the treadmill (p=0.02). Systolic pressure dropped steadily following exercise, reaching its lowest level (104 mmHg) after 14 hours, increasing thereafter and returning to pre-exercise levels by the 19 th hour. Diastolic pressure increased during exercise irrespective of the type of exercise (p=0.27), from 70 at rest to 75 mmHg on the bicycle (p=0.39) and from 70 at rest to 76 mmHg on the treadmill (p=0.18), with the lowest level (59 mmHg) being at the 13 th hour.

The effects of aerobic and resistance exercise on blood pressure in uncomplicated and at risk pregnancies: A systematic review and meta-analysis

“…One study comparing stationary cycling and treadmill walking found similar increases in SBP irrespective of the mode (bike: + 8 mmHg p = 0.06, treadmill: + 8 mmHg p = 0.02) and DBP (bike: + 5 mmHg p = 0.39, treadmill: + 6 mmHg p = 0.18). 51 Fieril et al 92 also reported an increase in SBP and DBP following 15 and 30 min of aerobic exercise (p = 0.01 and p = 0.001 respectively). These two studies, along with De Olivieria et al 91 found a post exercise hypotensive response, in which BP dropped below baseline levels from 50 min to 14 hours post exercise.…”

“…The risk of bias can be viewed in Supplementary file 2 (Tables S1–S5) . Overall, the risk of bias in the RCTs and randomized clinical trials was low, with 27 (71%) studies assessed as low risk, 20 , 34 , 36 – 39 , 41 , 42 , 51 – 69 10 (27%) studies classified as unclear 44 , 69 – 76 and one (2%) study considered high risk. 77 The cohort 78 – 84 and case control studies 85 – 90 were all classified as low (71%) to moderate (29%) risk of bias ( Tables S2 and S3 ), as were the two crossover studies ( Table S4 ).…”

“…These two studies, along with De Olivieria et al 91 found a post exercise hypotensive response, in which BP dropped below baseline levels from 50 min to 14 hours post exercise. 51 Two studies that observed BP responses to peak/max cycle tests found lower absolute BP responses in the first and second trimesters, increasing back to non-pregnant levels or above in the third trimester. 90 , 93 One study found a positive correlation between resting SBP and DBP in the second trimester and BP response to submaximal aerobic exercise on the treadmill.…”

“…Eighteen studies were identified that looked at the blood pressure response both during and following an acute bout of aerobic exercise in uncomplicated pregnancies. 51 , 73 , 75 , 77 – 79 , 82 – 84 , 87 , 89 – 96 All studies reported an acute increase in SBP and DBP during aerobic exercise. One study comparing stationary cycling and treadmill walking found similar increases in SBP irrespective of the mode (bike: + 8 mmHg p = 0.06, treadmill: + 8 mmHg p = 0.02) and DBP (bike: + 5 mmHg p = 0.39, treadmill: + 6 mmHg p = 0.18).…”

“…The risk of bias can be viewed in Supplementary file 2 (Tables S1-S5). Overall, the risk of bias in the RCTs and randomized clinical trials was low, with 27 (71%) studies assessed as low risk, 20,34,[36][37][38][39]41,42,[51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69] 10 (27%) studies classified as unclear 44,[69][70][71][72][73][74][75][76] and one (2%) study considered high risk. 77 The cohort [78][79][80][81][82][83][84] and case control studies [85][86][87][88][89][90] were all classified as low (71%) to moderate (29%) risk of bias (Tables…”