Physical activity and gestational weight gain predict physiological and perceptual responses to exercise during pregnancy

Abstract

Background Exercise is known to improve the health of the pregnant woman and her child. Studies that have evaluated physiological parameters during prenatal exercise have conflicting results. Better understanding of these physiological responses can modify exercise prescriptions, safety, and monitoring strategies. We examined the association between age, prepregnancy body mass index (BMI), gestational weight gain (GWG), and physical activity (PA) levels, factors that may influence a change in physiological (HR, VO2 responses) and perceptual (RPE) responses to acute exercise throughout pregnancy. Methods Twenty‐two healthy pregnant women (31.4 ± 3.7 years) performed a Submaximal incremental Walking Exercise Test (SWET). Early‐ (13–18 weeks), mid‐ (24–28 weeks), and late‐pregnancy (34–37 weeks) were compared. VO2 (L/min; ml/kg/min), HR (bpm), and RPE were collected at the end of each test stage. PA was determined by accelerometry. We associated PA levels, GWG, prepregnancy BMI, and age with HR, RPE, and VO2 responses. Results HR, RPE, and absolute VO2 were higher in late‐pregnancy compared to earlier time points (p < .05; η2 = 0.299–0.525). Regression models were built for HR (all time points), RPE (early‐ and late‐pregnancy), and VO2 (L/min; late‐pregnancy). HR (late‐pregnancy) was predicted by time in vigorous PA, GWG, age, and prepregnancy BMI (r2 = 0.645; SEE = 5.84). RPE (late‐pregnancy) was predicted by sedentary time, GWG, prepregnancy BMI, and age (r2 = 0.662; SEE = 1.21). Conclusion Physiological/perceptual responses were higher in late‐pregnancy compared to other time points and associated with combined PA, GWG, prepregnancy BMI, and age. These findings can be used to modify exercise prescriptions and designs for future PA interventions in pregnant women.

Walking Cadence during Moderate-Intensity Physical Activity in Pregnant Women

“…This may result in underestimation of energy expenditure during exercise. However, Dobson et al found increased absolute, but not relative VO 2 in late pregnancy compared to early [ 17 ], which supports the notion that walking does not elicit a significantly elevated metabolic rate in pregnant women compared to the non-pregnant state. While metabolism is indeed altered by pregnancy, the degree of change is insufficient to alter the 3 MET = moderate intensity heuristic, and thus this cut point can be used to prescribe exercise in this population as it can in typical healthy adults.…”

“…Walking is the most commonly utilized form of PA during pregnancy [ 8 , 9 ], and has been shown to reduce possible risk factors of gestational diabetes [ 10 , 11 ], preeclampsia [ 12 ], and excessive gestational weight gain [ 13 ], and increase the likelihood of healthy birthweight for the offspring [ 14 , 15 ]. However, perceptions of walking intensity may be altered as pregnancy progresses [ 16 , 17 ] due to many factors, including weight gain and altered center of gravity. Currently, the cut points for moderate-intensity PA for pregnant individuals are extrapolated from those used for general healthy non-pregnant populations.…”

Važnost primjene fizikalne terapije u skrbi za trudnice

“…Jedina neistražena "zapreka" vježbanju ostaju dugotrajne vježbe ili one s maksimalnim intenzitetom. 29,30,31 1996. godine provedeno je istraživanje koje je pratilo sto djece čije su majke bile tjelesno aktivne tijekom trudnoće, te kontrolnu skupinu žena koje nisu bile tjelesno aktivne tijekom trudnoće. Nakon jedne godine nije evidentirana značajna razlika u visini, težini i ostalim mjerenjima među djecom, no djeca tjelesno aktivnih majki ostvarila su bolje rezultate na standardiziranom testu razvoja, a i test mentalnih sposobnosti uglavnom je dao bolje rezultate.…”

“…Nekoliko istraživanja pokazalo je (spomenuto u prethodnom poglavlju) kako cirkulacija i protok krvi kod fetusa nisu značajno promijenjeni umjerenom tjelesnom aktivnošću. 30,31 Isto tako, porođajna težina djeteta nije bila znatno drugačija u usporedbi žena koje su bile tjelesno aktivne i onih koje to nisu bile. Utjecaji redovnog vježbanja su smanjenje krivulje rasta porođajne težine i same porođajne težine, ali i manji postotak masnoga tkiva novorođenčeta.…”