Exercise in pregnancy

Beneficial Effects of Exercise on Hypertension-Induced Cardiac Hypertrophy in Adolescents and Young Adults

PURPOSE OF REVIEW

Hypertension-induced cardiac hypertrophy is widely known as a major risk factor for increased cardiovascular morbidity and mortality. Although exercise is proven to exert overall beneficial effects on hypertension and hypertension-induced cardiac hypertrophy, there are some concerns among providers about potential adverse effects induced by intense exercise, especially in hypertensive athletes. We will overview the underlying mechanisms of physiological and pathological hypertrophy and delineate the beneficial effects of exercise in young people with hypertension and consequent hypertrophy.

RECENT FINDINGS

Multiple studies have demonstrated that exercise training, both endurance and resistance types, reduces blood pressure and ameliorates hypertrophy in hypertensives, but certain precautions are required for hypertensive athletes when allowing competitive sports: Elevated blood pressure should be controlled before allowing them to participate in high-intensity exercise. Non-vigorous and recreational exercise are always recommended to promote cardiovascular health. Exercise-induced cardiac adaptation is a benign and favorable response that reverses or attenuates pathological cardiovascular remodeling induced by persistent hypertension. Exercise is the most effective nonpharmacological treatment for hypertensive individuals. Distinction between recreational-level exercise and competitive sports should be recognized by medical providers when allowing sports participation for adolescents and young adults.

Prenatal gymnastics and psychological support benefit pregnant women

Background/Aim: The management of pregnant women is a significant public health concern. This study aims to demonstrate the benefits of prenatal gymnastics and psychological support on pain, walking, anxiety, and self-esteem during pregnancy. Methods: A quasi-experimental study was conducted over eight months, from September 2020 to April 2021, with 38 pregnant women participating. They underwent 16 sessions of prenatal gymnastics and psychological support once a week, lasting 45 min at low to moderate intensity. Pain, six-minute walk, anxiety, and self-esteem were measured using the visual analog scale (VAS), the six-minute walk test, the Hospital Anxiety and Depression Scale (HAD Scale), and the Rosenberg scale, respectively. The parametric Student's t-test and chi-square were used to compare quantitative and qualitative variables before and after the program, with P<0.05 considered statistically significant. Results: The study found that the distance traveled (377.45 m vs. 393 m; P=0.001) and VO2max (15.1 ml/kg/m2 vs. 18.5 ml/kg/m2; P=0.001) increased at the end of the program. However, pain (6 vs. 1.16; P=0.001) and walking speed (2.2 m/s vs. 1.9 m/s; P=0.001) decreased. The program also improved self-esteem (low: 55.3% before vs. 0% after; P=0.001, medium: 44.7% before vs. 13.2% after; P=0.001, strong: 0% before vs. 86.8% after; P=0.001) and anxiety (Uncertain anxiety: 31.6% before vs. 97.4% after; P=0.001, Questionable anxiety: 50% before vs. 2.6% after, Certain anxiety: 18.4% before vs. 0% after; P=0.001). Conclusion: Regular prenatal gymnastics and psychological support positively affect oxygen consumption, pain, anxiety, and self-esteem among pregnant women. This program should be provided continuously to minimize pregnancy-related complications.

Experiences of physical activity during pregnancy resulting from in vitro fertilisation: an interpretative phenomenological analysis

OBJECTIVE

To explore the qualitative experiences and decision-making processes surrounding physical activity (PA) for women who have undergone IVF treatment.

BACKGROUND

PA during pregnancy is safe for both mother and fetus in the majority of cases, including for women who have undergone in vitro fertilisation (IVF) treatment; however, there is a paucity of research into decision-making and PA in this population.

METHODS

Eight women, who had undergone successful IVF treatment and were currently pregnant or had given birth within the last two years, participated in semi-structured interviews about their experiences of infertility and PA during pregnancy. Interview transcripts were analysed using interpretative phenomenological analysis.

RESULTS

Three superordinate themes emerged from the data: 'navigating away from childlessness and towards motherhood', 'negotiating a safe passage' and 'balancing the challenges of pregnancy with the needs of the self'. Ten subthemes indicated the processes adopted to navigate experiences of infertility, the IVF process, and subsequent decision-making about PA during pregnancy.

CONCLUSION

PA during pregnancy was experienced as a way to soothe the self and control the experience of pregnancy; however, this was mediated by concerns about safety and physical limitations on PA. Limitations of the study are considered, as well as implications for clinical practice and directions for future research.

Management of pregnancy and obstetric complications in prehospital trauma care: faculty of prehospital care consensus guidelines

This consensus statement seeks to provide clear guidance for the management of pregnant trauma patients in the prehospital setting. Pregnant patients sustaining trauma injuries have certain clinical management priorities beyond that of the non-pregnant trauma patients and that if overlooked may be detrimental to maternal and fetal outcomes.

Treadmill exercise alleviates prenatal noise stress-induced impairment of spatial learning ability through enhancing hippocampal neurogenesis in rat pups

Stress alters brain cell properties and then disturbs cognitive processes, such as learning and memory. In this study, we investigated the effect of postnatal treadmill exercise on hippocampal neurogenesis and spatial learning ability of rat pups following prenatal noise stress. The impact of exercise intensity (mild-intensity exercise vs heavy-intensity exercise) was also compared. The pregnant rats in the stress-applied group were exposed to a 95 dB supersonic machine sound for 1 h once a day from the 15th day after mating until delivery. After birth, the rat pups in the exercise groups were made to run on a treadmill for 30 min once a day for 7 consecutive days, starting 4 weeks after birth. The spatial learning ability was tested using radial-arm maze task and hippocampal neurogenesis was determined by 5-bromo-2′-deoxyuridine (BrdU) immunohistochemistry. The rat pups born from the stress-applied maternal rats spent more time for the seeking of water and showed higher number of error in the radial-arm maze task compared to the control group. These rat pups showed suppressed neurogenesis in the hippocampus. In contrast, the rat pups performed postnatal treadmill exercise saved time for seeking of water and showed lower number of error compared to the stress-applied group. Postnatal treadmill exercise also enhanced neurogenesis in the hippocampus. The mild-intensity exercise showed more potent impact compared to the heavy-intensity exercise. The present results reveal that postnatal treadmill exercise lessens prenatal stress-induced deterioration of brain function in offspring.

The influence of maternal treadmill running during pregnancy on short-term memory and hippocampal cell survival in rat pups

Maternal exercise during pregnancy has been suggested to exert the beneficial effects on the brain functions of offspring. In the present study, we attempted to determine the effects of maternal treadmill running during pregnancy on short-term memory ability, hippocampal cell survival, and the expression of brain-derived neurotrophic factor (BDNF) mRNA in rat pups. After confirming pregnancy, the pregnant rats were divided into two groups: the control group and the running group (n = 6 in each group). Beginning on the 15th day of pregnancy, the pregnant rats in the running group were forced to run on a treadmill for 30 min at a mild-intensity, once a day until delivery. After all the pregnant rats had given birth, there were rat pups available for use in this study in each group (n = 15 in each group). The latency of the step-down avoidance task was used in order to evaluate the short-term memory ability of the rat pups on the 28 days after birth. Immunohistochemistry for 5-bromo-2'-deoxyuridine (BrdU) and reverse transcription-polymerase chain reaction (RT-PCR) for BDNF mRNA were performed to determine hippocampal neurogenesis and hippocampal BDNF mRNA expression of the rat pups on the 29 days after birth, respectively. Our results revealed that maternal running during pregnancy resulted in significant increase in the expression of BDNF mRNA, enhanced hippocampal cell survival, and improved the short-term memory capability of rat pups, as compared to those measured in the control group. The findings of our study provide evidence that maternal running during gestational period may enhance the brain functions of offspring.

Maternal swimming during pregnancy enhances short-term memory and neurogenesis in the hippocampus of rat pups

In the present study, the effects of maternal swimming during pregnancy on the short-term memory ability, hippocampal neurogenesis, and brain-derived neurotrophic factor (BDNF) mRNA expression of rat pups were investigated. After confirming their pregnancy, the pregnant rats were divided into two groups: the control group and the swimming group. From the 15th day of pregnancy until delivery, pregnant rats were subcutaneously injected with 100mg/kg of 5-bromo-2'-deoxyuridine (BrdU) once a day at 30min before the starting of swimming exercise. Pregnant rats in the swimming group were forced to swim for 10min once a day until delivery. On the 21 days after birth, the rat pups were trained in a step-down avoidance test. The latency time of the step-down avoidance task was determined on the 28 days after birth in order to evaluate the short-term memory ability of pups. On the 29 days after birth, the rat pups' brains were removed, and BrdU immunohistochemistry for the detection of neurogenesis and reverse transcription-polymerase chain reaction (RT-PCR) for the detection of BDNF mRNA expression were then performed. The rat pups born from the maternal rats that performed swimming during pregnancy showed significantly increased BDNF mRNA expression, enhanced hippocampal neurogenesis, and improved short-term memory capability. The present results have clearly shown that maternal swimming by rats during pregnancy enhances the memory of the rats' offspring by increasing neurogenesis. Our present study provides the evidence that maternal exercise during the gestational period may enhance the brain functions of the mothers' offspring.

Physical activity patterns and maternal well-being in postpartum women

OBJECTIVE

To examine changes in activity prepregnancy to postpartum; examine postpartum activity and sociodemographic predictors of maternal well-being; and, examine maternal well-being in subjects on the basis of sport/exercise activity prepregnancy to postpartum.

METHODS

Ninety-one postpartum women completed a Kaiser Physical Activity Survey (KPAS) Ainsworth BE, Sternfeld B, Richardson MT, Jackson K. Evaluation of the Kaiser Physical Activity Survey in women. Med Sci Sports Exerc 2000; 32:1327-38. and the Lederman Postpartum Questionnaire (PPQ) Lederman RP, Weingarten CT, Lederman E. Postpartum self-evaluation questionaire: Measures of maternal adaptation. In: Raff BS, Carrol P, editors. Perinatal parental behaviour: Nursing research and implications for newborn health. New York: Alan R. Liss, 1981:201-31. Subjects recalled activity prepregnancy and postpartum for the KPAS indexes that included household/care giving (HC), active living habits (AL), occupation (0), and sports/exercise (SE). The PPQ has seven well-being subscales.

RESULTS

Subjects with older infants or no other children increased HC and decreased O prepregnancy to postpartum compared to subjects with younger infants or > or =1 other child. Predictors of the variance in the PPQ subscales included SE and AL (21% in subscale one), SE (6.0% in subscale two), HC (5.3% in subscale three), socioeconomic status (19.7% in subscale four), O (5.0% in subscale five), education (5.2% in subscale seven). Subjects who maintained or increased SE showed better well-being as compared to subjects who reported no SE or decreased SE prepregnancy to postpartum.

CONCLUSIONS

In this group of women, subjects with older infants or no other children reported higher HC and lower O prepregnancy to postpartum. Postpartum SE, education, and socioeconomic status were predictors of maternal well-being. In general, better maternal well-being was found among subjects maintaining or increasing SE compared to no SE or decreased SE prepregnancy to postpartum. Support from partner/husband, family, and friends were significant factors in maintaining or increasing SE.

Low-impact exercise during pregnancy - a study of safety

BACKGROUND

Exercise is an important part of many women's lives. Women are often advised to refrain from physical exercise during pregnancy. The reason given is mainly safety, i.e. fear of maternal hyperthermia, which is known to be related to neural tube defects. However, exercise during pregnancy has not been shown to be related to hyperthermia.

OBJECTIVE

To study temperature and oxygen saturation responses to low-impact exercise in healthy pregnant women.

METHODS

Forty pregnant women and 11 controls participating in low-impact aerobic exercise were monitored before exercise, at maximum-exercise level, and after exercise with regard to core temperature, heart rate, and oxygen saturation level.

RESULTS

The core temperature among the pregnant women did not increase significantly at maximum exercise or after exercise (36.5 versus 36.7 or 36.5 degrees C, P = 0.1, P = 0.5). None of the pregnant women were even close to approaching a dangerous body temperature at an intensity level of 69% of their maximum heart rate. As compared with pre-exercise values, oxygen saturation among pregnant women was significantly reduced at both maximum-exercise and postexercise measurements, but no measurement was below 95% in oxygen saturation.

CONCLUSION

Low-impact aerobics at about 70% of one's maximum heart rate appears to be safe in terms of risk of maternal hyperthermia.

Self-reported leisure-time physical activity during pregnancy and relationship to psychological well-being

The psychological benefits of physical exercise have been reported in numerous populations. While studies have found elevated stress and depressed mood during pregnancy and no adverse birth effects associated with low to moderate intensity exercise, few have examined exercise in relation to psychosocial outcomes during pregnancy. The present study examined leisure-time physical activity (LTPA) patterns during pregnancy and its association to psychological well-being. In each trimester of pregnancy 180 women self-reported on frequency, form and duration of LTPA through structured interviews. Beginning in the third month of pregnancy, data was collected monthly on depressed mood (Lubin depression adjective checklist), state-anxiety, pregnancy-specific stress (pregnancy experiences questionnaire) and Hassles Scale. Independent samples t-tests comparing exercisers and non-exercisers in each trimester showed exercisers reported significantly less depressed mood, daily hassles, state-anxiety and pregnancy-specific stress in the first and second trimester. Women who exercised in the third trimester reported less state-anxiety in that trimester compared to non-exercisers. The results indicate a consistent association between enhanced psychological well-being, as measured by a variety of psychosocial inventories, and LTPA participation particularly during the first and second trimesters of pregnancy. In healthy pregnant women, even low-intensity regular exercise may be a potentially effective low-cost method of enhancing psychological well-being.