Influence of Exercise Type on Maternal Blood Pressure Adaptation throughout Pregnancy

BACKGROUND: It has been reported that 10% of all pregnancies are complicated by a hypertensive disorder of pregnancy. Previous research has shown that moderate-vigorous intensity exercise has a positive effect on maternal resting blood pressure. A research gap, however, exists related to how different types of exercise (resistance, aerobic, combined resistance and aerobic) affect maternal blood pressure. Most of the previous studies solely focused on aerobic exercise. OBJECTIVE: The aim of this study was to examine the effects of exercise types on maternal blood pressure throughout pregnancy. STUDY DESIGN: This study employed a secondary analysis using data from a randomized controlled prenatal exercise intervention trial. This study utilized 3 exercise intervention groups (aerobic, resistance, combination) and compared the results with those of a nonexercize control group. Participants completed 3 50-minute sessions weekly from 16 weeks of gestation until delivery. Maternal vital signs and physical measurements such as systolic blood pressure, diastolic blood pressure, and heart rate were measured every 4 weeks throughout the intervention period. Between-group mean differences in maternal measurements were assessed using Pearson's chi-square tests for continuous (age, prepregnancy body mass index, heart rate, systolic blood pressure, diastolic blood pressure, pulse pressure) variables. For gravida, exact Wilcox 2-sample tests were performed to determine between-group differences in mean values. Hierarchical linear growth curves were used to estimate maternal trajectories of systolic blood pressure and diastolic blood pressure from 16 weeks to 36 weeks’ gestation in each of the 4 groups (aerobic, combination, control, and resistance). RESULTS: There were no differences among the groups in maternal age or prepregnancy body mass index. Controlling for maternal body mass index, the lowest significant systolic blood pressure curve was noted throughout the pregnancy for women who participated in resistance exercise, followed by women in the aerobic exercise group all relative to the no exercise control group. At 36 weeks’ gestation, the systolic blood pressure was lower in the resistance group by 12.17 mm Hg (P<.001) and in the aerobic group by 7.90 mm Hg (P<.001) relative to controls. No significant change in systolic blood pressure was noted in the combination group in comparison with controls at 36 weeks’ gestation. Similarly, we demonstrated a significantly lower linear growth curve in diastolic blood pressure that was maintained throughout pregnancy in any exercise type relative to controls. After controlling for maternal body mass index, all 3 exercise types (combination, resistance, and aerobic) significantly predicted a similar decrease in diastolic blood pressure that was maintained throughout pregnancy. At 36 weeks’ gestation, the diastolic blood pressure was lower in the aerobic group by 7.30 mm Hg (P<.01), in the combination group by 6.43 mm Hg (P<.05), and in the resistance group relative to controls. CONCLUSION: Overall, all exercise types were beneficial in lowering maternal resting blood pressure throughout pregnancy. Resistance training was noted to be the most beneficial in improving systolic blood pressure, followed by aerobic exercise. All 3 exercise groups were noted to improve diastolic blood pressure equally. Further research needs to be done to determine if either resistance or aerobic exercise throughout pregnancy decreases the risk for hypertensive disorders of pregnancy and the associated morbidity and mortality

THE EFFECTS OF MATERNAL PERINATAL EXERCISE ON INFANT NEUROMOTOR OUTCOMES

BACKGROUND: Aerobic exercise during pregnancy has been well established as safe and effective for both mother and infant. Few studies have examined the effects of different exercise modes during pregnancy on infant outcomes. The purpose of this study is to examine the effects of exercise mode during pregnancy on 1-month infant neuromotor outcomes. METHODS: Pregnant women were recruited and randomized to either aerobic (AE), resistance (RE), combination (CE), or control (CON) groups. Participants completed 150 min each week of supervised activity. After delivery, 1-month infant neuromotor skills were assessed using the Alberta Infant Motor Scales (AIMs) and Peabody Developmental Motor Scales, 2nd Edition. ANOVAs were used to compare differences between exercise groups; data was stratified by pre-pregnancy BMI (healthy weight, HW vs. overweight-obese, OO) and infant sex (M, F). Regressions assessed predictors of 1-month neuromotor outcomes. RESULTS: Groups were similar in maternal, neonate, and 1-month descriptors. Trends for improved subscores included: AE and RE in Prone (p=.20); CE in Sitting (p=.11); RE in Standing (p=.20) relative to controls. In females (F) from Healthy Weight (HW) women, all exercise types had increased gestational age (p=.03), AE and CE had greater Stationary (p=.17) subscores; in males (M) of HW women, all exercise types had greater Sitting (p=.02) subscores. In F from OO women, AE had greater total AIMs score (p=.20), while AE and RE had greater Stationary (p=.02) Locomotion (p=.06) subscores, as well as GMQ (p=.05) scores; in M of OO women, all exercise with increased height (p=.03) and weight (p=.02), RE with greater Prone (p=.03) and Standing (p=.04) subscores, with greater total AIMS (p=.04) scores. Controlling for other factors, we found significant predictors of 1-month neuromotor scores. Reflex scores were predicted by maternal exercise attendance, pre-pregnancy activity, fitness level, ethnicity, infant sex and body fat. Stationary scores were predicted by exercise mode, pre-pregnancy activity, baby BMI. GMQ was predicted by maternal exercise mode, race, delivery type, pre-pregnancy activity, BMI, and 1-month body fat. CONCLUSION: Maternal exercise mode or attendance, and infant body fat influences 1-month neuromotor skills. There are differences in 1-month neuromotor outcomes based on infant sex as well as maternal pre-pregnancy BMI. Further research is needed to understand this

Self-Reported Intake and Circulating EPA and DHA Concentrations in US Pregnant Women

In the United States, pregnant women have low concentrations of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), which are essential for fetal development. Although maternal blood provides accurate polyunsaturated fatty acid (PUFA) concentrations, venipuncture is expensive and not always accessible. PUFA-containing foods consumption, both omega-3 ad omega-6 is supposed to reflect in the status (plasma, RBC, adipose tissue) of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). De novo synthesis of DHA and EPA during pregnancy is supposed to be higher compared to pre and/or post-pregnancy periods. Thus, this study aimed to determine the association between maternal self-reported dietary intake of foods high in DHA and EPA, along with vegetable oils as a source of omega-6 fatty acids, with maternal blood DHA and EPA concentrations. Pregnant women (13–16 weeks gestation) were recruited and asked to complete a food-frequency questionnaire (FFQ) and blood draw at enrollment and 36 weeks. Circulating concentrations of DHA and EPA were quantified and change scores were calculated. Correlations were done to determine associations between FFQ results and EPA/DHA maternal blood concentrations. Regression analyses were run to examine significant predictors of the main outcomes. Overall, PUFA-food consumption and RBC’s DHA levels decreased from early to late pregnancy; self-reported PUFA-rich food consumption positively correlated with DHA and EPA levels. DHA concentration was predicted by self-reported PUFA-rich oils (sunflower/soy/corn/olive) consumption, but EPA concentration was predicted by maternal BMI. These findings suggest that EPA and DHA consumption decreased across pregnancy and the FFQ can be utilized as an effective method for estimating PUFA blood concentration during pregnancy