User:M3701/Pregnancy

Vigorous Physical Activity in Pregnancy

Articles

i. How to HIIT

• Issues found above 90% HR max
• Top Level athlete able to continue with no change in intensity
• Uterine arterial blood flow decreased during all forms of exercise, but never outside of acceptable ranges
• No difference in cardiac function or birth outcomes (pain level,
• 150 min a week guidelines
• More efficient
• Positive effects for gestational diabetes
• Ex: resistance circuit training, running, stationary cycling
• Receive same benefits as non-pregnant high intensity exercisers
• No change in maternal weight gain
• Fetal Heart rate and umbilical artery blood flow remained at healthy levels during HIIT
• Needs more studying

ii. Vigorous intensity in the third trimester

• Information regarding vigorous exercise in the later more controversial trimester of the pregnancy
• Slight increase in time to gestation for vigorous vs light or no exercise
• No significant difference in maternal weight gain (other than those who started obese/overweight and could help with GDM)
• Need more studying
• No detrimental fetal blood flow effects during vigorous or high intensity exercise
• Similar health benefits as non pregnancy

iii. Strenuous Exercise Limit

• lower birth rate
• fetal HR remained within safe levels for both moderate and high intensity
• blood flow through the umbilical cord showed no change between the groups
• safe for mom and fetus

Missing Information From Current Article

• Dangers associated with vigorous intensity exercise (HR max above 90%)
• Why vigorous intensity guidelines are important to be studied and outlined (ex: athletes)
• Benefits of vigorous exercise, especially on the overweight or obese population (GDM)
• Specific exercises (biking, running, cross country skiing, resistance circuit training)
• ACOG and WHO 150 minute guidelines
• Around 70-85% of you maximal heart rate is vigorous
• personalized guidance is needed (tailored exercise

Similarities

- Potential risk if HR max is over 90%

- All say to consult healthcare professional

- Fetal HR and blood flow remained within range during high intensity/vigorous exercise

- Follow 150 min guidelines

- Similar health benefits (ex:body comp, cardiopulmonary fitness) to non-pregnancy

- Maternal weight gain remained constant

- All programs should be individualized

- Safe for active an inactive singleton non-complicated pregnancies

Differences

- Maternal weight gain reduced in obese/overweight pregnancies in the third trimester of pregnancy

- Type of activities (biking vs running vs skiing)

• Szumilewicz, A., Santos-Rocha, R., Worska, A., Piernicka, M., Yu, H., Pajaujiene, S., Shojaeian, N.-A., & Oviedo Caro, M. A. (2021a). How to HIIT while pregnant? the protocol characteristics and effects of high intensity interval training implemented during pregnancy – a systematic review. Baltic Journal of Health and Physical Activity, 14(1). https://doi.org/10.29359/bjhpa.14.1.01
  • This article is published by the Baltic Journal of Health and Physical Activity, a reliable source of information. It covers information related to HIIT guidelines, risks, related clinical trials, and other information related to high intensity exercise effects during pregnancy.^[1]
• Beetham, K. S., Giles, C., Noetel, M., Clifton, V., Jones, J. C., & Naughton, G. (2019). The effects of vigorous intensity exercise in the third trimester of pregnancy: A systematic review and meta-analysis. BMC Pregnancy and Childbirth, 19(1). https://doi.org/10.1186/s12884-019-2441-1
  • This meta-analysis is published by BMC pregnancy and childbirth, and an analysis of clinical trials and published information relating to effects of vigorous intensity exercise in the third trimester of pregnancy.^[2]
• Szymanski, L. M., & Satin, A. J. (2012). Strenuous exercise during pregnancy: Is there a limit? American Journal of Obstetrics and Gynecology, 207(3). https://doi.org/10.1016/j.ajog.2012.07.021
  • This article was published by the American Journal of Obstetrics and Gynecology, so it should be a reliable source. It covers current guidelines of physical activity during pregnancy and compares clinical trial results measuring fetal responses to strenuous exercise preformed by the mother, and is helpful providing information relating to high intensity exercise during pregnancy. ^[3]
  • Physical activity and exercise during pregnancy and the postpartum period. ACOG. (n.d.-b). https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2020/04/physical-activity-and-exercise-during-pregnancy-and-the-postpartum-period^[4]
    • ACOG physical activity guidelines, outline the current recommendations for exercise during pregnancies, includes risks and average weekly exercise prescription

Summary

The current guidelines for moderate intensity activity during pregnancy have been outlined by organizations such as ACOG to be the same 150 minutes per week as regular physical activity guidelines.^[1] Certain modifications such as avoiding supine position after 20 weeks are also recommended. ^[1] Vigorous activity guidelines during pregnancy have not been outlined as clearly or studied as much, so consulting a healthcare professional to get a safe, tailored, fitness plan is recommended. Current research supports that vigorous activity for most non-complicated singleton pregnancies is beneficial and has little negative impact on fetal wellbeing.^[2][3] It has also been shown to have similar benefits to those who preform the same level of activity outside of pregnancy. ^[3] The concerns related to high intensity exercise during pregnancy are usually around fetal wellbeing measures such as heart rate and blood flow. No abnormal measures of fetal distress, such as heart rate or maternal/fetal blood flow^[2]were found during high intensity/vigorous exercise, if the mother stayed under 90% of her heart rate maximum.^{[3] [2]} Risks of exceeding this heart rate included decreased uterine artery blood flow and fetal bradycardia.^[3][4] If using vigorous exercise as a means of lowering maternal weight gain during pregnancy, it's important to note there is little evidence to suggest that higher intensity has more of an effect than moderate intensity activity on normal pregnancies;^[4][3] It was shown in one study that the obese/overweight population during pregnancy had improved maternal weight gain with more vigorous exercise compared to moderate although more studies are needed.^[4] High intensity exercises such as stationary biking, uphill running, cross country skiing, and resistance circuit training, all showed similar benefits. ^[4][3] It is important to further study the effects and limitations of vigorous exercise during pregnancy as it becomes more prevalent for female athletes, and in the average population. Overall if one is already preforming vigorous activity before pregnancy, no negative effects were found with the continuation of similar activity levels during pregnancy, if staying under 90% of the mothers heart rate maximum.^[2][4][3] Always consult a physician to ensure any physical activity preformed is safe during pregnancy, as the recommended amount of physical activity can depend on other factors during pregnancy as well.