The Effect of Exercise During Pregnancy on Maternal and Offspring Vascular Outcomes: a Pilot Study
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DEVELOPMENTAL PROGRAMMING: ORIGINAL ARTICLE
The Effect of Exercise During Pregnancy on Maternal and Offspring Vascular Outcomes: a Pilot Study Áine Brislane 1,2
&
Helen Jones 1 & Sophie M. Holder 1 & David A. Low 1 & Nicola D. Hopkins 1
Received: 6 April 2020 / Accepted: 20 August 2020 # The Author(s) 2020
Abstract The aim of this pilot study is to obtain estimates for the change in maternal cerebrovascular (primary) and offspring vascular structure (secondary) during healthy pregnancy that includes structured exercise. Eighteen pregnant women self-assigned to a moderate-intensity aerobic exercise intervention or a control group. Maternal cerebral blood flow (CBF) at the middle cerebral artery, cerebro- and peripheral-vascular function was assessed at the end of each trimester. Offspring carotid artery intima-media thickness (IMT) was measured within 12 weeks of birth. For exploratory purposes, we performed statistical analysis to provide estimates of the change for primary and secondary outcome variables. Maternal CBF reduced (− 8 cm s−1 [− 14 to − 2]) with evidence of change to cerebral autoregulation (normalised gain: 0.12 %cm s−1% mmHg−1mmHg/% [− 0.18 to 0.40]) during pregnancy. Offspring carotid IMT was smaller in the exercise group (− 0.04 mm [− 0.12–0.03]) compared with controls. Based upon this data, a sample size of 33 and 57 in each group is required for low-frequency normalised gain and offspring IMT, respectively. This would provide 90% power to detect statistically significant (P < 0.05) between group differences in a randomised controlled trial. CBF is reduced in pregnancy, possibly due to reduced vascular resistance and altered maternal cerebral autoregulation. Maternal exercise had negligible effects on cerebrovascular adaptation to pregnancy, but we observed lower offspring carotid artery wall thickness following maternal exercise. Our directional findings and sample size estimations should be explored in a fully powered randomised control trial. Clinical trial registration: The trial was registered on March 14th at https://register.clinicaltrials.gov (NCT03079258). Participant enrolment began on 3rd April 2016. Keywords Pregnancy . Exercise . Cerebrovascular function . Endothelial function . Offspring
Introduction Pregnancy is associated with significant cardiovascular (CV) adaptations including increased cardiac output, blood volume and vasodilation alongside decreased mean arterial pressure [1]. Increased vasodilation is critical for adequate delivery of oxygen and nutrients to the foetus and is achieved in part, via an increased production of vasoactive substances such as nitric oxide (NO)
* Áine Brislane [email protected] 1
Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK
2
School of Sport, York St. John University, Lord Mayor’s Walk, York YO31 7EX, UK
at the vascular endothelium [2]. Underlying undetected endothelial injury may impede essential vascular adaptation during pregnancy and plausibly underpin the pathophysiol
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