General Obstetrics and Gynecology: Fetus-Placenta-Newborn
Fetal heart rate response to strenuous maternal exercise: Not a predictor of fetal distress,☆☆

https://doi.org/10.1067/mob.2002.125892Get rights and content

Abstract

Objective: The purpose of this study was to analyze the effects of maternal exercise on fetal heart rate changes to determine prognostic factors for an abnormal trace in labor. Study Design: Two hundred fifty-eight primiparous women who were 33 to 38 weeks of gestation with varying levels of activity were recruited. A symptom-limited incremental exercise test was preformed. Cardiotocography was carried out before and after exercise. Data were analyzed with specialized computer software. Results: A strenuous level of exercise was achieved. The most common fetal heart rate response seen was tachycardia. The incidence did not vary with the level of fitness, maternal body mass index, or fetal weight. Male fetuses were more prone to fetal distress. A significantly higher proportion of distressed babies were born to older women (P <.0001). The percentage of abnormal traces was equal in the vaginal and caesarean delivery groups. Conclusion: The results showed no correlation among the incidence of fetal distress, the mode of delivery, and the fetal heart rate changes after exercise. (Am J Obstet Gynecol 2002;187:811-6.)

Section snippets

Methods

This study was carried out with 258 nonsmoking primiparous women from 33 to 38 weeks of gestation as confirmed by a first trimester dating scan with uneventful pregnancies. This group is a subgroup of a larger study, with which we are observing the effects of exercise in pregnancy. This low-risk group had varying levels of activity, from none to exercising 3 to 4 times a week. The intensity of exercise was categorized by the frequency and level of exertion by each mother, in keeping with those

Results

Two hundred seventy women with uncomplicated singleton pregnancies were recruited. Twelve of these women were unsuitable to participate for a number of reasons (diabetes mellitus, hypertension, intrauterine growth restriction). Of these mothers, 112 women (43%) took no exercise; 119 women (46%) took mild exercise, and the remaining 27 women (11%) took moderate exercise. The amount of exercise taken differed with age, with significantly smaller proportions of mothers aged ≤25 undertaking mild or

Comment

This study addresses fetal cardiovascular hemodynamics in response to moderate exercise. Originally, Hon and Wohlgemuth 14 hypothesized that fetal heart rate response to maternal exercise could be used as a test for uteroplacental insufficiency. They suggested that exercise could reduce uterine blood flow and expose a compromised placental reserve. Previous studies have not analyzed factors in this population size to assess those mother who are at risk of the development of an abnormal trace in

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  • Cited by (24)

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    • Evaluation of floatingline and foetal heart rate variability

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    Supported by The Friends of the Rotunda.

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    Reprint requests: Mairead M. Kennelly, MRCOG, Research Department, Department of Obstetrics and Gynaecology, Rotunda Hospital, Parnell Square, Dublin, Ireland.

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