PMID- 30337345
OWN - NLM
STAT- MEDLINE
DCOM- 20190204
LR  - 20190215
IS  - 1473-0480 (Electronic)
IS  - 0306-3674 (Linking)
VI  - 53
IP  - 2
DP  - 2019 Jan
TI  - Effects of prenatal exercise on fetal heart rate, umbilical and uterine blood 
      flow: a systematic review and meta-analysis.
PG  - 124-133
LID - 10.1136/bjsports-2018-099822 [doi]
AB  - OBJECTIVE: To perform a systematic review and meta-analysis examining the 
      influence of acute and chronic prenatal exercise on fetal heart rate (FHR) and 
      umbilical and uterine blood flow metrics. DESIGN: Systematic review with 
      random-effects meta-analysis and meta-regression. DATA SOURCES: Online databases 
      were searched up to 6 January 2017. STUDY ELIGIBILITY CRITERIA: Studies of all 
      designs were included (except case studies) if published in English, Spanish or 
      French, and contained information on the population (pregnant women without 
      contraindication to exercise), intervention (subjective or objective measures of 
      frequency, intensity, duration, volume or type of exercise, alone 
      ["exercise-only"] or in combination with other intervention components [eg, 
      dietary; "exercise + co-intervention"]), comparator (no exercise or different 
      frequency, intensity, duration, volume and type of exercise) and outcomes (FHR, 
      beats per minute (bpm); uterine and umbilical blood flow metrics 
      (systolic:diastolic (S/D) ratio; Pulsatility Index (PI); Resistance Index (RI); 
      blood flow, mL/min; and blood velocity, cm/s)). RESULTS: 'Very low' to 'moderate' 
      quality evidence from 91 unique studies (n=4641 women) were included. Overall, 
      FHR increased during (mean difference (MD)=6.35bpm; 95% CI 2.30 to 10.41, 
      I(2)=95%, p=0.002) and following acute exercise (MD=4.05; 95% CI 2.98 to 5.12, 
      I(2)=83%, p<0.00001). The incidence of fetal bradycardia was low at rest and 
      unchanged with acute exercise. There were no significant changes in umbilical or 
      uterine S/D, PI, RI, blood flow or blood velocity during or following acute 
      exercise sessions. Chronic exercise decreased resting FHR and the umbilical 
      artery S/D, PI and RI at rest. CONCLUSION: Acute and chronic prenatal exercise do 
      not adversely impact FHR or uteroplacental blood flow metrics.
CI  - (c) Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Skow, Rachel J
AU  - Skow RJ
AD  - Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes 
      Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children's 
      Health Research Institute, Alberta Diabetes Institute, University of Alberta, 
      Edmonton, Alberta, Canada.
FAU - Davenport, Margie H
AU  - Davenport MH
AD  - Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes 
      Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children's 
      Health Research Institute, Alberta Diabetes Institute, University of Alberta, 
      Edmonton, Alberta, Canada.
FAU - Mottola, Michelle F
AU  - Mottola MF
AD  - R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of 
      Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, 
      Schulich School of Medicine and Dentistry, Children's Health Research Institute, 
      The University of Western Ontario, London, Ontario, Canada.
FAU - Davies, Gregory A
AU  - Davies GA
AD  - Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, 
      Canada.
FAU - Poitras, Veronica J
AU  - Poitras VJ
AD  - Independent researcher, Ottawa, Ontario, Canada.
FAU - Gray, Casey E
AU  - Gray CE
AD  - Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern 
      Ontario Research Institute, Ottawa, Ontario, Canada.
FAU - Jaramillo Garcia, Alejandra
AU  - Jaramillo Garcia A
AD  - Independent researcher, Ottawa, Ontario, Canada.
FAU - Barrowman, Nick
AU  - Barrowman N
AD  - Clinical Research Unit, Children's Hospital of Eastern Ontario Research 
      Institute, Ottawa, Ontario, Canada.
FAU - Meah, Victoria L
AU  - Meah VL
AD  - Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes 
      Laboratory, Faculty of Kinesiology, Sport, and Recreation, Women and Children's 
      Health Research Institute, Alberta Diabetes Institute, University of Alberta, 
      Edmonton, Alberta, Canada.
FAU - Slater, Linda G
AU  - Slater LG
AD  - John W. Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, 
      Canada.
FAU - Adamo, Kristi B
AU  - Adamo KB
AD  - School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 
      Ottawa, Ontario, Canada.
FAU - Barakat, Ruben
AU  - Barakat R
AD  - Facultad de Ciencias de la Actividad Fisica y del Deporte-INEF, Universidad 
      Politecnica de Madrid, Madrid, Spain.
FAU - Ruchat, Stephanie-May
AU  - Ruchat SM
AD  - Department of Human Kinetics, Universite du Quebec a Trois-Rivieres, 
      Trois-Rivieres, Quebec, Canada.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20181018
PL  - England
TA  - Br J Sports Med
JT  - British journal of sports medicine
JID - 0432520
SB  - IM
MH  - Bradycardia/epidemiology
MH  - *Exercise
MH  - Female
MH  - *Heart Rate, Fetal
MH  - Humans
MH  - Pregnancy
MH  - Randomized Controlled Trials as Topic
MH  - *Regional Blood Flow
MH  - Tachycardia/epidemiology
MH  - Umbilical Arteries/*blood supply
MH  - Uterus/*blood supply
OTO - NOTNLM
OT  - exercise
OT  - pregnancy
COIS- Competing interests: None declared.
EDAT- 2018/10/20 06:00
MHDA- 2019/02/05 06:00
CRDT- 2018/10/20 06:00
PHST- 2018/08/11 00:00 [accepted]
PHST- 2018/10/20 06:00 [pubmed]
PHST- 2019/02/05 06:00 [medline]
PHST- 2018/10/20 06:00 [entrez]
AID - bjsports-2018-099822 [pii]
AID - 10.1136/bjsports-2018-099822 [doi]
PST - ppublish
SO  - Br J Sports Med. 2019 Jan;53(2):124-133. doi: 10.1136/bjsports-2018-099822. Epub 
      2018 Oct 18.