The Influence of Physical Activity During Pregnancy on Maternal, Fetal or Infant Heart Rate Variability: a Systematic Review

Overview

Journal BMC Pregnancy Childbirth

Publisher Biomed Central

Specialty Gynecology & Obstetrics

Date 2016 Oct 28

PMID 27784276

Citations 10

Authors

Pavel Dietz

Estelle D Watson

Matteo C Sattler

Wolfgang Ruf

Sylvia Titze

Mireille van Poppel

Affiliations

Soon will be listed here.

Abstract

Background: Physical activity (PA) during pregnancy has been shown to be associated with several positive effects for mother, fetus, and offspring. Heart rate variability (HRV) is a noninvasive and surrogate marker to determine fetal overall health and the development of fetal autonomic nervous system. In addition, it has been shown to be significantly influenced by maternal behavior. However, the influence of maternal PA on HRV has not yet been systematically reviewed. Therefore, the aim of this systematic review was to assess the influence of regular maternal PA on maternal, fetal or infant HRV.

Methods: A systematic literature search following a priori formulated criteria of studies that examined the influence of regular maternal PA (assessed for a minimum period of 6 weeks) on maternal, fetal or infant HRV was performed in the databases Pubmed and SPORTDiscus. Quality of each study was assessed using the standardized Quality Assessment Tool for Quantitative Studies (QATQS).

Results: Nine articles were included into the present systematic review: two intervention studies, one prospective longitudinal study, and six post-hoc analysis of subsets of the longitudinal study. Of these articles four referred to maternal HRV, five to fetal HRV, and one to infant HRV. The overall global rating for the standardized quality assessment of the articles was moderate to weak. The articles regarding the influence of maternal PA on maternal HRV indicated contrary results. Five of five articles regarding the influence of maternal PA on fetal HRV showed increases of fetal HRV on most parameters depending on maternal PA. The article referring to infant HRV (measured one month postnatal) showed an increased HRV.

Conclusions: Based on the current evidence available, our overall conclusion is that the hypothesis that maternal PA influences maternal HRV cannot be supported, but there is a trend that maternal PA might increase fetal and infant HRV (clinical conclusion). Therefore, we recommend that further, high quality studies addressing the influence of maternal PA on HRV should be performed (methodological conclusion).

Citing Articles

Perceptions, attitudes and beliefs on antenatal exercises among primiparous pregnant women: a qualitative study in Sri Lanka.

Chathurika S, Rathnayake C, Nanayakkara D, Thennakoon S, Rathnayake A BMJ Open. 2024; 14(11):e086105.

PMID: 39500608 PMC: 11552607. DOI: 10.1136/bmjopen-2024-086105.

Methods for analyzing infant heart rate variability: A preliminary study.

Claiborne A, Williams A, Jolly C, Isler C, Newton E, May L Birth Defects Res. 2023; 115(10):998-1006.

PMID: 37078641 PMC: 11226182. DOI: 10.1002/bdr2.2177.

Immediate Effect of Pranava Pranayama on Fetal and Maternal Cardiovascular Parameters.

Vasundhara V, Ramanathan M, Ghose S, Bhavanani A Int J Yoga. 2023; 15(3):240-245.

PMID: 36949833 PMC: 10026336. DOI: 10.4103/ijoy.ijoy_151_22.

Comparing Full and Pre-Term Neonates' Heart Rate Variability in Rest Condition and during Spontaneous Interactions with Their Parents at Home.

Kokkinaki T, Markodimitraki M, Giannakakis G, Anastasiou I, Hatzidaki E Healthcare (Basel). 2023; 11(5).

PMID: 36900677 PMC: 10000654. DOI: 10.3390/healthcare11050672.

Determinants of Outdoor Time in Children and Youth: A Systematic Review of Longitudinal and Intervention Studies.

Larouche R, Kleinfeld M, Charles Rodriguez U, Hatten C, Hecker V, Scott D Int J Environ Res Public Health. 2023; 20(2).

PMID: 36674085 PMC: 9859594. DOI: 10.3390/ijerph20021328.

References

Mandigout S, Melin A, Fauchier L, Nguyen L, Courteix D, Obert P . Physical training increases heart rate variability in healthy prepubertal children. Eur J Clin Invest. 2002; 32(7):479-87. DOI: 10.1046/j.1365-2362.2002.01017.x. View

May L, Suminski R, Berry A, Langaker M, Gustafson K . Maternal physical activity mode and fetal heart outcome. Early Hum Dev. 2014; 90(7):365-9. DOI: 10.1016/j.earlhumdev.2014.04.009. View

May L, Scholtz S, Suminski R, Gustafson K . Aerobic exercise during pregnancy influences infant heart rate variability at one month of age. Early Hum Dev. 2013; 90(1):33-8. DOI: 10.1016/j.earlhumdev.2013.11.001. View

Henje Blom E, Olsson E, Serlachius E, Ericson M, Ingvar M . Heart rate variability (HRV) in adolescent females with anxiety disorders and major depressive disorder. Acta Paediatr. 2010; 99(4):604-11. PMC: 2855827. DOI: 10.1111/j.1651-2227.2009.01657.x. View

Bung P, Artal R . Gestational diabetes and exercise: a survey. Semin Perinatol. 1996; 20(4):328-33. DOI: 10.1016/s0146-0005(96)80025-5. View

Clapp 3rd J, Kiess W . Effects of pregnancy and exercise on concentrations of the metabolic markers tumor necrosis factor alpha and leptin. Am J Obstet Gynecol. 2000; 182(2):300-6. DOI: 10.1016/s0002-9378(00)70215-8. View

Raczak G, Danilowicz-Szymanowicz L, Kobuszewska-Chwirot M, Ratkowski W, Figura-Chmielewska M, Szwoch M . Long-term exercise training improves autonomic nervous system profile in professional runners. Kardiol Pol. 2006; 64(2):135-40. View

Clapp 3rd J . The effects of maternal exercise on fetal oxygenation and feto-placental growth. Eur J Obstet Gynecol Reprod Biol. 2003; 110 Suppl 1:S80-5. DOI: 10.1016/s0301-2115(03)00176-3. View

Norwitz E, Schust D, Fisher S . Implantation and the survival of early pregnancy. N Engl J Med. 2002; 345(19):1400-8. DOI: 10.1056/NEJMra000763. View

10.

Schobel H, Fischer T, Heuszer K, Geiger H, Schmieder R . Preeclampsia -- a state of sympathetic overactivity. N Engl J Med. 1996; 335(20):1480-5. DOI: 10.1056/NEJM199611143352002. View

11.

Stutzman S, Brown C, Hains S, Godwin M, Smith G, Parlow J . The effects of exercise conditioning in normal and overweight pregnant women on blood pressure and heart rate variability. Biol Res Nurs. 2010; 12(2):137-48. DOI: 10.1177/1099800410375979. View

12.

DSilva L, Davies R, Emery S, Lewis M . Influence of somatic state on cardiovascular measurements in pregnancy. Physiol Meas. 2013; 35(1):15-29. DOI: 10.1088/0967-3334/35/1/15. View

13.

Caspersen C, Powell K, Christenson G . Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985; 100(2):126-31. PMC: 1424733. View

14.

Dye T, Knox K, Artal R, Aubry R, Wojtowycz M . Physical activity, obesity, and diabetes in pregnancy. Am J Epidemiol. 1997; 146(11):961-5. DOI: 10.1093/oxfordjournals.aje.a009223. View

15.

Felber Dietrich D, Schindler C, Schwartz J, Barthelemy J, Tschopp J, Roche F . Heart rate variability in an ageing population and its association with lifestyle and cardiovascular risk factors: results of the SAPALDIA study. Europace. 2006; 8(7):521-9. DOI: 10.1093/europace/eul063. View

16.

Avery N, Wolfe L, Amara C, Davies G, McGrath M . Effects of human pregnancy on cardiac autonomic function above and below the ventilatory threshold. J Appl Physiol (1985). 2001; 90(1):321-8. DOI: 10.1152/jappl.2001.90.1.321. View

17.

Weissgerber T, Wolfe L . Physiological adaptation in early human pregnancy: adaptation to balance maternal-fetal demands. Appl Physiol Nutr Metab. 2006; 31(1):1-11. DOI: 10.1139/h05-003. View

18.

Oja P, Titze S, Bauman A, de Geus B, Krenn P, Reger-Nash B . Health benefits of cycling: a systematic review. Scand J Med Sci Sports. 2011; 21(4):496-509. DOI: 10.1111/j.1600-0838.2011.01299.x. View

19.

Brett K, Wilson S, Ferraro Z, Adamo K . Self-report Pregnancy Physical Activity Questionnaire overestimates physical activity. Can J Public Health. 2015; 106(5):e297-302. PMC: 6972273. DOI: 10.17269/cjph.106.4938. View

20.

May L, Knowlton J, Hanson J, Suminski R, Paynter C, Fang X . Effects of Exercise During Pregnancy on Maternal Heart Rate and Heart Rate Variability. PM R. 2015; 8(7):611-7. DOI: 10.1016/j.pmrj.2015.11.006. View