Med Sci Sports Exerc. 2021 Sep 1;53(9):1846-1854. doi: 10.1249/MSS.0000000000002647.
Despite immense research highlighting maternal-fetal benefits of exercise during pregnancy, there remain concerns that exercise may undermine placental function. Although maternal exercise has demonstrated favorable aerobic conditioning responses in the mother, it is not known whether maternal exercise promotes increased angiogenesis in the placenta, perhaps at the expense of impaired endoplasmic reticulum (ER) homeostasis and/or oxidative stress. We investigated if a mild (30% heart rate reserve) and/or moderate (70% heart rate reserve) exercise regime in healthy pregnant women affected placental markers of angiogenesis, ER stress, and oxidative stress. We hypothesized that the improved aerobic conditioning of mothers who exercise is beneficial to enhance placental angiogenesis and normal maternal-fetal outcomes.
Placental tissues were collected within 1 h of delivery from a convenience sample of 29 healthy mothers of full-term infants. Twenty-one women participated in routine exercise from midgestation (16-20 wk) until term of either mild or moderate intensity, whereas eight sedentary women served as controls.
No differences were identified between groups including gestational length, fetal-placental weight ratio, or APGAR scoring. All exercisers exhibited a significant 20-fold increase in the mRNA (as assessed by quantitative real-time polymerase chain reaction) and a 10-fold increase in the protein expression of angiogenin (e.g., ANG1) in the placenta. However, in both exercising groups, no increases in placental markers (i.e., HIF1α, VEGF), ER stress (i.e., spliced XBP1, ATF4, ATF6, CHOP, and BAX), or oxidative stress (i.e., SOD1, SOD2) were observed.
Overall, our study suggests that mild- and moderate-intensity exercise increases angiogenesis but does not increase placental oxidative or ER stress in healthy pregnancies, bolstering support for routine exercise as a part of standard care in pregnant women. Future studies are warranted to investigate the potential benefits of exercise on ANG1 in pathological pregnancies.
尽管大量研究强调了母亲在怀孕期间进行运动对母婴的益处，但仍有人担心运动可能会损害胎盘功能。虽然母亲运动已证明对母亲的有氧适应有积极影响，但尚不清楚母亲运动是否会促进胎盘内血管生成增加，这可能是以损害内质网（ER）稳态和/或氧化应激为代价的。我们研究了健康孕妇进行轻度（30%心率储备）和/或中度（70%心率储备）运动方案是否会影响胎盘血管生成、ER 应激和氧化应激的标志物。我们假设，运动的母亲的有氧适应能力提高有助于增强胎盘血管生成和正常的母婴结局。
从 29 名足月分娩的健康产妇的便利样本中，在分娩后 1 小时内收集胎盘组织。21 名女性从妊娠中期（16-20 周）开始一直到足月进行常规运动，运动强度为轻度或中度，而 8 名久坐不动的女性作为对照组。
两组之间在妊娠时间、胎儿-胎盘重量比或 APGAR 评分方面均无差异。所有的运动者的胎盘血管生成素（ANG1）的 mRNA（通过实时定量聚合酶链反应评估）增加了 20 倍，蛋白质表达增加了 10 倍。然而，在两组运动者中，胎盘标志物（即 HIF1α、VEGF）、ER 应激（即剪接 XBP1、ATF4、ATF6、CHOP 和 BAX）或氧化应激（即 SOD1、SOD2）均未增加。
总的来说，我们的研究表明，轻度和中度运动可以增加血管生成，但不会增加健康妊娠中的胎盘氧化应激或 ER 应激，为在孕妇中常规运动作为标准护理的一部分提供了支持。需要进一步的研究来调查运动对 ANG1 在病理性妊娠中的潜在益处。
