母亲和胎儿心血管对妊娠期急性高强度间歇和中等强度连续训练运动的反应：一项随机交叉试验。
Maternal and Fetal Cardiovascular Responses to Acute High-Intensity Interval and Moderate-Intensity Continuous Training Exercise During Pregnancy: A Randomized Crossover Trial.
机构信息
Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, 1-052 Li Ka Shing Centre for Health Research Innovation, 8602-112 St NW, Edmonton, AB T6G, Canada.
Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, Waterloo, ON, Canada.
出版信息
Sports Med. 2023 Sep;53(9):1819-1833. doi: 10.1007/s40279-023-01858-5. Epub 2023 May 22.
OBJECTIVE
We aimed to compare maternal and fetal cardiovascular responses to an acute bout of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) during pregnancy.
METHODS
Fifteen women with a singleton pregnancy (27.3 ± 3.5 weeks of gestation, 33 ± 4 years of age) were recruited. Following a peak fitness test, participants engaged in a session of HIIT (10 × 1-min intervals ≥ 90% maximum heart rate [HR]) interspersed with 1 min of active recovery) and MICT (30 min at 64-76% HR) 48 h apart in random order. Maternal HR, blood pressure, middle (MCAv), and posterior cerebral artery blood velocity (PCAv), as well as respiratory measures were monitored continuously throughout HIIT/MICT. Fetal heart rate, as well as umbilical systolic/diastolic (S/D) ratio, resistive index (RI), and pulsatility index (PI) were assessed immediately before and after exercise.
RESULTS
Average maternal heart rate was higher for HIIT (82 ± 5% HR) compared with MICT (74 ± 4% HR; p < 0.001). During the HIIT session, participants achieved a peak heart rate of 96 ± 5% HR (range of 87-105% HR). Maternal cerebral blood velocities increased with exercise but was not different between HIIT and MICT for MCAv (p = 0.340) and PCAv (p = 0.142). Fetal heart rate increased during exercise (p = 0.244) but was not different between sessions (HIIT: Δ + 14 ± 7 bpm; MICT: Δ + 10 ± 10 bpm). Metrics of umbilical blood flow decreased with exercise and were not different between exercise sessions (PI: p = 0.707; S/D ratio: p = 0.671; RI: p = 0.792). Fetal bradycardia was not observed, and S/D ratio, RI, and PI remained within normal ranges both before and immediately after all exercise sessions.
CONCLUSIONS
An acute bout of HIIT exercise consisting of repeated 1-min near-maximal to maximal exertions, as well as MICT exercise is well tolerated by both mother and fetus.
CLINICAL TRIAL REGISTRATION
NCT05369247.
目的
比较孕妇在进行高强度间歇训练（HIIT）和中等强度持续训练（MICT）时的母婴心血管反应。
方法
招募了 15 名单胎妊娠的女性（妊娠 27.3±3.5 周，33±4 岁）。在达到峰值体能测试后，参与者在 48 小时内以随机顺序分别进行 HIIT（10×1 分钟间隔≥90%最大心率[HR]）和 MICT（64-76% HR 持续 30 分钟）。在整个 HIIT/MICT 过程中，连续监测母体 HR、血压、大脑中动脉（MCAv）和大脑后动脉（PCAv）的血流速度，以及呼吸措施。在运动前后，立即评估胎儿心率以及脐动脉收缩/舒张（S/D）比值、阻力指数（RI）和搏动指数（PI）。
结果
HIIT（82±5% HR）时母体平均心率高于 MICT（74±4% HR；p<0.001）。在 HIIT 过程中，参与者达到了 96±5% HR 的峰值心率（范围为 87-105% HR）。母体脑血流速度随运动而增加，但 HIIT 和 MICT 之间 MCAv（p=0.340）和 PCAv（p=0.142）无差异。胎儿心率在运动过程中增加（p=0.244），但两次运动之间无差异（HIIT：Δ+14±7 bpm；MICT：Δ+10±10 bpm）。脐血流指标随运动而减少，两次运动之间无差异（PI：p=0.707；S/D 比值：p=0.671；RI：p=0.792）。未观察到胎儿心动过缓，并且 S/D 比值、RI 和 PI 在所有运动前后均保持在正常范围内。
结论
由重复 1 分钟接近最大或最大强度的运动以及 MICT 运动组成的急性 HIIT 运动，母亲和胎儿均能很好耐受。
临床试验注册
NCT05369247。
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