Rawat Anurag, Vyas Kinnari
Interventional Cardiology, Himalayan Institute of Medical Sciences, Dehradun, IND.
Plastic Surgery, Shri Guru Ram Rai Institute of Medical & Health Sciences, Dehradun, IND.
Cureus. 2024 Dec 14;16(12):e75703. doi: 10.7759/cureus.75703. eCollection 2024 Dec.
Pregnancy issues such as gestational hypertension, preeclampsia, and gestational diabetes mellitus (GDM) are significant contributors to long-term cardiovascular diseases (CVDs) in women. Recent research has proved the impact of exercise on improving cardiovascular outcomes, particularly in women with pregnancy-related disorders. This review explores the outcomes of various exercise interventions on cardiovascular health in pregnant women. Among these, aerobic exercise has been widely studied, with results from observational studies and randomized controlled trials (RCTs) showing its positive outcomes on cardiovascular health in pregnant women, especially with complications. It has been found that regular aerobic exercise has been associated with reduced hypertension and improved endothelial function, particularly in women with a history of preeclampsia. Evidently, aerobic exercise results in better blood pressure regulation and enhanced vascular health that directly attends to the risk of cardiovascular diseases associated with pregnancy complications. Another form of exercise is resistance training, which despite being studied less, has shown potential benefits as well. Some advantages of resistance exercise have been found to improve muscle strength and overall enhancement in metabolic control. This is important, especially in women with GDM whereby improvement in insulin sensitivity reduces the overall risk of type 2 diabetes and future CVDs. Combined exercise that incorporates both aerobic and resistance elements has been known to offer the most comprehensive benefits. Various studies suggest that a combinatory approach maximizes the positive cardiovascular effects. Practicing women have experienced better overall heart health, with improved blood pressure regulation, enhanced endothelial function, and reduced metabolic risks. However, despite these findings, there are challenges such as small sample sizes and limited follow-up durations that hinder the generalizability of current research. Importantly, previous studies targeting exercise interventions for women experiencing complications during pregnancy have been limited in evidence by small sample sizes, short follow-ups, and lack of diversity. Such broader, more diverse populations were needed to reflect the various health risks and responses to exercise. Future research must include multi-center RCTs, diverse exercise regimens, and digital health tools for monitoring exercise adherence. This warrants future large-scale, multicenter trials that are necessary to establish more definitive evidence. Additionally, clinicians should consider including tailored exercise programs in care plans for women with pregnancy complications to mitigate long-term cardiovascular risks.
妊娠期高血压、先兆子痫和妊娠期糖尿病(GDM)等妊娠问题是女性长期心血管疾病(CVD)的重要促成因素。最近的研究证明了运动对改善心血管结局的影响,特别是对患有妊娠相关疾病的女性。本综述探讨了各种运动干预对孕妇心血管健康的影响。其中,有氧运动已得到广泛研究,观察性研究和随机对照试验(RCT)的结果表明,有氧运动对孕妇的心血管健康有积极影响,尤其是对有并发症的孕妇。研究发现,规律的有氧运动与高血压降低和内皮功能改善有关,特别是对于有先兆子痫病史的女性。显然,有氧运动能更好地调节血压并增强血管健康,直接降低与妊娠并发症相关的心血管疾病风险。另一种运动形式是抗阻训练,尽管对其研究较少,但也显示出潜在益处。已发现抗阻运动的一些优势包括改善肌肉力量和全面增强代谢控制。这一点很重要,尤其是对于患有妊娠期糖尿病的女性,胰岛素敏感性的改善可降低2型糖尿病和未来心血管疾病的总体风险。已知结合有氧和抗阻元素的联合运动能带来最全面的益处。各种研究表明,联合运动方法能使心血管方面的积极效果最大化。进行联合运动的女性总体心脏健康状况更好,血压调节改善,内皮功能增强,代谢风险降低。然而,尽管有这些发现,但仍存在一些挑战,如样本量小和随访时间有限,这阻碍了当前研究结果的推广。重要的是,以往针对孕期有并发症的女性进行运动干预的研究,由于样本量小、随访时间短和缺乏多样性,证据有限。需要更广泛、更多样化的人群来反映各种健康风险以及对运动的反应。未来的研究必须包括多中心随机对照试验、多样化的运动方案以及用于监测运动依从性的数字健康工具。这需要未来进行大规模、多中心试验,以建立更确凿的证据。此外,临床医生应考虑在患有妊娠并发症的女性的护理计划中纳入量身定制的运动方案,以降低长期心血管风险。