Fetal and maternal Doppler adaptation to maternal exercise during
pregnancy: A randomized controlled trial
Abstract
Objective: To analyse the longitudinal effect of a supervised
mild-moderate physical exercise program during pregnancy on
uteroplacental and fetal Doppler. Design: Planned secondary analysis of
an RCT Setting: Hospital Universitario de Torrejón, Madrid-Spain Sample:
124 women were randomized at 12+0-15+6 weeks to exercise vs
non-exercise. Methods: Obstetric appointments were scheduled at about
12, 20, 28 and 36 weeks of gestation. GEE models were adjusted to assess
longitudinal changes in Doppler measurements according to randomization
group. Main Outcome Measures: Fetal middle cerebral artery, umbilical
artery, cerebral placental ratio and uterine artery pulsatility index,
were longitudinally measured by Doppler ultrasound throughout gestation,
and normalized by MoMs or z-score calculation Results: No significant
differences in fetal or maternal Doppler measurements were found at any
check-up time-points. However, umbilical artery behaved differently in
the exercise group where, starting from a not significantly higher
pulsatility index, it showed a continuous decrease during pregnancy to a
lower level than the non-exercise group, in which it remained unmodified
throughout pregnancy. Conclusion: A regular supervised mild-moderate
exercise program during pregnancy does not deteriorate fetal or maternal
Doppler, suggesting that fetal wellbeing is not compromised. UAPI
z-score decreases during pregnancy in the exercise group, while it
remains stable in the non-exercise group. Funding statement: Research
Grants were provided by Hospital Universitario de Torrejón (Madrid,
Spain), Universidad Politécnica de Madrid (Madrid, Spain), Sanitas
Healthcare and iMaterna Foundation.