162 Association between cardiorespiratory fitness and hypertensive disorders of pregnancy: a systematic review and meta-analysis

Abstract

To review and summarize the literature to date on cardiorespiratory fitness (CRF) before, during and after hypertensive disorders of pregnancy (HDP), compared with women with no HDP. We included observational and intervention studies with a clearly defined diagnosis of HDP (gestational hypertension and/or preeclampsia) and a control group of women with no HDP. Eligible studies measured CRF including maximal or peak oxygen consumption (VO2), VO2 at anaerobic threshold or work rate at peak VO2. MEDLINE, EMBASE and Cochrane Library were searched from July 2018 to July 2019. References of included studies were hand searched to identify additional records. Risk of bias assessments used the Joanna-Briggs Institute Critical Appraisal Tools. Abstracts of 1949 records identified by the literature search were screened. Of 194 full-text articles assessed, 15 studies were included (n=2581 women). CRF was examined before, during and after pregnancy in 2, 9 and 4 studies, respectively. Although the risk of information bias was low, potential confounding variables between HDP and CRF were not examined. Nine references with HDP-specific data were included in the meta-analysis, reported as mean differences with 95% CI. Women with HDP had lower postpartum VO2max [2 studies, n=129 women; -0.39 mL/kg/min (-0.76, -0.02)] and lower antepartum VO2peak [1 study, n=140 women; -0.78 L/min (-0.99, -0.57)], compared to controls. Women with HDP did not attain a significantly lower mean work rate [2 studies, n=88 women; -0.08 watts (-1.01, 0.85)] or earlier lactate threshold [1 study, n=47 women; -0.32 mL/kg/min (-1.25, 0.61)]. Using VO2 showed significantly (p<0.05) lower CRF in women both after (Fig. 1) and during (Fig. 2) HDP. Few studies examined VO2 in relation to HDP, while the remaining studies analyzed used other CRF indices or did not directly look at CRF with respect to HDP. Additional studies using VO2 are needed to shed light on its utility as a measure of CRF and to quantify its association with HDP.View Large Image Figure ViewerDownload Hi-res image Download (PPT)