Maternal and Fetal Cardiovascular Responses to Acute High-Intensity Interval and Moderate-Intensity Continuous Training Exercise During Pregnancy: A Randomized Crossover Trial.

Abstract

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. Fifteen women with a singleton pregnancy (27.3 ± 3.5weeks of gestation, 33 ± 4years of age) were recruited. Following a peak fitness test, participants engaged in a session of HIIT (10 × 1-min intervals ≥ 90% maximum heart rate [HRmax]) interspersed with 1min of active recovery) and MICT (30min at 64-76% HRmax) 48h 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. Average maternal heart rate was higher for HIIT (82 ± 5% HRmax) compared with MICT (74 ± 4% HRmax; p < 0.001). During the HIIT session, participants achieved a peak heart rate of 96 ± 5% HRmax (range of 87-105% HRmax). 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 ± 7bpm; MICT: Δ + 10 ± 10bpm). 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. 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. NCT05369247.