ECSS Paris 2023: OP-MH34
INTRODUCTION: To avoid blood pressure (BP) disorders, pregnant women have been advised to engage in moderate to vigorous physical activity (MVPA). However, there is little data available on the cardiovascular effects of high-intensity interval training (HIIT) in the perinatal period. We aimed to determine how an 8-week HIIT programme affects insulin, leptin, resistin, and irisin levels and their role in BP regulation during pregnancy. METHODS: The study involved 54 Caucasian participants identifying as women in uncomplicated, singleton pregnancies (age 32 ± 4 years, week of gestation 24 ± 4, mean ± SD). Thirty-four were randomly allocated to the 8-week supervised HIIT programme (HIIT group). The comparative (EDU) group consisted of twenty pregnant women who completed an educational programme and were encouraged to perform MVPA on their own. Before and after the interventions, maternal blood pressure (BP), serum glucose, carbohydrate and lipid metabolism markers (including insulin, leptin, resistin, and irisin) from blood samples taken in fasting conditions were assessed. RESULTS: All participants had normal glucose and lipid profile values throughout the study. At baseline, both HIIT and EDU groups presented similar systolic (111.76 ± 9.42 and 115.95 ± 11.77 mmHg) and diastolic BP (73.12 ± 6.63 and 72.95 ± 8.66 mmHg) at rest. Although all participants met the inclusion criteria (normotension, normoglycaemia, and normolipidaemia), further analyses showed statistically significant differences in baseline levels of blood insulin (p = 0.001), leptin (p = 0.001), and resistin (p = 0.046). The baseline irisin concentration did not differ between groups (p = 0.266). In the HIIT group, we observed a significant decrease in diastolic BP (p = 0.031), and in the EDU group, a significant decrease in systolic BP (p = 0.005), but all values were within the normotension range. HIIT training induced a statistically significant increase in insulin (p = 0.005) and resistin (p < 0.001) levels. Moreover, leptin production tended to increase but did not reach statistical significance (p = 0.071). The only significant change observed in the EDU group was the decrease in resistin (p = 0.037). Despite these differences between groups, we observed similar associations of selected biomarkers with BP after eight weeks of interventions. In both groups, higher diastolic BP was significantly correlated with higher insulin (r = 0.51 and r = 0.45; p < 0.05) and leptin (r = 0.39 and r = 0.62; p < 0.05). After both interventions, we observed no associations of resistin and irisin with systolic or diastolic BP. CONCLUSION: Physical activity in pregnancy, regardless of intensity, optimises physiological and biochemical responses, maintaining normotension. HIIT, similarly to the commonly recommended MVPA, due to the interconnection of hormones regulating the cardiovascular and metabolic systems, can help avoid BP disorders without negatively affecting the course of pregnancy or neonatal outcomes.
Read CV Anna SzumilewiczECSS Paris 2023: OP-MH34
INTRODUCTION: Female athletes, or those in arduous occupations, lack objective guidance on effective and safe rigorous training postpartum. Our investigation examined the effectiveness and safety of sprint interval training (SIT) undertaken soon postpartum (PP) in a cohort of healthy females ranging from recreationally active to international-level athletes. METHODS: Nine new mothers completed laboratory testing pre-intervention (PPpre) and post-intervention (PPpost). We measured maximal oxygen consumption (V ̇O_2 max) with a metabolic cart, peak cardiac output (Q ̇peak) with inert gas rebreathing, and blood volume (BV), plasma volume (PV), and haemoglobin mass (Hbmass) with carbon monoxide rebreathing. Between laboratory visits, participants completed six weeks of home-based SIT at 130% of V ̇O_2 max peak power output (PPO). Sessions were conducted thrice weekly and progressed from four to eight 30-second sprints. Freely chosen moderate-intensity aerobic exercise was performed on alternate days. The training was supervised remotely by an experienced exercise physiologist. RESULTS: No adverse events occurred, and collectively, 155/162 sessions were completed. All participants breastfed with no difficulties throughout the study duration. Mean study entry was 8.0±2.5 weeks PP and parity 1.6±0.8 children. Absolute (2.44±0.34 vs 2.79±0.27 L/min p<0.0001) and relative V ̇O_2 max (36.1±4.8 vs 42.0±4.8 mL/kg/min p<0.0001) both increased from PPpre to PPpost. Similarly, absolute (236±25 vs 267±21 watts p<0.0001) and relative (3.5±4 vs 4.0±0.4 watts/kg p<0.0001) PPO also increased from PPpre to PPpost. Q ̇peak remained stable from PPpre to PPpost (14.7±2.0 vs 14.6±2.1 L/min, 8.3±1.2 vs 8.3±1.1 L/min/m2). Values for Hbmass (617±76 vs 631±84 g, 9.2±1.3 vs 9.6±1.4 g/kg), BV (4737±610 vs 4877±611 mL, 71±11 vs 74.12 mL/kg) and PV (2937±428 vs 3014±391mL, 44±7 vs 46±8 mL/kg) tended to be increased at PPpost, although this did not reach statistical significance. CONCLUSION: Lack of change in Q ̇peak despite an increased V ̇O_2 max could be explained by a greater arterio-venous oxygen difference at PPpost. In addition, variability in study entry time, combined with cardio-haematological transitions, could account for the nonsignificant changes in haematological and Q ̇peak results. Breastfeeding may have influenced Q ̇ and PV. In summary, six weeks of SIT rapidly improves cardiovascular fitness, as demonstrated by enhanced PPO, in previously trained women. Ergometer cycling SIT is safe, can be started as soon as five weeks postpartum, and does not impede breastfeeding. Our intervention was effective in recreationally active females to professional sportswomen.
Read CV Normand RichardECSS Paris 2023: OP-MH34
INTRODUCTION: High maternal body mass index (BMI) is associated with adverse pregnancy outcomes. The adipokines adiponectin and leptin are involved in metabolic regulation. Exercise training during pregnancy can potentially influence the concentrations of these adipokines, lower the risk of several adverse pregnancy outcomes, and improve the intrauterine environment for the fetus. We aimed to study the effects of exercise training during pregnancy on adiponectin and leptin concentrations in maternal blood and cord blood in individuals with pre-pregnancy overweight/obesity. METHODS: This is a secondary analysis of the Exercise Training in Pregnancy (ETIP) randomized controlled trial. ETIP was a parallel-group randomized controlled trial in pregnant individuals (N = 91) with a pre-pregnancy BMI ≥ 28 kg/m2. We offered the intervention group (n = 46) three weekly supervised exercise sessions (35 minutes of moderate-intensity endurance training and 25 minutes of strength training), starting in gestational week (GW) 12-18 and continuing throughout pregnancy. We collected maternal blood samples at baseline, in GW 34-37, and 3 months postpartum, and cord blood at delivery. Adiponectin and leptin concentrations were assessed by enzyme-linked immunosorbent assays (ELISA). We compared changes over time and between groups in maternal blood using linear mixed models and differences between groups in cord blood with t-tests. RESULTS: Seventeen participants were lost to follow-up in the ETIP trial and 50% of the women in the exercise group adhered to the exercise protocol as prescribed a priori. We measured adiponectin in samples from 58 participants at baseline and in GW 34-37, and from 62 participants postpartum. There was no change in adiponectin concentrations from baseline to GW 34-37 (estimated mean difference [MD], -0.05 μg/mL, p = .91) or from baseline to postpartum (MD, -0.05 μg/mL, p = .90), and no differences between groups at any time-point. We measured leptin from 64 participants at baseline, 59 in GW 34-37, and 56 postpartum. Leptin increased from baseline to GW 34-37 (MD, 8.8 ng/mL, p < .001) and decreased between baseline and postpartum (MD, -16.2 ng/mL, p < .001), with no between-groups differences from baseline to GW 34-37 (MD, -4.0 ng/mL, p = .18) or from baseline to postpartum (MD, -0.8 ng/mL, p = .82). Cord blood adiponectin concentration was 24.4 μg/mL (standard deviation [SD] 5.4) in the exercise group (n = 22) and 24.8 μg/mL (SD 5.4) in the control group (n = 28, p = .77). There was no statistically significant difference in leptin concentrations in cord blood samples: 25.6 ng/mL (SD 22.0) in the exercise group (n = 19) versus 29.6 ng/mL (SD 17.9) in the control group (n = 25, p = 0.54). CONCLUSION: Offering pregnant women with overweight/obesity supervised exercise training during pregnancy had no statistically significant effect on maternal or cord blood concentrations of adiponectin or leptin. The suboptimal adherence rates to exercise may explain these findings.
Read CV Trine MoholdtECSS Paris 2023: OP-MH34