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CC BY 4.0 · Rev Bras Ginecol Obstet 2019; 41(09): 531-538
DOI: 10.1055/s-0039-1697035
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Is Moderate Intensity Exercise during Pregnancy Safe for the Fetus? An Open Clinical Trial

Exercício de intensidade moderada durante a gravidez é seguro para o feto? Ensaio clínico aberto
Adriana Suely Oliveira Melo
1   Instituto de Pesquisa Professor Joaquim Amorim Neto, Campina Grande, PB, Brazil
,
João Luiz Pinto e Silva
2   Universidade Estadual de Campinas, Campinas, SP, Brazil
,
Fabiana de Oliveira Melo
1   Instituto de Pesquisa Professor Joaquim Amorim Neto, Campina Grande, PB, Brazil
,
Emanuela Santos Barros
1   Instituto de Pesquisa Professor Joaquim Amorim Neto, Campina Grande, PB, Brazil
,
Hugo Leonardo Santos
1   Instituto de Pesquisa Professor Joaquim Amorim Neto, Campina Grande, PB, Brazil
,
Melania Maria Ramos Amorim
1   Instituto de Pesquisa Professor Joaquim Amorim Neto, Campina Grande, PB, Brazil
3   Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil
4   Universidade Federal de Campina Grande, Campina Grande, Brazil
,
Alex Sandro Rolland Souza 
1   Instituto de Pesquisa Professor Joaquim Amorim Neto, Campina Grande, PB, Brazil
3   Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil
5   Universidade Federal de Pernambuco, Recife, PE, Brazil
6   Universidade Católica de Pernambuco, Recife, PE, Brazil
› Author Affiliations
Further Information

Publication History

23 October 2018

06 August 2019

Publication Date:
23 September 2019 (online)

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Resumo

Objetivo Determinar o efeito da caminhada em esteira sobre a frequência cardíaca materna (FCM) e parâmetros cardiotocográficos (batimentos cardiofetais basais [BCFs], movimentos ativos fetais [MAFs], número de acelerações e desacelerações e variabilidade de curta [STV] e longa [LTV] duração da frequência cardíaca fetal) em gestantes na 36a semana.

Métodos Foi realizado um ensaio clínico não randomizado e aberto com 88 gestantes saudáveis submetidas a caminhada de moderada intensidade na esteira e a cardiotocografia computadoriza em 3 momentos de 20 minutos (antes, durante e após a caminhada).

Resultados A média dos BCFs diminuiu durante a caminhada, retornando a níveis prévios (antes: 137 bpm; durante: 98 bpm; após: 140 bpm; p < 0,001), com bradicardia ocorrendo em 56% dos fetos nos primeiros 10 minutos do exercício, e em 47% após 20 minutos. A bradicardia fetal não foi observada em outros momentos (antes ou depois). As médias da STV e da LTV foram 7,9, 17,0 e 8,0 milissegundos (p < 0,001) e 7,6, 10,7 e 7,6 bpm (p = 0,002) antes, durante e após a caminhada, respectivamente. A média dos números dos MAFs em 1 hora foi 29,9, 22,2 e 45,5, respectivamente, nos três momentos (p < 0,001). Nas mulheres com sobrepeso/obesidade, a média da FCM foi menor (p = 0,02). Após a análise de regressão logística, duas variáveis permaneceram significativamente associadas a bradicardia: aptidão maternal na 28a semana de gravidez (efeito protetor) e peso materno (aumento do risco).

Conclusão Em fetos saudáveis, o exercício físico mostrou-se seguro, uma vez que, embora os BCFs e os MAFs diminuam durante a caminhada na esteira, foi observado um aumento da SVT e da LTV.

Abstract

Objective To determine the effect of treadmill walking on maternal heart rate (MHR) and cardiotocographic parameters (basal fetal heart rate [FHR], active fetal movements [AFM], number of accelerations and decelerations, and short-term variation [STV] and long-term variation [LTV] of fetal heart rate) in pregnant women at 36 weeks.

Methods A nonrandomized, open clinical trial involving 88 healthy pregnant women submitted to moderate intensity walking and computed cardiotocography in 3 20-minute periods (resting, treadmill walking, and postexercise recovery).

Results The mean FHR decreased during walking (resting: 137 bpm; treadmill: 98 bpm; recovery: 140 bpm; p < 0.001), with bradycardia occurring in 56% of the fetuses in the first 10 minutes of exercise, and in 47% after 20 minutes. Bradycardia was not detected in the other phases. The mean STV and HV were 7.9, 17.0, and 8.0 milliseconds (p < 0.001) and 7.6, 10.8 and 7.6 bpm (p = 0.002) in the resting, walking and recovery phases, respectively. The mean number of fetal movements in 1 hour was 29.9, 22.2 and 45.5, respectively, in the 3 periods (p < 0.001). In overweight/obese women, the mean FHR was lower (p = 0.02). Following the logistic regression analysis, two variables remained significantly associated with bradycardia: maternal fitness in the 28th week of pregnancy (protective effect) and maternal weight (increased risk).

Conclusion In healthy fetuses, physical exercise proved to be safe, since, although FHR and AFM decreased during treadmill walking, an increase in SVT and LTV was observed.

Palavras-chave

cardiotocografia - frequência cardíaca fetal - caminhada - exercício - gravidez

Keywords

cardiotocography - fetal heart rate - walking - exercise - pregnancy

Contributions

The present study was conceived by Amorim M. and implemented by Melo A., with the analytical strategy developed in collaboration with Melo F., Barros E. S., Cruz H. L., and Souza A. S. R.. Amorim M. performed all the data handling and statistical analyses and is the guarantor. Silva J. L. P. contributed to the methodological discussions. Melo A. and Amorim M. drafted the first version of the paper, and all the coauthors revised the paper on several occasions.


 

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