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Antepartum Fetal Assessment

Poster Session 2

(556) Fetal effects of maternal exercise on pregnancies with fetal growth restriction

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Exercise has been shown to be safe for uncomplicated pregnancies. Less is known about exercise in pregnancies with fetal growth restriction (FGR). We sought to evaluate the immediate fetal response to exercise in pregnancies with FGR.

Study Design: In this single-institution, prospective cohort, 15 individuals between 28w0d and 36w6d gestation with a diagnosis of FGR (fetal weight estimate < 10%ile) were enrolled. Participants were excluded for BMI >40, tobacco or substance use, hypertension on medications, or other contraindications to exercise. Participants exercised on a treadmill at a moderate intensity (defined by rate of perceived exertion (RPE), Borg scale) for 30 minutes. Fetal umbilical artery (UA), middle cerebral artery (MCA) and aortic dopplers were sampled immediately before and after exercise. Vital signs and RPE were monitored throughout exercise.  Doppler waveforms were reviewed by blinded study personnel. Cerebro-placental ratios (CPR) were calculated after sampling. Pre and post-exercise dopplers were compared using related samples Wilcoxon Signed Rank Sum tests after testing for normality.

Results: Biophysical profiles and non-stress tests were reassuring after exercise. Pre-exercise UA dopplers were not different from post-exercise. Dopplers were recorded immediately after completion of exercise with a focus on UA dopplers first [mean time 1 min (SD 0.193)]. No differences were noted between pre- and post-exercise aortic or MCA dopplers or in CPR. (Table 1). Mean maximal maternal heart rate was 141.3 (SD 11.3) bpm. A single participant had hypoglycemia (BG 52) post-exercise.

Conclusion: Our preliminary data suggests no changes in fetal well-being among pregnancies with FGR after a single bout of moderate intensity exercise. Continued data collection is ongoing with the aim to support safety of moderate intensity exercise in the third trimester for FGR pregnancies. Future work to determine long-term effects of exercise in this population is needed.