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- Title
Cardiorespiratory fitness, exercise haemodynamics and birth outcomes: the Coronary Artery Risk Development in Young Adults Study.
- Authors
Lane‐Cordova, A. D.; Carnethon, M. R.; Catov, J. M.; Montag, S.; Lewis, C. E.; Schreiner, P. J.; Dude, A.; Sternfeld, B.; Badon, S. E.; Greenland, P.; Gunderson, E. P.; Lane-Cordova, A D
- Abstract
<bold>Objective: </bold>Determine associations of cardiorespiratory fitness, exercise systolic blood pressure (SBP) and heart rate recovery (HRR) following a maximal exercise test performed years preceding pregnancy with odds of preterm birth (PTB; <37 weeks' gestation) and small for gestational age (SGA; birthweight <10th percentile) delivery.<bold>Design: </bold>Prospective, longitudinal.<bold>Setting: </bold>Multi-site, observational cohort study initially consisting of 2787 black and white women aged 18-30 at baseline (1985-86) and followed for 25 years (Y25; 2010-2011).<bold>Population: </bold>768 nulliparous women at baseline who reported ≥1 live birth by the Y25 exam.<bold>Methods: </bold>We used Poisson regression to determine associations of exposures with PTB/SGA.<bold>Main Outcome Measures: </bold>PTB and/or SGA births.<bold>Results: </bold>Women with PTB (n = 143) and/or SGA (n = 88) were younger, had completed fewer years of education and were more likely to be black versus women without PTB/SGA (n = 546). Women with PTB/SGA had lower fitness (501 ± 9 versus 535 ± 6 seconds, P < 0.002) and higher submaximal SBP than women without PTB/SGA (144 ± 1 versus 142 ± 1 mmHg, P < 0.04). After adjustment, no exercise test variables were associated with PTB/SGA, though the association with HRR and submaximal SBP approached significance in the subset of women who completed the exercise test <5 years before the index birth.<bold>Conclusions: </bold>Neither fitness nor haemodynamic responses to exercise a median of 5 years preceding pregnancy, were associated with PTB/SGA. These findings indicate excess likelihood of PTB/SGA is not detectable by low fitness or exercise haemodynamic responses 5 years preceding pregnancy, but exercise testing, especially HRR and submaximal SBP, may be more useful when conducted closer to the onset of pregnancy.<bold>Tweetable Abstract: </bold>Exercise testing conducted >5 years before pregnancy may not detect women likely to have PTB/SGA.
- Subjects
EXERCISE; CARDIOPULMONARY system physiology; SYSTOLIC blood pressure; PREMATURE labor; BIRTH size; CARDIOVASCULAR diseases in pregnancy; COMPARATIVE studies; CORONARY disease; HEMODYNAMICS; PREMATURE infants; LONGITUDINAL method; RESEARCH methodology; EVALUATION of medical care; MEDICAL cooperation; POISSON distribution; PREGNANCY; REGRESSION analysis; RESEARCH; RESEARCH funding; EVALUATION research; PARITY (Obstetrics)
- Publication
BJOG: An International Journal of Obstetrics & Gynaecology, 2018, Vol 125, Issue 9, p1127
- ISSN
1470-0328
- Publication type
journal article
- DOI
10.1111/1471-0528.15146