Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Physical activity and maternal–fetal circulation measured by Doppler ultrasound

Journal of Perinatology volume 33, pages 87–93 (2013)Cite this article

Subjects

Abstract

Objective:

To examine the association of physical activity on maternal–fetal circulation measured by uterine and umbilical artery Doppler flow velocimetry waveforms.

Study Design:

Participants included 781 pregnant women with Doppler ultrasounds of the uterine and umbilical artery and who self-reported past week physical activity. Linear and generalized estimating equation regression models were used to examine these associations.

Result:

Moderate-to-vigorous total and recreational activity were associated with higher uterine artery pulsatility index (PI) and an increased risk of uterine artery notching as compared with reporting no total or recreational physical activity, respectively. Moderate-to-vigorous work activity was associated with lower uterine artery PI and a reduced risk of uterine artery notching as compared with no work activity. No associations were identified with the umbilical circulation measured by the resistance index.

Conclusion:

In this epidemiologic study, recreational and work activity were associated with opposite effects on uterine artery PI and uterine artery notching, although associations were modest in magnitude.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. ACOG. Exercise during pregnancy and the postpartum period. ACOG Committee Opinion No. 267. 2002. Obstet Gynecol 2002; 99: 171–173.

    Google Scholar 

  2. Artal R, O’Toole M, White S . Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br J Sports Med 2003; 37: 6–12.

    Article  CAS  Google Scholar 

  3. Dempsey J, Butler C, Williams M . No need for a pregnant pause: physical activity may reduce the occurrence of gestational diabetes mellitus and preeclampsia. Exercise Sport Sci Rev 2005; 33: 141–149.

    Article  Google Scholar 

  4. Paisley TS, Joy EA, Price Jr RJ . Exercise during pregnancy: a practical approach. Current Sports Med Reports 2003; 2: 325–330.

    Article  Google Scholar 

  5. Clapp III JF, Kim H, Burciu B, Schmidt S, Petry K, Lopez B . Continuing regular exercise during pregnancy: effect of exercise volume on fetoplacental growth. Am J Obstet Gynecol 2002; 186: 142–147.

    Article  Google Scholar 

  6. Pivarnik JM, Mauer MB, Ayres NA, Kirshon B, Dildy GA, Cotton DB . Effects of chronic exercise on blood volume expansion and hematologic indices during pregnancy. Obstet Gynecol 1994; 83: 265–269.

    CAS  PubMed  Google Scholar 

  7. Clapp III JF . The effects of maternal exercise on fetal oxygenation and feto-placental growth. Eur J Obstet Gynecol Reprod Biol 2003; 110 (Suppl 1): S80–S85.

    Article  Google Scholar 

  8. Jackson MR, Gott P, Lye SJ, Ritchie JW, Clapp III JF . The effects of maternal aerobic exercise on human placental development: placental volumetric composition and surface areas. Placenta 1995; 16: 179–191.

    Article  CAS  Google Scholar 

  9. Clapp JF . Endurance exercise and diet on human placental development and fetal growth. Placenta 2006; 27: 527–534.

    Article  CAS  Google Scholar 

  10. Divon MY . Umbilical artery Doppler velocimetry: clinical utility in high-risk pregnancies. Am J Obstet Gynecol 1996; 174: 10–14.

    Article  CAS  Google Scholar 

  11. Tekay A, Campbell S . Doppler ultrasonography in obstetrics In: Harrington K, Campbell S (eds). A Colour Atlas of Doppler Ultrasonography in Obstetrics. An Introduction to its Use in Maternal Fetal Medicine. Hodder Arnold Publications: London, 2000 pp 677–712.

    Google Scholar 

  12. Axt-Fliedner R, Schwarze A, Nelles I, Altgassen C, Friedrich M, Schmidt W et al. The value of uterine artery Doppler ultrasound in the prediction of severe complications in a risk population. Arch Gynecol Obstet 2005; 271: 53–58.

    Article  CAS  Google Scholar 

  13. Bower S, Schuchter K, Campbell S . Doppler ultrasound screening as part of routine antenatal scanning: prediction of pre-eclampsia and intrauterine growth retardation. Br J Obstet Gynaecol 1993; 100: 989–994.

    Article  CAS  Google Scholar 

  14. Aquilina J, Barnett A, Thompson O, Harrington K . Comprehensive analysis of uterine artery flow velocity waveforms for the prediction of pre-eclampsia. Ultrasound Obstet Gynecol 2000; 16: 163–170.

    Article  CAS  Google Scholar 

  15. Coleman MA, McCowan LM, North RA . Mid-trimester uterine artery Doppler screening as a predictor of adverse pregnancy outcome in high-risk women. Ultrasound Obstet Gynecol 2000; 15: 7–12.

    Article  CAS  Google Scholar 

  16. Irion O, Masse J, Forest JC, Moutquin JM . Prediction of pre-eclampsia, low birthweight for gestation and prematurity by uterine artery blood flow velocity waveforms analysis in low risk nulliparous women. Br J Obstet Gynaecol 1998; 105: 422–429.

    Article  CAS  Google Scholar 

  17. Todros T, Ronco G, Fianchino O, Rosso S, Gabrielli S, Valsecchi L et al. Accuracy of the umbilical arteries Doppler flow velocity waveforms in detecting adverse perinatal outcomes in a high-risk population. Acta Obstet Gynecol Scand 1996; 75: 113–119.

    Article  CAS  Google Scholar 

  18. Seyam YS, Al-Mahmeid MS, Al-Tamimi HK . Umbilical artery Doppler flow velocimetry in intrauterine growth restriction and its relation to perinatal outcome. Int J Gynaecol Obstet 2002; 77: 131–137.

    Article  CAS  Google Scholar 

  19. Ertan AK, Schanz S, Tanriverdi HA, Meyberg R, Schmidt W . Doppler examinations of fetal and uteroplacental blood flow in AGA and IUGR fetuses before and after maternal physical exercise with the bicycle ergometer. J Perinat Med 2004; 32: 260–265.

    Article  Google Scholar 

  20. Moore DH, Jarrett II JC, Bendick PJ . Exercise-induced changes in uterine artery blood flow, as measured by Doppler ultrasound, in pregnant subjects. Am J Perinatol 1988; 5: 94–97.

    Article  CAS  Google Scholar 

  21. Steegers EA, Buunk G, Binkhorst RA, Jongsma HW, Wijn PF, Hein PR . The influence of maternal exercise on the uteroplacental vascular bed resistance and the fetal heart rate during normal pregnancy. Eur J Obstet Gynecol Reprod Biol 1988; 27: 21–26.

    Article  CAS  Google Scholar 

  22. Erkkola RU, Pirhonen JP, Kivijarvi AK . Flow velocity waveforms in uterine and umbilical arteries during submaximal bicycle exercise in normal pregnancy. Obstet Gynecol 1992; 79: 611–615.

    CAS  PubMed  Google Scholar 

  23. Kennelly MM, Geary M, McCaffrey N, McLoughlin P, Staines A, McKenna P . Exercise-related changes in umbilical and uterine artery waveforms as assessed by Doppler ultrasound scans. Am J Obstet Gynecol 2002; 187: 661–666.

    Article  Google Scholar 

  24. Morrow RJ, Ritchie JW, Bull SB . Fetal and maternal hemodynamic responses to exercise in pregnancy assessed by Doppler ultrasonography. Am J Obstet Gynecol 1989; 160: 138–140.

    Article  CAS  Google Scholar 

  25. Rafla NM, Etokowo GA . The effect of maternal exercise on uterine artery velocimetry waveforms. J Obstet Gynaecol 1998; 18: 14–17.

    Article  CAS  Google Scholar 

  26. Rafla NM . Umbilical artery flow velocity waveforms following maternal exercise. J Obstet Gynaecol 1999; 19: 385–389.

    Article  CAS  Google Scholar 

  27. Evenson KR and Wen F . Measuring physical activity in pregnant women using a structured one-week recall questionnaire: evidence for validity and reliability. Intl J Behavioral Nutr Physical Activity 2010; 7: 21. Available at http://www.ijbnpa.org/content/7/1/21.

    Article  Google Scholar 

  28. Borg G, Linderholm H . Perceived exertion and pulse rate during graded exercise in various age groups. Acta Med Scand 1974; 472: 194–206.

    Google Scholar 

  29. Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett Jr DR, Tudor-Locke C et al. 2011 Compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc 2011; 43: 1575–1581.

    Article  Google Scholar 

  30. Affairs AMACoS. Summaries and recommendations of Council on Scientific Affairs Reports: 1999 AMA Annual Meeting. Effects of Work on Pregnancy 1999, Accessed 7 November 2011 at http://www.ama-assn.org/ama1/pub/upload/mm/443/csaa-99.pdf.

  31. Pollock M, Gaesser G, Butcher J, Despres J, Dishman R, Franklin B et al. American College of Sports Medicine Position Stand: the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sport Exer 1998; 30: 975–991.

    Google Scholar 

  32. Proctor B, Dalaker J . US Bureau of the Census, Current Population Reports. Series P 60-219 US Government Printing Office: Washington, DC, 2002.

    Google Scholar 

  33. Institute of Medicine. Nutrition During Pregnancy: Part I, Weight Gain; Part II Nutrient Supplements. Committee on Nutritional Status During Pregnancy and Lactation, Food and Nutrition Board, National Academy Press: Washington, DC, 1990.

  34. Kleinbaum D, Kupper L, Muller K, Nizam A . Applied Regression Analysis and Other Multivariable Methods. 3rd edn Duxbury Press: Pacific Grove, CA, 1998.

    Google Scholar 

  35. Diggle P, Heagerty P, Liang K, Zeger S . Analysis of Longitudinal Data. 2nd edn Oxford University Press: Oxford, 2002.

    Google Scholar 

  36. Carbillon L, Challier JC, Alouini S, Uzan M, Uzan S . Uteroplacental circulation development: Doppler assessment and clinical importance. Placenta 2001; 22: 795–799.

    Article  CAS  Google Scholar 

  37. Bergmann A, Zygmunt M, Clapp III JF . Running throughout pregnancy: effect on placental villous vascular volume and cell proliferation. Placenta 2004; 25: 694–698.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This study was funded by the following grants: National Institutes of Health (NIH)/National Institute of Child Health and Human Development #HD37584, NIH/General Clinical Research Center #RR00046 and NIH/National Cancer Institute #R01CA109804. Dr Nguyen was funded in part by a grant from the Vietnam Education Foundation (VEF). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or VEF. The Pregnancy, Infection and Nutrition Study, along with the ancillary projects, is a joint effort of many investigators and staff members whose work is gratefully acknowledged.

Author information

Authors and Affiliations

  1. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    N C Nguyen, K R Evenson & J L Daniels

  2. Department of Research and Training, Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam

    N C Nguyen

  3. Division of Biological and Medical Sciences, Department of Community Health Epidemiology Section, and Department of Obstetrics and Gynecology, Brown University, Providence, RI, USA

    D A Savitz

  4. Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA

    H Chu

  5. Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    J M Thorp

Authors
  1. N C Nguyen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K R Evenson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. D A Savitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H Chu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J M Thorp
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J L Daniels
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to K R Evenson.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nguyen, N., Evenson, K., Savitz, D. et al. Physical activity and maternal–fetal circulation measured by Doppler ultrasound. J Perinatol 33, 87–93 (2013). https://doi.org/10.1038/jp.2012.68

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2012.68

Keywords

This article is cited by

Search

Advanced search

Quick links