Journal
JOURNAL OF CLINICAL MEDICINE
Volume 11, Issue 15, Pages -Publisher
MDPI
DOI: 10.3390/jcm11154364
Keywords
cardiorespiratory fitness; hypertensive disorders of pregnancy; gestational hypertension; preeclampsia; pregnancy; physical activity; oxygen consumption; exercise testing
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Hypertensive disorders of pregnancy (HDP) are associated with future cardiovascular disease (CVD), which may be mediated by diminished cardiorespiratory fitness (CRF). This systematic review and meta-analysis summarize evidence linking CRF with HDP before, during, and after pregnancy. The findings suggest that CRF can identify women at risk for HDP, and that HDP may have a negative impact on a woman's cardiorespiratory reserve.
Hypertensive disorders of pregnancy (HDP) are associated with future cardiovascular disease (CVD), which may be mediated by diminished cardiorespiratory fitness (CRF). In this systematic review and meta-analysis, we summarize evidence linking CRF with HDP before, during, and after pregnancy. We searched relevant databases to identify observational or randomized studies that measured CRF (VO2 max or peak, VO2 at anaerobic threshold, or work rate at peak VO2) in women with and without HDP. We pooled results using random effects models. Fourteen studies (n = 2406 women) reporting on CRF before, during, and after pregnancy were included. Before pregnancy, women who developed HDP had lower CRF (e.g., VO(2)max < 37 vs. >= 37 mL O-2/min) than those without HDP (two studies, 811 women). VO(2)max at 14-18 weeks of pregnancy was marginally lower among women who developed preeclampsia vs. normotensive women (three studies, 275 women; mean difference 0.43 mL/kg/min [95% CI 0.97, 0.10]). Postpartum, there was a trend towards lower VO(2)peak in women with previous preeclampsia (three studies, 208 women; 0.26 mL/kg/min [-0.54, 0.02]). While exploratory, our findings raise the possibility that CRF can identify women at risk for HDP, and furthermore, that HDP confers a hit to a woman's cardiorespiratory reserve.
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