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  • 1.
    Thorell, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Physical Fitness and Pregnancy2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Objectives To assess physical fitness in pregnancy and to evaluate its effect on perceived health, back pain, blood pressure and duration of gestation. Also, to evaluate the effect of serum relaxin levels on blood pressure and duration of gestation.

    Material and methods A prospective cohort of 520 pregnant women were examined in early pregnancy and five months postpartum with regard to socio-demographic characteristics and estimated peak oxygen uptake (V̇O2 peak, est.). Serum concentrations of relaxin were carried out in early pregnancy. Physical exercise, possible back pain and blood pressure were measured repeatedly throughout pregnancy.

    Results Absolute V̇O2 peak, est. in early pregnancy was positively correlated to perceived health, which was lower during than after pregnancy. The average absolute V̇O2 peak, est. in early pregnancy of 2.4 l/minute was 0.02 l/minute less than the V̇O2 peak, est. postpartum, while regular physical exercise decreased throughout pregnancy. Absolute V̇O2 peak, est. in early pregnancy was not associated to the incidence of any low back pain location in pregnancy or postpartum, but inversely to intensity of back pain and diastolic blood pressure and positively with duration of gestation. Elevated serum relaxin levels were associated with decreased diastolic blood pressure and higher duration of gestation among women with miscarriage.

    Conclusions Perceived health, diastolic blood pressure and duration of gestation were positively affected by physical fitness while no effect was shown on the incidence of back pain. The effect of physical fitness on duration of gestation and diastolic blood pressure might have clinical implications as well as the increased serum relaxin levels on miscarriages.

  • 2.
    Thorell, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Goldsmith, Laura
    Weiss, Gerson
    Kristiansson, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Physical fitness, serum relaxin levels and duration of gestation2015In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 15, article id 168Article in journal (Refereed)
    Abstract [en]

    Background: Women are recommended to perform regular exercise during pregnancy but the impact of physical fitness on duration of gestation including miscarriage is inconsistent. In addition, an increased risk of miscarriage in early pregnancy among women with higher levels of physical activities has been noted. Previous studies have mostly used an epidemiologic method. Larger studies using careful measurement of physical fitness are needed. Besides physical fitness, elevated maternal circulating levels of the hormone relaxin have been associated with decreased duration of gestation.

    Methods: A prospective cohort including 20 women with miscarriage and 460 women with spontaneous start of labour, recruited from maternal health care centres in central Sweden, were examined regarding estimated absolute peak oxygen uptake (V̇O2 peak, est..) by cycle ergometer test, and maternal circulating relaxin levels in early pregnancy.

    Results: Women with miscarriage displayed the highest level of absolute V̇O2 peak, est. (2.61 l/min) and the lowest serum relaxin levels (640 ng/l). Among women with spontaneous start of labour, the mean absolute V̇Opeak, est. increased successively from the lowest level (2.31 l/min) among those with preterm birth (n=28), to 2.49 l/min among women with post term birth (n=31). An opposite trend was shown regarding serum relaxin levels from women with miscarriage to those with post term birth. Serum relaxin concentrations, but not absolute V̇O2 peak, est. was significantly and independently associated with duration of gestation in women with miscarriages, and absolute V̇O2 peak, est., age and multiple pregnancy were independently associated with duration of gestation in women with spontaneous start of labour.

    Conclusions: Physical fitness appears to be a protective factor of established pregnancies and not significantly involved in the risk of early miscarriage. Additional studies are needed to more clearly define the role of relaxin in miscarriage.

  • 3. Thorell, Eva
    et al.
    Kristiansson, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Pregnancy related back pain, is it related to aerobic fitness?: A longitudinal cohort study2012In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 12, p. 30-Article in journal (Refereed)
    Abstract [en]

    Background: Low back pain with onset during pregnancy is common and approximately one out of three women have disabling pain. The pathogenesis of the pain condition is uncertain and there is no information on the role of physical fitness. Whether poorer physical conditioning is a cause or effect of back pain is also disputed and information from prospective studies needed. Methods: A cohort of pregnant women, recruited from maternal health care centers in central Sweden, were examined regarding estimated peak oxygen uptake by cycle ergometer test in early pregnancy, reported physical activity prior to pregnancy, basic characteristics, back pain during pregnancy and back pain postpartum. Results: Back pain during the current pregnancy was reported by nearly 80% of the women. At the postpartum appointment this prevalence was 40%. No association was displayed between estimated peak oxygen uptake and incidence of back pain during and after pregnancy, adjusted for physical activity, back pain before present pregnancy, previous deliveries, age and weight. A significant inverse association was found between estimated peak oxygen uptake and back pain intensity during pregnancy and a direct association post partum, in a fully adjusted multiple linear regression analysis. Conclusions: Estimated peak oxygen uptake and reported physical activity in early pregnancy displayed no influence on the onset of subsequent back pain during or after pregnancy, where the time sequence support the hypothesis that poorer physical deconditioning is not a cause but a consequence of the back pain condition. The mechanism for the attenuating effect of increased oxygen uptake on back pain intensity is uncertain.

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