Can exercise raise the risk of developing pre-eclampsia?
Pre-eclampsia is an increase in blood pressure (compared to pre-pregnancy levels) and high levels of protein in the urine, usually occurring in the 2nd half of the pregnancy. While mild pre-eclampsia can be managed, if the pre-eclampsia is severe, the only way to cure it is to deliver the baby, which of course can be very risky for mother and baby depending on how early delivery is.
So when research comes out claiming that exercise can contribute to pre-eclampsia, it should give us reason to stop and look at the details of the study, its validity and how it may affect exercise prescription to our pre-natal clients (‘Does leisure time physical activity in early pregnancy protect against pre-eclampsia? Prospective cohort in Danish women’ study led by Doctor ML Osterdal from the Maternal Nutrition Group at the Statens Serum Institut in Copenhagen, published in The British Journal of Obstetrics and Gynaecology; report available online at www3.interscience.wiley.com
The study did show that there was a ‘65% risk in women who engaged in any intensity of physical exercise for 4.5-7 hours a week and a 78% increase for women doing more than 7 hours a week compared to those who did no exercise’. This does seem like a high value, however, there is still quite a degree of uncertainty about the subjects. In the study the age, BMI, and number of previous pregnancies was recorded, as was whether they smoked. However, it was not stated if these factors correlated with the high exercisers. Other risk factors should also have been recorded and used to create more specificity in the results.
These risk factors include:
• Family history of pre-eclampsia
• Multiple births
• Pre-existing high blood pressure
• Kidney issues
• Age below 18 or over 40
• Dietary issues such as high salt, low calcium
• Smoking before falling pregnant.
We do not know from this study if any of the subjects that exercised intensely had any of these risk factors, so it is easy to feel alarmed by the findings without actually having all of the necessary information to properly illustrate the relationship between high amounts of exercise and pre-eclampsia. There needs to be more research into the type and intensity (time and effort) of exercise, the specifics of the client and much larger numbers of subjects.
As trainers and instructors, however, this study does reiterate the need to screen pre-natal clients thoroughly and to look for risk factors pre-training and warning signs along the way to delivery. Your client should be visiting a midwife or doctor during pregnancy and her blood pressure should be checked each time. As trainers we should keep a record of our client’s blood pressure and be aware of symptoms our client may have, particularly throughout the 2nd half of the pregnancy.
Some of these symptoms are:
• Bloating or water retention
• Noticeably swollen ankles or feet (some mild swelling during pregnancy may be normal)
• Swelling of the face and upper body when waking up
• Blurred vision or sensitivity to light
• Upper abdominal pain
• Nausea or vomiting
• Seizures or convulsions.
Remember that during pregnancy, we are training our clients to maintain the health of mother and baby and not to increase fitness and fatloss. If your client shows warning signs, refer immediately to a doctor and wait to be given the go-ahead for exercise. Exercise throughout pregnancy has many positive effects on both mother and baby, so lets be aware and cautious so we can keep clients moving safely.
Blog information provided by Zosha Piotrowski (firstname.lastname@example.org)