Preconception physical activity alters the cardiovascular profile of women at risk for gestational hypertensive disorders in a profile-specific way

Objective. To evaluate the effect of physical activity on the cardio­vascular functions of pre-conceptional women at risk for gesta­tional hypertensive disorders (GHD) in a subsequent pregnancy.
Materials and Methods. A non-invasive haemodynamics assess­ment of arteries, veins and heart was performed on 40 non-preg­nant women with a history of complicated pregnancy or trying to conceive with co-morbidities. Measurements of electrocar­diogram Doppler ultrasound, impedance cardiography and bio-impedance spectrum analysis were taken before and after they engaged in physical activity (30-50 min, 3x/week) for a pe­riod of 4-6 months. Pre- and post-activity parameters were com­pared using the two-sided paired Student’s t-test or the Wilcoxon signed-rank test depending on the normality of the data.
Results. After physical activity, the total peripheral resistance (TPR), diastolic blood pressure and mean arterial pressure decreased in the total study population, without changing cardiac output (CO). However, in 42% (9/21) of women cat­egorized in high or low baseline CO (> P75 or < P25 resp.) a shift in CO was observed towards the normal reference inter­quartile range (P25-P50). This was associated with improved hepatic venous and central arterial haemodynamic functions. Similar changes in TPR occurred in 38% (11/29) of women classified into low or high baseline TPR.
Conclusions. As shown in pregnancy, output- or resis­tance-dominant cardiovascular profiles already exist prior to conception. This study illustrates that physical activity in the pre-conceptional period shifts high or low CO and/or TPR to­wards the normal midrange, allowing women at risk for GHD to start a subsequent pregnancy with a more gestation-adapt­able cardiovascular system.