Key result
Women who developed preeclampsia had a trend toward lower VO2max at 14-18 weeks of pregnancy compared to normotensive women (MD -0.43 mL/kg/min, p=0.11).
Why the study?
Hypertensive disorders of pregnancy are associated with future cardiovascular disease, which may be mediated by diminished cardiorespiratory fitness, but evidence linking the two across pregnancy stages had not been synthesized.
Does hypertensive disorders of pregnancy correlate with reduced cardiorespiratory fitness in women before, during, and after pregnancy?
Meta-Analysis (n=2,406)
Does hypertensive disorders of pregnancy correlate with reduced cardiorespiratory fitness in women before, during, and after pregnancy?
Reduced cardiorespiratory fitness may be a mechanism connecting hypertensive disorders of pregnancy to future cardiovascular disease, emphasizing the potential utility of postpartum cardiovascular rehabilitation.
Trend toward lower mid-pregnancy VO2max does not support CRF screening in pregnancy; leaves open whether pre-pregnancy fitness modifies HDP risk.
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., VO2max < 37 vs. ≥37 mL O2/min) than those without HDP (two studies, 811 women). VO2max 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 VO2peak 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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Al-Huda et al. (2022) conducted a meta-analysis in Hypertensive disorders of pregnancy (n=2,406). Hypertensive disorders of pregnancy vs. Normotensive pregnancy was evaluated on VO2max at 14-18 weeks of pregnancy (preeclampsia vs normotensive) (MD -0.43 mL/kg/min, 95% CI -0.97, 0.10, p=0.11). Women who developed preeclampsia had a trend toward lower VO2max at 14-18 weeks of pregnancy compared to normotensive women (MD -0.43 mL/kg/min, p=0.11).
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