We performed a randomised controlled trial measuring dynamic cerebral autoregulation (dCA) using a sit-to-stand maneuver before (SS1) and following (SS2) an acute exercise test at 16-20 weeks gestation (trimester 2; TM2) and then again at 34-37 weeks gestation (third trimester; TM3). Following the first assessment, women were randomised into exercise training or control (standard care) groups; women in the exercise training group were prescribed moderate intensity aerobic exercise for 25-40 minutes on 3-4 days per week for 14±1weeks. Resting seated mean blood velocity in the middle cerebral artery (MCAvmean) was lower in TM3 compared to TM2 but not impacted by exercise training intervention. dCA was not impacted by gestational age, or exercise training during SS1. During SS2, dCA was altered such that there were greater absolute and relative decreases in mean arterial blood pressure (MAP) and MCAvmean, but this was not impacted by the intervention. There was also no difference in the relationship between the decrease in MCAvmean compared to the decrease in MAP (%/%), or the onset of the regulatory response with respect to acute exercise, gestational age, or intervention; however, rate of regulation was faster in women in the exercise group following acute exercise (interaction effect, p=0.048). These data highlight the resilience of the cerebral circulation in that dCA was well maintained or improved in healthy pregnant women between TM2 and TM3. However, future work addressing the impact of acute and chronic exercise on dCA in women who are at risk for cardiovascular complications during pregnancy is needed.
Recommendations for Recruiting and Retaining Adolescent Girls in Chronic Exercise (Training) Research Studies