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Fetal wellbeing may be compromised during strenuous exercise among pregnant elite athletes
  1. Kjell Å Salvesen1,2,
  2. Erlend Hem3,
  3. Jorunn Sundgot-Borgen3
  1. 1National Center for Fetal Medicine, Trondheim University Hospital (St Olav's Hospital), Trondheim, Norway
  2. 2Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
  3. 3Department of Sports Medicine, The Norwegian School of Sport Sciences, Oslo, Norway
  1. Correspondence toDr Kjell Å Salvesen, National Center for Fetal Medicine, Trondheim University Hospital (St Olav's Hospital), N-7006 Trondheim, Norway; pepes{at}


Objectives To study fetal wellbeing and uteroplacental blood flow during strenuous treadmill running in the second trimester.

Methods Six pregnant Olympic-level athletes in endurance events aged 28–37 years and training 15–22 h per week before the pregnancy were tested once at 23–29 weeks of pregnancy. The women ran three to five submaximal workloads on a treadmill with approximately 60–90% of maximal oxygen consumption. The maternal–fetal circulation was assessed with Doppler ultrasound of the uterine and umbilical arteries before, during and after exercise.

Results Mean uterine artery volume blood flow was reduced to 60–80% after warming up and stayed at 40–75% of the initial value during exercise. Fetal heart rate (FHR) was within the normal range (110–160 bpm) as long as the woman exercised below 90% of maximal maternal heart rate (MHR). Fetal bradycardia and high umbilical artery pulsatility index (PI) occurred when the woman exercised more than 90% of maximal MHR and the mean uterine artery volume blood flow was less than 50% of the initial value. FHR and umbilical artery PI normalised quickly after stopping the exercise.

Conclusions Exercise at intensity above 90% of maximal MHR in pregnant elite athletes may compromise fetal wellbeing.

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  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Regional Committee for Medical and Health Science Research Ethics in Southern Norway.

  • GE Healthcare Norway provided the ultrasound device (Logic 7) free of charge. GE had no influence on writing the study protocol, analysing the data or interpreting the results.

  • Provenance and peer review Not commissioned; externally peer reviewed.