Heat stress and fetal risk. Environmental limits for exercise and passive heat stress during pregnancy: a systematic review with best evidence synthesis
Ravanelli N, Casasola W, English T, Edwards KM, Jay O
British journal of sports medicine · 53 citas
Cómo se estudió
- Diseño
- Revisión sistemática (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Universidad u hospital
- University of Ottawa
- Gobierno
- Bộ Giáo dục và Ðào tạo
Según 2 financiadores declarados.
Publicación
- Publicado
- 2018-03-01 · Br J Sports Med · vol. 53 · número 13 · págs. 799–805
- Editorial
- BMJ
- Citado
- 96 citas · más que el 70% de estudios similares · 0.9× el promedio de su campo
- Referencias
- 83 trabajos
- Acceso
- De pago
- Áreas de investigación
- Thermoregulation and physiological responses · Gestational Diabetes Research and Management · Cancer Risks and Factors
- Palabras clave
- Medicine, CINAHL, Pregnancy, Hyperthermia, Heat stress, Meta-analysis, Gestation, Core (optical fiber), Physical therapy, Obstetrics, Internal medicine, Psychological intervention, Animal science
- MeSH
- humans, heat stress disorders, body temperature, treatment outcome, exercise, body temperature regulation, heat-shock response, pregnancy, female, teratogenesis
5 autores
- Nicholas Ravanelli🇦🇺🇨🇦The University of Sydney; University of Ottawa
- William Casasola🇦🇺🇬🇧The University of Sydney; University of Exeter
- Timothy English🇦🇺The University of Sydney
- Kate M. Edwards🇦🇺The University of Sydney
- Ollie Jay🇦🇺🇨🇦 · autor de correspondenciaThe University of Sydney; University of Ottawa
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objective
Pregnant women are advised to avoid heat stress (eg, excessive exercise and/or heat exposure) due to the risk of teratogenicity associated with maternal hyperthermia; defined as a core temperature (Tcore) ≥39.0°C. However, guidelines are ambiguous in terms of critical combinations of climate and activity to avoid and may therefore unnecessarily discourage physical activity during pregnancy. Thus, the primary aim was to assess Tcore elevations with different characteristics defining exercise and passive heat stress (intensity, mode, ambient conditions, duration) during pregnancy relative to the critical maternal Tcore of ≥39.0°C.
Design
Systematic review with best evidence synthesis.
Data sources
EMBASE, MEDLINE, SCOPUS, CINAHL and Web of Science were searched from inception to 12 July 2017.
Study eligibility criteria
Studies reporting the Tcore response of pregnant women, at any period of gestation, to exercise or passive heat stress, were included.
Results
12 studies satisfied our inclusion criteria (n=347). No woman exceeded a Tcore of 39.0°C. The highest Tcore was 38.9°C, reported during land-based exercise. The highest mean end-trial Tcore was 38.3°C (95% CI 37.7°C to 38.9°C) for land-based exercise, 37.5°C (95% CI 37.3°C to 37.7°C) for water immersion exercise, 36.9°C (95% CI 36.8°C to 37.0°C) for hot water bathing and 37.6°C (95% CI 37.5°C to 37.7°C) for sauna exposure.
Conclusion
The highest individual core temperature reported was 38.9°C. Immediately after exercise (either land based or water immersion), the highest mean core temperature was 38.3°C; 0.7°C below the proposed teratogenic threshold. Pregnant women can safely engage in: (1) exercise for up to 35 min at 80%-90% of their maximum heart rate in 25°C and 45% relative humidity (RH); (2) water immersion (≤33.4°C) exercise for up to 45 min; and (3) sitting in hot baths (40°C) or hot/dry saunas (70°C; 15% RH) for up to 20 min, irrespective of pregnancy stage, without reaching a core temperature exceeding the teratogenic threshold.
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