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PregnancyPEACHNCT02948439

Prenatal Exercise and Cardiovascular Health (PEACH)

A study testing Aerobic exercise in people with Pregnancy, run by University of Alberta at 1 site in Canada.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Maintenance of a healthy pregnancy depends on an appropriate adaptation and responsiveness of blood vessels, to ensure appropriate blood flow to the fetus during everyday stressors. Read more about this study

Who is it for?
Ages 18 years and older, women onlyHealthy volunteers can take part
Conditions the study is for
Pregnancy
What is being tested?
Aerobic exercise
Could I receive a placebo?
No, everyone receives an active treatment
How many people
64 participants
Where
1 siteCanada
Study dates
May 2016to Feb 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • >18 years old
  • singleton pregnancy
  • cleared to exercise by health care provider using Par Med X for Pregnancy (CSEP)

Who cannot join

  • multiple gestation
  • absolute contraindication to exercise (CSEP)
  • <18 years old
  • develops any contraindication during intervention

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • Program for Pregnancy and Postpartum Health, University of Alberta

    Edmonton, Alberta, T6G 2E1

Other trials in Canada

About this study

Official title: Exercise and Neurovascular Function During Pregnancy

Maintenance of a healthy pregnancy depends on an appropriate adaptation and responsiveness of blood vessels, to ensure appropriate blood flow to the fetus during everyday stressors. Previous work by the investigators has demonstrated that during pregnancy, the part of the nervous system responsible for cardiovascular function (the sympathetic nervous system) is hyperactive. The investigators also know that in women who develop high blood pressure during pregnancy that sympathetic nervous system activity is even higher. Yet, very little is known about why this occurs and how this might be affected.

Pregnant women are encouraged to be active, yet, less than 15% of women perform sufficient exercise to meet current guidelines. This is important because hyperactivity of the sympathetic nervous system is observed in other inactive populations and has been linked to adverse cardiovascular health outcomes including hypertension, atherosclerosis, heart attack, and stroke. Indeed, in 2011, the American Heart Association stated that inactivity was a risk factor as potent as cigarette smoking for the development of future cardiovascular disease in women.

The investigators' work and others have demonstrated that exercise during pregnancy is beneficial for both the mom and baby; however, the effect of prenatal exercise on neurovascular function is not known. If exercise is effective in controlling the increase in sympathetic activity that occurs during pregnancy, or its effects on the cardiovascular system, this may help prevent the development of high blood pressure or other cardiovascular problems during pregnancy.

Read the detailed description

The objectives of this study are to: 1) examine the impact of exercise on sympathetic and vascular function during pregnancy; 2) examine the role of endothelial function on the vascular effects of exercise during pregnancy.

Study design:

100 women (>18yrs) will be recruited in the first or second trimester (<20 wks). Women with multiple pregnancies will be excluded. Eligible women will be randomized between an aerobic exercise intervention (EXER) or no intervention (CTRL).

Initial testing will take place between 16-20 weeks of pregnancy. Following initial baseline testing, women will be randomly assigned to an exercise intervention or no intervention. Women will receive an opaque sequentially numbered envelop with their allocation. Allocation will be determined using a randomly generated allocation sequence by an individual not associated with the research study. The intervention will consist of aerobic exercise equivalent to 50-70% of heart rate reserve, 3-4 times per week until the end of the study (34-36 weeks). For initial baseline testing (16-20 weeks) and at the end of the intervention (34-36 weeks), participants will visit the laboratory twice

On Day 1, participants will complete a peak exercise test on the treadmill or bike to volitional fatigue to measures fitness and cardiovascular/cerebrovascular responses to exercise.

On Day 2 Participants will arrive fasted (12 hrs) and blood samples will be collected. Anthropometrics, personal/familial history of hypertension and pregnancy complications will be recorded. Following a standardized breakfast, participants will undergo an assessment of reflex neurovascular control including a cold pressor test, flow mediated dilation and end expiratory voluntary breath hold. Muscle sympathetic nerve activity, ultrasound (blood flow and diameter of brachial, femoral and carotid arteries), blood pressure, heart rate and respiratory variables will be measured.

OUTCOME/IMPACT

Pregnancy is a stress-test for life; with women who develop complications during pregnancy having a higher risk for cardiovascular disease later in life. Exercise is well known to prevent cardiovascular disease through improvements in endothelial function and the sympathetic nervous system. Whether this improvements is also seen in pregnancy remains to be seen.

Conditions
Pregnancy
Being tested
Aerobic exercise
Keywords
pregnancy, cardiovascular, nervous system, exercise
Medical subject headings
Neurologic Manifestations, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Aerobic exerciseOther

    Also called walking program

    Brisk walking 3-4 times per week for up to 40 minutes of activity.

Study groups in NCT02948439
Study groupRoleWhat they receive
Exercise InterventionExperimentalThe aerobic exercise intervention will consist of a walking program at 50-70% of individual heart rate reserve. This will begin at 16-20 weeks gestation and continue 3-4 times per week until the end of the study (34-36 weeks). The duration of exercise will increase each week up to a maximum of 40 minutes (5 min warm up, 25 minutes exercise, 5 min cool down). Women will have at least one supervised exercise session per week. The investigators will also monitor other activity using questionnaires and accelerometry. This will occur at baseline (16-20 weeks), mid-intervention (24-26 weeks) and at the end (34-36 weeks).
Receives: Other: Aerobic exercise
Control GroupNo interventionThese women will continue regular daily activities. Activity will be monitored periodically with questionnaires and accelerometry. This will occur at baseline (16-20 weeks), mid-intervention (24-26 weeks) and at the end (34-36 weeks).

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Sympathetic Nerve Activity - cold pressor test response

    Response of the sympathetic nervous system to cold pressor test (% change in activity)

    Measured: 16-20 weeks and 34-36 weeks gestation

Secondary outcomes (32)
  1. Respiratory measures - respiratory frequency

    Breathing frequency (breaths per minute). Measured using spirometry.

    Measured: 16-20 weeks and 34-36 weeks gestation

  2. Sympathetic Nerve Activity - breath hold response

    Response of the sympathetic nervous system to voluntary breath hold (% change in activity)

    Measured: 16-20 weeks and 34-36 weeks gestation

  3. Respiratory measures - tidal volume

    Tidal Volume (Liters per breath). Measured using spirometry.

    Measured: 16-20 weeks and 34-36 weeks gestation

  4. Respiratory measures - oxygen

    Oxygen metabolism (% oxygen used per breath). Measured using a gas analyzer.

    Measured: 16-20 weeks and 34-36 weeks gestation

  5. Respiratory measures - carbon dioxide

    Carbon Dioxide production (% carbon dioxide per breath). Measured using a gas analyzer.

    Measured: 16-20 weeks and 34-36 weeks gestation

  6. Respiratory measures - lung volume

    Total Lung Capacity (Liters). Measured using spirometry.

    Measured: 16-20 weeks and 34-36 weeks gestation

  7. Cerebral blood flow at rest

    Brain blood flow in the middle cerebral artery at rest (cm/s). Measured using transcranial doppler ultrasound.

    Measured: 16-20 weeks and 34-36 weeks gestation

  8. Cerebral autoregulation

    Brain blood flow in the middle cerebral artery in response to standing (cm/s). Measured using transcranial doppler ultrasound.

    Measured: 16-20 weeks and 34-36 weeks gestation

  9. Cerebral blood flow during exercise

    Brain blood flow in the middle cerebral artery during the acute incremental peak exercise test (cm/s). Measured using transcranial doppler ultrasound.

    Measured: 16-20 weeks and 34-36 weeks gestation

  10. fasted blood sample - blood volume

    Fasted blood samples (~30ml) will be analyzed for markers of blood volume (hematocrit; %)

    Measured: 16-20 weeks and 34-36 weeks gestation

  11. fasted blood sample - neurotransmitters

    Fasted blood samples (~30ml) will be analyzed for sympathetic nervous system neurotransmitters (Norepinephrine, Epinephrine, Neuropeptide-Y).

    Measured: 16-20 weeks and 34-36 weeks gestation

  12. fasted blood sample- inflammatory markers

    Fasted blood samples (~30ml) will be analyzed for inflammatory markers (i.e. C-Reactive Protein).

    Measured: 16-20 weeks and 34-36 weeks gestation

  13. fasted blood sample- epigenetics

    Fasted blood samples (~30ml) will be analyzed for epigenetics (optional).

    Measured: 16-20 weeks and 34-36 weeks gestation

  14. fasted blood sample- sex hormones

    Fasted blood samples (~30ml) will be analyzed for sex hormones (estrogen, progesterone, testosterone).

    Measured: 16-20 weeks and 34-36 weeks gestation

  15. fasted blood sample- metabolic

    Fasted blood samples (~30ml) will be analyzed for metabolic parameters (i.e. glucose)

    Measured: 16-20 weeks and 34-36 weeks gestation

  16. fetal outcomes- birth weight

    Participants will provide the investigators with birth weight for the infant (grams).

    Measured: within one month postpartum

  17. fetal outcomes- length

    Participants will provide the investigators with birth length for the infant (cm).

    Measured: within one month postpartum

  18. fetal outcomes- gestational age

    Participants will provide the investigators with gestational age at delivery (weeks).

    Measured: within one month postpartum

  19. maternal outcomes- mode of delivery

    Participants will provide the investigators with mode of delivery (vaginal or cesarean).

    Measured: within one month postpartum

  20. maternal outcomes- delivery complications

    Participants will provide the investigators with information regarding any delivery complications.

    Measured: within one month postpartum

  21. maternal outcomes- pregnancy complications

    Participants will provide the investigators with information regarding any pregnancy complications (gestational diabetes, pregnancy induced hypertension, preeclampsia).

    Measured: any time during study

  22. fetal outcomes- apgar score

    Participants will provide the investigators with APGAR scores (out of 10) for the infant

    Measured: within one month postpartum

  23. fetal outcomes- NICU

    Participants will provide the investigators with information regarding length (days) of admission to Neonatal Intensive Care Unit (NICU) if applicable.

    Measured: within one month postpartum

  24. maternal outcomes- gestational weight gain

    Participants will provide the investigators with the last maternal weight immediately before delivery. This will be used to calculate gestational weight gain (kg; last maternal weight - self reported pre-pregnancy weight).

    Measured: within one month postpartum

  25. Endothelial Function - time to peak dilation

    The investigators will assess endothelial function using flow mediated dilation (FMD, time to maximal dilation; s)

    Measured: 16-20 weeks and 34-36 weeks gestation

  26. Endothelial Function- flow mediated dilation

    The investigators will assess endothelial function using flow mediated dilation (change in diameter; mm)

    Measured: 16-20 weeks and 34-36 weeks gestation

  27. Endothelial Function - shear stress

    The investigators will assess endothelial function using flow mediated dilation (shear stress; pascals).

    Measured: 16-20 weeks and 34-36 weeks gestation

  28. Accelerometry

    The investigators will objectively measure physical activity using an accelerometer for one week. Average number of minutes per day spent in various activity levels will be determined.

    Measured: 16-20 weeks and 34-36 weeks gestation

  29. Physical Activity Questionnaire

    The participants will report physical activity using the pregnancy physical activity questionnaire (gives metabolic equivalent hours per week (MET-hr/week).

    Measured: 16-20 weeks and 34-36 weeks gestation

  30. Depression rating

    Participants will answer a 10-question questionnaire regarding their mood. A score of 10 or higher is indicative of depressive symptoms. The investigators will report the over number of women in each group who have a score of 10+ at the start and end of the intervention.

    Measured: 16-20 weeks and 34-36 weeks gestation

  31. Sleep Quality

    Participants will report their sleep quality using the Pittsburgh Sleep Quality index. A score of 5 or more indicates poor sleep quality. The investigators will compare this score between groups before and after the intervention.

    Measured: 16-20 weeks and 34-36 weeks gestation

  32. Food log

    The investigators will objectively measure nutrients in diet using a three day food record. This is completed through Food Prodigy/ Food Processor software.

    Measured: 16-20 weeks and 34-36 weeks gestation

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Oct 2016 (estimated)
  2. Study startMay 2016
  3. Primary completionDec 2018
  4. Study completionFeb 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
64 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02948439
Sponsor's protocol ID
Pro00061045
Acronym
PEACH
Status last verified
Nov 2024
First submitted
13 Jul 2016
Last updated
4 Dec 2024
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Publications

  • Boparai R, Skow RJ, Farooq S, Steinback CD, Davenport MH. Prenatal exercise and cardiovascular health (PEACH) study: the remote effect of aerobic exercise training on conduit artery and resistance vessel function. Appl Physiol Nutr Metab. 2021 Dec;46(12):1459-1468. doi: 10.1139/apnm-2020-0902. Epub 2021 Jun 23.

    PubMed 34161737
  • Skow RJ, Fraser GM, Steinback CD, Davenport MH. Prenatal Exercise and Cardiovascular Health (PEACH) Study: Impact on Muscle Sympathetic Nerve (Re)Activity. Med Sci Sports Exerc. 2021 Jun 1;53(6):1101-1113. doi: 10.1249/MSS.0000000000002583.

    PubMed 33315812

Questions about this trial

What is this clinical trial studying?

A study testing Aerobic exercise in people with Pregnancy, run by University of Alberta at 1 site in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 4 Dec 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Sympathetic Nerve Activity - cold pressor test response (time frame: 16-20 weeks and 34-36 weeks gestation). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02948439, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Dec 2024.

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