- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne NCT02948439
Prenatal Exercise and Cardiovascular Health (PEACH) (PEACH)
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.
Przegląd badań
Szczegółowy opis
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.
Typ studiów
Zapisy (Oczekiwany)
Faza
- Nie dotyczy
Kontakty i lokalizacje
Lokalizacje studiów
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Alberta
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Edmonton, Alberta, Kanada, T6G 2E1
- Rekrutacyjny
- Program for Pregnancy and Postpartum Health, University of Alberta
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Kontakt:
- Margie Davenport, PhD
- Numer telefonu: 780-492-0642
- E-mail: mdavenpo@ualberta.ca
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Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
Akceptuje zdrowych ochotników
Płeć kwalifikująca się do nauki
Opis
Inclusion Criteria:
- >18 years old
- singleton pregnancy
- cleared to exercise by health care provider using Par Med X for Pregnancy (CSEP)
Exclusion Criteria:
- multiple gestation
- absolute contraindication to exercise (CSEP)
- <18 years old
- develops any contraindication during intervention
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Podstawowa nauka
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Brak (otwarta etykieta)
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
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Eksperymentalny: Exercise Intervention
The 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).
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Brisk walking 3-4 times per week for up to 40 minutes of activity.
Inne nazwy:
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Brak interwencji: Control Group
These 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).
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Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
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Sympathetic Nerve Activity - cold pressor test response
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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Response of the sympathetic nervous system to cold pressor test (% change in activity)
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16-20 weeks and 34-36 weeks gestation
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Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
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Respiratory measures - respiratory frequency
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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Breathing frequency (breaths per minute).
Measured using spirometry.
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16-20 weeks and 34-36 weeks gestation
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Sympathetic Nerve Activity - breath hold response
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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Response of the sympathetic nervous system to voluntary breath hold (% change in activity)
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16-20 weeks and 34-36 weeks gestation
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Respiratory measures - tidal volume
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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Tidal Volume (Liters per breath).
Measured using spirometry.
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16-20 weeks and 34-36 weeks gestation
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Respiratory measures - oxygen
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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Oxygen metabolism (% oxygen used per breath).
Measured using a gas analyzer.
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16-20 weeks and 34-36 weeks gestation
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Respiratory measures - carbon dioxide
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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Carbon Dioxide production (% carbon dioxide per breath).
Measured using a gas analyzer.
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16-20 weeks and 34-36 weeks gestation
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Respiratory measures - lung volume
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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Total Lung Capacity (Liters).
Measured using spirometry.
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16-20 weeks and 34-36 weeks gestation
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Cerebral blood flow at rest
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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Brain blood flow in the middle cerebral artery at rest (cm/s).
Measured using transcranial doppler ultrasound.
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16-20 weeks and 34-36 weeks gestation
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Cerebral autoregulation
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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Brain blood flow in the middle cerebral artery in response to standing (cm/s).
Measured using transcranial doppler ultrasound.
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16-20 weeks and 34-36 weeks gestation
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Cerebral blood flow during exercise
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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Brain blood flow in the middle cerebral artery during the acute incremental peak exercise test (cm/s).
Measured using transcranial doppler ultrasound.
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16-20 weeks and 34-36 weeks gestation
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fasted blood sample - blood volume
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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Fasted blood samples (~30ml) will be analyzed for markers of blood volume (hematocrit; %)
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16-20 weeks and 34-36 weeks gestation
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fasted blood sample - neurotransmitters
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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Fasted blood samples (~30ml) will be analyzed for sympathetic nervous system neurotransmitters (Norepinephrine, Epinephrine, Neuropeptide-Y).
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16-20 weeks and 34-36 weeks gestation
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fasted blood sample- inflammatory markers
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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Fasted blood samples (~30ml) will be analyzed for inflammatory markers (i.e.
C-Reactive Protein).
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16-20 weeks and 34-36 weeks gestation
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fasted blood sample- epigenetics
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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Fasted blood samples (~30ml) will be analyzed for epigenetics (optional).
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16-20 weeks and 34-36 weeks gestation
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fasted blood sample- sex hormones
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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Fasted blood samples (~30ml) will be analyzed for sex hormones (estrogen, progesterone, testosterone).
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16-20 weeks and 34-36 weeks gestation
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fasted blood sample- metabolic
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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Fasted blood samples (~30ml) will be analyzed for metabolic parameters (i.e.
glucose)
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16-20 weeks and 34-36 weeks gestation
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fetal outcomes- birth weight
Ramy czasowe: within one month postpartum
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Participants will provide the investigators with birth weight for the infant (grams).
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within one month postpartum
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fetal outcomes- length
Ramy czasowe: within one month postpartum
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Participants will provide the investigators with birth length for the infant (cm).
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within one month postpartum
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fetal outcomes- gestational age
Ramy czasowe: within one month postpartum
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Participants will provide the investigators with gestational age at delivery (weeks).
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within one month postpartum
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Wyniki matczyne - sposób porodu
Ramy czasowe: w ciągu miesiąca po porodzie
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Uczestnicy podają badaczom sposób porodu (waginalny lub cesarski).
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w ciągu miesiąca po porodzie
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Wyniki matczyne - powikłania porodowe
Ramy czasowe: w ciągu miesiąca po porodzie
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Uczestnicy przekażą badaczom informacje dotyczące ewentualnych powikłań porodowych.
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w ciągu miesiąca po porodzie
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Wyniki matczyne - powikłania ciąży
Ramy czasowe: w dowolnym momencie podczas nauki
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Uczestnicy przekażą badaczom informacje dotyczące wszelkich powikłań ciąży (cukrzyca ciążowa, nadciśnienie indukowane ciążą, stan przedrzucawkowy).
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w dowolnym momencie podczas nauki
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fetal outcomes- apgar score
Ramy czasowe: within one month postpartum
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Participants will provide the investigators with APGAR scores (out of 10) for the infant
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within one month postpartum
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fetal outcomes- NICU
Ramy czasowe: within one month postpartum
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Participants will provide the investigators with information regarding length (days) of admission to Neonatal Intensive Care Unit (NICU) if applicable.
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within one month postpartum
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Wyniki matczyne - przyrost masy ciała w ciąży
Ramy czasowe: w ciągu miesiąca po porodzie
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Uczestnicy dostarczą badaczom ostatnią wagę matki bezpośrednio przed porodem.
Zostanie to wykorzystane do obliczenia przyrostu masy ciała w czasie ciąży (kg; ostatnia waga matki — waga zgłoszona przed ciążą).
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w ciągu miesiąca po porodzie
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Endothelial Function - time to peak dilation
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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The investigators will assess endothelial function using flow mediated dilation (FMD, time to maximal dilation; s)
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16-20 weeks and 34-36 weeks gestation
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Endothelial Function- flow mediated dilation
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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The investigators will assess endothelial function using flow mediated dilation (change in diameter; mm)
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16-20 weeks and 34-36 weeks gestation
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Endothelial Function - shear stress
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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The investigators will assess endothelial function using flow mediated dilation (shear stress; pascals).
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16-20 weeks and 34-36 weeks gestation
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Accelerometry
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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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.
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16-20 weeks and 34-36 weeks gestation
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Physical Activity Questionnaire
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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The participants will report physical activity using the pregnancy physical activity questionnaire (gives metabolic equivalent hours per week (MET-hr/week).
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16-20 weeks and 34-36 weeks gestation
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Depression rating
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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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.
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16-20 weeks and 34-36 weeks gestation
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Sleep Quality
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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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.
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16-20 weeks and 34-36 weeks gestation
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Food log
Ramy czasowe: 16-20 weeks and 34-36 weeks gestation
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The investigators will objectively measure nutrients in diet using a three day food record.
This is completed through Food Prodigy/ Food Processor software.
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16-20 weeks and 34-36 weeks gestation
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Współpracownicy i badacze
Śledczy
- Dyrektor Studium: Rachel Skow, MSc, University of Alberta
Publikacje i pomocne linki
Publikacje ogólne
- 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.
- 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.
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów
Zakończenie podstawowe (Oczekiwany)
Ukończenie studiów (Oczekiwany)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Oszacować)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Inne numery identyfikacyjne badania
- Pro00061045
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
produkt wyprodukowany i wyeksportowany z USA
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