Pregnancy reference intervals and exertion and breathlessness ratings for the six minute walk test in healthy nulliparous people

doi:10.1016/j.heliyon.2024.e25863

. 2024 Feb 10;10(4):e25863.

doi: 10.1016/j.heliyon.2024.e25863. eCollection 2024 Feb 29.

Pregnancy reference intervals and exertion and breathlessness ratings for the six minute walk test in healthy nulliparous people

Alaina R Francis^{1

2

3}, Tahila J Sugrue^{1

2

3}, Alicia T Dennis^{1

3

4}

Affiliations

¹ Melbourne, Australia.
² Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Australia.
³ The Department of Anaesthesia, The Royal Women's Hospital, Parkville, Australia.
⁴ School of Medicine, Faculty of Health, Deakin University, Department of Obstetrics and Gynaecology, and Department of Critical Care (previously Department of Medicine and Radiology), and Department of Pharmacology, The University of Melbourne, Parkville, Australia.

PMID: 38404878
PMCID: PMC10884447
DOI: 10.1016/j.heliyon.2024.e25863

Pregnancy reference intervals and exertion and breathlessness ratings for the six minute walk test in healthy nulliparous people

Alaina R Francis et al. Heliyon. 2024.

. 2024 Feb 10;10(4):e25863.

doi: 10.1016/j.heliyon.2024.e25863. eCollection 2024 Feb 29.

Authors

Alaina R Francis^{1

2

3}, Tahila J Sugrue^{1

2

3}, Alicia T Dennis^{1

3

4}

Affiliations

¹ Melbourne, Australia.
² Department of Obstetrics and Gynaecology, The University of Melbourne, Parkville, Australia.
³ The Department of Anaesthesia, The Royal Women's Hospital, Parkville, Australia.
⁴ School of Medicine, Faculty of Health, Deakin University, Department of Obstetrics and Gynaecology, and Department of Critical Care (previously Department of Medicine and Radiology), and Department of Pharmacology, The University of Melbourne, Parkville, Australia.

PMID: 38404878
PMCID: PMC10884447
DOI: 10.1016/j.heliyon.2024.e25863

Abstract

Background: The Six Minute Walk Test (6MWT) is a simple, non-invasive, well-validated test that assesses cardiorespiratory fitness however is rarely used in pregnant people. It may have clinical utilization to assess fitness, breathing and exertion in pregnancy however no reference intervals exist for people 14⁺⁰ to 35⁺⁶ weeks gestation. We determined the reference intervals for distance walked for the 6MWT, including exertional and breathlessness ratings for this group.

Method: We conducted a prospective observational cohort study of 196 healthy nulliparous pregnant people in earlier pregnancy (EP) 14⁺⁰ to 23⁺⁶ weeks, and middle pregnancy (MP) 24⁺⁰ to 35⁺⁶ gestation, who performed a standardized 6MWT protocol including rating exertion and breathlessness (Rating Perceived Exertion (RPE) scale (1 none -15 maximal) and Modified Borg Dyspnea (MBD) scale (0 none - 10 maximal)).

Results: The mean ± SD distance walked was 548 ± 80.9 (EP) versus 547 ± 87.3 (MP) meters (m) P = 0.928. 6MWT reference intervals for the distance walked for the 6MWT were 392-704 m (EP) and 376-718 m (MP). Median (IQR) exertion and breathlessness ratings with exercise for the EP and MP group were 6 (4,7) and 0.5 (0,1) and 6 (4,8) and 0.5 (0,1) respectively. There were no adverse events.

Conclusion: The 6MWT is safe, feasible and acceptable in pregnant people. The reference intervals for the 6MWT are 392-704 m in people 14⁺⁰ to 23⁺⁶ weeks gestation and 376-718 m for people 24⁺⁰ to 35⁺⁶ weeks gestation. Exertion was light and breathlessness was just noticeable with the 6MWT.

Keywords: Breathlessness; Cardiac disease; Exercise; Exertion; Obstetrics; Perioperative medicine; Physiology; Pregnancy; Reference interval; Six minute walk test.

PubMed Disclaimer

Figures

**Fig. 1**
Participant flow chart Created with BioRender.com.

**Fig. 2**
Heart rate, systolic and diastolic blood pressure changes from resting to 5 min after exercise for the two pregnancy groups.

See this image and copyright information in PMC

References

1. Centers for Disease Control and Prevention . 2022. Reproductive Health. Pregnancy Mortality Surveillance System (PMSS)https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mort...
1. Knight M., Bunch K., Patel R., Shakespeare J., Kotnis R., Kenyon S., Kurinczuk J.J., editors. Saving Lives, Improving Mothers' Care Core Report - Lessons Learned to Inform Maternity Care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2018-20. National Perinatal Epidemiology Unit, University of Oxford; Oxford: 2022. On behalf of MBRRACE-UK.
1. Dennis A.T., Castro J.M. Hypertension and haemodynamics in pregnant women - is a unified theory of pre-eclampsia possible? Anaesthesia. 2014;69:1183–1189. - PubMed
1. Dennis A.T., Castro J., Carr C., Simmons S., Permezel M., Royse C. Haemodynamics in women with untreated pre-eclampsia. Anaesthesia. 2012;67:1105–1118. - PubMed
1. Easterling T.R., Benedetti T.J., Schmucker B.C., Millard S.P. Maternal hemodynamics in normal and preeclamptic pregnancies: a longitudinal study. Obstet. Gynecol. 1990;76:1061–1069. - PubMed

LinkOut - more resources

Full Text Sources

[1] Centers for Disease Control and Prevention . 2022. Reproductive Health. Pregnancy Mortality Surveillance System (PMSS)https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mort...

[2] Centers for Disease Control and Prevention . 2022. Reproductive Health. Pregnancy Mortality Surveillance System (PMSS)https://www.cdc.gov/reproductivehealth/maternal-mortality/pregnancy-mort...

[3] Knight M., Bunch K., Patel R., Shakespeare J., Kotnis R., Kenyon S., Kurinczuk J.J., editors. Saving Lives, Improving Mothers' Care Core Report - Lessons Learned to Inform Maternity Care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2018-20. National Perinatal Epidemiology Unit, University of Oxford; Oxford: 2022. On behalf of MBRRACE-UK.

[4] Knight M., Bunch K., Patel R., Shakespeare J., Kotnis R., Kenyon S., Kurinczuk J.J., editors. Saving Lives, Improving Mothers' Care Core Report - Lessons Learned to Inform Maternity Care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2018-20. National Perinatal Epidemiology Unit, University of Oxford; Oxford: 2022. On behalf of MBRRACE-UK.

[5] Dennis A.T., Castro J.M. Hypertension and haemodynamics in pregnant women - is a unified theory of pre-eclampsia possible? Anaesthesia. 2014;69:1183–1189. - PubMed

[6] Dennis A.T., Castro J.M. Hypertension and haemodynamics in pregnant women - is a unified theory of pre-eclampsia possible? Anaesthesia. 2014;69:1183–1189. - PubMed

[7] Dennis A.T., Castro J., Carr C., Simmons S., Permezel M., Royse C. Haemodynamics in women with untreated pre-eclampsia. Anaesthesia. 2012;67:1105–1118. - PubMed

[8] Dennis A.T., Castro J., Carr C., Simmons S., Permezel M., Royse C. Haemodynamics in women with untreated pre-eclampsia. Anaesthesia. 2012;67:1105–1118. - PubMed

[9] Easterling T.R., Benedetti T.J., Schmucker B.C., Millard S.P. Maternal hemodynamics in normal and preeclamptic pregnancies: a longitudinal study. Obstet. Gynecol. 1990;76:1061–1069. - PubMed

[10] Easterling T.R., Benedetti T.J., Schmucker B.C., Millard S.P. Maternal hemodynamics in normal and preeclamptic pregnancies: a longitudinal study. Obstet. Gynecol. 1990;76:1061–1069. - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Pregnancy reference intervals and exertion and breathlessness ratings for the six minute walk test in healthy nulliparous people

Affiliations

Pregnancy reference intervals and exertion and breathlessness ratings for the six minute walk test in healthy nulliparous people

Authors

Affiliations

Abstract

Figures

Similar articles

References

LinkOut - more resources

Full Text Sources

Abstract

Figures

Similar articles

References

Related information

LinkOut - more resources

Full Text Sources