We assessed the impact of a structured lower-limb aerobic exercise training intervention during pregnancy on brachial artery endothelial function, shear rate and patterns, and forearm blood flow and reactive hyperemia. Twenty-seven pregnant women were recruited and randomized into either a control group (n = 11; 31.0 +/- 0.7 years), or an exercise intervention group (n = 16; 32.6 +/- 0.9 years; NCT02948439). The exercise group completed 40 minutes of aerobic exercise (50 to 70% heart rate reserve) 3 to 4 times per week, between the second and third trimester of pregnancy. Endothelial function was assessed using flow-mediated dilation (FMD, normalized for shear stress) pre- (16 to 20 weeks) and post-intervention (34 to 36 weeks). The exercise training group experienced an attenuated increase in mean arterial pressure (MAP) relative to the control group (MAP exercise +2 +/- 2 mmHg versus control +7 +/- 3 mmHg; p = 0.044) from pre- to post-intervention. % FMD change corrected for shear stress was not different between groups (p = 0.460); however, the post occlusion mean flow rate (exercise 437 +/- 32 mL/min versus control 364 +/- 35 mL/min; p = 0.001) and post occlusion anterograde flow rate (exercise 438 +/- 32 mL/min versus control 364 +/- 46 mL/min; p = 0.001) were larger for the exercise training group compared to controls, post-intervention. Although endothelial function was not different between groups, we observed an increase in microcirculatory dilatory capacity, as suggested by the augmented reactive hyperemia in the exercise training group.

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