Evaluation of Pulmonary Function and Body Composition in Pregnant Women

Authors

  • Andrea Carla Brandao da Costa Santos Instituto de Medicina Integral Professor Fernando Figueira (IMIP)
  • Alex Sandro Rolland Souza Instituto de Medicina Integral Professor Fernando Figueira (IMIP)
  • Jousilene de Sales Tavares Instituto Paraibano de Pesquisa Professor Joaquim Amorim Neto (IPESQ), Campina Grande, PB, Brazil
  • Melania Maria Ramos Amorim Instituto de Medicina Integral Professor Fernando Figueira (IMIP)

DOI:

https://doi.org/10.3823/2114

Keywords:

Pregnant, Pulmonary function test, Body Composition

Abstract

Objectives: To compare the pulmonary function and the body composition between trimesters of pregnancy and, to determine the variables correlated to the peak expiratory flow (PEF) and the expiratory flow between 25% and 75% of vital capacity (FEF25%75%). Methods: A cross-sectional study examined 120 healthy low-risk pregnant women in the three trimesters of pregnancy, measured by spirometry and multisegmental electrical impedance. Women between the fifth and 40th gestational week, ages between 18-35 years, singletons, and sedentary were included. Smokers, individuals with cardio-respiratory diseases, neurological and chest deformities were excluded. For data analysis, descriptive statistic was used to characterize the sample and analysis of variance for comparing the groups with post hoc Tukey test. The correlation between the independent variables and the flow was performed by Pearson correlation coefficient. Multiple linear regression was used to estimate the degree of relationship between the dependent and independent variables. Results: The vital capacity, the expiratory volume in one second, the peak expiratory flow and expiratory flow between 25% and 75% of vital capacity decreased with the progression of pregnancy, but no significant statistically difference was found. An increase of the current weight (p <0.02) and BMI (p <0.003), total body water (p < 0.04), extracellular water (p<0.03), fat mass (p<0,04) and fat-free mass (p<0,04) was observed during the gestational trimesters. There were correlations between PEF and FEF25%75% with some variables, such as maternal age, height, pre-pregnancy weight, total body weight and extracellular water, lean mass and fat-free mass.  The multiple linear regression analysis showed that height and maternal age were associated with PEF, being responsible for explaining 14.7% of its variability. The pre- pregnancy weight explained 6.5% of the variability of the FEF25%75%. The multiple linear regression analysis showed that height and maternal age were associated with PEF, explaining 14.7% of its variability. Conclusion: This study showed that the volumes and lung capacity in healthy pregnant women do not seem to change with the progress of pregnancy. The pre-pregnancy weight was related to the FEF25%75%. Height and maternal age had greater influence on PEF changes, while the body composition and obstetric variables did not influence it.

Author Biographies

Andrea Carla Brandao da Costa Santos, Instituto de Medicina Integral Professor Fernando Figueira (IMIP)

Post-Graduate Program in Maternal-Infant Health

Alex Sandro Rolland Souza, Instituto de Medicina Integral Professor Fernando Figueira (IMIP)

Post-Graduate Program in Maternal-Infant Health

Melania Maria Ramos Amorim, Instituto de Medicina Integral Professor Fernando Figueira (IMIP)

Post-Graduate Program in Maternal-Infant Health

References

Tan EK, Tan EL. Alterations in physiology and anatomy during pregnancy. Best Pract Res Clin Obstet Gynaecol. 2013;27(6):791-802.

LoMauro A, Aliverti A. Respiratory physiology of pregnancy. Breathe. 2015;11(4):297-301.

Wise RA, Polito AJ, Krishnan V. Respiratory physiologic changes in pregnancy. Immunol Allergy Clin North Am. 2006;26(1):1-12.

ACOG. Pulmonary disease in pregnancy. Int J Gynecol Obstet. 1996;54:187-96.

Pereira A, Krieger BP. Pulmonary complications of pregnancy. Clin Chest Med. 2004;25(2):299-310.

Campbell DC. Physiological changes of pregnancy. Perioper Med Pain. 2000;19(3):149-56.

Puranik BM, Kaore SB, Kurhade GA, Agrawal SD, Patwardhan SA, Kher JR. A longitudinal study of pulmonary function tests during pregnancy. Indian J Physiol Pharmacol. 1994;38(2):129-32.

Phatak MS, Kurhade GA. A longitudinal study of antenatal changes in lung function tests and importance of postpartum exercises in their recovery. Indian J Physiol Pharmacol. 2003;47(3):352-6.

Fadia A, Dhadse M. A comparative study of static pulmonary function tests in Indian pregnant and non-pregnant women. International Journal of Research in Medical Sciences. 2016;4(2):545-8.

Kolarzyk E, Szot WM, Lyszczarz J. Lung function and breathing regulation parameters during pregnancy. Arch Gynecol Obstet. 2005;272(1):53-8.

Brancazio LR, Laifer SA, Schwartz T. Peak expiratory flow rate in normal pregnancy. Obstet Gynecol. 1997;89(3):383-6.

Neppelenbroek GA, Mauad-Filho F, Cunha SP, Duarte G, Costa AG, Spara P, et al. Investigação do fluxo expiratório máximo em gestantes saudáveis. Rev Bras Ginecol. 2005;27(16):37-43.

Puranik BM, Kurhade GA, Kaore SB, Patwardhan SA, Kher R. PEFR in pregnancy: a longitudinal study. Indian J Physiol Pharmacol. 1995;39(2):135-9.

Singh S, Singh KC, Sircar SS, Sharma KN. Airway functions in pregnant indian women. Indian J Physiol Pharmacol. 1995;39(2):160-2.

Maiolo C, Mohamed EI, Carbonelli MG. Body composition and respiratory function. Acta Diabetol. 2003;40:32-8.

Engstrom JL, Sittler CP. Fundal height measurement. Part 1-Techniques for measuring fundal height. J Nurse Midwifery. 1993;38(1):5-16.

Renstrøm SBH, Andersen CS, Pedersen CHB, Madsen FF. Correct measurement of height is important when assessing lung function values. Dan Med J. 2012;59(2):1-5

Thomson JL, Tussing-Humphreys LM, Goodman MH, Olender S. Baseline demographic, anthropometric, psychosocial, and behavioral characteristics of rural, southern women in early pregnancy. Matern Child Health J. 2016;4:1-9

User's manual. InBody 720. Available in: <https://sportedu.um.ac.ir/images/177/stories/pictures/azmayeshgah/manual/1inbody.pdf >.

Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Gómez, JM, et al. Bioelectrical impedance analysis- Part II: Utilization in clinical practice. Clin Nutr. 2004;23(6):1430-53.

Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319-38.

Pereira CA de C. Espirometria. J Pneumol. 2002;28(10):1-82.

Gee JB, Packer BS, Millen JE, Robin ED. Pulmonary mechanics during pregnancy. J Clin Invest. 1967;46(6):945-52.

Liberatore SM, Pistelli R; Patalano F, Moneta E, Incalzi RA, Ciappi G. Respiratory function during pregnancy. Respiration. 1984;46:145-50.

Monga U, Kumari K. Pulmonary functions in punjabi pregnant women. Indian J Physiol Pharmacol. 2000;44(1):115-6.

Teli A, Bagali S, Aithala M. A study of FVC, PEFR and MEP in different trimesters of pregnancy. Int J Biomed Adv Res. 2012;3(8):648-52.

Widen EM, Gallagher D. Body composition changes in pregnancy: measurement, predictors and outcomes. Eur J Clin Nutr. 2014;68:643-52.

Castro LC, Avina RL. Maternal obesity and pregnancy outcomes. Curr Opin Obstet Gynecol. 2002;14(6):601-6.

Morais AAC, Tavares GM, Pezzin AC, Moana AA, Galvão HP, Faintuch J. Avaliação da composição corporal em gestantes de termo. Rev Assoc Med Bras. 1997;43(2):109-13.

Larciprete G, Valensise H, Vasapollo B, Altomare F, Sorge R, Casalino B, et al. Body composition during normal pregnancy: reference ranges. Acta Diabetol. 2003;40:225-32.

Valensise H, Andreoli A, Lello S, Magnani F, Romanini C, De Lorenzo A. Multifrequency bioelectrical impedance analysis in women with a normal and hypertensive pregnancy. Am J Clin Nutr. 2000;72:780-3

Unterborn J. Pulmonary function testing in obesity, pregnancy, and extremes of body habitus. Clin Chest Med. 2001;22(4):759-67.

Hasnain AD, Ahmad F, Erum A, Ali AMA, Mansoor AMR, Syed MAA, et al. Variation of peak expiratory flow rate with body mass index in medical students of Karachi, Pakistan. International Archives of Medicine. 2015;8(121):1-5.

Downloads

Published

2016-09-20

Issue

Section

Obstetrics & Gynecology