# Online supervised high-intensity interval training during pregnancy: effects on maternal mental health and cardiorespiratory fitness in a randomized controlled trial

PMID: 36550564
Journal: BMC Sports Science, Medicine and Rehabilitation
Published: 2022 Dec 22
Authors: Wilczyńska D, Walczak-Kozłowska T, Radzimiński Ł, Oviedo-Caro MÁ, Santos-Rocha R, Szumilewicz A

## Question

Can online supervised HIIT during pregnancy improve or maintain maternal mental health and cardiorespiratory fitness compared with online education alone?

## Summary

In pregnant women with uncomplicated singleton pregnancies, 8 weeks of online supervised bodyweight HIIT maintained VO2max while an education-only group declined. Mental-health measures improved modestly across groups, with mixed patterns by outcome. This is useful pregnancy-specific evidence, but it should not be generalized to unscreened pregnancy or non-pregnant users.

## Population

- Caucasian pregnant women with uncomplicated singleton pregnancies.
- Sample size: 54
- Age: 32 +/- 4 years
- Sex: Female
- Fitness level: Pregnant adults cleared for adapted physical activity
- Health status: Uncomplicated singleton pregnancy at about 22 +/- 4 weeks gestation

## Methodology

- Randomized controlled trial
- 8 weeks
- Online MS Teams sessions in Poland during 2021
- Randomized and controlled study design.

## Protocol

- Online prenatal HIIT.
- Modality: Bodyweight mixed aerobic, resistance, postural, neuromotor, pelvic-floor, and relaxation exercises.
- Work intervals: 30-60 seconds.
- Recovery: 30-60 seconds.
- Sets or repetitions: Interval block individualized within a 15-20 minute main set.
- Intensity: Intervals above individually measured anaerobic threshold as comfortable; HR/AT averaged 87% +/- 5% HRmax.
- Session duration: 60 minutes.
- Frequency: 3 sessions per week.
- Program length: 8 weeks; 23 prescribed sessions.
- Progression: Work-rest ratios adjusted from 1:2 to 1:1 or 2:1 according to capability, progression, and pregnancy stage.
- Online education.
- Modality: Weekly real-time online education plus self-directed physical activity encouragement.
- Work intervals: Not applicable.
- Recovery: Not applicable.
- Sets or repetitions: Weekly education sessions.
- Intensity: Encouraged at least 150 minutes per week of moderate-vigorous activity using RPE and Talk Test.
- Session duration: Weekly education session duration not fully specified.
- Frequency: Weekly education plus self-directed activity.
- Program length: 8 weeks.
- Progression: Self-directed activity guided by diaries and RPE/Talk Test.

## Outcomes

### VO2max
Status: mixed
HIIT maintained VO2max while the education group declined.

Time effect F=20.387, p<0.001, eta2=0.290; group x time F=16.928, p<0.001, eta2=0.253; final HIIT 25.21 +/- 5.11 vs EDU 19.72 +/- 4.14, p<0.001.

### COVID fear
Status: improved
Fear of COVID decreased in both groups.

HIIT Z=-3.328, p<0.001; EDU Z=-2.661, p=0.008.

### Mental health
Status: mixed
Mental-health measures showed modest and outcome-specific improvements rather than a uniform HIIT advantage.

The article reports positive trends in both groups, with statistically significant mental-health improvement mainly in HIIT and stronger response for some fear/anxiety outcomes in EDU.

### Physical activity
Status: no clear change
Self-reported physical activity did not significantly change within or between groups.

IPAQ analyses showed no significant within- or between-group changes.

## Practical Insights

- Remote supervised prenatal HIIT can be delivered with bodyweight exercises, HR watches, RPE, and Talk Test when participants are obstetrically cleared.
- Pregnancy-specific screening and professional supervision are central to the protocol.
- Fitness maintenance during pregnancy is a more defensible claim than broad mental-health superiority.

## Limitations

- Pregnancy-specific sample limits generalization.
- Self-reported physical activity may be biased.
- Missed second assessments reduced available outcome data.
- COVID fear scale was not validated specifically for pregnant women.
- Education and social contact may have contributed to mental-health changes.

## Safety And Adherence

- All participants remained under obstetric care.
- The interventions were not associated with negative effects on pregnancy course or childbirth parameters.
- The protocol required pregnancy-specific clearance and specialist supervision.

## Original Sources

- [PubMed](https://pubmed.ncbi.nlm.nih.gov/36550564/) (pubmed)
- [DOI](https://doi.org/10.1186/s13102-022-00610-2) (doi)
- [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9773485/) (full text)

## Agent Guidance

Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.