The effect of regular maternal exercise on erythropoietin in cord blood and amniotic fluid

OBJECTIVE: Our purpose was to test the hypothesis that continuing regular, high-intensity exercise until the onset of labor produces significant fetal hypoxemia, as evidenced by elevated erythropoietin levels in the fetal compartment. STUDY DESIGN: Erythropoietin levels were measured in samples of amniotic fluid and cord blood obtained from fetuses born to 31 exercising women and 29 matched controls. RESULTS: Erythropoietin levels (mean ± SEM) in amniotic fluid obtained at the time of membrane rupture (9 ± 2 vs 11 ± 2 mU/ml) and in cord blood (38 ± 6 vs 53 ± 16 mU/ml) and amniotic fluid at delivery (9 ± 1 vs 24 ± 12 mU/ml) were no different in women who exercised regularly until the onset of labor. In both groups the majority of elevated cord blood levels (>50 mU/ml) could be explained by labor events. Amniotic fluid erythropoietin levels correlated directly ( r = 0.52) with cord blood hematocrit and increased slowly during labor. CONCLUSION: We conclude that the initial hypothesis is incorrect and speculate that cord blood erythropoietin reflects fetal oxygenation during labor, whereas amniotic fluid erythropoietin primarily reflects the adequacy of oxygenation before the onset of labor.