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CC BY 4.0 · Rev Bras Ginecol Obstet 2019; 41(02): 068-075
DOI: 10.1055/s-0038-1675613
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Exercise in Pregnancy: The Impact of an Intervention Program in the Duration of Labor and Mode of Delivery

Exercício na gravidez: impacto de um programa de intervenção na duração do trabalho de parto e via de parto
Cátia Liliana Martins Ferreira 
1   Gynecology and Obstetrics Service, Hospital Senhora da Oliveira, Guimarães, Portugal
,
Cláudia Maria Lopes Guerra
1   Gynecology and Obstetrics Service, Hospital Senhora da Oliveira, Guimarães, Portugal
,
Ana Isabel Teixeira Jesus Silva
2   Institute of Education, University of Minho, Minho, Portugal
3   Research Centre in Child Studies, University of Minho, Minho, Portugal
,
Helena Rafaela Vieira do Rosário
3   Research Centre in Child Studies, University of Minho, Minho, Portugal
4   School of Nursing, University of Minho, Minho, Portugal
,
Maria Beatriz Ferreira Leite de Oliveira Pereira
2   Institute of Education, University of Minho, Minho, Portugal
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Publikationsverlauf

12. Juli 2018

18. September 2018

Publikationsdatum:
14. November 2018 (online)

   Lizenzen und Reprints

Abstract

Objective To access the benefits or harms of an exercise program, based on the current American College of Obstetricians and Gynecologists guidelines, on the mode of delivery, duration and onset of labor.

Methods A study performed at the Hospital Senhora da Oliveira between October 2015 and February 2017. This was a quasi-experimental study involving 255 women divided into two groups: an intervention group engaged in a controlled and supervised exercise program during pregnancy (n = 99), and a control group that did not participate in the exercise program (n = 156). Data were collected in two stages: during the 1st trimester biochemical screening (before the beginning of the program), through a written questionnaire, and after delivery, from the medical files of the patients. The significance level in the present study was 5% (p = 0.05).

Results The control group had higher odds of induced labor (odds ratio [OR] 2.71; 95% confidence interval [CI]: 1.42–5.17; p = 0.003), when compared with women who underwent the intervention. No differences were found between the groups in instrumental vaginal deliveries, cesarean rate, time until the beginning of the active phase, duration of the active phase, and duration of the second stage of labor.

Conclusion The implementation of a controlled and supervised exercise program in pregnancy was associated with significantly lower odds of induced deliveries.

Resumo

Objetivo Avaliar o efeito de um programa de exercícios na gravidez (baseado nas recomendações do American College of Obstetricians and Gynecologists) na via, duração e início do trabalho de parto.

Métodos Estudo realizado no Hospital Senhora da Oliveira entre outubro de 2015 e fevereiro de 2017. Trata-se de um estudo quasi-experimental com 255 grávidas, divididas em dois grupos: grupo de intervenção, constituído por mulheres que participaram de um programa controlado e supervisionado de exercícios físicos (n = 99), e um grupo de controle, formado por grávidas que não participaram do programa de exercícios (n = 156). Os dados foram colhidos em dois momentos: durante o rastreio bioquímico do primeiro trimestre (antes do início do programa), através de um questionário escrito, e após o parto, através da consulta do processo clínico da paciente. O nível de significância estatística adotado neste projeto foi de 5% (p = 0,05).

Resultados O grupo controle apresentou maior probabilidade de indução do trabalho de parto (razão de chances [RC] 2,71; intervalo de confiança [IC] 95%: 1,42–5,17; p = 0,003) quando comparado com o grupo de intervenção. Não foram encontradas diferenças estatisticamente significativas entre os dois grupos em relação à via de parto, tempo até início da fase ativa, duração da fase ativa e duração do segundo estadio do trabalho de parto.

Conclusão A implementação de um programa de exercícios controlado e supervisionado na gravidez foi associada a uma probabilidade significativamente menor de indução do trabalho de parto.

Keywords

exercise - pregnancy - mode of delivery - duration of labor - labor induction

Palavras-chave

exercício - gravidez - via de parto - duração do trabalho de parto - indução do trabalho de parto
 

  • References

  • 1 ACOG Committee Opinion No. 650: Physical activity and exercise during pregnancy and the postpartum period. Obstet Gynecol 2015; 126 (06) e135-e142 Doi: 10.1097/AOG.0000000000001214
    CrossrefPubMedSuche in Google Scholar
  • 2 Perales M, Santos-Lozano A, Ruiz JR, Lucia A, Barakat R. Benefits of aerobic or resistance training during pregnancy on maternal health and perinatal outcomes: A systematic review. Early Hum Dev 2016; 94: 43-48 Doi: 10.1016/j.earlhumdev.2016.01.004
    CrossrefPubMedSuche in Google Scholar
  • 3 Tinloy J, Chuang CH, Zhu J, Pauli J, Kraschnewski JL, Kjerulff KH. Exercise during pregnancy and risk of late preterm birth, cesarean delivery, and hospitalizations. Womens Health Issues 2014; 24 (01) e99-e104 Doi: 10.1016/j.whi.2013.11.003
    CrossrefPubMedSuche in Google Scholar
  • 4 Szumilewicz A, Wojtyła A, Zarębska A, Drobnik-Kozakiewicz I, Sawczyn M, Kwitniewska A. Influence of prenatal physical activity on the course of labour and delivery according to the new Polish standard for perinatal care. Ann Agric Environ Med 2013; 20 (02) 380-389
    PubMedSuche in Google Scholar
  • 5 Sanda B, Vistad I, Sagedal LR, Haakstad LAH, Lohne-Seiler H, Torstveit MK. What is the effect of physical activity on duration and mode of delivery? Secondary analysis from the Norwegian Fit for Delivery trial. Acta Obstet Gynecol Scand 2018; 97 (07) 861-871 Doi: 10.1111/aogs.13351
    CrossrefPubMedSuche in Google Scholar
  • 6 Barakat R, Pelaez M, Lopez C, Montejo R, Coteron J. Exercise during pregnancy reduces the rate of cesarean and instrumental deliveries: results of a randomized controlled trial. J Matern Fetal Neonatal Med 2012; 25 (11) 2372-2376 Doi: 10.3109/14767058.2012.696165
    CrossrefPubMedSuche in Google Scholar
  • 7 Rogozińska E, Marlin N, Jackson L. , et al. Effects of antenatal diet and physical activity on maternal and fetal outcomes: individual patient data meta-analysis and health economic evaluation. Health Technol Assess 2017; 21 (41) 1-158 Doi: 10.3310/hta21410
    CrossrefPubMedSuche in Google Scholar
  • 8 Shepherd E, Gomersall JC, Tieu J, Han S, Crowther CA, Middleton P. Combined diet and exercise interventions for preventing gestational diabetes mellitus. Cochrane Database Syst Rev 2017; 11: CD010443 Doi: 10.1002/14651858.CD010443.pub3
    PubMedSuche in Google Scholar
  • 9 Portela SN, Rocha-de-Souza R, Oppermann-Lisboa K, Donatto GB, Dal Bosco SN, El Beitune P. Maternal physical activity, cervical length and its relation to spontaneous vaginal birth at term. Arch Gynecol Obstet 2014; 290 (02) 257-262 Doi: 10.1007/s00404-014-3198-4
    CrossrefPubMedSuche in Google Scholar
  • 10 Price BB, Amini SB, Kappeler K. Exercise in pregnancy: effect on fitness and obstetric outcomes-a randomized trial. Med Sci Sports Exerc 2012; 44 (12) 2263-2269 Doi: 10.1249/MSS.0b013e318267ad67
    CrossrefPubMedSuche in Google Scholar
  • 11 Nielsen EN, Andersen PK, Hegaard HK, Juhl M. Mode of delivery according to leisure time physical activity before and during pregnancy: a multicenter cohort study of low-risk women. J Pregnancy 2017; 2017 (17) 6209605
    PubMedSuche in Google Scholar
  • 12 International Weight Management in Pregnancy (i-WIP) Collaborative Group. Effect of diet and physical activity based interventions in pregnancy on gestational weight gain and pregnancy outcomes: meta-analysis of individual participant data from randomised trials. BMJ 2017; 358: j3119 Doi: 10.1136/bmj.j3991
    PubMedSuche in Google Scholar
  • 13 Poyatos-León R, García-Hermoso A, Sanabria-Martínez G, Álvarez-Bueno C, Sánchez-López M, Martínez-Vizcaíno V. Effects of exercise during pregnancy on mode of delivery: a meta-analysis. Acta Obstet Gynecol Scand 2015; 94 (10) 1039-1047 Doi: 10.1111/aogs.12675
    CrossrefPubMedSuche in Google Scholar
  • 14 Domenjoz I, Kayser B, Boulvain M. Effect of physical activity during pregnancy on mode of delivery. Am J Obstet Gynecol 2014; 211 (04) 401.e1-401.e11 Doi: 10.1016/j.ajog.2014.03.030
    CrossrefPubMedSuche in Google Scholar
  • 15 Silveira LC, Segre CA. Physical exercise during pregnancy and its influence in the type of birth. Einstein (Sao Paulo) 2012; 10 (04) 409-414 Doi: 10.1590/S1679-45082012000400003
    CrossrefPubMedSuche in Google Scholar
  • 16 May LE. Effects of maternal exercise on labor and delivery. In: May LE. Physiology of Prenatal Exercise and Fetal Development. New York, NY: Springer; 2012: 11-14
    CrossrefSuche in Google Scholar
  • 17 Morris SN, Johnson NR. Exercise during pregnancy: a critical appraisal of the literature. J Reprod Med 2005; 50 (03) 181-188
    PubMedSuche in Google Scholar
  • 18 Muktabhant B, Lawrie TA, Lumbiganon P, Laopaiboon M. Diet or exercise, or both, for preventing excessive weight gain in pregnancy. Cochrane Database Syst Rev 2015; (06) CD007145 Doi: 10.1002/14651858.CD007145.pub3
    PubMedSuche in Google Scholar
  • 19 Lewis B, Avery M, Jennings E, Sherwood N, Martinson B, Crain AL. The effect of exercise during pregnancy on maternal outcomes: practical implications for practice. Am J Lifestyle Med 2008; 2: 441-455 Doi: 10.1177/1559827608320134
    CrossrefPubMedSuche in Google Scholar
  • 20 Perales M, Calabria I, Lopez C, Franco E, Coteron J, Barakat R. Regular exercise throughout pregnancy is associated with a shorter first stage of labor. Am J Health Promot 2016; 30 (03) 149-154 Doi: 10.4278/ajhp.140221-QUAN-79
    CrossrefPubMedSuche in Google Scholar
  • 21 Thangaratinam S, Rogozinska E, Jolly K. , et al. Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ 2012; 344: e2088 Doi: 10.1136/bmj.e2088
    CrossrefPubMedSuche in Google Scholar
  • 22 Cavalcante SR, Cecatti JG, Pereira RI, Baciuk EP, Bernardo AL, Silveira C. Water aerobics II: maternal body composition and perinatal outcomes after a program for low risk pregnant women. Reprod Health 2009; 6: 1 Doi: 10.1186/1742-4755-6-1
    CrossrefPubMedSuche in Google Scholar
  • 23 Barakat R, Ruiz JR, Stirling JR, Zakynthinaki M, Lucia A. Type of delivery is not affected by light resistance and toning exercise training during pregnancy: a randomized controlled trial. Am J Obstet Gynecol 2009; 201 (06) 590.e1-590.e6 Doi: 10.1016/j.ajog.2009.06.004
    CrossrefPubMedSuche in Google Scholar
  • 24 Bovbjerg ML, Siega-Riz AM. Exercise during pregnancy and cesarean delivery: North Carolina PRAMS, 2004-2005. Birth 2009; 36 (03) 200-207 Doi: 10.1111/j.1523-536X.2009.00324.x
    CrossrefPubMedSuche in Google Scholar
  • 25 Krause Neto W, Gama EF. Physical exercise, type of delivery and related outcomes: systematic review and meta-analysis of randomized and non-randomized trials. Aust J Basic Appl Sci 2015; 9: 111-116
    PubMedSuche in Google Scholar
  • 26 Kardel KR, Johansen B, Voldner N, Iversen PO, Henriksen T. Association between aerobic fitness in late pregnancy and duration of labor in nulliparous women. Acta Obstet Gynecol Scand 2009; 88 (08) 948-952 Doi: 10.1080/00016340903093583
    CrossrefPubMedSuche in Google Scholar
  • 27 Ghodsi Z, Asltoghiri M, Hajiloomohajerani M. Exercise and pregnancy: duration of labor stages and perinea tear rates. Procedia Soc Behav Sci 2012; 31: 441-445 Doi: 10.1016/j.sbspro.2011.12.082
    CrossrefPubMedSuche in Google Scholar
  • 28 Chasan-Taber L, Schmidt MD, Roberts DE, Hosmer D, Markenson G, Freedson PS. Development and validation of a Pregnancy Physical Activity Questionnaire. Med Sci Sports Exerc 2004; 36 (10) 1750-1760 Doi: 10.1249/01.MSS.0000142303.49306.0D
    CrossrefPubMedSuche in Google Scholar
  • 29 Zhang J, Landy HJ, Branch DW. , et al; Consortium on Safe Labor. Contemporary patterns of spontaneous labor with normal neonatal outcomes. Obstet Gynecol 2010; 116 (06) 1281-1287 Doi: 10.1097/AOG.0b013e3181fdef6e
    CrossrefPubMedSuche in Google Scholar
  • 30 Santos PC, Abreu S, Moreira C. , et al. Physical activity patterns during pregnancy in a sample of portuguese women: a longitudinal prospective study. Iran Red Crescent Med J 2016; 18 (03) e22455 Doi: 10.5812/ircmj.22455
    CrossrefPubMedSuche in Google Scholar
  • 31 Salvesen KA, Stafne SN, Eggebø TM, Mørkved S. Does regular exercise in pregnancy influence duration of labor? A secondary analysis of a randomized controlled trial. Acta Obstet Gynecol Scand 2014; 93 (01) 73-79 Doi: 10.1111/aogs.12260
    CrossrefPubMedSuche in Google Scholar
  • 32 Haakstad LA, Bø K. Exercise in pregnant women and birth weight: a randomized controlled trial. BMC Pregnancy Childbirth 2011; 11: 66 Doi: 10.1186/1471-2393-11-66
    CrossrefPubMedSuche in Google Scholar
  • 33 Barakat R, Stirling JR, Lucia A. Does exercise training during pregnancy affect gestational age? A randomised controlled trial. Br J Sports Med 2008; 42 (08) 674-678 Doi: 10.1136/bjsm.2008.047837
    CrossrefPubMedSuche in Google Scholar
  • 34 Sanabria-Martínez G, García-Hermoso A, Poyatos-León R, González-García A, Sánchez-López M, Martínez-Vizcaíno V. Effects of exercise-based interventions on neonatal outcomes: a meta-analysis of randomized controlled trials. Am J Health Promot 2016; 30 (04) 214-223 Doi: 10.1177/0890117116639569
    CrossrefPubMedSuche in Google Scholar
  • 35 Owe KM, Nystad W, Skjaerven R, Stigum H, Bø K. Exercise during pregnancy and the gestational age distribution: a cohort study. Med Sci Sports Exerc 2012; 44 (06) 1067-1074 Doi: 10.1249/MSS.0b013e3182442fc9
    CrossrefPubMedSuche in Google Scholar