Impact of Sport Activity and Physical Exercise on Obstetrical and Perineal Outcomes at Delivery: A Prospective Study
25 June 2019 (online)
Objective This study was aimed to investigate the effects of physical activity on perineal outcomes at delivery according to the different levels and types of maternal physical activity before and during pregnancy.
Study Design We prospectively evaluated the obstetrical and perineal outcomes of all consecutive women who delivered at the Del Ponte Hospital, in the period between July 2014 and September 2014. Women were divided into three groups according to the features of physical activity performed before pregnancy: group 1: “very sporty women,” group 2: “moderately sporty women,” and group 3: “inactive women.” A subanalysis of our data was performed based on the specific type of sport activity, on the degree of involvement of perineal muscles during physical activity, and on the continuation/discontinuation of this activity during pregnancy.
Results A total of 135, 84, and 85 women were included in group 1, group 2, and group 3, respectively. The demographic characteristics were comparable among all the groups. Sport activity during pregnancy was more frequent in groups 1 and 2 (59.3 and 53.6%, respectively, vs. 29.4% in group 3; p = 0.003). No differences among groups were detected in terms of perineal outcomes. A lower rate of episiotomy/lacerations ≥ 2nd degree was found among women who practiced sports that specifically involved the perineal muscles and who continued this practice during pregnancy.
Conclusion Perineal outcomes are not influenced by the intensity of sport activity performed before/during pregnancy. Continuous sports during pregnancy that specifically train the perineal muscles are associated with a lower rate of episiotomy and perineal lacerations ≥ 2nd degree.
Sport activity and physical exercise do not appear to impair perineal outcomes at delivery.
- 1 ACOG Committee Opinion No. 650: Physical activity and exercise during pregnancy and the postpartum period. Obstet Gynecol 2015; 126 (06) e135-e142
- 2 American College of Sports Medicine. 2008 Physical Activity Guideline for Americans: ACSM's Guidelines for Exercise Testing and Prescription. 9th ed. Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilinkins; 2014
- 3 Barakat R, Perales M, Garatachea N, Ruiz JR, Lucia A. Exercise during pregnancy. A narrative review asking: what do we know?. Br J Sports Med 2015; 49 (21) 1377-1381
- 4 Evenson KR, Barakat R, Brown WJ. , et al. Guidelines for physical activity during pregnancy: comparisons from around the world. Am J Lifestyle Med 2014; 8 (02) 102-121
- 5 Sanabria-Martínez G, García-Hermoso A, Poyatos-León R, Álvarez-Bueno C, Sánchez-López M, Martínez-Vizcaíno V. Effectiveness of physical activity interventions on preventing gestational diabetes mellitus and excessive maternal weight gain: a meta-analysis. BJOG 2015; 122 (09) 1167-1174
- 6 Nascimento SL, Surita FG, Godoy AC, Kasawara KT, Morais SS. Physical activity patterns and factors related to exercise during pregnancy: a cross sectional study. PLoS One 2015; 10 (06) e0128953
- 7 Leet T, Flick L. Effect of exercise on birthweight. Clin Obstet Gynecol 2003; 46 (02) 423-431
- 8 Ornö AK, Marsál K, Herbst A. Ultrasonographic anatomy of perineal structures during pregnancy and immediately following obstetric injury. Ultrasound Obstet Gynecol 2008; 32 (04) 527-534
- 9 Sultan AH. Obstetric perineal injury and anal incontinence. Clin Risk 1999; 5 (04) 193-196
- 10 Cromi A, Bonzini M, Uccella S. , et al. Provider contribution to an episiotomy risk model. J Matern Fetal Neonatal Med 2015; 28 (18) 2201-2206
- 11 Bø K, Hilde G, Jensen JS, Siafarikas F, Engh ME. Too tight to give birth? Assessment of pelvic floor muscle function in 277 nulliparous pregnant women. Int Urogynecol J Pelvic Floor Dysfunct 2013; 24 (12) 2065-2070
- 12 Frohlich J, Kettle C. Perineal care. BMJ Clin Evid 2015; 2015: 1401
- 13 Serati M, Salvatore S, Khullar V. , et al. Prospective study to assess risk factors for pelvic floor dysfunction after delivery. Acta Obstet Gynecol Scand 2008; 87 (03) 313-318
- 14 Bisson M, Lavoie-Guénette J, Tremblay A, Marc I. Physical activity volumes during pregnancy: a systematic review and meta-analysis of observational studies assessing the association with infant's birth weight. AJP Rep 2016; 6 (02) e170-e197
- 15 Calvert S, Fleming V. Minimizing postpartum pain: a review of research pertaining to perineal care in childbearing women. J Adv Nurs 2000; 32 (02) 407-415
- 16 Olivieri I, Bova S M, Fazzi E. , et al; SOLE VLBWI Questionnaire Study Group. Patient-reported outcomes measure for children born preterm: validation of the SOLE VLBWI Questionnaire, a new quality of life self-assessment tool. Dev Med Child Neurol 2016; 58 (09) 957-964