Research
Obstetrics
Effect of physical activity during pregnancy on mode of delivery

https://doi.org/10.1016/j.ajog.2014.03.030Get rights and content

Objective

The purpose of this study was to evaluate the effect of structured physical exercise programs during pregnancy on the course of labor and delivery.

Study Design

We conducted a systematic review and metaanalysis using the following data sources: Medline and The Cochrane Library. In our study, we used randomized controlled trials (RCT) that evaluated the effects of exercise programs during pregnancy on labor and delivery. The results are summarized as relative risks.

Results

In the 16 RCTs that were included there were 3359 women. Women in exercise groups had a significantly lower risk of cesarean delivery (relative risk, 0.85; 95% confidence interval [CI], 0.73–0.99). Birthweight was not significantly reduced in exercise groups. The risk of instrumental delivery was similar among groups (relative risk, 1.00; 95% CI, 0.82–1.22). Data on Apgar score, episiotomy, epidural anesthesia, perineal tear, length of labor, and induction of labor were insufficient to draw conclusions. With the use of data from 11 studies (1668 women), our analysis showed that women in the exercise groups gained significantly less weight than women in control groups (mean difference, –1.13 kg; 95% CI, –1.49 to –0.78).

Conclusion

Structured physical exercise during pregnancy reduces the risk of cesarean delivery. This is an important finding to convince women to be active during their pregnancy and should lead the physician to recommend physical exercise to pregnant women, when this is not contraindicated.

Section snippets

Materials and Methods

This review was conducted in accordance with the “preferred reporting items for systematic reviews and metaanalyses” statement.9, 10

Study selection

We screened the abstracts of the 376 identified articles and excluded 203 clearly irrelevant references and 92 observational studies (Figure 1).

The full text of the 81 potentially relevant articles were obtained and assessed with the use of the eligibility criteria. Twenty-six articles were excluded because they reported none of the outcomes, even after attempted contact with the authors; 33 articles reported interventions that did not correspond to the inclusion criteria. A total of 19 reports

Comment

Our metaanalysis shows that structured aerobic or resistance exercise programs during pregnancy decrease the risk of cesarean delivery by 15% and reduce maternal weight gain by 1 kg on average. This finding represents a further argument to promote physical activity and exercise programs for pregnant women.

Most of the included studies were of small sample size, and cesarean delivery was not the primary outcome. Therefore, the power of each individual study to demonstrate a reduction in the

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  • Cited by (0)

    The authors report no conflict of interest.

    Cite this article as: Domenjoz I, Kayser B, Boulvain M. Effect of physical activity during pregnancy on mode of delivery. Am J Obstet Gynecol 2014;211:401.e1-11.

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