Abstract
Objective
: to examine the influence of an exercise program throughout pregnancy on the duration
of labor in healthy pregnant women.
Study design
: A randomized clinical trial was used (Identifier: NCT02109588). In all, 508 healthy
pregnant women were randomly assigned between 9 and 11 weeks of gestation to either
a Control Group (CG, N = 253) or an Exercise Group (EG, N = 255). A moderate aerobic
exercise program throughout pregnancy (three weekly sessions) was used as the intervention.
Mann-Whitney and Pearson χ2 tests were performed to analyze differences between groups. Survival techniques through
the Kaplan-Meier method were used to estimate the median time to delivery of each
group; and Gehan-Breslow-Wilcoxon tests were performed to compare survival distribution
between the two arms. The primary outcome studied was the length of the stages of
labor. Secondary outcomes included mode of delivery, gestational age, maternal weight
gain, preterm delivery, use of epidural, birthweight, Apgar scores and arterial cord
pH.
Results
: Women randomized to the EG had shorter first stage of labor (409 vs 462 min, p = 0.01), total duration of labor (450 vs 507 min, p = 0.01) as well as combined duration of first and second stages of labor (442 vs
499 min, p = 0.01). The probabilities of a woman being delivered at 250 min and 500 min (median
times) were 19.1% and 62.5% in the experimental group vs 13.7% and 50.8% in the control
group (Z = −2.37, p = 0.018). Results also revealed that women in the intervention group were less likely
to use an epidural; and that the prevalence of neonate macrosomia was higher in the
control group.
Conclusion
: A supervised physical exercise program throughout pregnancy decreased the duration
of the first phase of labor as well as total time of the first two phases together,
leading to a decrease in total labor time.
Keywords
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References
- Maternal and perinatal outcomes with increasing duration of the second stage of labor.Obstet Gynecol. 2009; 113: 1248-1258
- Pattern of cervical dilatation among parturients in Ilorin, Nigeria.Ann Afr Med. 2009; 8: 181-184
- Obstructed labour: a public health problem in Gombe, Gombe state, Nigeria.J Obstet Gynaecol. 2003; 23: 369-373
- Prolonged labour.in: Agboola A. Textbook of obstetrics and gynaecology for medical students. 2nd ed. Heinemann educational books Ibadan, 2006: 439-441
- The second stage of labor: factors influencing duration.Am J Obstet Gynecol. 1991; 165: 976-979
- Maternal body mass index and duration of labor.Eur J Obstet Gynecol Reprod Biol. 2013; 171: 49-53
- Maternal age and the duration of the second stage of labor.Ann N Y Acad Sci. 2006; 1092: 414-417
- Obstetrical parameters influencing the duration of the second stage of labor.Eur J Obstet Gynecol Reprod Biol. 2005; 118: 17-20
- The duration of the third stage of labor and related factors.Iran J Nurs Midwifery Res. 2012; 17: S76-9
- Pushing Early or Pushing Late with Epidural study group: Effect of fetal position on second-stage duration and labor outcome.Obstet Gynecol. 2005; 105: 763-772
- Length of the second stage of labor as a predictor of perineal outcome after vaginal delivery.J Reprod Med. 2006; 51: 115-119
- Vacuum assisted delivery in Ecuador for prolonged second stage of labor: maternal-neonatal outcome.J Matern Fetal Neonatal Med. 2007; 20: 381-384
- Randomized controlled trial of prolonged second stage: extending the time limit vs usual guidelines.Am J Obstet Gynecol. 2016; 214 (361.e1-6)
- Reduction of total labor length through the addition of parenteral dextrose solution in induction of labor in nulliparous: results of DEXTRONS prospective randomized controlled trial.Am J Obstet Gynecol. 2017; 216 (508.e1-508.e7)
- Exercise during pregnancy protects against hypertension and macrosomia.Randomized Clinical Trial. Am J Obstet Gynecol. 2016; 214 (649.e1-8)
- Resistance exercise in pregnancy and outcome.Clin Obstet Gynecol. 2016; 59: 591-599
- Exercise in pregnancy.Am J Obstet Gynecol. 2017; 216: 335-337
- Pregnancy and physical exercise: myths, evidence and recommendations.Acta Med Port. 2007; 20: 209-214
- Does regular exercise in pregnancy influence duration of labor? A secondary analysis of a randomized controlled trial.Acta Obstet Gynecol Scand. 2014; 93: 73-79
- Regular exercise throughout pregnancy is associated with a shorter first stage of labor.Am J Health Promot. 2016; 30: 149-154
- Committee opinion No. 650: physical activity and exercise during pregnancy and the postpartum period.Obstet Gynecol. 2015; 126: e135-e142
- Accuracy of Borg’s ratings of perceived exertion in the prediction of heart rates during pregnancy.Br J Sports Med. 1992; 26: 121-124
- Exercise throughout pregnancy does not cause preterm delivery. A randomized, controlled trial.J Phys Act Health. 2014; 11: 1012-1017
- Asistencia al parto normal en sus diferentes períodos. Influencia del parto sobre madre y feto. Dirección médica del parto.in: Cabero L. Tratadode Ginecología, Obstetricia y Medicina de la Reproducción. Panamericana, Madrid. Españaa2003: 439-445
- Weight gain during pregnancy: reexamining the guidelines.the National Academies Press, Washington DC2009: 324
- Sample size calculation in clinical trials.Dtsch Arztebl Int. 2010; 107: 552-556
- Poor uterine contractility in obese women.BJOG. 2007; 114: 343-348
- Does regular exercise in pregnancy influence duration of labor: a secondary analysis of a randomized controlled trial.Acta Obstet Gynecol Scand. 2014; 93: 73-79
- Effect of pelvic floor muscle training on labor and newborn outcomes: a randomized controlled trial.Rev Bras Fisioter. 2011; 15: 487-493
- Does antenatal pelvic floor muscle training affect the outcome of labour: a randomized controlled trial.Int Urogynecol J Pelvic Floor Dysfunct. 2008; 19: 85-88
- Association between aerobic fitness in late pregnancy and duration of labor in nulliparous women.Acta Obst Gynecol. 2009; 88: 948-952
Article info
Publication history
Published online: March 06, 2018
Accepted:
March 6,
2018
Received in revised form:
February 27,
2018
Received:
January 21,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
