Rodríguez-Blanque Raquel, Sanchez-Garcia Juan Carlos, Sanchez-Lopez Antonio Manuel, Expósito-Ruiz Manuela, Aguilar-Cordero Maria Jose
J Obstet Gynecol Neonatal Nurs. 2019 May;48(3):321-331. doi: 10.1016/j.jogn.2019.02.003. Epub 2019 Apr 4.
To determine the effect of an aquatic physical exercise program performed during pregnancy on rate of intact perineum after childbirth.
Randomized clinical trial.
Health centers in the metropolitan health district of Granada, Spain.
A total of 129 pregnant women (control group [CG] = 64; aquatic exercise group [EG] = 65).
The intervention was an aquatic physical exercise program specifically designed for pregnant women (Study of Water Exercise During Pregnancy [SWEP] method). Participants were randomly assigned to the CG or EG by simple random sampling. Participants in the EG performed three sessions per week of physical exercises, which were led by the principal investigator. All participants received routine prenatal care. We evaluated status of the perineum after birth, including laceration and episiotomy rates. We also evaluated participants' weight, body mass index (BMI) in the first and third trimesters, parity, the administration of anesthesia, and birth weight of the neonate as potential confounding variables.
The women in the EG had a greater rate of intact perineum than those in the CG (odds ratio [OR] = 13.54, 95% confidence interval [CI] [2.75, 66.56]). After adjusting for infant birth weight, the effect of the intervention on intact perineum was an OR of 8.57 (95% CI [1.85, 39.68]. Maternal weight gain did not influence the odds of intact perineum (OR = 1.072, 95% CI [0.896, 1.283]). Women who previously gave birth and followed the SWEP method had an OR of 10.197 (95% CI [2.190, 47.476] for an intact perineum. The administration of anesthesia and previous pregnancy also were associated with intact perineum (OR = 6.68, 95% CI [1.21, 36.84] and OR = 5.42, 95% CI [1.64, 17.89] respectively.
The women who followed the SWEP method were significantly more likely to have intact perinea after childbirth.
确定孕期进行的水上体育锻炼计划对产后会阴完整率的影响。
随机临床试验。
西班牙格拉纳达大都市健康区的健康中心。
共129名孕妇（对照组[CG]=64名；水上运动组[EG]=65名）。
干预措施是专门为孕妇设计的水上体育锻炼计划（孕期水上运动研究[SWEP]方法）。通过简单随机抽样将参与者随机分配到CG组或EG组。EG组的参与者每周进行三次体育锻炼，由主要研究者指导。所有参与者均接受常规产前护理。我们评估了产后会阴状况，包括裂伤和会阴切开率。我们还评估了参与者的体重、孕早期和孕晚期的体重指数（BMI）、产次、麻醉管理以及新生儿出生体重等潜在混杂变量。
EG组女性的会阴完整率高于CG组（优势比[OR]=13.54，95%置信区间[CI][2.75，66.56]）。在调整婴儿出生体重后，干预对会阴完整的影响的OR为8.57（95%CI[1.85，39.68]）。孕妇体重增加并未影响会阴完整的几率（OR=1.072，95%CI[0.896，1.283]）。既往分娩且采用SWEP方法的女性会阴完整的OR为10.197（95%CI[2.190，47.476]）。麻醉管理和既往妊娠也与会阴完整相关（分别为OR=6.68，95%CI[1.21，36.84]和OR=5.42，95%CI[1.64，17.89]）。
采用SWEP方法的女性产后会阴完整的可能性显著更高。
