Associate Professor, Exercise Scientist, Norwegian School of Sports Sciences, Department of Sports Medicine, PO Box 4014, Ullevål Stadion, Oslo, Norway.
Professor, Exercise Scientist, Physical Therapist, Norwegian School of Sports Sciences, Department of Sports Medicine, Norway.
Eur J Obstet Gynecol Reprod Biol. 2020 Aug;251:8-13. doi: 10.1016/j.ejogrb.2020.05.014. Epub 2020 May 12.
Today all pregnant women are recommended to participate in moderate intensity aerobic and resistance-based physical activity/exercise ≥150 min/week. However, there are still controversies and scant knowledge on the role of regular exercise on delivery outcomes, including mode of delivery and length of active labour. In addition, nutritional counselling have often been examined together with exercise, which may independently effect the outcomes. Hence, the aims of the present study were to investigate the sole effect of supervised group exercise, including pelvic floor muscle training on course of labour and mode of delivery.
A single blind, randomized controlled trial, performed in the municipality of Oslo, Norway. Out of 105 healthy, inactive nulliparous women, initially enrolled (gestation week 17.7 ± 4.2) to study the effect regular aerobic exercise (60 min 2/week) on health benefits for both mother and her baby, 90 (85.7%) completed postpartum follow-up (7.7 ± 1.7) on labour outcomes (exercise: 43 and control: 47). Data were collected via standardized interviews and birth partographs from hospital records, reported on the postpartum visit (weeks after labour 7.6 ± 1.6). The primary investigator was unaware of the original randomization at the time of the interviews. The principal analysis was done on an intention to treat basis (ITT). For the planned subgroup analyses (per protocol), acceptable intervention adherence was defined as attending ≥ 80% of the recommended exercise program (≥ 19 exercise sessions).
There were no differences between the exercise and control groups in induction of labour, use of analgesia, duration of active labour or prolonged labour, according to ITT. Per protocol analyses, showed a shorter duration of total active labour in the exercise group (6.8 ± 5.5 h) than the control group (9.8 ± 5.4 h), with a mean between group difference of 3.1 h (95% CI 0.31-5.9, p = 0.029). Rate of normal vaginal delivery was 85.7% among adherent participants and 62.3% in the control group (p = 0.051).
Regular exercise during pregnancy decreased duration of total active labour and showed a trend towards more normal vaginal deliveries among participants who adhered to the prescribed program.
ClinicalTrials.gov: NCT00617149.
如今，所有孕妇都被建议每周至少进行 150 分钟的中强度有氧运动和抗阻运动。然而，关于常规运动对分娩结局的作用（包括分娩方式和活跃分娩时间）仍存在争议和缺乏了解。此外，营养咨询通常与运动一起进行，这可能会独立影响结果。因此，本研究旨在调查监督下的团体运动（包括骨盆底肌肉训练）对分娩过程和分娩方式的单独作用。
这是一项单盲、随机对照试验，在挪威奥斯陆市进行。共有 105 名健康、不活跃的初产妇参与了该试验（妊娠第 17.7 ± 4.2 周），旨在研究定期进行有氧运动（每周 60 分钟，2 次/周）对母婴健康的益处。其中 90 名（85.7%）完成了产后随访（分娩后 7.7 ± 1.7 周），以了解分娩结局（运动组 43 名，对照组 47 名）。数据通过标准化访谈和医院记录中的分娩图收集，并在产后访视时报告（产后 7.6 ± 1.6 周）。主要研究者在访谈时并不知道原始随机分组情况。主要分析采用意向治疗（ITT）原则进行。对于计划中的亚组分析（按方案分析），可接受的干预依从性定义为参加≥推荐运动方案的 80%（≥19 次运动）。
根据 ITT，运动组和对照组在引产、使用镇痛剂、活跃分娩时间或延长分娩时间方面没有差异。按方案分析显示，运动组的总活跃分娩时间（6.8 ± 5.5 小时）短于对照组（9.8 ± 5.4 小时），两组之间的平均差异为 3.1 小时（95%CI 0.31-5.9，p=0.029）。遵守方案的参与者中正常阴道分娩率为 85.7%，对照组为 62.3%（p=0.051）。
在怀孕期间定期运动可缩短总活跃分娩时间，并显示出在遵守规定方案的参与者中，正常阴道分娩的比例有增加的趋势。
ClinicalTrials.gov：NCT00617149。
