Aparicio Virginia A, Marín-Jiménez Nuria, Castro-Piñero Jose, Flor-Alemany Marta, Coll-Risco Irene, Baena-García Laura
Department of Physiology, Institute of Nutrition and Food Technology, University of Granada, 18003 Granada, Spain.
Sport and Health University Research Institute (iMUDSmuds), University of Granada, 18007 Granada, Spain.
J Clin Med. 2024 Sep 4;13(17):5245. doi: 10.3390/jcm13175245.
This study explored whether assessing flexibility levels in clinical settings might predict the odds of oxytocin administration and caesarean section to stimulate labour. Pregnant women from the GESTAFIT Project (n = 157), participated in this longitudinal study. Maternal upper-body flexibility was assessed at 16 gestational weeks (g.w.) through the Back-scratch test. Clinical data, including oxytocin administration and type of birth, were registered from obstetric medical records. Pregnant women who required oxytocin administration or had caesarean sections showed lower flexibility scores ( < 0.05 and < 0.01, respectively). The receiver operating characteristic curve analysis showed that the Back-scratch test was able to detect the need for oxytocin administration ((area under the curve [AUC] = 0.672 (95% confidence interval [CI]: 0.682 (95% CI: 0.59-0.78, = 0.001)). The AUC to establish the ability of flexibility to discriminate between vaginal and caesarean section births was 0.672 (95% CI: 0.60-0.77, = 0.002). A Back-scratch test worse than 4 centimetres was associated with a ~5 times greater increased odds ratio of requiring exogenous oxytocin administration (95% CI: 2.0-11.6, = 0.001) and a ~4 times greater increased odds ratio of having a caesarean section (95% CI: 1.7-10.2, = 0.002). These findings suggest that lower flexibility levels at the 16th g.w. discriminates between pregnant women who will require oxytocin and those who will not, and those with a greater risk of a caesarean section than those with a vaginal birth. Pregnant women below the proposed Back-scratch test cut-offs at 16th g.w. might specifically benefit from physical therapies that include flexibility training.
本研究探讨了在临床环境中评估柔韧性水平是否可以预测使用缩宫素和剖宫产以促进分娩的几率。来自GESTAFIT项目的157名孕妇参与了这项纵向研究。在孕16周时通过背部抓痒试验评估孕妇上身的柔韧性。从产科医疗记录中记录包括缩宫素使用情况和分娩类型在内的临床数据。需要使用缩宫素或进行剖宫产的孕妇柔韧性得分较低(分别为P<0.05和P<0.01)。受试者工作特征曲线分析表明,背部抓痒试验能够检测出是否需要使用缩宫素(曲线下面积[AUC]=0.672,95%置信区间[CI]:0.59-0.78,P=0.001)。用于确定柔韧性区分阴道分娩和剖宫产能力的AUC为0.672(95%CI:0.60-0.77,P=0.002)。背部抓痒试验结果差于4厘米与需要使用外源性缩宫素的几率增加约5倍相关(95%CI:2.0-11.6,P=0.001),与进行剖宫产的几率增加约4倍相关(95%CI:1.7-10.2,P=0.002)。这些发现表明,孕16周时较低的柔韧性水平可以区分需要使用缩宫素的孕妇和不需要使用缩宫素的孕妇,以及剖宫产风险高于阴道分娩的孕妇。孕16周时背部抓痒试验结果低于建议临界值的孕妇可能会特别受益于包括柔韧性训练在内的物理治疗。