Terres Marcela Tatsch, de Carvalho Souza Marcus Vinicius, Costa Lucas Manoel Oliveira, Novaes Laiz, de Avila Marina Ferreira, Barros Serafim Garcia, Provinciatto Henrique, Piovezan Anna Paula
Universidade do Sul de Santa Catarina, Av. Pedra Branca, 25, Palhoça, SC, Brazil.
Post-Graduate Program in Health Sciences (PPGCS) Universidade do Sul de Santa Catarina, Av. Pedra Branca, 25, Palhoça, SC, Brazil.
Arch Gynecol Obstet. 2025 May;311(5):1331-1341. doi: 10.1007/s00404-024-07930-3. Epub 2025 Jan 18.
This updated systematic review and meta-analysis aims to evaluate the impact of a birthing ball (BB) exercises on low-risk parturients during labor, offering a more comprehensive understanding through a larger sample size, robust analysis, and focus on relevant endpoints that were underexplored in previous studies due to limited data.
We searched PubMed, Embase, Scopus, and Cochrane Central for randomized controlled trials (RCTs) comparing BB (also named Swiss ball) exercises with no intervention or standard care in parturients undergoing low-risk labor. Risk ratios (RR) and mean differences (MD) were calculated using a random-effects model. I heterogeneity was assessed. All statistical analyses were performed using Review Manager 5.4.
We included 10 RCTs with 1,008 parturients, 51.2% of whom were assigned to BB exercises. In the pooled analysis, the BB group showed significantly lower cesarean section rates (MD 0.55, p = 0.007, I = 32%), reduced pain scores at 4 and 8 cm dilation by approximately 20% (p < 0.001), and a reduction of over two hours in the duration of the first stage of labor (MD -130.12 min, p < 0.001). There were no significant differences between groups in the duration of the second stage of labor (p = 0.090) and in the incidence of instrumental delivery, amniotomy, labor induction, oxytocin use, or epidural analgesia.
BB exercises significantly reduced cesarean section rates, alleviated labor pain, and shortened the first stage of labor, supporting their use as a safe and effective non-pharmacological intervention in low-risk labor management.
本更新的系统评价和荟萃分析旨在评估分娩球运动对低风险产妇分娩期间的影响，通过更大的样本量、有力的分析，并聚焦于因数据有限而在以往研究中未充分探索的相关终点，以提供更全面的理解。
我们在PubMed、Embase、Scopus和Cochrane Central中检索了比较分娩球（也称为瑞士球）运动与未干预或标准护理对低风险分娩产妇影响的随机对照试验（RCT）。使用随机效应模型计算风险比（RR）和均值差（MD）。评估异质性。所有统计分析均使用Review Manager 5.4进行。
我们纳入了10项RCT，共1008名产妇，其中51.2%被分配到分娩球运动组。在汇总分析中，分娩球运动组剖宫产率显著降低（MD 0.55，p = 0.007，I = 32%），宫颈扩张4厘米和8厘米时疼痛评分降低约20%（p < 0.001），第一产程持续时间缩短超过两小时（MD -130.12分钟，p < 0.001）。两组在第二产程持续时间（p = 0.090）以及器械助产、人工破膜、引产、使用缩宫素或硬膜外镇痛的发生率方面无显著差异。
分娩球运动显著降低了剖宫产率，减轻了分娩疼痛，并缩短了第一产程，支持其作为低风险分娩管理中一种安全有效的非药物干预措施使用。
