Anatomy and Cell Biology Publications

Title

Impact of prenatal exercise on maternal harms, labour and delivery outcomes: a systematic review and meta-analysis

Authors

Margie H. Davenport, Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
Stephanie-May Ruchat, Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
Frances Sobierajski, Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
Veronica J. Poitras, Independent researcher, Ottawa, Ontario, Canada
Casey E. Gray, Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
Courtney Yoo, Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
Rachel J. Skow, Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
Alejandra Jaramillo Garcia, Independent researcher, Ottawa, Ontario, Canada
Nick Barrowman, Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
Victoria L. Meah, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
Taniya S. Nagpal, R. Samuel McLaughlin Foundation - Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Children's Health Research Institute , The University of Western Ontario, London, Ontario, Canada
Laurel Riske, Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
Marina James, Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
Megan Nuspl, Alberta Research Centre for Health Evidence, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
Ashley Weeks, Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
Andree-Anne Marchand, Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec, Canada
Linda G. Slater, John W. Scott Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada
Kristi B. Adamo, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
Gregory A. Davies, Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada
Ruben Barakat, Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
Michelle F. Mottola, R. Samuel McLaughlin Foundation - Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Children's Health Research Institute , The University of Western Ontario, London, Ontario, Canada

Document Type

Review

Publication Date

1-2019

Issue

2

Journal

British Journal of Sports Medicine

Volume

53

First Page

99

Last Page

107

URL with Digital Object Identifier

https://doi.org/10.1136/bjsports-2018-099821

Abstract

Objective To perform a systematic review of the relationships between prenatal exercise and maternal harms including labour/delivery outcomes. Design Systematic review with random effects meta-analysis and meta-regression. Datasources Online databases were searched up to 6 January 2017. Study eligibility criteria Studies of all designs were included (except case studies) if they were published in English, Spanish or French and contained information on the population (pregnant women without contraindication to exercise), intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise), comparator (no exercise or different frequency, intensity, duration, volume and type of exercise, alone ["exercise-only"] or in combination with other intervention components [e.g., dietary; "exercise + co-intervention"]) and outcome (preterm/prelabour rupture of membranes, caesarean section, instrumental delivery, induction of labour, length of labour, vaginal tears, fatigue, injury, musculoskeletal trauma, maternal harms (author defined) and diastasis recti). Results 113 studies (n=52 858 women) were included. 'Moderate' quality evidence from exercise-only randomised controlled trials (RCTs) indicated a 24% reduction in the odds of instrumental delivery in women who exercised compared with women who did not (20 RCTs, n=3819; OR 0.76, 95% CI 0.63 to 0.92, I (2)= 0 %). The remaining outcomes were not associated with exercise. Results from meta-regression did not identify a dose-response relationship between frequency, intensity, duration or volume of exercise and labour and delivery outcomes. Summary/conclusions Prenatal exercise reduced the odds of instrumental delivery in the general obstetrical population. There was no relationship between prenatal exercise and preterm/prelabour rupture of membranes, caesarean section, induction of labour, length of labour, vaginal tears, fatigue, injury, musculoskeletal trauma, maternal harms and diastasis recti.

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