REVIEW PAPER
Influence of prenatal physical activity on the course of labour and delivery according to the new Polish standard for perinatal care
1
Gdansk University of Physical Education and Sport, Poland
2
Department of Mother and Child Health, University of Medical Sciences, Poznan, Poland
Ann Agric Environ Med. 2013;20(2):380-389
KEYWORDS
ABSTRACT
Introduction. Prenatal physical activity has been increasingly recommended in recent years as the fundamental condition of physiological pregnancy and birth by health promoting organizations throughout the world.
Objective. To determine the influence of prenatal physical activity on the course of labour and delivery. The practical purpose was to present prenatal physical activity as an effective tool in the implementation of the new Polish standard for perinatal care.
Brief description of the state of knowledge. Reviewed publications report either a positive impact or no impact of physical activity on selected parameters of labour and delivery. The most frequently cited benefits of physical exercise during pregnancy include: shorter delivery, less frequent need for anesthesia, reduced risk of operative births, a lower rate of induction of labor, amniotomy, episiotomy and perineum lacerations, and improved neonatal outcome.
Conclusions. A review of the literature shows that regular prenatal physical activity can help reduce medical interventions during labour, without having negative consequences for either the mother or the foetus. It should be an important tool to implement the Polish standard for perinatal care. There is a need to promote regular prenatal physical activity among women, medical personnel, and physical education staff. Detailed instructions for designing prenatal exercise programmes should be included in the new guidelines for physical activity during pregnancy, both in Poland and abroad. To support or negate the hypothesis of the positive effects of physical activity on the course of labour and delivery, well-designed research trials should be conducted with the properly structured prenatal exercise programmes in the intervention groups.
REFERENCES (102)
1.
Odent M. New reasons and new ways to study birth physiology. Int J Gynaecol Obstet. 2001; 75 Suppl 1: 39–45.
3.
Care in normal birth. A practical guide. Reproductive Health and Research. World Health Organization. Geneva, 1996.
4.
Maternity Standard, National Service Framework for Children, Young People and Maternity Services. Department of Health, London, 2004.
5.
Intrapartum care. Care of healthy women and their babies during childbirth. NICE clinical guideline 55. National Institute for Health and Clinical Excellence (NHS), 2007.
6.
Artal R, O’Toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br J Sports Med. 2003; 37:6–12.
7.
2008 Physical Activity Guidelines for Americans. US Dept of Health and Human Services, 2008.
8.
ACSM’s Guidelines for Exercise Testing and Prescription. American College of Sports Medicine (ACSM). 8th ed. Baltimore, Lippincott Williams & Wilkins, 2010.
9.
Exercise in pregnancy. Sports Medicine Australia. http://sma.org.au/ wp-content/uploads/2009/10/WIS-ExPreg.pdf (access: 31.08.2012).
10.
Davies GAL, Wolfe LA, Mottola MF, Mackinnon C. Joint SOGC/CSEP Clinical Practice Guideline: Exercise in Pregnancy and the Postpartum Period. Can J Appl Physiol. 2003; 28(3): 330–341.
11.
Physical Activity for pregnant women. Danish Health and Medicines Authority. http://www.sst.dk/English/Heal... Recommendations_for_pregnant_women.aspx (access: 31.08.2012).
12.
Exercise in pregnancy. Royal College of Obstetricians and Gynaecologists (RCOG). 2006; Statement 4.
13.
A National Clinical Guideline for Antenatal Care. Directorate for Health and Social Affairs, Norway, 2005.
14.
Regulation of the Ministry of Health of October the 7th, 2010 on the standards of conduct and medical procedures for the delivery of health services in the field of perinatal care provided to women during physiological pregnancy, physiological birth, confinement and infant care. (Original title: Rozporządzenie Ministerstwa Zdrowia z dnia 7 października 2010 r. w sprawie standardów postępowania oraz procedur medycznych przy udzielaniu świadczeń zdrowotnych z zakresu opieki okołoporodowej sprawowanej nad kobietą w okresie fizjologicznej ciąży, fizjologicznego porodu, połogu oraz opieki nad noworodkiem). (Dz.U.10.187.1259).
15.
Wojtyła A, Kapka-Skrzypczak L, Paprzycki P, Skrzypczak M, Biliński P. Epidemiological studies in Poland on effect of physical activity of pregnant women on the health of offspring and future generations – adaptation of the hypothesis Development Origin of Health and Diseases. Ann Agric Environ Med. 2012; 19(2): 315–326.
16.
Haakstad LAH, Voldner A, Tore H, Bø K. Why do pregnant women stop exercising in the third trimester? Acta Obstet Gynecol Scand. 2009; 88 (11):1267–1275.
17.
Mottola MF, Campbell MK. Activity patterns during pregnancy. Can J Appl Physiol. 2003; 28 (4): 642–653.
18.
Evenson KR, Pompeii LA. Obstetrician practice patterns and recommendations for physical activity during pregnancy. J Womens Health. 2010; 19 (9): 1733–1740.
19.
Beckmann CR, Beckmann CA. Effect of a structured antepartum exercise program on pregnancy and labor outcome in primiparas. J Reprod Med. 1990; 35: 704–9.
20.
Clapp JF. The course of labor after endurance exercise during pregnancy. Am J Obstet Gynecol. 1990;163:1799–805.
21.
Valgesoo T, Linkberg R. Effect of different physical exercises on pregnancy outcome. Acta Medica Baltica. 1997; 4 (1): 101–106.
22.
Ghodsi Z, Asltoghiri M, Hajiloomohajerani M. Exercise and pregnancy: duration of labor stages and Perinea tear rates. Procedia – Social and Behavioral Sciences. 2012; 31: 441–445.
23.
Wong SC. McKenzie DC. Cardiorespiratory fitness during pregnancy and its effect on outcome. Int J Sports Med 1987; 8; 79–83.
24.
Baciuk EP, Pereira RI, Cecatti JG, Braga AF, Cavalcante SR. Water aerobics in pregnancy: Cardiovascular response, labor and neonatal outcomes. Reprod Health. 2008; 5: 10–22.
25.
Hall DC, Kaufmann DA. Effects of aerobic and strength conditioning on pregnancy outcomes. Am J Obstet Gynecol. 1987; 157: 1199–203.
26.
Bungum TJ, Peaslee DL, Jackson AW, Perez MA. Exercise during pregnancy and type of delivery in nulliparae. J Obstet Gynecol Neonatal Nurs. 2000; 29, 3: 258–64.
27.
Melzer K, Schutz Y, Soehnchen N. Othenin-Girard V, Martinez de Tejada B, Irion O, Boulvain M, Kayser B. Effects of recommended levels of physical activity on pregnancy outcomes. Am J Obstet Gynecol. 2010; 202: 266–272.
28.
Salvesen KL, Mørkved S. Randomised controlled trial of pelvic floor muscle training during pregnancy. BMJ. 2004; 329: 378–80.
29.
Kardel KR, Kase T. Training in pregnant women: effects on fetal development and birth. Am J Obstet Gynecol. 1998; 178 (2): 280–286.
30.
Magann EF, Evans SF, Weitz B, Newnham J. Antepartum, intrapartum, and neonatal significance of exercise on healthy low-risk pregnant working women. Obstet Gynecol. 2002; 99, 3:466–72.
31.
Nathan NS, Gelber SE, Chasen ST. Physical And Sexual Activity During Pregnancy Are Not Associated With The Onset Of Labor And Mode Of Delivery In Low Risk Term Nulliparous Women. Int J Gynecol Obstet. 2007; 7, 2nd edition. (access: 24.08.2012).
32.
Agur W, Steggles P, Waterfield M, Freeman R. Does antenatal pelvic floor muscle training affect the outcome of labour? A randomised controlled trial. Int Urogynecol J Pelvic Floor Dysfunct. 2008; 19(1): 85–88.
33.
Bovbjerg ML, Siega-Riz AM. Exercise During Pregnancy and Cesarean Delivery: North Carolina PRAMS, 2004–2005. Birth: Issues in Perinatal Care. 2009; 36(3): 200–207.
34.
Bø K, Fleten C, Nystad W. Effect of antenatal pelvic floor muscle training on labor and birth. Obstet Gynecol. 2009; 113: 1279–1284.
35.
Gawade P, Pekow P, Markenson G, Plevyak M, Goh W, Chasan-Taber L. Physical activity before and during pregnancy and duration of second stage of labor among Hispanic women. J Reprod Med. 2009; 54(7): 429–435.
36.
Dias LAR, Driusso P, Aita DLCC, Quintana SM, Bø K, Ferreira CHJ. Effect of pelvic floor muscle trainingon labour and newborn outcomes: a randomized controlled trial. Rev Bras Fisioter. 2011; 15(6): 487–493.
37.
Elliott ML. Induction of labour. In: Chapman V, Charles C. The midwife’s labour and birth handbook. 2nd ed. Blackwell Publishing Ltd., 2009.p.253–263.
38.
Gülmezoglu AM, Crowther CA, Middleton P, Heatley E. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database Syst Rev. 2012; 6.
39.
National Institute of Clinical Excellence. Induction of labour. 2008. National Collaborating Centre for Women’s and Children’s Health. http://www.nice.org.uk/nicemed... (access: 28.08.2012).
40.
Seyb ST, Berka RJ, Socol ML, Dooley SL. Risk of cesarean delivery with elective induction of labor at term in nulliparous women. Obstet Gynecol. 1999; 94(4): 600–607.
41.
Maslow AS, Sweeny AL. Elective induction of labor as a risk factor for cesarean delivery among low-risk women at term. Obstet Gynecol. 2000; 95: 917–922.
42.
Boulvain M, Marcoux S, Bureau M, Fortier M, Fraser W. Risks of induction of labour in uncomplicated term pregnancies. Paediatr Perinat Epidemiol. 2001; 15(2): 131–138.
43.
Kurinczuk JJ, Zarko A, Patsy S, Brocklehurst P, Knight M. Uterine rupture by intended mode of delivery in the UK: A national case-control study. PLoS Medicine. 2012; 9(3): 1–12.
44.
Induction of labour (IOL) – labour augmentation – oxytocin infusion guideline (CP–MA16) Clinical Protocols and Guidelines, Maternity. Southern Health, 2009.
45.
Smyth RM, Alldred SK, Markham C. Amniotomy for shortening spontaneous labour. Cochrane Database Syst Rev. 2007; 17(4).
46.
Anim-Somuah M, Smyth RM, Jones L. Epidural versus non-epidural or no analgesia in labour. Cochrane Database Syst Rev. 2011; 7.
47.
Leap N, Sandall J, Buckland S, Huber U. Journey to confidence: women’s experiences of pain in labour and relational continuity of care. J Midwifery Womens Health. 2010; 55(3): 234–42.
48.
Guszkowska M. Physical activity in relation to affective states and labor anxiety in pregnant women. Medicina Sportiva. 2011; 15, 3: 114–118.
49.
Low JA. Operative Delivery: Yesterday and Today. J Obstet Gynaecol Can. 2009; 31(2): 132–141.
50.
Operative Vaginal Delivery (Green-top Guideline No. 26). Royal College of Obstetricians and Gynaecologists. 2011.
51.
Baessler K, Schuessler B. Childbirth-induced trauma to the urethral continence mechanism: review and recommendations. Urology. 2003; 62 (Suppl 4A): 39–44.
52.
World Health Organization (WHO). Appropriate technology for birth. Lancet. 1985; 2: 436–437.
53.
Health and Health Care in 2010. Statictical information and elaboration. Central Statistical Office. Warsaw 2012. (Original title: Zdrowie i ochrona zdrowia w 2010 r. Informacje i opracowania statystyczne. Główny Urząd Statystyczny. Warszawa 2012).
54.
Kilsztajn S, Carmo MS, Machado LC Jr, Lopes ES, Lima LZ. Caesarean sections and maternal mortality in Sao Paulo. Eur J Obstet Gynecol Reprod Biol. 2007 May;132(1): 64–69.
55.
Gibbons L, Belizan JM, Lauer JA, Betran AP, Merialdi M, Althabe F. Inequities in the use of cesarean section deliveries in the world. Am J Obstet Gynecol. 2012; 206(4): 331–350.
56.
Karabulut A, Derbent AU, Yildirim M, Simavli S, Turhan NÖ. Evaluation of risk factors and effect of physical activity in caesarean section in nulliparous women. J Matern Fetal Neonatal Med. 2012; 25(8): 1447–1452.
57.
Altman MR, Lydon-Rochelle MT. Prolonged Second Stage of Labor and Risk of Adverse Maternal and Perinatal Outcomes: A Systematic Review. Birth: Issues in Perinatal Care. 2006, 33(4): 315–322.
58.
Cheng YW, Hopkins LM, Laros RK Jr, Caughey AB. Duration of the second stage of labor in multiparous women: maternal and neonatal outcomes. Am J Obstet Gynecol. 2007; 196(6): 585–590.
59.
Collings CA, Curet LB, Mullin JP. Maternal and fetal responses to a maternal aerobic exercise program. Am J Obstet Gynecol. 1983; 145: 702–707.
60.
Kardel KR, Johansen B, Voldner N, Iversen P, Henriksen T. Association between aerobic fitness in late pregnancy and duration of labor in nulliparous women. Acta Obstet Gynecol Scand. 2009; 88: 948–52.
61.
Horsley K. Fitness in the child-bearing years. In: Sapsford R, BullockSaxton J, Markwell S, editors. Women’s health. A textbook for physiotherapists. London, WB Saunders Company Ltd. 1998. p.168–191.
62.
Perineal Repair following Delivery. Northern Health and Social Care Trust (HSC), 2010.
63.
Voldner N, Frøslie KF, Haakstad LAH, Bø K, Henriksen T. Birth complications, overweight, and physical inactivity. Acta Obstet Gynecol Scand. 2009; 88: 550–555.
64.
Clapp JF III. Exercising through your pregnancy. Addicus Books, Omaha, Nebraska, 2002.
65.
Sternfeld B. Physical activity and pregnancy outcome: review and recommendations. Sports Med. 1997; 23(1): 33–47.
66.
Russell JB, Mitchell D, Musey PI, Collins DC. The relationship of exercise to anovulatory cycles in female athletes: hormonal and physical characteristics. Obstet Gynecol. 1984; 63(4): 452–6.
67.
Gomez-Merino D, Chennaoui M, Drogou C, Bonneau D, Guezennec CY. Decrease in serum leptin after prolonged physical activity in men. Med Sci Sports Exerc. 2002; 34(10): 1594–1599.
68.
ACSM’s Resources for the Personal Trainer, 3rd ed. American College of Sports Medicine. Lippincott Wiliams &Wilkins, 2010.
69.
Bryant CX, Franklin BA, Newton-Merrill S. ACE’s guide to exercise testing and program design: a fitness professional’s handbook. 2nd ed. Monterey (CA), Healthy Learning, 2007.
70.
Zarębska A. Physical activity “fitness” as a means of fitness and health improvement. Doctoral dissertation. Gdansk University of Physical Education and Sport, Gdansk, Poland, 2007.
71.
Melzer K, Schutz Y, Boulvain M, Kayser B. Physical Activity and Pregnancy: Cardiovascular Adaptations, Recommendations and Pregnancy Outcomes. Sports Med. 2010; 40(6): 493–507.
72.
Karowicz-Bilińska A, Sikora A, Estemberg D, Brzozowska M, BernerTrąbska M, Kuś E, Kowalska-Koprek U. Physiotherapy in obstetrics. Ginekol Pol. 2010; 81(6): 441–445.
73.
Nielsen CA, Sigsgaard I, Olsen M, Tolstrup M, Danneskiold-Samsoee B, Bock JE. Trainability of the pelvic floor. A prospective study during pregnancy and after delivery. Acta Obstet Gynecol Scand. 1988; 67: 437–40.
74.
Reilly ET, Freeman RM, Waterfield MR, Waterfield AE, Steggles P, Pedlar F. Prevention of postpartum stress incontinence in primigravidae with increased bladder neck mobility: a randomized controlled trial of antenatal pelvic floor exercises. BJOG. 2002; 109(1): 68–76.
76.
Ciobanu DI, Relaxation and breathing techniques – positive factors in the deployment of pregnant women’s labor and delivery. Eur J Physic Health Educ. 2010; 3(2): 39–48.
77.
Zwelling E. Overcoming the challenges: maternal movement and positioning to facilitate labor progress. MCN Am J Matern Child Nurs. 2010; 35(2): 72–78.
78.
De Jonge A, Lagro-Janssen ALM. Birthing positions. A qualitative study into the views of women about various birthing positions. J Psychosom Obstet Gynecol. 2004; 25(1): 47–55.
79.
Smith MDH. Preparation for labor and delivery. In: Mostofsky DL, Zaichkowsky LD. Medical and psychological aspects of sport and exercise. Fitness Information Technology, Morgantown, WV, 2002. p. 83–90.
80.
Wagg A, Bunn F. Unassisted pelvic exercise for postnatal women: a systematic review. J Adv Nurs. 2007; 58,5: 407–417.
81.
Lemos A, Impieri de Souza A, Ferreira ALCG, Figueiroa JN, CabralFilho JE. Do perineal exercises during pregnancy prevent the development of urinary incontinence? A systematic review. Int J Urol. 2008; 15: 875–880.
82.
Jóźwik M, Jóźwik M. The effect of pelvic floor exercises in the antepartum and postpartum periods on occurrence of stress urinary incontinence: implications for health care provision. Ginekol Pol. 2002; 72(9): 681–687.
83.
Wojtyła A, Kapka-Skrzypczak L, Biliński P, Paprzycki P. Physical activity among women at reproductive age and during pregnancy (Youth Behavioural Polish Survey – YBPS and Pregnancy-related Assessment Monitoring Survay – PrAMS) – epidemiological population studies in Poland during the period 2010–2011. Ann Agric Environ Med. 2011; 18(2): 365–374.
84.
Sternfeld B, Quesenberry CP, Eskenazi B, Newman LA. Exercise during pregnancy and pregnancy outcome. Med Sci Sports Exerc. 1995; 27(5): 634–640.
85.
Rice PL, Fort IL. The relationship of maternal exercise on labor, delivery and health of the newborn. J Sports Med Phys Fitness 1991; 31(1):95–9.
86.
Kramer MS, McDonald SW. Aerobic exercise for women during pregnancy. Cochrane Database Syst Rev. 2006; 19(3).
87.
Schlüssel MM, Bicalho de Souza E, Reichenheim ME, Kac G. Physical activity during pregnancy and maternal-child health outcomes: a systematic literature review. Cad. Saúde Pública, Rio de Janeiro. 2008; 24 Sup 4: 531–544.
88.
Both MI, Overvest MA, Wildhagen MF, Golding J, Wildschut HIJ. The association of daily physical activity and birth outcome: a populationbased cohort study. Eur J Epidemiol. 2010; 25: 421–429.
89.
Rousham EK, Clarke PE, Gross H. Significant changes in physical activity among pregnant women in the UK as assessed by accelerometry and self-reported activity. Eur J Clin Nutr. 2006; 60: 393–400.
90.
Chasan-Taber L, Schmidt MD, Dawn RE, David H, Glenn M, Patty F. Development and Validation of a Pregnancy Physical Activity Questionnaire. Med Sci Sports Exerc. 2004; 36(10): 1750–1760.
91.
Schmidt MD, Freedson PS, Pekow P, Roberts D, Sternfeld B, ChasanTaber L. Validation of the Kaiser Physical Activity Survey in pregnant women. Med Sci Sports Exerc. 2006; 38: 42–50.
92.
Sallis JF, Saelens BE. Assessment of physical activity by self-report: status, limitations, and future directions [published erratum appears in Res Q Exerc Sport 2000;71:409]. Res Q Exerc Sport. 2000; 71: 1–14.
93.
Ainsworth BE. Challenges in measuring physical activity in women. Exerc Sport Sci Rev. 2000; 28: 93–96.
94.
Conway JM, Seale JL, Jacobs DR, Irwin ML, Ainsworth BE. Comparison of energy expenditure estimates form doubly labeled water, a physical activity questionnaire, and physical activity records. Am J Clin Nutr. 2002; 75: 519–525.
95.
Harrison ChL, Thompson RG, Teede HJ, Lombard CB. Measuring physical activity during pregnancy. Int J Behav Nutr Phys Activity. 2011; 8:19–27.
96.
Smith KM, Foster RC, Campbell ChG. Accuracy of physical activity assessment during pregnancy: an observational study. BMC Pregnancy and Childbirth. 2011; 11: 86–95.
97.
Cannella D, Lobel M, Monheit A. Knowing is believing: information and attitudes towards physical activity during pregnancy. J Psychosom Obstet Gynecol. 2010; 31(4): 236–242.
98.
Physical Activity Readiness Medical Examination for Pregnancy. Canadian Society for Exercise Physiology. www.csep.ca/cmfiles/ publications/parq/parmed-xpreg.pdf (access: 17.08.2012).
99.
Kardel KR. Effects of intense training during and after pregnancy in top-level athletes. Scand J Med Sci Sports. 2005; 15: 79–86.
100.
Dempsey JC, Butler CL, Williams MA. No need for a pregnant pause: physical activity may reduce the occurrence of gestational diabetes mellitus and preeclampsia. Exerc Sport Sci Rev. 2005;/33:/141–149.
101.
Weissgerber TL, Wolfe LA, Davies GAL, Mottola MF. Exercise in the prevention and treatment of maternal-fetal disease: a review of the literature. Appl Physiol Nutr Metab. 2006; 31: 661–674.
102.
Ferraro ZM, Gaudet L, Adamo KB. The potential impact of physical activity during pregnancy on maternal and neonatal outcomes. Obstet Gynecol Surv. 2012; 67(2): 99-110.
Share
RELATED ARTICLE
| eISSN: | 1898-2263 |
| ISSN: | 1232-1966 |
Improvement of visual identification of the journal - task financed under the agreement No. 618/P-DUN/2019 by the Minister of Science and Higher Education allocated to the activities of disseminating science.
Generation of the DOI (Digital Object Identifier) - task financed under the agreement No. 618/P-DUN/2019 by the Minister of Science and Higher
© 2006-2024 Journal hosting platform by Bentus
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
