Effect of antenatal exercises on pulmonary functions and labour outcome in uncomplicated primigravida women: a randomized controlled study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20150732Keywords:
Antenatal exercises, Pulmonary functions, Neonatal outcomes, Labour outcomesAbstract
Background: Physical fitness could influence pulmonary functions, labour and neonatal outcomes in pregnancy. The present study was undertaken to evaluate the effect of antenatal exercises on pulmonary functions and labour outcomes.
Methods: Study included 122 uncomplicated primigravida in age group of 18-35 years at 24th - 28th week of gestation were randomly allocated into study and control groups. Antenatal exercises were performed by study group for a minimum of 3 days a week for 20 minute duration till their delivery. Pulmonary function tests (PFTs) were done for all subjects at 24th week of gestation and after 36th week of gestation.
Results: A significant improvement in FEV1, FVC, FEF25-75%, MEF50%, MIF50% and MVV between 24 & 36 weeks was observed in the study group after exercises. In study group 85.24% patients had spontaneous onset of labour, 14.8% patients had induction of labour as compared to 75.4% and 24.6% respectively in control group, however statistically insignificant. In the study group 41.67% patients did not require augmentation compared to 22.95% in the control group. In study group 13.11% patients had meconium stained liquor which was significantly less in comparison to 41% patients in the control group. Mean duration of first, second and third stage of labour was shorter in study group than control group. In study group 96.72% had normal and none had instrumental vaginal delivery compared to 88.52% and 6.6% from control group respectively. Caesarean section rate was 3.3% in study group and 4.9% in control group. APGAR score was normal in all the neonates. Fetal weight gain, birth weight, birth length and head circumference was significantly higher and NICU stay was significantly lesser in study group compared to control group.
Conclusions: Antenatal exercises lead to improvement of pulmonary functions and hence labour and neonatal outcomes
References
Bungum TJ, Peaslee OL, Jackson AW, et al. Exercise during pregnancy and type of delivery in nulliparae. J Obstet Gynaecol Neonatal Nurs. 2000;29:258-61.
Neeraj Sodhi C, Pramod J, Singh J, Kaur V. Effect of advanced uncomplicated pregnancy on pulmonary function parameters of North Indian subjects. Indian J Physiol Pharmacol. 2010;54(1):69-72.
Cunningham G, Leveno KJ, Bloom SL, Hauth JC, Gilstrap LC, Wenstrom KD. Maternal physiology. In: Cunningham G, Leveno KJ, Bloom SL, Hauth JC, Gilstrap LC, Wenstrom KD, eds. William Obstetrics, 23rd ed. New York: McGraw-Hill. 2005:105-35.
ACOG Committee Obstetric Practice. ACOG Committee opinion. Number 267, January 2002: exercise during pregnancy and the postpartum period. Obstet Gynecol. 2002;99(1):171-3.
Kardel KR, Johansen B, Voldner N, Iversen PO, Henriksen T. Association between aerobic fitness in late pregnancy and duration of labor in nulliparous women. Acta Obstet Gynecol Scand. 2009;88(8):948-52.
Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C, et al. Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA. 1995;273(5):402-7.
Macera CA, Ham SA, Yore MM, Jones DA, Ainsworth BE, Kimsey CD, Kohl HW 3rd. Prevalence of physical activity in the United States: Behavioral Risk Factor Surveillance System, 2001. Prev Chronic Dis. 2005;2(2):A17.
Kramer MS. Aerobic exercise for women during pregnancy. Cochrane Database Syst Rev. 2010;(6).
Shashikala L, Sarath R. Effects of exercise on pulmonary function test. Indian J Fundamental App Life Sci. 2011;1:230-1.
Grindheim G, Toska K, Estensen ME, Rosseland LA. Changes in pulmonary function during pregnancy: a longitudinal cohort study. BJOG. 2012;119(1):94-101
Puranik BM, Kaore SB, Kurhade GA, Agrawal SD, Patwardhan SA, Kher JR. A longitudinal study of pulmonary function tests during pregnancy. Indian J Physiol Pharmacol. 1994;38(2):129-32.
Sroczyński T. Evaluation of respiratory tract function in healthy women in the last month of uncomplicated pregnancy. Ann Acad Med Stetin. 2002;48:331-50.
Phatak MS, Kurhade GA. A longitudinal study of antenatal changes in lung function tests and importance of postpartum exercises in their recovery. Indian J Physiol Pharmacol. 2003;47(3):352-6.
Harirah HM, Donia SE, Nasrallah FK, Saade GR, Belfort MA. Effect of gestational age and position on peak expiratory flow rate: a longitudinal study. Obstet Gynecol. 2005;105(2):372-6.
Deshpande H, Makkar C, Dahiya P. A study of pulmonary function tests in different stages of pregnancy. Int J Biol Med Res. 2013;4:2713-6.
Gupta L, Dixit R. Study of pulmonary function tests in normal pregnant women of third trimester. IMJ. 2011;105(2):67-70.
Barakat R, Stirling JR, Lucia A. Does exercise training during pregnancy affect gestational age? A randomised controlled trial. Br J Sports Med. 2008;42(8):674-8.
Dias LA, Driusso P, Aita DL, Quintana SM, Bo K, Ferreira CH. Effect of pelvic floor muscle training on labour and newborn outcomes: a randomized controlled trial. Rev Bras Fisioter. 2011;15(6):487-93.
Price BB, Amini SB, Kappeler K. Exercise in Pregnancy: Effect on Fitness and Obstetric Outcomes- A Randomized Trial. Med Sci Sports Exerc. 2012;44:2263-69.
Bechman CR, Beckmann CA. Effect of a structured antepartum exercise programme on pregnancy and labour outcome in primiparas. J Reprod Med. 1990;35:704-9.
Clapp JF III. The course of labor after endurance exercises during pregnancy. Am J Obstet Gynecol. 1990;163:1799-805.
Rad LS, Jahanshiri A. Effect of a period of exercise during pregnancy on certain delivery parameters. Eur J Exp Biol. 2013;3:78-85.
Forouhari S, Yazdanpanahi Z, Parsanezhad ME, Raigan-Shirazi M. The effects of regular exercise on pregnancy outcome. Iranian Red Cres Med J. 2009;11:57-60.
Melzer K, Schutz Y, Soehnchen N, Othenin-Girard V, Martinez de Tejada B, Irion O, et al. Effects of recommended levels of physical activity on pregnancy outcomes. Am J Obstet Gynecol. 2010;202(3):266.
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.
Collings CA, Curet LB, Mullin JP. Maternal and fetal responses to maternal aerobic exercise program. Am J Obstet Gynaecol. 1983;145:702-7.
Kardel KR, Kase T. Training in pregnant women: effect on fetal development and birth. Am J Obstet Gynecol. 1998;178:280-6.
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.
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):85-8.
Saftlas AF, Logsden-Sackett N, Wang W, Woolson R, Bracken MB. Work, leisure-time physical activity, and risk of preeclampsia and gestational hypertension. Am J Epidemiol. 2004;160(8):758-65.
Goodwin A, Astbury J, McMeeken J. Body image and psychological well-being in pregnancy. A comparison of exercisers and non-exercisers. Aust N Z J Obstet Gynaecol. 2000;40(4):442-7.
Horns PN, Ratcliffe LP, Leggett JC, Swanson MS. Pregnancy outcomes among active and sedentary primiparous women. J Obstet Gynecol Neonatal Nurs. 1996;25(1):49-54.
Hatch MC, Shu XO, McLean DE, Levin B, Begg M, Reuss L, Susser M. Maternal exercise during pregnancy, physical fitness, and fetal growth. Am J Epidemiol. 1993;137(10):1105-14.
