Efecto de un programa de actividad física en el medio acuático sobre las constantes hemodinámicas en mujeres embarazadas

Therapeutic Aquatic Exercise in Pregnancy: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis aimed to assess evidence on the effects of aquatic exercise in pregnant women. The search included the following databases: Medline-PubMed, Web of science, PEDro, Scopus and SPORTDiscus databases. Seventeen randomized controlled trials were included (n = 2439, age 20–39 years; 31.30 ± 1.30 years). The systematic review carried out has indicated that aquatic exercise in pregnant women appears to have positive effects on preventing excessive maternal weight gain, improving maternal body image, as well as promoting healthy behavior, decreasing medical leave due to lower back pain during pregnancy, preventing gestational depression by improving maternal glucose tolerance levels, and reducing O’Sullivan test values. The Physiotherapy Evidence Database was used to evaluate the quality of the methodology of the selected studies, which were found to present an average methodological quality (PEDro scale: 5.05 points). Meta-analysis showed that aquatic exercise in pregnant women appears to have positive effects in the prevention of excessive maternal weight gain (mean difference −1.66 kg, 95% CI −2.67 to −0.66) and also to reduce birth weight mean differences (−89.13 g, 95% CI −143.18 to −35.08). The practice of aquatic exercise is appropriate throughout pregnancy. However, more research is needed to build more solid knowledge on the benefits of aquatic physical exercise on physical fitness (endurance, flexibility, agility and strength).

Effects on the maternal-fetal health outcomes of various physical activity types in healthy pregnant women. A systematic review and meta-analysis

BACKGROUND

Physical activity (PA) promotes health in pregnancy.

OBJECTIVE

To collate the recent randomized controlled trial (RCT) on the effects of various types of PA during pregnancy on maternal-fetal health outcomes, among healthy mothers, and to report the variability in the outcomes reported.

SEARCH STRATEGY

Registered in PROSPERO (CRD42019143522). Systematic search conducted in EMBASE, CENTRAL, MEDLINE and CINAHL, from 2015-2020.

SELECTION CRITERIA

RCT examining PA interventions and maternal-fetal outcomes.

DATA COLLECTION AND ANALYSIS

Were independently extracted by two reviewers. Quality of studies was assessed with Cochrane Collaboration's risk of bias tool.

RESULTS

37 studies (6857 women) were included. PA had a protective effect on gestational weight gain (overall SMD -0.32, 95 % CI -0.46, -0.17, I² 77 %; supervised exercise SMD -0.15, 95 % CI -0.28, -0.02, I² 51 %; static cycling SMD -0.32, 95 % CI -0.59, -0.05; I² 49 %), gestational diabetes (overall OR 0.65, 95 % CI: 0.43, 0.98, I² 48 %), and hypertensive disorders (overall OR 0.51, 95 % CI: 0.31, 0.83, I² 0%).

CONCLUSIONS

PA in pregnancy had a preventive effect on weight gain, gestational diabetes, and hypertensive disorders. Supervised exercise and static cycling had a protective effect on gestational weight gain. Variation in outcomes reported suggest establishing a core outcome set.