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Zhang D, Ruchat SM, Silva-Jose C, Gil-Ares J, Barakat R, Sánchez-Polán M. Influence of Physical Activity during Pregnancy on Type and Duration of Delivery, and Epidural Use: Systematic Review and Meta-Analysis. J Clin Med 2023; 12:5139. [PMID: 37568541 PMCID: PMC10419719 DOI: 10.3390/jcm12155139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
Cesarean delivery may increase the need for anesthesia administration, thereby causing potential risks to both maternal and fetal health. This article aimed to investigate the effect of physical activity during pregnancy on the type of delivery, the duration of labor, and the use of epidurals (registration No.: CRD42022370646). Furthermore, 57 RCTs (n = 15301) were included showing that physical activity could decrease the risk of cesarean section (z = 3.22, p = 0.001; RR = 0.87, 95% CI = 0.79, 0.95, I2 = 37%, Pheterogeneity = 0.004), and 32 RCTs (n = 9468) showed significant decreases in instrumental delivery through performing physical activity (z = 3.48, p < 0.001; RR = 0.84, 95% CI = 0.76, 0.93, I2 = 0%, Pheterogeneity = 0.63). A significant decrease in the 15 RCTs' (n = 4797) duration of first stage labor was found in physically active pregnant women (z = 2.09, p = 0.04; MD = -62.26, 95% CI = -120.66, -3.85, I2 = 93%, Pheterogeneity < 0.001) compared to those not active. Prenatal physical activity could decrease the risk of cesarean section and instrumental delivery and the duration of first stage labor.
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Affiliation(s)
- Dingfeng Zhang
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Stephanie-May Ruchat
- Department of Human Kinetics, Université du Québec à Trois, Trois-Rivières, QC G8T 0A1, Canada
| | - Cristina Silva-Jose
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Javier Gil-Ares
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Rubén Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
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Zhou WS, Zheng TT, Mao SJ, Xu H, Wang XF, Zhang SK. Comparing the effects of different exercises on blood pressure and arterial stiffness in postmenopausal women: A systematic review and meta-analysis. Exp Gerontol 2023; 171:111990. [PMID: 36397637 DOI: 10.1016/j.exger.2022.111990] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 10/08/2022] [Accepted: 10/23/2022] [Indexed: 12/14/2022]
Abstract
The present study aimed to compare the efficacy of different exercises on systolic blood pressure (SBP), diastolic blood pressure (DBP), and aortic pulse wave velocity (PWV) in postmenopausal women. We searched the China National Knowledge Infrastructure (CNKI), Wanfang database, Web of Science, PubMed, and Cochrane library databases, up to July 2022. The randomized controlled trials (RCTs) were selected following the inclusion criteria. We assessed study quality with the PEDro scale. The Stata software was used for statistical analysis. Twenty-three papers (26 RCTs) and 729 participants were included. Meta-analysis demonstrated that exercise decreased SBP (WMD = -6.74 mmHg, 95%CI: -9.08, -4.41, p = 0.000), DBP (WMD = -4.13 mmHg, 95%CI: -5.78, -2.48, p = 0.000) and aortic PWV (WMD = -0.79 m/s, 95%CI: -1.02, -0.56, p = 0.000). Aerobic exercise can significantly decrease SBP (WMD = -7.97 mmHg, 95%CI: -12.99, -2.60, p = 0.003) and DBP (WMD = -5.97 mmHg, 95%CI: -8.55, -3.39, p = 0.000). Resistance exercise can significantly decrease SBP (WMD = -5.62 mmHg, 95%CI: -9.00, -2.23, p = 0.001), DBP (WMD = -1.87 mmHg, 95%CI: -2.75, -0.99, p = 0.000) and aortic PWV (WMD = -0.67 m/s,95%CI: -0.98, -0.36, p = 0.000). Combined aerobic and resistance exercise can significantly decrease SBP (WMD = -5.42 mmHg, 95%CI: -10.17, -0.68, p = 0.025). The efficacy of mind-body exercise (Tai Chi/Yoga) on SBP, DBP, and aortic PWV were not obvious (p > 0.05). Exercise significantly improved SBP, DBP, and aortic PWV in postmenopausal women. Aerobic exercise decreased SBP and DBP. Resistance exercise decreased SBP, DBP, and aortic PWV. Additionally, further research is required to confirm the efficacy of mind-body exercise (Tai Chi/Yoga) on blood pressure and arterial stiffness.
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Affiliation(s)
- Wen-Sheng Zhou
- College of Physical Education, Nanjing Xiao-Zhuang University, Nanjing, China
| | - Ting-Ting Zheng
- College of Physical Education, Nanjing Xiao-Zhuang University, Nanjing, China
| | - Su-Jie Mao
- College of Physical Education, Nanjing Xiao-Zhuang University, Nanjing, China; Graduate School, Nanjing Sport Institute, Nanjing, China
| | - Hong Xu
- Department of Sport & Health Science, College of Natural Science, Sangmyung University, Seoul, Republic of Korea
| | - Xue-Feng Wang
- College of Physical Education, Nanjing Xiao-Zhuang University, Nanjing, China
| | - Shi-Kun Zhang
- Department of Police Physical Education, Jiangsu Police Institute, Nanjing, China.
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Corso M, Miarka B, Figueiredo T, Bragazzi N, Carvalho D, Dias I. Effects of aerobic, strength, and combined training during pregnancy in the blood pressure: A systematic review and meta-analysis. Front Physiol 2022; 13:916724. [PMID: 36111150 PMCID: PMC9468920 DOI: 10.3389/fphys.2022.916724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 08/01/2022] [Indexed: 11/16/2022] Open
Abstract
Gestational hypertension can lead to fetal complications, and, if untreated, high blood pressure during pregnancy may cause eclampsia and even death in the mother and fetus. Exercise is a strategy for preventing blood pressure disorders. There is little knowledge about the physiological impacts of different physical types of training on blood pressure during pregnancy. For that, this meta-analysis aimed to compare the effects of different physical exercise modalities (i.e., aerobic training—AT, strength training—ST, and combined training—AT + ST) on systolic blood pressure (SBP) and diastolic blood pressure (DBP) of pregnant women. A search was performed on PUBMED, LILACS, CINAHL, Sport discus, EMBASE, SCOPUS, and Cochrane Central Register of Controlled Trials to identify researchers. From 3,450 studies, 20 and 19 were included in the qualitative and quantitative analyses. AT studies presented a medium effect size (ES) on SBP [−0.29 (−2.95 to 2.36) p = 0.83], with substantial heterogeneity (I2 = 64%), and had a large impact on DBP [−1.34 (−2.98 to 0.30) p = 0.11], with moderate heterogeneity (I2 = 30%). ST researchers showed a large ES on SBP [−1.09 (−3.66 to 1.49) p = 0.41], with a reduced heterogeneity (I2 = 0%), and a medium ES on DBP [−0.26 (−2.77 to 2.19) p = 0.83] with moderate heterogeneity (I2 = 38%). AT + ST studies had a large ES on SBP [−1.69 (−3.88 to 0.49) p = 0.13] and DBP [−01.29 (−2.26 to 0.31) p = 0.01] with considerable (I2 = 83%) and moderate heterogeneity (I2 = 47%), respectively. These findings are essential for developing new research protocols to avoid gestational hypertension and preeclampsia. AT + ST had a large impact on the SBP and DBP reduction; however, there is a need for more similar procedures to reduce heterogeneity between studies, promoting consensual results. Systematic Review Registration: [PROSPERO], identifier [CRD42021256509].
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Affiliation(s)
- Marcelo Corso
- Physical Education Postgraduate Program, School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bianca Miarka
- Physical Education Postgraduate Program, School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- *Correspondence: Bianca Miarka,
| | - Tiago Figueiredo
- Physical Education Program, Estácio de Sá University, Rio de Janeiro, Brazil
| | - Nicola Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Danilo Carvalho
- Physical Education Postgraduate Program, School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ingrid Dias
- Physical Education Postgraduate Program, School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Brislane Á, Steinback CD, Davenport MH. The Nine Month Stress Test: Pregnancy and Exercise - Similarities and Interactions. Can J Cardiol 2021; 37:2014-2025. [PMID: 34534622 DOI: 10.1016/j.cjca.2021.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/18/2021] [Accepted: 09/03/2021] [Indexed: 11/29/2022] Open
Abstract
Of all physiological systems, the cardiovascular system takes on the most profound adaptation in pregnancy to support fetal growth and development. The adaptations that arise are systemic and involve structural and functional changes that can be observed at the cerebral, central, peripheral, and microvascular beds. This includes, although is not limited to increased heart rate, stroke volume and cardiac output with negligible change to blood pressure, reductions in vascular resistance and cerebral blood flow velocity, systemic artery enlargement, enhanced endothelial function. All of this takes place to accommodate blood volume expansion and ensure adequate fetal and maternal oxygen delivery. In some instances, the demand placed on the vasculature can manifest as cardiovascular maladaptation and thus, cardiovascular complications can arise. Exercise is recommended in pregnancy because of its powerful ability to reduce the incidence and severity of cardiovascular complications in pregnancy. However, the mechanism by which it acts is poorly understood. The first aim of this review is to describe the systemic adaptations that take place in pregnancy. Secondly, this review aims to describe the influence of exercise on these systemic adaptations. It is anticipated that this review can comprehensively capture the extent of knowledge in this area while identifying areas that warrant further investigation.
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Affiliation(s)
- Áine Brislane
- Program for Pregnancy & Postpartum Health, Neurovascular Health Lab, Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Alberta, Canada
| | - Craig D Steinback
- Program for Pregnancy & Postpartum Health, Neurovascular Health Lab, Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Alberta, Canada
| | - Margie H Davenport
- Program for Pregnancy & Postpartum Health, Neurovascular Health Lab, Faculty of Kinesiology, Sport, and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Alberta, Canada.
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Díaz-Burrueco JR, Cano-Ibáñez N, Martín-Peláez S, Khan KS, Amezcua-Prieto C. Effects on the maternal-fetal health outcomes of various physical activity types in healthy pregnant women. A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2021; 262:203-215. [PMID: 34058612 DOI: 10.1016/j.ejogrb.2021.05.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 05/11/2021] [Accepted: 05/16/2021] [Indexed: 02/08/2023]
Abstract
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.
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Affiliation(s)
- Javier Ramón Díaz-Burrueco
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
| | - Naomi Cano-Ibáñez
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain; CIBER de Epidemiología y Salud Pública, (CIBERESP), Granada, Spain; Instituto de Investigación Biosanitaria ibs, GRANADA, Granada, Spain.
| | - Sandra Martín-Peláez
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria ibs, GRANADA, Granada, Spain
| | - Khalid S Khan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain; CIBER de Epidemiología y Salud Pública, (CIBERESP), Granada, Spain
| | - Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain; CIBER de Epidemiología y Salud Pública, (CIBERESP), Granada, Spain; Instituto de Investigación Biosanitaria ibs, GRANADA, Granada, Spain
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Carson J, Lewis M, Rassi D, Van Loon R. A data-driven model to study utero-ovarian blood flow physiology during pregnancy. Biomech Model Mechanobiol 2019; 18:1155-1176. [PMID: 30838498 PMCID: PMC6647440 DOI: 10.1007/s10237-019-01135-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 02/20/2019] [Indexed: 12/30/2022]
Abstract
In this paper, we describe a mathematical model of the cardiovascular system in human pregnancy. An automated, closed-loop 1D-0D modelling framework was developed, and we demonstrate its efficacy in (1) reproducing measured multi-variate cardiovascular variables (pulse pressure, total peripheral resistance and cardiac output) and (2) providing automated estimates of variables that have not been measured (uterine arterial and venous blood flow, pulse wave velocity, pulsatility index). This is the first model capable of estimating volumetric blood flow to the uterus via the utero-ovarian communicating arteries. It is also the first model capable of capturing wave propagation phenomena in the utero-ovarian circulation, which are important for the accurate estimation of arterial stiffness in contemporary obstetric practice. The model will provide a basis for future studies aiming to elucidate the physiological mechanisms underlying the dynamic properties (changing shapes) of vascular flow waveforms that are observed with advancing gestation. This in turn will facilitate the development of methods for the earlier detection of pathologies that have an influence on vascular structure and behaviour.
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Affiliation(s)
- Jason Carson
- College of Engineering, Swansea University, Bay Campus, Fabian Way, Swansea, SA1 8EN UK
| | - Michael Lewis
- College of Engineering, Swansea University, Bay Campus, Fabian Way, Swansea, SA1 8EN UK
| | - Dareyoush Rassi
- College of Human and Health Sciences, Swansea University, Singleton Campus, Singleton Park, Swansea, SA2 8PP UK
| | - Raoul Van Loon
- College of Engineering, Swansea University, Bay Campus, Fabian Way, Swansea, SA1 8EN UK
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Efecto de un programa de actividad física en el medio acuático sobre las constantes hemodinámicas en mujeres embarazadas. ENFERMERIA CLINICA 2018; 28:316-325. [DOI: 10.1016/j.enfcli.2017.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/27/2017] [Accepted: 07/29/2017] [Indexed: 11/21/2022]
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