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

Author

Davenport, Margie H, Ruchat, Stephanie-May, Sobierajski, Frances, Poitras, Veronica J, Gray, Casey E, Yoo, Courtney, Skow, Rachel J, Garcia, Alejandra Jaramillo, Barrowman, Nick, Meah, Victoria L, Nagpal, Taniya S, Riske, Laurel, James, Marina, Nuspl, Megan, Weeks, Ashley, Marchand, Andree-Anne, Slater, Linda G, Adamo, Kristi B, Davies, Gregory A, Barakat, Ruben, and Mottola, Michelle F

Subjects
Cell and Developmental Biology, pregnancy, exercise, Anatomy
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.

Published
2019

13. Prenatal exercise (including but not limited to pelvic floor muscle training) and urinary incontinence during and following pregnancy: a systematic review and meta-analysis

Author

Davenport, Margie H, Nagpal, Taniya S, Mottola, Michelle F, Skow, Rachel J, Riske, Laurel, Poitras, Veronica J, Jaramillo Garcia, Alejandra, Gray, Casey E, Barrowman, Nick, Meah, Victoria L, Sobierajski, Frances, James, Marina, Nuspl, Megan, Weeks, Ashley, Marchand, Andree-Anne, Slater, Linda G, Adamo, Kristi B, Davies, Gregory A, Barakat, Ruben, and Ruchat, Stephanie-May

Subjects
Cell and Developmental Biology, Anatomy, exercise, pregnancy, urinary incontinence
Abstract

Objective To examine the relationships between prenatal physical activity and prenatal and postnatal urinary incontinence (UI). Design Systematic review with random effects meta-analysis and meta-regression. Data sources 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, alone ["exercise-only"] or in combination with other intervention components [e.g., dietary; exercise + co-intervention]), Comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and Outcome (prenatal or postnatal UI). Results 24 studies (n=15982 women) were included. Low' to moderate' quality evidence revealed prenatal pelvic floor muscle training (PFMT) with or without aerobic exercise decreased the odds of UI in pregnancy (15 randomised controlled trials (RCTs), n=2764 women; OR 0.50, 95% CI 0.37 to 0.68, I-2=60%) and in the postpartum period (10 RCTs, n=1682 women; OR 0.63, 95%CI 0.51, 0.79, I-2=0%). When we analysed the data by whether women were continent or incontinent prior to the intervention, exercise was beneficial at preventing the development of UI in women with continence, but not effective in treating UI in women with incontinence. There was low' quality evidence that prenatal exercise had a moderate effect in the reduction of UI symptom severity during (five RCTs, standard mean difference (SMD) -0.54, 95%CI -0.88 to -0.20, I-2=64%) and following pregnancy (three RCTs, moderate' quality evidence; SMD -0.54, 95% CI -0.87 to -0.22, I-2=24%). Conclusion Prenatal exercise including PFMT reduced the odds and symptom severity of prenatal and postnatal UI. This was the case for women who were continent before the intervention. Among women who were incontinent during pregnancy, exercise training was not therapeutic.

Published
2018

14. Prenatal exercise (including but not limited to pelvic floor muscle training) and urinary incontinence during and following pregnancy: a systematic review and meta-analysis

Author

Davenport, Margie H, primary, Nagpal, Taniya S, additional, Mottola, Michelle F, additional, Skow, Rachel J, additional, Riske, Laurel, additional, Poitras, Veronica J, additional, Jaramillo Garcia, Alejandra, additional, Gray, Casey E, additional, Barrowman, Nick, additional, Meah, Victoria L, additional, Sobierajski, Frances, additional, James, Marina, additional, Nuspl, Megan, additional, Weeks, Ashley, additional, Marchand, Andree-Anne, additional, Slater, Linda G, additional, Adamo, Kristi B, additional, Davies, Gregory A, additional, Barakat, Ruben, additional, and Ruchat, Stephanie-May, additional

Published
2018
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15. Impact of prenatal exercise on maternal harms, labour and delivery outcomes: a systematic review and meta-analysis

Author

Davenport, Margie H, primary, Ruchat, Stephanie-May, additional, Sobierajski, Frances, additional, Poitras, Veronica J, additional, Gray, Casey E, additional, Yoo, Courtney, additional, Skow, Rachel J, additional, Jaramillo Garcia, Alejandra, additional, Barrowman, Nick, additional, Meah, Victoria L, additional, Nagpal, Taniya S, additional, Riske, Laurel, additional, James, Marina, additional, Nuspl, Megan, additional, Weeks, Ashley, additional, Marchand, Andree-Anne, additional, Slater, Linda G, additional, Adamo, Kristi B, additional, Davies, Gregory A, additional, Barakat, Ruben, additional, and Mottola, Michelle F, additional

Published
2018
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16. Effectiveness of exercise interventions in the prevention of excessive gestational weight gain and postpartum weight retention: a systematic review and meta-analysis

Author

Ruchat, Stephanie-May, primary, Mottola, Michelle F, additional, Skow, Rachel J, additional, Nagpal, Taniya S, additional, Meah, Victoria L, additional, James, Marina, additional, Riske, Laurel, additional, Sobierajski, Frances, additional, Kathol, Amariah J, additional, Marchand, Andree-Anne, additional, Nuspl, Megan, additional, Weeks, Ashley, additional, Gray, Casey E, additional, Poitras, Veronica J, additional, Jaramillo Garcia, Alejandra, additional, Barrowman, Nick, additional, Slater, Linda G, additional, Adamo, Kristi B, additional, Davies, Gregory A, additional, Barakat, Ruben, additional, and Davenport, Margie H, additional

Published
2018
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17. Impact of prenatal exercise on neonatal and childhood outcomes: a systematic review and meta-analysis

Author

Davenport, Margie H, primary, Meah, Victoria L, additional, Ruchat, Stephanie-May, additional, Davies, Gregory A, additional, Skow, Rachel J, additional, Barrowman, Nick, additional, Adamo, Kristi B, additional, Poitras, Veronica J, additional, Gray, Casey E, additional, Jaramillo Garcia, Alejandra, additional, Sobierajski, Frances, additional, Riske, Laurel, additional, James, Marina, additional, Kathol, Amariah J, additional, Nuspl, Megan, additional, Marchand, Andree-Anne, additional, Nagpal, Taniya S, additional, Slater, Linda G, additional, Weeks, Ashley, additional, Barakat, Ruben, additional, and Mottola, Michelle F, additional

Published
2018
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18. Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysis

Author

Davenport, Margie H, primary, Ruchat, Stephanie-May, additional, Poitras, Veronica J, additional, Jaramillo Garcia, Alejandra, additional, Gray, Casey E, additional, Barrowman, Nick, additional, Skow, Rachel J, additional, Meah, Victoria L, additional, Riske, Laurel, additional, Sobierajski, Frances, additional, James, Marina, additional, Kathol, Amariah J, additional, Nuspl, Megan, additional, Marchand, Andree-Anne, additional, Nagpal, Taniya S, additional, Slater, Linda G, additional, Weeks, Ashley, additional, Adamo, Kristi B, additional, Davies, Gregory A, additional, Barakat, Ruben, additional, and Mottola, Michelle F, additional

Published
2018
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19. A Scoping Review of Enterovirus D-68

Author

Weeks, Ashley, primary, Waddell, Lisa, additional, Nwosu, Andrea, additional, Bancej, Christina, additional, Desai, Shalini, additional, Booth, Tim, additional, and Shane, Amanda, additional

Published
2018
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20. Impact of prenatal exercise on maternal harms, labour and delivery outcomes: a systematic review and meta-analysis.

Author

Davenport, Margie H., Ruchat, Stephanie-May, Sobierajski, Frances, Poitras, Veronica J., Gray, Casey E., Courtney Yoo, Skow, Rachel J., Garcia, Alejandra Jaramillo, Barrowman, Nick, Meah, Victoria L., Nagpal, Taniya S., Riske, Laurel, James, Marina, Nuspl, Megan, Weeks, Ashley, Marchand, Andree-Anne, Slater, Linda G., Adamo, Kristi B., Davies, Gregory A., and Barakat, Ruben

Subjects
EXERCISE for pregnant women, PREGNANCY complications, CHILDBIRTH, DELIVERY (Obstetrics), LABOR (Obstetrics), META-analysis
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. [ABSTRACT FROM AUTHOR]

Published
2019
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