Clinical Obstetrics
Poster Session 4
Chen Ben David, MD
Rambam Healthcare Campus
Haifa, Hefa, Israel
Rayna Boyarsky, MS
Technion University
Haifa, Hefa, Israel
Devorah Rozenberg, MS
Technion University
Haifa, Hefa, Israel
Yaniv Zipori, MD
Rambam Healthcare Campus
BINYAMINA, Hefa, Israel
Naphtali Justman, MD, MPH
Rambam Medical Center
Haifa, Hefa, Israel
Gal Bachar, MD (she/her/hers)
Rambam Healthcare Campus
Haifa, Hefa, Israel
Nizar Khatib, MD
Rambam health care campus, Haifa, Israel
Acre, Hefa, Israel
Yuval Ginsberg, MD
Deputy Ob/Gyn department
Rambam Health Care Campus
Haifa, HaZafon, Israel
Zeev Weiner, MD
Rambam Medical Health Campus
Haifa, HaZafon, Israel
Ron Beloosesky, MD
Harbor UCLA Medical Center
Los Angeles, CA, United States
This study explores the association between maternal physical activity, as indicated by the number of steps taken daily during pregnancy and adverse pregnancy outcomes.
Study Design:
A prospective observational study in a tertiary center (January-July 2023). Only women with singleton pregnancies attempting vaginal delivery were included. The number of steps taken during gestation (STDG) was measured using validated phone apps. Regression models and correlation tests investigated the association between the mean number of STDG and perinatal outcomes. Results were adjusted for age, parity, body mass index, medical and obstetric history. The primary outcome was mode of delivery. The secondary outcomes included adverse neonatal and maternal complications.
Results:
A total of 401 patients met the inclusion criteria. We observed a gradual decrease in maternal physical activity as pregnancy progressed (mean of 3,184, 2,700, and 2,152 daily steps in the first trimester, mid-pregnancy, and third-trimester, respectively). The overall incidence of intrapartum cesarean section (CS) was 10.5%. More active patients (higher mean daily steps during gestation) had a significantly lower incidence of CS (2,818.± 1,300.4 vs. 2,065.± 729.2 steps, p< 0.001). The area under the ROC curve, with a cut-off set at 2,093.5 daily steps, was 0.694 (95% CI, 0.615–0.773), resulting in a significant risk reduction in the CS rate (odd ratio of 0.22, 95% CI 0.104-0.465). More active patients also showed: 1. reduced composite outcome of gestational diabetes, gestational hypertension and preeclampsia; 2. epidural analgesia use; 3. and postpartum hemorrhage (figure 1). Preterm birth, labor induction, neonatal weight, and neonatal intensive care unit admission were not significantly affected.
Conclusion:
Increased physical activity during pregnancy, as reflected by a higher STDG, significantly improves perinatal outcome, including decreased rates of C-section, gestational hypertension, gestational diabetes, epidural use, and postpartum hemorrhage. Maintaining an active lifestyle during pregnancy should be strongly encouraged.