Date of Graduation

Summer 8-11-2018

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

Abstract

Background: Overall cesarean section rates have increased in the United States from 20.7% in 1996 to 32.9% in 2009. Research shows that maternal morbidity is higher among women who have cesarean deliveries versus patients who have vaginal deliveries. With the rate of cesarean sections increasing in recent years, there have been efforts put in place to reduce these numbers. One method of combating this trend could be increasing exercise throughout the course of pregnancy. This review assesses the current evidence of the benefits of moderate exercise in decreasing the risk of unplanned cesarean section.

Methods: An exhaustive search of available medical literature was conducted using MEDLINE-Ovid, Google Scholar, and Web of Science were used. The search terms pregnancy, exercise, and cesarean section. Applicable articles were assessed for quality using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).

Results: Two studies met eligibility criteria and were included. Both were randomized control trials. One study of 290 healthy, singleton pregnancies found that the percentage of cesarean deliveries were lower in the exercise group compared to the control group (16% versus 23%). The second study of 62 singleton pregnancies found that the percentage of cesarean deliveries was lower in the active group compared to the control group (6.4% versus 32.2%). Both studies had a moderate quality of evidence based on GRADE guidelines.

Conclusion: The two studies reviewed demonstrated a decreased rate of cesarean section in patients who exercised moderately throughout all 3 trimesters. Exercise throughout pregnancy did not have any negative effects on overall newborn health status. Providers should encourage moderate aerobic exercise to patients throughout the entire course of pregnancy.

Keywords: Exercise, pregnancy, cesarean section

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