Atividade física nos trimestres gestacionais e desfechos perinatais em puérperas do SUS
DOI:
https://doi.org/10.11606/s1518-8787.2021055003067Palavras-chave:
Gestantes, Exercício Físico, Parto normal, Cesárea, Nascimento Prematuro, Estudos TransversaisResumo
OBJETIVO: Testar a associação entre a prática de atividade física (AF) de acordo com os trimestres gestacionais e a ocorrência de parto cesáreo, prematuridade e baixo peso ao nascer em puérperas atendidas no Sistema Único de Saúde de Santa Catarina, Brasil. MÉTODOS: Estudo transversal realizado com amostra probabilística de puérperas que tiveram seus partos em maternidades da rede pública de Santa Catarina no período de janeiro a agosto de 2019. O desfecho parto cesáreo foi autorreferido e as informações sobre parto prematuro (< 37 semanas gestacionais) e baixo peso ao nascer (< 2.500 gramas) foram obtidas dos prontuários. A prática de AF durante a gestação e conforme cada trimestre foi autorreferida. Foram realizadas análises de Regressão Logística Multivariável e entrevistas com 3.580 puérperas. RESULTADOS: A prática de AF durante qualquer período da gestação foi relatada por 20,6% da amostra, com redução gradativa das prevalências conforme os trimestres gestacionais (16,2%, 15,4% e 12,8%). As maiores prevalências dos desfechos em relação à amostra total, foram observadas nas puérperas não praticantes de AF no terceiro trimestre, sendo 43,9% para o parto cesáreo, 7,7% para o baixo peso ao nascer e 5,5% para o parto prematuro. As chances de parto cesáreo (OR = 1,40; IC95% 1,10–1,76) e de baixo peso ao nascer (OR = 1,99; IC95% 1,04–3,79) foram, respectivamente, 40% e 99% maiores entre as puérperas que não praticaram AF no terceiro trimestre da gestação quando comparadas àquelas que praticaram AF. Não houve associação da prática de AF com a prematuridade. CONCLUSÃO: As puérperas que não praticavam AF no terceiro trimestre da gestação tiveram maiores chances de parto cesáreo e de terem recém-nascidos com baixo peso.
Referências
Santini C, Imakawa TS, Moisés ECD. Physical activity during pregnancy: recommendations and assessment tools. Rev Bras Ginecol Obstet. 2017;39(8):424-32. https://doi.org/10.1055/s-0037-1604180 [ Links ]
Dipietro L, Evenson KR, Bloodgood B, Sprow K, Troiano R, Pierce KL, et al. Benefits of physical activity during pregnancy and postpartum: an umbrella review. Med Sci Sport Exerc. 2019;51(6):1292-302. https://doi.org/10.1249/mss.0000000000001941 [ Links ]
Poyatos-León R, García-Hermoso A, Sanabria-Martínez G, Álvarez-Bueno C, Cavero-Redondo I, Martinez-Vizcaino V. Effects of exercise-based interventions on postpartum depression: a meta-analysis of randomized controlled trials. Birth. 2017;44(3):200-8. https://doi.org/10.1111/birt.12294 [ Links ]
Davenport MH, Ruchat SM, Poitras VJ, Garcia AJ, Gray CE, Barrowman N, et al. Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysis. Br J Sports Med. 2018:52(21):1367-75. https://doi.org/10.1136/bjsports-2018-099355 [ Links ]
Padmapriya N, Bernard JY, Liang S, Loy SL, Shen A, Kwek K, et al. Association of physical activity and sedentary behavior with depression and anxiety symptoms during pregnancy in a multiethnic cohort of Asian women. Arch Womens Mental Health. 2016:19(6):1119-28. https://doi.org/10.1007/s00737-016-0664-y [ Links ]
Lozada-Tequeanes AL, Campero-Cuenca MLE, Hernandez B, Rubalcava-Peñafiel L, Neufeld LM. Barreras y facilitadores para actividad física durante el embarazo y posparto en mujeres pobres de México. Salud Publica Mex. 2015;57(3):242-51. [ Links ]
Coll CVN, Domingues MR, Hallal PC, Silva ICM, Bassani DG, Matisajevich A, et al. Changes in leisure-time physical activity among Brazilian pregnant women: comparison between two birth cohort studies (2004-2015). BMC Public Health. 2017;17(1):119. https://doi.org/10.1186/s12889-017-4036-y [ Links ]
Rêgo AS, Alves MTSSB, Batista RFL, Ribeiro CCC, Bettiol H, Cardoso VC, et al. Physical activity in pregnancy and adverse birth outcomes. Cad Saude Publica. 2016;32(11):e00086915. https://doi.org/10.1590/0102-311X00086915 [ Links ]
Davenport MH, Ruchat SM, Sobierajski F, Poitras VJ, Gray CE, Yoo C, et al. Impact of prenatal exercise on maternal harms, labour and delivery outcomes: a systematic review and meta-analysis. Br J Sports Med. 2019;53(2):99-107. https://doi.org/10.1136/bjsports-2018-099821 [ Links ]
Di Mascio D, Magro-Malosso ER, Saccone G, Marhefka GD, Berghella V. Exercise during pregnancy in normal-weight women and risk of preterm birth: a systematic review and meta-analysis of randomized controlled trials. Am J Obstet Gynecol. 2016;215(5):561-71. https://doi.org/10.1016/j.ajog.2016.06.014 [ Links ]
Dumith SC, Domingues MR, Mendoza-Sassi RA, Cesar JA. Atividade física durante a gestação e associação com indicadores de saúde materno-infantil. Rev Saude Publica. 2012;46(2):327-33. https://doi.org/10.1590/S0034-89102012005000012 [ Links ]
Betran AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, Torloni MR. The increasing trend in caesarean section rates: global, regional and national estimates: 1990-2014. PLoS One. 2016;11(2):e0148343. https://doi.org/10.1371/journal.pone.0148343 [ Links ]
Rudey EL, Leal MC, Rego G. Cesarean section rates in Brazil: trend analysis using the Robson classification system. Medicine (Baltimore). 2020;99(17):e19880. https://doi.org/10.1097/MD.0000000000019880 [ Links ]
Santos SP, Oliveira LMB. Baixo peso ao nascer e sua relação com obesidade e síndrome metabólica na infância e adolescência. Rev Cienc Med Biol. 2011;10(3):329-36. https://doi.org/10.9771/cmbio.v10i3.5898 [ Links ]
MacDorman MF, Mathews TJ, Mohangoo AD, Zeitlin J. International comparisons of infant mortality and related factors: United States and Europe, 2010. Natl Vital Stat Rep. 2014;24;63(5):1-6. [ Links ]
Teixeira GA, Carvalho JBL, Sena AV, Morais PC, Alves TRM. Características maternas de partos prematuros. Rev Enferm Atual InDerme. 2017;81(19). https://doi.org/10.31011/reaid-2017-v.81-n.19-art.317 [ Links ]
Caminha MF, Santos CC, Silva SL, Lustosa TF, Fariasas LCQ, Lima JNA, et al. Low birth weight in a subnormal urban cluster under Family Health Strategy’s care. Rev Bras Saude Matern Infant. 2019;19(4):1045-51. https://doi.org/10.1590/1806-93042019000400017 [ Links ]
Watson ED, Brage S, White T, Westgate K, Norris SA, Van Poppel MNM, et al. The influence of objectively measured physical activity during pregnancy on maternal and birth outcomes in urban black South African women. Matern Child Health J. 2018;22(8):1190-9. https://doi.org/10.1007/s10995-018-2504-3 [ Links ]
Ko YL, Chen CP, Lin PC. Physical activities during pregnancy and type of delivery in nulliparae. Eur J Sport Sci. 2016;16(3):374-80. https://doi.org/10.1080/17461391.2015.1028468 [ Links ]
Prather H, Spitznagle T, Hunt D. Benefits of exercise during pregnancy. PM&R. 2012;4(11):845-50. https://doi.org/10.1016/j.pmrj.2012.07.012 [ Links ]
Haakstad LAH, Bø K. Exercise in pregnant women and birth weight: a randomized controlled trial. BMC Pregnancy Childbirth. 2011;11:66. https://doi.org/10.1186/1471-2393-11-66 [ Links ]
Nielsen EN, Andersen PK, Hegaard HK, Juhl M. Mode of delivery according to leisure time physical activity before and during pregnancy: a multicenter cohort study of low-risk women. J Pregnancy. 2017;2017:6209605. https://doi.org/10.1155/2017/6209605 [ Links ]
Rajabi A, Maharlouei N, Rezaianzadeh A, Lankaranni KB, Esmaeilzadeh F, Gholami Ali, et al. Physical activities (exercises or choreses) during pregnancy and mode of delivery in nulliparous women: a prospective cohort study. Taiwan J Obstet Gynecol. 2018;57(1):18-22. https://doi.org/10.1016/j.tjog.2017.12.003 [ Links ]
Chen CH, Tzeng YL, Ying TH, Kuo PC. [The relationship among physical activity during the third trimester, maternal pre-pregnancy body mass index, gestational weight gain, and pregnancy outcomes]. Hu Li Za Zhi. 2017;64(1):80-9. Chinese. https://doi.org/10.6224/jn.64.1.80 [ Links ]
Domenjoz I, Kayser B, Boulvain M. Effect of physical activity during pregnancy on mode of delivery. Am J Obstet Gynecol. 2014;211(4):401.e1-11. https://doi.org/10.1016/j.ajog.2014.03.030 [ Links ]
Clapp JF 3rd, Kim H, Burciu B, Schmidt S, Petry K, Lopez B. Continuing regular exercise during pregnancy: effect of exercise volume on fetoplacental growth. Am J Obstet Gynecol. 2002;186(1):142-7. https://doi.org/10.1067/mob.2002.119109 [ Links ]
Owe KM, Nystad W, Skjaerven R, Stigum H, Bø K. Exercise during pregnancy and the gestational age distribution: a cohort study. Med Sci Sports Exerc. 2012;44(6):1067-74. https://doi.org/10.1249/MSS.0b013e3182442fc9 [ Links ]
Juhl M, Andersen PK, Olsen J, Madsen M, Jørgensen T, Nøhr EA, et al. Physical exercise during pregnancy and the risk of preterm birth: a study within the Danish National Birth Cohort. Am J Epidemiol. 2008;167(7):859-66. https://doi.org/10.1093/aje/kwm364 [ Links ]
Beetham KS, Giles C, Noetel M, Clifton V, Jones JC, Naughton G. The effects of vigorous intensity exercise in the third trimester of pregnancy: a systematic review and meta-analysis. BMC Pregnancy Childbirth. 2019;19(1):281. https://doi.org/10.1186/s12884-019-2441-1 [ Links ]
Gregg VH, Ferguson JE 2nd. Exercise in pregnancy. Clin Sport Med. 2017;36(4):741-52. https://doi.org/10.1016/j.csm.2017.05.005 [ Links ]
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Copyright (c) 2021 Tauana Prestes Schmidt, Talita Tuon, Katia J. Pudla Wagner, Antonio Fernando Boing, Ana Lúcia Danielewicz
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
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Fundação de Amparo à Pesquisa e Inovação do Estado de Santa Catarina
Números do Financiamento 2017TR1364
