Efeito do exercício físico supervisionado durante a gestação e risco de parto cesárea: uma revisão sistemática com metanálise

Abstract

Objective: to verify the effect of physical exercise during pregnancy on the cesarean delivery risk. Materials and method: only randomized controlled studies were included where the intervention of physical exercises during the gestational period was carried out under supervision and the immune cesarean rate. The search for studies was carried out in MEDLINE, LILACS, PEDro, Web of Science, Scopus, SPORTDiscus, Science-Direct, CINAHL, SciELO and Embase databases. Methodological quality and risk of bias were assessed using the Jadad Scale and RoB-2, respectively. The level of evidence from the meta-analysis was analyzed using the GRADE tool. The type of delivery, whether vaginal or cesarean, was considered a dichotomous outcome. The measure of effect considered was the relative risk. The statistical method was the Mantel-Haenszel. The analysis model was fixed effect (I2 = 9%; P = 0.33). The significance level adopted was 0.05. The Review Manager statistical package was used. Results: the meta-analysis of the 43 included studies revealed that pregnant women who performed physical exercises demonstrated a significantly lower risk of 19% (RR = 0.81; 95%CI = 0.75–0.88) for cesarean delivery, when unexpectedly, pregnant women of the group control. The level of evidence from the meta-analysis was considered high. Conclusion: a supervised physical exercise program during pregnancy is capable of significantly reducing the risk of cesarean delivery