Uticaj aerobnog fizičkog vežbanja na učestalost vaginalnog porođaja – meta analiza
Abstract
Uvod/Cilj. Trudnoća je stanje kada dolazi do različitih morfoloških i fizioloških promena u organizmu trudnice. Mnogi su faktori koji imaju uticaja, na održavanje zdrave trudnoće. Fizička aktivnost je jedan od mogućih faktora koji može imati uticaja na kvalitet života tokom trudnoće. Zdravim trudnicama, bez medicinskih ili akušerskih komplikacija, preporučuje se umereno i pravilno fizičko vežbanje. Cilj ove meta-analize je bio da proceni uticaj kontinuiranog aerobnog fizičkog vežbanja na učestalost vaginalnog porođaja kod zdravih trudnica sa normalnim vrednostima indeks telesne mase (ITM). Metode. Ova meta-analiza je bila zasnovana na sistematskom pregledu i selekciji randomizovanih kliničkih studija. Uticaj fizičkog vežbanja je procenjen pomoću "RStudio" programskog jezika i okruženja. Heterogenost studija je procenjena Q statistikom. Utvrđena je moguća publikaciona pristrasnost studija. Analiza primarnih ishoda odnosila se na učestalost vaginalnog porođaja, dok se analiza sekundarnih ishoda odnosila na ITM u prvom merenju i ukupnom dobitku telesne mase nakon drugog merenja. Podobnost 10 individualnih studija prikazana je grafičkom i statistčkom analizom ekstrahovanih podataka. Rezultati. Fizički aktivne trudnice, koje su vežbale lakim do umerenim intenzitetom 3 puta nedeljno (35–60 minuta), imale su češće vaginalni porođaj u odnosu na sedentarne trudnice [67,4% prema 60.5%, relativni rizik (RR) 1.11, 95% indeks poverenja: 1.04–1.18]. RR je bio statistički značajno različit od jedinice (p = 0,002). Sve trudnice su imale optimalne vrednosti ITM u prvom merenju pre intervencije. Takođe, sve trudnice su dobile preporučen broj kilograma tokom trudnoće. Zaključak. Analiza odabranih individualnih studija pokazala je da kontinuirano aerobno fizičko vežbanje, tokom drugog i trećeg trimestra, nema negativan uticaj na mereni ishod trudnoće. Fizički aktivne trudnice su se češće imale vaginalni porođaj u odnosu na sedentarne trudnice.
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