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Review
. 2022 Apr 1;34(2):77-81.
doi: 10.1097/GCO.0000000000000770.

Activity restriction and preterm birth prevention

Emily E Nuss  1 , Anthony C Sciscione
Affiliations
Review

Activity restriction and preterm birth prevention

Emily E Nuss et al. Curr Opin Obstet Gynecol. .

Abstract

Purpose of review: Since the 1900s, activity restriction (AR) has been widely prescribed as a strategy for preventing preterm birth (PTB). Over the past decade, the practice has been called into question as numerous studies have demonstrated that AR does not improve obstetrical and perinatal outcomes but does confer significant physical and psychological risks. The purpose of this review is to offer clinicians a summary of the latest data on the risks, benefits, and efficacy of AR for the prevention of PTB.

Recent findings: Both retrospective and prospective studies have demonstrated that AR does not significantly prolong pregnancy including those with multiple gestations, short cervices, ruptured membranes, and increased body mass indexes. Several studies have also shown that physical activity during pregnancy is associated with a higher incidence of vaginal delivery, a lower incidence of gestational diabetes mellitus, and a lower incidence of hypertensive disorders without increasing the risk of adverse neonatal outcomes.

Summary: The culmination of these data led to the Society for Maternal-Fetal Medicines' release of an updated committee recommendation in August of 2020; AR should not be routinely prescribed as a treatment to prevent PTB.

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References

    1. American College of Obstetricians and Gynecologists. Prediction and prevention of spontaneous preterm birth: ACOG Practice Bulletin, Number 234. Obstet Gynecol 2021; 138:e65–90.
    1. Spinnewijn WE, Lotgering FK, Struijk PC, Wallenburg HC. Fetal heart rate and uterine contractility during maternal exercise at term. Am J Obstet Gynecol 1996; 174:43–48.
    1. Bauer I, Hartkopf J, Kullmann S, et al. Spotlight on the fetus: how physical activity during pregnancy influences fetal health: a narrative review. BMJ Open Sport Exerc Med 2020; 6:e000658.
    1. Elliott JP, Miller HS, Coleman S, et al. A randomized multicenter study to determine the efficacy of activity restriction for preterm labor management in patients testing negative for fetal fibronectin. J Perinatol 2005; 25:626–630.
    1. Hobel CJ, Ross MG, Bemis RL, et al. The West Los Angeles preterm birth prevention project: I. program impact on high-risk women. Am J Obstet Gynecol 1994; 170:54–62.

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