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Sigurdardottir T.1, Steingrimsdottir T.1, Geirsson R.T.2, Halldorsson T.I.1, Hardardottir H.2, Bø K.3
1University of Iceland, School of Health Sciences, Reykjavik, Iceland, 2Landspitali, University Hospital, Dept. of Obstetrics and Gynecology, Reykjavik, Iceland, 3Norwegian School of Sport Sciences, Oslo, Norway
Background: Participation in moderate physical activity before and during pregnancy is associated with improved pregnancy outcomes and less birth complications in the general population. Less information is available on how high level training and long lasting physical activity, such as in competitive sports, may influence childbirth. We have studied whether impact from sporting activities could affect the female pelvic floor and possibly have an adverse impact on delivery.
Purpose: To compare delivery outcome between low and high impact elite athletes and among women who were not in competitive sports but were active at a recreational level.
Methods: This was a retrospective observational study with a convenience sample consisting of elite athletes and a control group consisting of women who did not compete in sports but were physically active to some extent. Their activity included strength, endurance and flexibility training.
The athletes competed in the highest division possible, (58% of them for national teams) for at least 3 years before first childbirth. Participants were identified through Icelandic media, sports federations and snowball sampling. Replies were compared with birth register information. In all, 248 of 293 women answered questionnaires (84% response rate) about physical activity before first childbirth, 41 athletes from low impact sports (ballroom dancing, golf, jockey/horseback riding, motocross, pole fitness, swimming, weight lifting), 89 from high impact sports (basketball, crossfit, football, handball, racketsports, selfdefence sports, team gymnastics, track and field sports) and 118 women in control group (non-competing group).
Results: Women in the control group exercised on average for 1.6 hours per week (SD 3.1),
women competing in the low impact vs. high impact sports trained for 20.3 hours per week (SD 10.7) and 14.4 hours (SD 4.3) respectively.
Women in the high impact group had a non-significant highest rate of cesarean section (14.6%) compared with low impact athletes (7.3%) and control group (8.5%) (p=0.3). Low impact athletes had significantly higher rate of 3rd and 4th degree perineal ruptures (23.7%) when compared to high impact athletes (5.3%), (p 0.05) but not compared to the control group (12.1%). When adjusting for other covariates, only birthweight was associated with 3rd and 4th degree perineal ruptures.
Conclusion(s): Based on this sample, participation at elite level of sports does not correlate with adverse delivery outcome.
Implications: Further larger studies are warranted to study the association between different types of sports and delivery outcome.
Funding acknowledgements: The Icelandic Physiotherapy Association Science Fund, University of Iceland Research Fund, Public Health Fund (Directorate of Health), Iceland.
Topic: Women's & mens pelvic health
Ethics approval: The National Bioethics Committee, The Data Protection Authority, The University Hospital of Iceland ethics committee.
All authors, affiliations and abstracts have been published as submitted.
