Randomized Controlled Trial of Aerobic Exercise Versus Standard Care in the Prevention of Pre-Eclampsia Among Primigravida in Aminu Kano Teaching Hospital (AKTH)

Abstract

Background: Pre-eclampsia is associated with increased maternal and perinatal morbidity and mortality. Lifestyle modification is a recommended strategy for its prevention.

Aim: To determine the role of supervised exercise in pregnancy in preventing pre-eclampsia among primigravida; and pregnancy outcome in AKTH.

Methodology: A double-blind randomized control trial carried out on 96 primigravida randomized into either the intervention/exercise (n=47) or control group (n=49). Intervention consisted of a circuit of supervised pilates and aerobic exercise training of 60 minutes duration performed twice-weekly for 12 weeks, at moderate intensity from 18-30 weeks gestational age(GA). The control had routine antenatal care only.

Result: Eighty nine (92.7%) were included in the final analysis [intervention: n=45(50.6%); control n=44(49.4%)]. Supervised moderate exercise in pregnancy was beneficial to primigravida in preventing pre-eclampsia; 27(61.4%) in the control arm developed pre-eclampsia compared to 10(22.2%) in the intervention arm and this was statistically significant (p=0.0001). Mean systolic (sBP) and diastolic blood pressures (dBP) as well as mean gestational weight gain (GWG) in the intervention group at delivery were significantly lower compared to the control [sBP vs dBP: p<0.001;Cohen(d)=0.69  vs p=0.001;d=0.61; GWG (p=0.001)]. Intervention group had a significantly higher incidence of vaginal delivery 39(86.7%) compared to the control 23(52.3%) (p=0.001). Mean GA (p=0.085), macrosomia (p=0.544) and Special Care Baby Unit (SCBU) admission (p=0.585) did not differ significantly between the two groups.

 Conclusion: Supervised physical exercise in pregnancy was a safe preventive measure for pre-eclampsia in primigravida and was associated with increased incidence of vaginal delivery and reduced incidence of excessive GWG.

Key words: Physiotherapy exercise, pre-eclampsia, pregnancy