Mother's Exercise decreases Fetal Macrosomia

Exercise during pregnancy is beneficial for mom. But, does it have an effect on baby, too?

Fetal macrosomia is defined as a baby weighing greater than 4000 to 4500 grams (approximately nine pounds). Fetal macrosomia contributes to increased maternal risks including increased perineal lacerations, cesarean delivery and postpartum hemorrhage. Fetal macrosomia contributes to fetal risks such as shoulder dystocia (which can result in temporary or permanent injury), other birth trauma, low Apgar scores and obesity.

In the October, 2009 edition of Obstetrics and Gynecology a large, Norwegian, prospective pregnancy cohort study included outcomes of 36,869 singleton pregnancies lasting at least 37 weeks. 10.9% of the babies were macrosomic at the time of birth. Regular exercise (at least 3 times per week) during pregnancy significantly decreased the likelihood of a woman delivering a macrosomic fetus. Regular exercise before pregnancy had no effect on the rate of delivering a newborn with excessive birth weight if the exercise did not continue during pregnancy.

The exercise most likely to be associated with a normal birth weight included walking, running, dancing and low-impact aerobics. Women who participated in swimming during pregnancy were more likely to give birth to a newborn with an excessive birth weight.

Conclusion: Regular exercise during pregnancy at least 3 days per week reduces the odds of giving birth to newborns with excessive birth weight by 23-28%.

Reference:
Owe KM, Nystad W, Bo K. Association between regular exercise and excessive newborn birth weight. Obstetrics and Gynecology 2009;114(4)770-776.

Home Birth Gone Awry

This is an excellent MedScape article that discusses the potential perils of home birth but offers a balanced discussion about improving the care for women who opt for a home birth in the United States. Important clarifications about the different midwifery certifications is reviewed - they are not one size fits all. As medical costs continue to climb in the United States, and home birth is 1/3 as expensive as hospital delivery, consideration should be given to European systems that deliver safe and less expensive care for pregnant women. Women who opt for home deliveries, almost without exception, are seeking more autonomy surrounding the delivery of their baby.

It is time for the medical community to have meaningful discussions with women about their desires for childbirth. It is time to better educate women about the potential risks associated with childbirth - whether within a controlled medical environment or at home. This, of course, assumes that the medico-legal environment surrounding childbirth be reexamined, as well.

Read: Home Birth Gone Awry