Influencia del ejercicio físico aeróbico durante el embarazo en los niveles de hemoglobina y de hierro maternos. (Influence of the fhysical aerobic exercise during pregnancy in the maternal haemoglobin and iron levels).

Resumen

Son bien conocidos los efectos beneficiosos que el ejercicio físico tiene sobre la salud en general, aunque no se cuenta con la misma información cuando se desarrolla durante el embarazo. La mayor incertidumbre es saber si pueden coexistir ambos procesos, ejercicio y embarazo, sin conflictos materno-fetales y sin resultados del embarazo alterados. Especialmente cuando día a día, son más las mujeres que desean continuar ejercitándose de alguna forma, durante su embarazo. El objetivo de este trabajo es conocer la influencia del ejercicio físico aeróbico moderado desarrollado durante el segundo y tercer trimestres en los niveles de hemoglobina y de hierro maternos. Material y métodos: Se llevó acabo un estudio experimental que incluyó un total de 142 gestantes. Grupo casos: integrado por 72 mujeres. Grupo control: integrado por 70 mujeres. Los parámetros maternos estudiados fueron: niveles de hierro, nivel de hemoglobina previo al parto, edad gestacional, tipo de parto. Fetales: Peso de nacimiento, talla, perímetro craneal, test de Apgar (1´y 5´). Resultados: No se encontraron diferencias significativas a nivel estadístico entre ambos grupos (p menor que 0,05), el grupo de casos (ejercicio) presento medias similares en los niveles de hemoglobina: 12.1 ± 0.8 y de hierro: 65.90 ± 7.1; que el grupo de control: hemoglobina: 12.3 ± 0.8 y hierro: 66.42 ± 8.4. El peso de nacimiento fue inferior en el grupo de casos dentro de valores normales (-142.1 grs.). Conclusión: El ejercicio aeróbico moderado desarrollado durante el segundo y tercer trimestre de embarazo parece no alterar los niveles de hierro y hemoglobina maternos.

Palabras clave/key words: ejercicio fisico | embarazo | parametros hematologicos | physical exercise | pregnancy | hematologic indices

Abstract

They are very well-known the beneficial effects that the physical exercise has about the health in general, although it is not had the same information when it refers to a pro- cess of remarkable importance: the pregnancy. The biggest uncertainty is to know if both processes, exercise and pregnancy can coexist without maternal-foetal conflicts and without the pregnancy outcome are altered. Especially when day by day, they are more the women that want to continue training in some way, during their pregnancy. The aim of this investigation is to know the influence of the moderate aerobic exercise developed during the second and third pregnancy trimesters on haemoglobin and iron maternal levels. Materials and methods: An experimental design was used. It included a total of 142 pregnant. Cases Group: integrated by 72 women. Control Group: integrated by 70 women. The studied maternal parameters were: iron levels, haemoglobin level, gestational age, type of delivery. Foetal: birth weight, size, cranial perimeter, Apgar test (1´y 5´). Results: Results show not significant differences between both groups at statistical level (p menor que 0.05), cases group (exercise) present similar results related to haemoglobin levels: 12.1 ± 0.8 and iron: 65.90 ± 7.1 that the control group: haemoglobin: 12.3 ± 0.8 and iron: 66.42 ± 8.4. The birth weight was inferior in the case group inside normal values (-142.1grs.). Conclusion: The moderate and aerobic exercise developed during the second and third pregnancy trimester seems not to influence in maternal haemoglobin and iron levels.

doi:10.5232/ricyde2008.01102

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Referencias/references

ACOG. American College of Obstetricians and Gynecologists. (2002). Exercise during pregnancy and the postpartum period . Committe Opinion Nº 267. Washington, DC. January. Obstet Gynecol, 99:171-3.
doi:10.1016/S0029-7844(01)01749-5

Bell, R. Palma, S. and Lumley, J. (1995). The effects of vigorous exercise during pregnancy on birth weight. Ast N Z Obstet Gynaecol, 35: 46-51.
doi:10.1111/j.1479-828X.1995.tb01829.x
PMid:7771999

Berkowitz, G. Kelsey, J. Holford, T. and Berkowitz, R. (1983). Physical activity and the risk of spontaneous preterm delivery. J Reprod Med, 28:581-8.
PMid:6631844

Clapp, JF III. and Capeless, E. (1990). Neonatal morphometrics after endurance exercise during pregnancy. Am J Obstet Gynecol, 163:1805-11.
PMid:2256486

Clapp, JF III. Kim, H. Burciu, B. and Lopez, B. (2000). Beginning regular exercise in early pregnancy: Effect on fetoplacental growth. Am J Obstet Gynecol, 183: 1484-8.
doi:10.1067/mob.2000.107096
PMid:11120515

Clapp, JF III. Simonian, S. Lopez, B. Appleby-Wineberg, S. and Harcar-Sevcik R. (1998). The one-year morphometric and neurodevelopmental outcome of the offspring of women who continued to exercise regularly throughout pregnancy. Am J Obst Gynecol, 178:594-9.
doi:10.1016/S0002-9378(98)70444-2

Clapp, JF III. (1989). Oxigen consumption during treadmill exercise before, during and after pregnancy. Am J Obstet Gynecol, 161: 1458-64.
PMid:2603899

Erkkola R. (1976). The physical work capacity of the expectant mother and its effects on pregnancy, labour and the newborn. Int J Gynecol Obstet, 14:153-9 .
PMid:10206

Ertan, A. Schanz, S. Tanriverdi, H. Meyberg, R. Schmidt, W. (2004). Doppler examinations of fetal and uteroplacental blood flow in AGA and IUGR fetuses before and after maternal physical exercise with the bicycle ergometer. J Perinat Med, 32(3):260-5.
doi:10.1515/JPM.2004.049
PMid:15188802

Gouveia, R. Martins, S. Sandes, A. Nascimento, C. Figueira, J. Valente, S. Correia, S. Rocha, E. and Silva, L. (2007). Pregnancy and physical exercise: myths, evidence and recommendations. Acta Med Port, 20(3): 209-14.
PMid:17868529

Hatch, M. Shu, X. McLean, D. Levin, B. Begg, M. Reuss, L. et al. (1993): Maternal exercise during pregnancy, physical fitness and fetal growth. Am J Epidemiol, 137:1105-14.
PMid:8317440

Heenan, A. Wolfe, L. and Davies, G. (2001). Maximal exercise testing in late gestation: maternal responses. Obstet Gynecol, 97: 127-34.
doi:10.1016/S0029-7844(00)01089-9

Kardel, K. and Kase, T. (1998). Training in pregnant women: effects on fetal development and birth. Am J Obstet Gynecol, 178:280-6.
doi:10.1016/S0002-9378(98)80013-6

Kemp, J. Greer, F. and Wolfe, L. (1997). Acid-base regulation after maximal exercise testing in late gestation. J Appl Physiol, 83 (2): 644-51.
PMid:9262463

Klebanoff, M. Shiono, P. and Carey, J. (1990). The effects of physical activity during pregnancy on preterm delivery and birth weight. Am J Obstet Gynecol, 163:1450-1456.
PMid:2240086

Koltyn, K. and Schultes, S. (1997). Pychological effects of an aerobic exercise session and a rest session following pregnancy. J Sports Med Phys Fitness, 37: 287-91.
PMid:9509828

Lokey, E. Tran, Z. Wells, C. Myers, B. and Tran, A. (1991). Effects of physical exercise on pregnancy outcomes: a meta analytic review. Med Sci Sports Exerc, 23(11): 1234-1239.
doi:10.1249/00005768-199111000-00006

Lotgering, F. Gilbert, R. and Longo, L. (1983). Exercise responses in pregnant sheep: oxygen consumption, uterine blood flow and blood volume. J Appl Physiol, 55: 834-41.
PMid:6629921

Macphail, A. Davies, G. Victory, R. and Wolfe, L. (2000). Maximal exercise testing in late gestation: fetal responses. Obtet Gynecol, 96: 565-70.
doi:10.1016/S0029-7844(00)00940-6

Sibley, L. Ruhling, R. Cameron-Foster, J. Christensen, C. and Bolen, T. (1981). Swimming and physical fitness during pregnancy. J Nurse-Midwif, 26:3-12.
doi:10.1016/0091-2182(81)90169-5

Wolfe, L. and Mottola, M. (1993). Aerobic exercise in pregnancy: an update. Can J Appl Physiol, 18: 119-147.
PMid:8513287

Wolfe, L. Brenner, I. and Mottola, M. (1994). Maternal exercise, fetal well- being and pregnancy outcome. Exerc Sport Sci Rev, 22: 145-94.
doi:10.1249/00003677-199401000-00008
PMid:7925542

Wong, S. and McKenzie, D. (1987). Cardiorespiratory fitness during pregnancy and its effect on outcome. Int J Sports Med, 8 (2): 79-83.
doi:10.1055/s-2008-1025645
PMid:3596880
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