Activity restriction for women with arrested preterm labor: a randomized controlled trial

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Reproductive Health

Background:

• Historically, activity restriction was recommended for pregnant women at risk of preterm birth.
• This was based on the theory that exercise-induced catecholamine release could stimulate myometrial activity.

Purpose of the Study:

• To evaluate the effectiveness of activity restriction in reducing preterm birth rates.
• To test the hypothesis that activity restriction lowers preterm birth in singleton pregnancies with arrested preterm labor.

Main Methods:

• A randomized controlled trial involving 120 women with arrested preterm labor.
• Participants were randomized to either activity restriction (pelvic rest, no sexual activity, reduced work/non-work activity) or no restriction.
• The primary outcome was preterm birth before 37 weeks of gestation.

Main Results:

• Preterm birth occurred in 25.0% of the activity restriction group versus 38.3% in the control group (RR 0.65; 95% CI 0.38-1.12).
• No significant difference was observed in preterm birth before 32 weeks or in neonatal outcomes.
• The study was not powered to detect differences in secondary outcomes.

Conclusions:

• Activity restriction does not reduce the rate of preterm birth in singleton gestations with arrested preterm labor.
• The findings suggest that activity restriction, including pelvic rest and reduced activity, offers no benefit for this population.
• The use of activity restriction in women with arrested preterm labor should be discouraged.