Comparison of Vitamin D3 Serum and Method of Deliveries among Pregnant Women Who did and did not Performe Regular Outdoor Aerobic Activities

Abstract

The maternal mortality rate in Indonesia is still very high. One of the main factors is postpartum hemorrhage and an increase in the cesarean section rate (CSR). The American College of Obstetrics and Gynecology has recommended aerobic exercise. We assumed that outdoor aerobic exercise could be useful for the advancement of labor and the reduction of CSR. This study aimed to assess whether regular exercise can have a good impact on reducing labor and CSR, which is likely to be affected by an increase in vitamin D 3 levels. It was an experimental study involving 40 patients at Al Islam Awibitung Hospital and Ibrahim Adjie Healthcare Center in Bandung in February–April 2018, who met the inclusion criteria and divided into two groups, who performed regular outdoor aerobic activity and those who did not. Patient characteristics, work progress, and vitamin D 3 levels recorded. The data collected was then tested and compared between pre-and post-treatment, a paired t test was done. There was a relationship between the increase in-vitamin D 3 and the ease of childbirth in the treatment group (p<0.05). The comparison of vitamin D 3 levels among the two groups was −18.8% vs −26.8% respectively (p<0.05). Method of delivery were spontaneous delivery 80% vs 25%, vacuum extraction 15% vs 55%, and cesarean section 5% vs 20%, respectively (p<0.05). In conclusion that regular outdoor aerobic exercise in a pregnant woman could increase vitamin D 3 levels, ease labor, and reduce CSR. PERBANDINGAN KADAR VITAMIN D 3 SERUM DAN METODE PERSALINAN ANTARA IBU HAMIL YANG MENJALANKAN DAN TIDAK MENJALANKAN AKTIVITAS AEROBIK DI RUANG TERBUKA SECARA RUTIN Saat ini angka kematian maternal di Indonesia masih sangat tinggi. Salah satu faktor penyebab utama adalah perdarahan pasca salin dan meningkatnya insidensi seksio sesarea. Aktivitas aerobik telah direkomendasikan oleh American College of Obstetrics and Gynecology (ACOG). Kami mempunyai hipotesis bahwa aktivitas aerobik rutin di udara terbuka dapat memengaruhi kadar vitamin D 3 serum ibu yang dapat meningkatkan kelancaran persalinan dan menurunkan risiko seksio sesarea. Penelitian ini bertujuan membuktikan hipotesis di atas. Metode penelitian adalah studi eksperimental terhadap 40 ibu hamil di RS Al Islam Awibitung dan Puskesmas Ibrahim Adjie Bandung pada bulan Februari–April 2018 yang memenuhi kriteria inklusi, serta dibagi dalam 2 grup, yaitu grup perlakuan yang melaksanakan aktivitas aerobik di udara terbuka secara rutin dan grup kontrol yang tidak melaksanakan aktivitas aerobik. Dilakukan pencatatan karakteristik pasien, kemajuan persalinan, metode persalinan, dan kadar vitamin D 3 sebelum dan setelah perlakuan, serta dilakukan analisis statistik dengan paired t test . Terdapat hubungan bermakna antara perubahan kadar vitamin D 3 dan metode persalinan (p<0,05). Perbandingan perubahan kadar vitamin D 3 antara kedua kelompok adalah −18,8% vs −26,8% (p<0.05). Metode persalinan adalah persalinan spontan 80% vs 25%, ekstraksi vakum 15% vs 55%, dan seksio sesarea 5% vs 20% (p<0,05). Simpulan, aktivitas aerobik rutin di udara terbuka pada ibu hamil berdampak terhadap kadar vitamin D 3 serum ibu dan dapat memperlancar proses persalinan serta menurunkan risiko seksio sesarea.