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Do female elite athletes experience more complicated childbirth than non-athletes? A case–control study
  1. Thorgerdur Sigurdardottir1,2,
  2. Thora Steingrimsdottir1,2,
  3. Reynir Tomas Geirsson1,2,
  4. Thorhallur Ingi Halldorsson3,
  5. Thor Aspelund1,
  6. Kari Bø4,5
  1. 1 Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
  2. 2 Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavik, Iceland
  3. 3 Faculty of Food Sciences and Nutrition, School of Health Sciences, University of Iceland, Reykjavik, Iceland
  4. 4 Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
  5. 5 Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway
  1. Correspondence to Thorgerdur Sigurdardottir, Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavík 101, Iceland; th.sigurdardottir{at}


Objective Previous studies have suggested that female athletes might be at higher risk of experiencing complications such as caesarean sections and perineal tears during labour than non-athletes. Our aim was to study delivery outcomes, including emergency caesarean section rates, length of the first and second stages of labour and severe perineal tears, in first-time pregnant elite athletes compared with non-athletes.

Methods This is a retrospective case–control study comparing birth outcomes of primiparous female elite athletes engaging in high-impact and low-impact sports compared with non-athletic controls. The athletes had prior to birth competed at a national team level or equivalent. Participant characteristics and frequency of training for at least 3 years before a first pregnancy were collected via a self-administered questionnaire. Information on delivery outcome was retrieved from the Icelandic Medical Birth Registry.

Results In total, 248 participated, 118 controls, 41 low-impact and 89 high-impact elite athletes. No significant differences were found between the groups with regard to incidence of emergency caesarean section or length of the first and second stages of labour. The incidence of third-degree to fourth-degree perineal tears was significantly higher (23.7%) among low-impact athletes than in the high-impact group (5.1%, p=0.01), but no significant differences were seen when the athletes were compared with the controls (12%; p=0.09 for low-impact and p=0.12 for high-impact athletes).

Conclusion Participation in competitive sports at the elite level was not related to adverse delivery outcome, including length of labour, the need for caesarean section during delivery and severe perineal tears.

  • athlete
  • female
  • obstetrics
  • pelvic floor

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  • Contributors TSi, TSt, RTG and KB contributed to the design, execution, analysis and interpretation of the study, while TIH and TA contributed to the design and analysis of the material. All authors have contributed to the writing of the manuscript.

  • Funding This study is part of a PhD study which has received grants from the following: University of Iceland Research Fund, Public Health Fund, Icelandic Directorate of Health, Icelandic Physiotherapy Association Science Fund, Landspitali University Hospital and Iceland Science Fund.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Ethical approval was obtained from Icelandic National Bioethics Committee (Ref: VSN-13–189), and the Data Protection Authority granted permission as well (Ref: 2014030475TS/--). The study was conducted in accordance with the Helsinki Declaration on human experimentation.

  • Provenance and peer review Not commissioned; externally peer reviewed.