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Siti F, Dubouchaud H, Hininger I, Quiclet C, Vial G, Galinier A, Casteilla L, Fontaine E, Batandier C, Couturier K. Maternal exercise before and during gestation modifies liver and muscle mitochondria in rat offspring. ACTA ACUST UNITED AC 2019; 222:jeb.194969. [PMID: 31019067 DOI: 10.1242/jeb.194969] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 04/05/2019] [Indexed: 01/09/2023]
Abstract
It is now well established that the intrauterine environment is of major importance for offspring health during later life. Endurance training during pregnancy is associated with positive metabolic adjustments and beneficial effects on the balance between pro-oxidants and antioxidants (redox state) in the offspring. Our hypothesis was that these changes could rely on mitochondrial adaptations in the offspring due to modifications of the fetal environment induced by maternal endurance training. Therefore, we compared the liver and skeletal muscle mitochondrial function and the redox status of young rats whose mothers underwent moderate endurance training (treadmill running) before and during gestation (T) with those of young rats from untrained mothers (C). Our results show a significant reduction in the spontaneous H2O2 release by liver and muscle mitochondria in the T versus C offspring (P<0.05). These changes were accompanied by alterations in oxygen consumption. Moreover, the percentage of short-chain fatty acids increased significantly in liver mitochondria from T offspring. This may lead to improvements in the fluidity and the flexibility of the membrane. In plasma, glutathione peroxidase activity and protein oxidation were significantly higher in T offspring than in C offspring (P<0.05). Such changes in plasma could represent an adaptive signal transmitted from mothers to their offspring. We thus demonstrated for the first time, to our knowledge, that it is possible to act on bioenergetic function including alterations of mitochondrial function in offspring by modifying maternal physical activity before and during pregnancy. These changes could be crucial for the future health of the offspring.
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Affiliation(s)
- Farida Siti
- Université Grenoble Alpes, INSERM, LBFA, 38058 Grenoble, France.,Université Grenoble Alpes, UFR STAPS, SFR Sport Exercice Motricité, 38058 Grenoble, France.,Department of Medical Pharmacy, Universitas Indonesia, 10430 Jakarta, Indonesia
| | - Hervé Dubouchaud
- Université Grenoble Alpes, INSERM, LBFA, 38058 Grenoble, France.,Université Grenoble Alpes, UFR STAPS, SFR Sport Exercice Motricité, 38058 Grenoble, France
| | | | - Charline Quiclet
- Université Grenoble Alpes, INSERM, LBFA, 38058 Grenoble, France.,Université Grenoble Alpes, UFR STAPS, SFR Sport Exercice Motricité, 38058 Grenoble, France
| | - Guillaume Vial
- Université Grenoble Alpes, INSERM, HP2, 38000 Grenoble, France
| | - Anne Galinier
- Université de Toulouse, STROMALab, CNRS: ERL5311, EFS: INP-ENVT, INSERM: U-1031, UPS, 31100 Toulouse, France
| | - Louis Casteilla
- Université de Toulouse, STROMALab, CNRS: ERL5311, EFS: INP-ENVT, INSERM: U-1031, UPS, 31100 Toulouse, France
| | - Eric Fontaine
- Université Grenoble Alpes, INSERM, LBFA, 38058 Grenoble, France.,Centre Hospitalier Universitaire Grenoble Alpes, 38000 Grenoble, France
| | | | - Karine Couturier
- Université Grenoble Alpes, INSERM, LBFA, 38058 Grenoble, France .,Université Grenoble Alpes, UFR STAPS, SFR Sport Exercice Motricité, 38058 Grenoble, France
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52
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Rabiepoor S, Sadeghi E, Sayyadi H. Spiritual Health and Physical Activity Among Iranian Pregnant Women. JOURNAL OF RELIGION AND HEALTH 2019; 58:506-515. [PMID: 28836086 DOI: 10.1007/s10943-017-0487-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study was aimed to investigate the relationship between spiritual health and physical activity among Iranian pregnant women during 2015. A cross-sectional descriptive-analytic design was adopted. A total number of 411 participants were selected by convenience sampling from Iranian women who regularly attended health centers for prenatal care. Data were collected using demographic questionnaire and Health-Promoting Lifestyle Profile questionnaire, 2nd edition. (Spiritual health and physical activity are two components of health-promoting lifestyle.) The data were analyzed, using descriptive statistics, t test, one-way ANOVA, Pearson's correlation coefficient, and regression. p values <0.05 were considered significant. The mean age of pregnant women was 27.90 ± 6.03 years. Spiritual health had the highest score (25.86 ± 4.7) and physical activity had the lowest score (11.31 ± 3.27), among six Health-Promoting Lifestyle Profile subscales. In fact, there was a statistically significant correlation between spiritual health and physical activity (p = 0.000). According to results, pregnant women have higher spiritual health and lower physical activity scores. There was a statistically significant correlation between spiritual health and physical activity. The findings of this study can be used in prenatal care, midwifery education, and maternal health policies.
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Affiliation(s)
- Soheila Rabiepoor
- Reproductive Health Research Centre, Midwifery Department, Urmia University of Medical Sciences, Urmia, Iran
| | - Elham Sadeghi
- Midwifery Department, Urmia University of Medical Sciences, Urmia, Iran.
| | - Hojjat Sayyadi
- Department of Biostatistics and Epidemiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
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53
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Sattler MC, Jaunig J, Watson ED, van Poppel MNM, Mokkink LB, Terwee CB, Dietz P. Physical Activity Questionnaires for Pregnancy: A Systematic Review of Measurement Properties. Sports Med 2019; 48:2317-2346. [PMID: 30094797 PMCID: PMC6132497 DOI: 10.1007/s40279-018-0961-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background In order to assess physical activity (PA) during pregnancy, it is important to choose the instrument with the best measurement properties. Objectives To systematically summarize, appraise, and compare the measurement properties of all self-administered questionnaires assessing PA in pregnancy. Methods We searched PubMed, Embase, and SPORTDiscus with the following inclusion criteria: (i) the study reported at least one measurement property (reliability, criterion validity, construct validity, responsiveness) of a self-administered questionnaire; (ii) the questionnaire intended to measure PA; (iii) the questionnaire was evaluated in healthy pregnant women; and (iv) the study was published in English. We evaluated results, quality of individual studies, and quality of evidence using a standardized checklist (Quality Assessment of Physical Activity Questionnaires [QAPAQ]) and the GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) approach. Results Seventeen articles, reporting 18 studies of 11 different PA questionnaires (17 versions), were included. Most questionnaire versions showed insufficient measurement properties. Only the French and Turkish versions of the Pregnancy Physical Activity Questionnaire (PPAQ) showed both sufficient reliability and construct validity. However, all versions of the PPAQ pooled together showed insufficient construct validity. The quality of individual studies was usually high for reliability but varied considerably for construct validity. Overall, the quality of evidence was very low to moderate. Conclusions We recommend the PPAQ to assess PA in pregnancy, although the pooled results revealed insufficient construct validity. The lack of appropriate standards in data collection and processing criteria for objective devices in measuring PA during pregnancy attenuates the quality of evidence. Therefore, research on the validity of comparison instruments in pregnancy followed by consensus on validation reference criteria and standards of PA measurement is needed. Electronic supplementary material The online version of this article (10.1007/s40279-018-0961-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Johannes Jaunig
- Institute of Sport Science, University of Graz, Graz, Austria
| | - Estelle D Watson
- Centre for Exercise Science and Sports Medicine, Faculty of Health Sciences, School of Therapeutic Sciences, University of Witwatersrand, Private Bag 3, Johannesburg, 2050, South Africa.,MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of Witwatersrand, Private Bag 3, Johannesburg, 2050, South Africa
| | - Mireille N M van Poppel
- Institute of Sport Science, University of Graz, Graz, Austria.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Lidwine B Mokkink
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Pavel Dietz
- Institute of Sport Science, University of Graz, Graz, Austria.,Institute of Occupational, Social and Environmental Medicine, University Medical Centre, University of Mainz, Mainz, Germany
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54
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Gustafsson MK, Romundstad PR, Stafne SN, Helvik AS, Stunes AK, Mørkved S, Salvesen KÅ, Thorsby PM, Mosti MP, Syversen U. The effect of an exercise program in pregnancy on vitamin D status among healthy, pregnant Norwegian women: a randomized controlled trial. BMC Pregnancy Childbirth 2019; 19:76. [PMID: 30786861 PMCID: PMC6381613 DOI: 10.1186/s12884-019-2220-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 02/11/2019] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Vitamin D insufficiency is common in pregnant women worldwide. Regular prenatal exercise is considered beneficial for maternal and fetal health. There is a knowledge gap regarding the impact of prenatal exercise on maternal vitamin D levels. The objective of this study was to investigate whether a prenatal exercise program influenced serum levels of total, free and bioavailable 25-hydroxyvitamin D (25(OH)D) and related parameters. This is a post hoc analysis of a randomized controlled trial with gestational diabetes as the primary outcome. METHODS Healthy, pregnant women from two Norwegian cities (Trondheim and Stavanger) were randomly assigned to a 12-week moderate-intensity exercise program (Borg perceived rating scale 13-14) or standard prenatal care. The intervention group (n = 429) underwent exercise at least three times weekly; one supervised group training and two home based sessions. The controls (n = 426) received standard prenatal care, and exercising was not denied. Training diaries and group training was used to promote compliance and evaluate adherence. Serum levels of 25(OH)D, parathyroid hormone, calcium, phosphate, magnesium and vitamin D-binding protein were measured before (18-22 weeks' gestation) and after the intervention (32-36 weeks' gestation). Free and bioavailable 25(OH)D concentrations were calculated. Regression analysis of covariance (ANCOVA) was applied to assess the effect of the training regime on each substance with pre-intervention levels as covariates. In a second model, we also adjusted for study site and sampling month. Intention-to-treat principle was used. RESULTS A total of 724 women completed the study. No between-group difference in serum 25(OH)D and related parameters was identified by ANCOVA using baseline serum levels as covariates. The second model revealed a between-group difference in levels of 25(OH)D (1.9, 95% CI 0.0 to 3.8 nmol/L; p = 0.048), free 25(OH)D (0.55, 95% CI 0.10 to 0.99 pmol/L; p = 0.017) and bioavailable 25(OH)D (0.15 95% CI 0.01 to 0.29 nmol/L; p = 0.036). No serious adverse events related to regular exercise were seen. CONCLUSION This study, a post hoc analysis, indicates that exercise may affect vitamin D status positively, and emphasizes that women with uncomplicated pregnancies should be encouraged to perform regular exercise. TRIAL REGISTRATION ClinicalTrials.gov: NCT00476567 , registered May 22, 2007.
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Affiliation(s)
- Miriam K Gustafsson
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), PO Box 8905, 7491, Trondheim, Norway. .,Division of Mental Health Care, Trondheim University Hospital (St. Olavs hospital), Trondheim, Norway.
| | - Pål R Romundstad
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), PO Box 8905, 7491, Trondheim, Norway
| | - Signe Nilssen Stafne
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), PO Box 8905, 7491, Trondheim, Norway.,Clinic of Clinical Services, Trondheim University Hospital (St. Olavs hospital), Trondheim, Norway
| | - Anne-Sofie Helvik
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), PO Box 8905, 7491, Trondheim, Norway.,Trondheim University Hospital (St. Olavs hospital), Trondheim, Norway
| | - Astrid Kamilla Stunes
- Trondheim University Hospital (St. Olavs hospital), Trondheim, Norway.,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Siv Mørkved
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), PO Box 8905, 7491, Trondheim, Norway.,Trondheim University Hospital (St. Olavs hospital), Trondheim, Norway
| | - Kjell Åsmund Salvesen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Obstretics and Gynaecology, Trondheim University Hospital (St. Olavs hospital), Trondheim, Norway
| | - Per Medbøe Thorsby
- Hormone Laboratory, Department of Medical Biochemistry, Oslo University Hospital, Aker sykehus, Oslo, Norway
| | - Mats Peder Mosti
- Trondheim University Hospital (St. Olavs hospital), Trondheim, Norway.,Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Unni Syversen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Endocrinology, Trondheim University Hospital (St. Olavs hospital), Trondheim, Norway
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55
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Forczek W, Ivanenko Y, Curyło M, Frączek B, Masłoń A, Salamaga M, Suder A. Progressive changes in walking kinematics throughout pregnancy-A follow up study. Gait Posture 2019; 68:518-524. [PMID: 30623846 DOI: 10.1016/j.gaitpost.2019.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 12/22/2018] [Accepted: 01/03/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Progressive weight gain and changes in its distribution following pregnancy may be challenging for the gravidas' ability to move in a stable way. RESEARCH QUESTION How is gait kinematics changing throughout pregnancy and to what extend is it affected by physical activity level and energy balance? METHODS 30 women were enrolled. Three experimental sessions were arranged according to the same protocol in the first, second and third trimesters of pregnancy. Walking kinematics at a self-selected speed was registered. The total physical activity (TPA) was assessed from the subjects' questionnaires. Energy balance ('positive', 'balanced' or 'negative') was estimated as the difference between dietary energy intake and energy expenditure during 7 days. RESULTS No significant differences were found in the spatiotemporal variables between experimental sessions. However, the gait analysis revealed significant increments in the single support and base of support (BoS) measures. Generally, the sagittal plane mobility of the lower limb joints did not differ, however, the pelvic tilt increased in late pregnancy. The hip and pelvis angles were significantly different over the gait cycle throughout gestation. The 'balanced' energy was dominant in the first trimester although the relative number of participants with negative balance increased over pregnancy. Overall, gait parameters were independent of the energy balance. However, significant correlation was found between gait parameters, such as BoS, velocity, stride length, and TPA in the advanced pregnancy. SIGNIFICANCE The longitudinal assessment of walking kinematics demonstrates few changes adopted to accommodate for pregnancy. The enlargement of BoS is considered as a strategy to provide safety and stability. The increased pelvic tilt is likely to compensate for changes in the body mass distribution. The physical activity correlates with the BoS measures and stride length and thus may be important for enhancing gait stability.
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Affiliation(s)
- W Forczek
- Section of Biomechanics, Faculty of Physical Education and Sport, University of Physical Education, Krakow, Poland.
| | - Y Ivanenko
- Laboratory of Neuromotor Physiology, Santa Lucia Foundation, Rome, Italy.
| | - M Curyło
- Section of Rehabilitation in Internal Diseases, Department of Clinical Rehabilitation, Faculty of Motor Rehabilitation, University of Physical Education, Krakow, Poland.
| | - B Frączek
- Section of Sports Medicine and Human Nutrition, Faculty of Physical Education and Sport, University of Physical Education, Krakow, Poland.
| | - A Masłoń
- Section of Rehabilitation in Orthopaedics, Department of Clinical Rehabilitation and Laboratory of Pathology of the Musculoskeletal System, Faculty of Motor Rehabilitation, University of Physical Education, Krakow, Poland.
| | - M Salamaga
- Department of Statistics, Cracow University of Economics, Krakow, Poland.
| | - A Suder
- Section of Anatomy, Department of Physiotherapy, Faculty of Motor Rehabilitation, University of Physical Education, Krakow, Poland.
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56
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Cusack L, Sbihi H, Larkin A, Chow A, Brook JR, Moraes T, Mandhane PJ, Becker AB, Azad MB, Subbarao P, Kozyrskyj A, Takaro TK, Sears MR, Turvey SE, Hystad P. Residential green space and pathways to term birth weight in the Canadian Healthy Infant Longitudinal Development (CHILD) Study. Int J Health Geogr 2018; 17:43. [PMID: 30514315 PMCID: PMC6280529 DOI: 10.1186/s12942-018-0160-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 11/22/2018] [Indexed: 01/30/2023] Open
Abstract
Background A growing number of studies observe associations between the amount of green space around a mother’s home and positive birth outcomes; however, the robustness of this association and potential pathways of action remain unclear.
Objectives To examine associations between mother’s residential green space and term birth weight within the Canadian Healthy Infant Longitudinal Development (CHILD) study and examine specific hypothesized pathways. Methods We examined 2510 births located in Vancouver, Edmonton, Winnipeg, and Toronto Canada. Green space was estimated around mother’s residences during pregnancy using Landsat 30 m normalized difference vegetation index (NDVI). We examined hypothesized pathways of: (1) reduction of environmental exposure; (2) built environment features promoting physical activity; (3) psychosocial conditions; and (4) psychological influences. Linear regression was used to assess associations between green space and term birth weight adjusting first for a comprehensive set of confounding factors and then incrementally for pathway variables. Results Fully adjusted models showed non-statistically significant increases in term birth weight with increasing green space. For example, a 0.1 increase in NDVI within 500 m was associated with a 21.5 g (95% CI − 4.6, 47.7) increase in term birth weight. Associations varied by city and were most robust for high-density locations. For the two largest cities (Vancouver and Toronto), we observed an increase in birth weight of 41.2 g (95% CI 7.8, 74.6) for a 0.1 increase in NDVI within 500 m. We did not observe substantial reductions in the green space effect on birth weight when adjusting for pathway variables. Conclusion Our results highlight the need to further characterize the interactions between green space, urban density and climate related factors as well as the pathways linking residential green space to birth outcomes.
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Affiliation(s)
| | - Hind Sbihi
- University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital, Vancouver, BC, Canada
| | | | | | | | - Theo Moraes
- Hospital for Sick Children, Toronto, ON, Canada
| | | | | | | | | | | | | | | | - Stuart E Turvey
- University of British Columbia, Vancouver, BC, Canada.,BC Children's Hospital, Vancouver, BC, Canada
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, 2520 SW Campus Way, Corvallis, OR, 97331, USA.
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Isacco L, Miles-Chan JL. Gender-specific considerations in physical activity, thermogenesis and fat oxidation: implications for obesity management. Obes Rev 2018; 19 Suppl 1:73-83. [PMID: 30511503 DOI: 10.1111/obr.12779] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 09/11/2018] [Indexed: 12/25/2022]
Abstract
With current 'one-size-fits-all' obesity prevention and management strategies proving largely ineffective, the focus has shifted towards a more tailored, individualized approach. However, investigation of the mechanisms underlying inter-individual variability in metabolic profile and response to intervention often yield conflicting results. Indeed, it is perhaps surprising that despite at least a century of recognition that sex hormones influence metabolism, firm conclusions regarding the effects of the menstrual cycle, hormonal contraception and menopause on many aspects of energy expenditure and substrate utilization remain to be drawn. In this review, we examine current evidence relating to gender-specific considerations in the promotion of physical activity, thermogenesis and fat oxidation for body-weight regulation, including the relationship between sex hormone status and non-exercise activity thermogenesis - an energy expenditure compartment that is often overlooked in favour of traditional exercise/sport physical activities yet presents a viable target in the search for effective weight management.
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Affiliation(s)
- L Isacco
- Research Unit EA3920 Prognostic Markers and Regulatory Factors of Cardiovascular Diseases and Exercise Performance Health Innovation Platform, University of Bourgogne Franche-Comté, Besançon, France
| | - J L Miles-Chan
- Human Nutrition Unit, School of Biological Sciences, University of Auckland, Auckland, New Zealand
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Lifestyle intervention strategies in early life to improve pregnancy outcomes and long-term health of offspring: a narrative review. J Dev Orig Health Dis 2018; 10:314-321. [PMID: 30409238 DOI: 10.1017/s2040174418000855] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Adverse exposures during fetal life and the postnatal period influence physical, cognitive and emotional development, and predispose to an increased risk of various chronic diseases throughout the life course. Findings from large observational studies in various populations and experimental animal studies have identified different modifiable risk factors in early life. Adverse maternal lifestyle factors, including overweight, unhealthy diet, sedentary behavior, smoking, alcohol consumption and stress in the preconception period and during pregnancy, are the most common modifiable risk factors leading to a suboptimal in-utero environment for fetal development. In the postnatal period, breastfeeding, infant growth and infant dietary intake are important modifiable factors influencing long-term offspring health outcomes. Despite the large amount of findings from observational studies, translation to lifestyle interventions seems to be challenging. Currently, randomized controlled trials focused on the influence of lifestyle interventions in these critical periods on short-term and long-term maternal and offspring health outcomes are scarce, have major limitations and do not show strong effects on maternal and offspring outcomes. New and innovative approaches are needed to move from describing these causes of ill-health to start tackling them using intervention approaches. Future randomized controlled lifestyle intervention studies and innovative observational studies, using quasi-experimental designs, are needed focused on the effects of an integrated lifestyle advice from preconception onwards on pregnancy outcomes and long-term health outcomes in offspring on a population level.
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Prenatal stress and the development of psychopathology: Lifestyle behaviors as a fundamental part of the puzzle. Dev Psychopathol 2018; 30:1129-1144. [PMID: 30068418 DOI: 10.1017/s0954579418000494] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Maternal psychological stress, depression, and anxiety during pregnancy (prenatal stress; PNS) are thought to impact fetal development with long-term effects on offspring outcome. These effects would include physical and mental health, including psychopathology. Maternal sleep, diet, and exercise during pregnancy are lifestyle behaviors that are understudied and often solely included in PNS studies as confounders. However, there are indications that these lifestyle behaviors may actually constitute essential mediators between PNS and fetal programming processes. The goal of this theoretical review was to investigate this idea by looking at the evidence for associations between PNS and sleep, diet, and exercise, and by piecing together the information on potential underlying mechanisms and causal pathways through which these factors may affect the offspring. The analysis of the literature led to the conclusion that sleep, diet, and exercise during pregnancy, may have fundamental roles as mediators between PNS and maternal pregnancy physiology. By integrating these lifestyle behaviors into models of prenatal programming of development, a qualitatively higher and more comprehensive understanding of the prenatal origins of psychopathology can be obtained. The review finalizes by discussing some of the present challenges facing the field of PNS and offspring programming, and offering solutions for future research.
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60
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Amiri FN, Faramarzi M, Bakhtiari A, Omidvar S. Risk Factors for Gestational Diabetes Mellitus: A Case-Control Study. Am J Lifestyle Med 2018; 15:184-190. [PMID: 33786034 DOI: 10.1177/1559827618791980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: The underlying causes of gestational diabetes mellitus (GDM) are important because they are effective for the diagnosis and prevention of this condition. The aim of this study was to identify the risk factors for GDM and the possible etiological agents. Materials and Methods: This case-control study was conducted with 100 women with GDM and 100 healthy pregnant women at a tertiary care hospital, affiliated to Babol University. GDM was identified by impaired oral glucose tolerance test based on the Carpenter and Coustan criteria. Healthy women were randomly selected from the prenatal health care clinic of the same center and were matched to gestational age of 24 to 28 weeks. Descriptive and inferential statistics were used for data analysis via the SPSS software. Results: After adjusting variables, multivariate analysis identified 4 significant risk factors of GDM, including prepregnancy low physical activity (odds ratio [OR] = 2.85, 95% confidence interval [CI]= 0.97-8.34), advanced maternal age (OR = 1.24, 95% CI = 1.13-1.35), body mass index ⩾ 30 kg/m2 (OR = 1.10, 95% CI = 1.02-1.20), and family history of diabetes mellitus (OR = 5.62, 95% CI = 2.26-13.96). Conclusion: We observed significant associations between low prepregnancy physical activity and obesity with GDM risk. Thus the finding of this study can help devise strategies for the prevention of GDM.
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Affiliation(s)
- Fatemeh Nasiri Amiri
- Midwifery Department, Fateme Zahra Fertility & Infertility Research Health Center, Health Research Institute (FNA, AB, SO) and Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mahbobeh Faramarzi
- Midwifery Department, Fateme Zahra Fertility & Infertility Research Health Center, Health Research Institute (FNA, AB, SO) and Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Afsaneh Bakhtiari
- Midwifery Department, Fateme Zahra Fertility & Infertility Research Health Center, Health Research Institute (FNA, AB, SO) and Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Shabnam Omidvar
- Midwifery Department, Fateme Zahra Fertility & Infertility Research Health Center, Health Research Institute (FNA, AB, SO) and Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Omar A. The Effect of Activity Restriction on Infant's Birth Weight and Gestational Age at Birth: PRAMS Data Analysis. Can J Nurs Res 2018; 51:14-22. [PMID: 29886769 DOI: 10.1177/0844562118778976] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND: Activity restriction is extensively prescribed for pregnant women with major comorbidities despite the lack of evidence to support its effectiveness in preventing preterm birth or low birth weight. PURPOSE: To determine the moderation effect of home activity restriction for more than a week on infant's birth weight and gestational age at birth for high-risk women with obstetrical and medical comorbidities. METHODS: A secondary analysis of 2004-2008 New York Pregnancy Risk Assessment Monitoring System was conducted with 1426 high-risk women. RESULTS: High-risk group included 41% of women treated with activity restriction and 59% of those not treated with activity restriction. Women with preterm premature rupture of membrane (PPROM) who were treated with activity restriction had a lower infant birth weight ( b = -202.85, p = ≤.001) and gestational age at birth ( b = -.91, p = ≤.001) than those without activity restriction. However, women with preterm labor and hypertensive disorders of pregnancy who were not treated with activity restriction had lower infant gestational age at birth ( b = -96, p = ≤.01) and ( b = -92, p = ≤.001), respectively, compared to those who were treated with activity restriction. CONCLUSION: Findings suggest a contrary effect of activity restriction on infants born to women with PPROM, which is a major reason for prescribing activity restriction. The current study results may trigger the need to conduct randomized control trials to determine the effect of severity of activity restriction on maternal and infant outcomes.
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Affiliation(s)
- Abeer Omar
- 1 Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
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Jacobson LT, Zackula R, Redmond ML, Duong J, Collins TC. Pioneer baby: suggestions for pre- and postnatal health promotion programs from rural English and Spanish-speaking pregnant and postpartum women. J Behav Med 2018; 41:653-667. [PMID: 29721813 DOI: 10.1007/s10865-018-9930-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 04/24/2018] [Indexed: 01/22/2023]
Abstract
In the United States, more than 9 million rural women (15-44 years old) experience limited access and delivery of reproductive healthcare services. Rurality coupled with lower socio-economic status are associated with increased maternal and neonatal morbidity and mortality. The purpose of this qualitative study was to gain in-depth information from underserved English- and Spanish-speaking pregnant and postpartum rural women on what they would value in a health promotion program. Three focus group sessions were conducted exploring four domains: (1) physical activity, (2) dietary habits, (3) fetal movement/kick counts, and (4) breastfeeding and other support resources. Five overarching themes were observed across domains, with the following health promotion needs: (1) information on safe exercises, (2) advice on healthy food and drink, (3) breastfeeding support, (4) guidance on counting fetal movement, and (5) self- and peer-education. Study findings will inform intervention programming that aims to improve pregnancy and birth outcomes.
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Affiliation(s)
- Lisette T Jacobson
- University of Kansas School of Medicine-Wichita, 1010 North Kansas, Wichita, KS, 67214-3199, USA.
| | - Rosalee Zackula
- University of Kansas School of Medicine-Wichita, 1010 North Kansas, Wichita, KS, 67214-3199, USA
| | - Michelle L Redmond
- University of Kansas School of Medicine-Wichita, 1010 North Kansas, Wichita, KS, 67214-3199, USA
| | - Jennifer Duong
- University of Kansas School of Medicine-Wichita, 1010 North Kansas, Wichita, KS, 67214-3199, USA
| | - Tracie C Collins
- University of Kansas School of Medicine-Wichita, 1010 North Kansas, Wichita, KS, 67214-3199, USA
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63
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Chaunchaiyakul R, Pinthong M, Ajjimaporn A. Acute physiological responses in pregnant women during exercises in different positions. Physiother Theory Pract 2018; 35:444-450. [DOI: 10.1080/09593985.2018.1449276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Rungchai Chaunchaiyakul
- College of Sports Science and Technology, Mahidol University, Salaya, Nakhonpathom, Thailand
| | - Metta Pinthong
- College of Sports Science and Technology, Mahidol University, Salaya, Nakhonpathom, Thailand
| | - Amornpan Ajjimaporn
- College of Sports Science and Technology, Mahidol University, Salaya, Nakhonpathom, Thailand
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64
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Ravanelli N, Casasola W, English T, Edwards KM, Jay O. Heat stress and fetal risk. Environmental limits for exercise and passive heat stress during pregnancy: a systematic review with best evidence synthesis. Br J Sports Med 2018; 53:799-805. [PMID: 29496695 DOI: 10.1136/bjsports-2017-097914] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2018] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Pregnant women are advised to avoid heat stress (eg, excessive exercise and/or heat exposure) due to the risk of teratogenicity associated with maternal hyperthermia; defined as a core temperature (Tcore) ≥39.0°C. However, guidelines are ambiguous in terms of critical combinations of climate and activity to avoid and may therefore unnecessarily discourage physical activity during pregnancy. Thus, the primary aim was to assess Tcore elevations with different characteristics defining exercise and passive heat stress (intensity, mode, ambient conditions, duration) during pregnancy relative to the critical maternal Tcore of ≥39.0°C. DESIGN Systematic review with best evidence synthesis. DATA SOURCES EMBASE, MEDLINE, SCOPUS, CINAHL and Web of Science were searched from inception to 12 July 2017. STUDY ELIGIBILITY CRITERIA Studies reporting the Tcore response of pregnant women, at any period of gestation, to exercise or passive heat stress, were included. RESULTS 12 studies satisfied our inclusion criteria (n=347). No woman exceeded a Tcore of 39.0°C. The highest Tcore was 38.9°C, reported during land-based exercise. The highest mean end-trial Tcore was 38.3°C (95% CI 37.7°C to 38.9°C) for land-based exercise, 37.5°C (95% CI 37.3°C to 37.7°C) for water immersion exercise, 36.9°C (95% CI 36.8°C to 37.0°C) for hot water bathing and 37.6°C (95% CI 37.5°C to 37.7°C) for sauna exposure. CONCLUSION The highest individual core temperature reported was 38.9°C. Immediately after exercise (either land based or water immersion), the highest mean core temperature was 38.3°C; 0.7°C below the proposed teratogenic threshold. Pregnant women can safely engage in: (1) exercise for up to 35 min at 80%-90% of their maximum heart rate in 25°C and 45% relative humidity (RH); (2) water immersion (≤33.4°C) exercise for up to 45 min; and (3) sitting in hot baths (40°C) or hot/dry saunas (70°C; 15% RH) for up to 20 min, irrespective of pregnancy stage, without reaching a core temperature exceeding the teratogenic threshold.
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Affiliation(s)
- Nicholas Ravanelli
- Thermal Ergonomics Laboratory, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.,School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - William Casasola
- Thermal Ergonomics Laboratory, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.,Exeter Medical School, University of Exeter, Exeter, UK
| | - Timothy English
- Thermal Ergonomics Laboratory, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Kate M Edwards
- Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Ollie Jay
- Thermal Ergonomics Laboratory, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.,School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.,Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia
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Horsch A, Gilbert L, Lanzi S, Gross J, Kayser B, Vial Y, Simeoni U, Hans D, Berney A, Scholz U, Barakat R, Puder JJ. Improving cardiometabolic and mental health in women with gestational diabetes mellitus and their offspring: study protocol for MySweetHeart Trial, a randomised controlled trial. BMJ Open 2018; 8:e020462. [PMID: 29487077 PMCID: PMC5855393 DOI: 10.1136/bmjopen-2017-020462] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 11/10/2017] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) carries prenatal and perinatal risk for the mother and her offspring as well as longer-term risks for both the mother (obesity, diabetes, cardiovascular disease) and her child (obesity, type 2 diabetes). Compared with women without GDM, women with GDM are twice as likely to develop perinatal or postpartum depression. Lifestyle interventions for GDM are generally limited to physical activity and/or nutrition, often focus separately on the mother or the child and take place either during or after pregnancy, while their results are inconsistent. To increase efficacy of intervention, the multifactorial origins of GDM and the tight link between mental and metabolic as well as maternal and child health need to be heeded. This calls for an interdisciplinary transgenerational approach starting in, but continuing beyond pregnancy. METHODS AND ANALYSIS This randomised controlled trial will assess the effect of a multidimensional interdisciplinary lifestyle and psychosocial intervention aimed at improving the metabolic and mental health of 200 women with GDM and their offspring. Women with GDM at 24-32 weeks gestational age who understand French or English, and their offspring and partners can participate. The intervention components will be delivered on top of usual care during pregnancy and the first year postpartum. Metabolic and mental health outcomes will be measured at 24-32 weeks of pregnancy, shortly after birth and at 6-8 weeks and 1 year after childbirth. Data will be analysed using intention-to-treat analyses. The MySweetHeart Trial is linked to the MySweetHeart Cohort (clinicaltrials.gov/ct2/show/NCT02872974). ETHICS AND DISSEMINATION We will disseminate the findings through regional, national and international conferences and through peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT02890693; Pre-results.
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Affiliation(s)
- Antje Horsch
- Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
| | - Leah Gilbert
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Stefano Lanzi
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
- Service of Angiology, Heart and Vessel Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Justine Gross
- Service of Endocrinology, Diabetes and Metabolism, Lausanne University Hospital, Lausanne, Switzerland
| | - Bengt Kayser
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Yvan Vial
- Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Umberto Simeoni
- DOHad Laboratory, Pediatrics Division, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Didier Hans
- Center of Bone Diseases, Rheumatology Service, Bone and Joint Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Alexandre Berney
- Consultation Liaison Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Urte Scholz
- Applied Social and Health Psychology, Department of Psychology, University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Lausanne, Switzerland
| | - Ruben Barakat
- Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Jardena J Puder
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Lausanne, Switzerland
- Service of Pediatric Endocrinology, Diabetology and Obesity, Lausanne University Hospital, Lausanne, Switzerland
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Jang Y, Lee B, Kim EK, Shim WS, Yang YD, Kim SM. Involuntary swimming exercise in pregnant rats disturbs ERK1/2 signaling in embryonic neurons through increased cortisol in the amniotic fluid. Biochem Biophys Res Commun 2018; 495:1208-1213. [DOI: 10.1016/j.bbrc.2017.11.153] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 11/22/2017] [Indexed: 12/27/2022]
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Sadeghi B, Sirati-Nir M, Hajimini Z, Ebadi A, Ali-Asgari M. Comparing the Effects of Progressive Muscle Relaxation and Physical Activity on Pregnant Women's General Health. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2018; 23:298-304. [PMID: 30034491 PMCID: PMC6034525 DOI: 10.4103/ijnmr.ijnmr_54_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Pregnancy is important because maternal health and well-being directly affects another person's life. This study aimed to compare the effects of progressive muscle relaxation (PMR) and physical activity (PA) on the general health of pregnant women. Materials and Methods: This randomized clinical trial was conducted among 96 primiparous women enrolled in a prenatal clinic in Tehran (Iran) between May 3, 2013 and August 7, 2013. The participants were selected through convenience sampling over 3 weeks and randomly assigned to the PMR, PA, and control groups, comprising 32 participants each. Six participants did not complete the follow-up measurement (N = 90). The PMR group underwent three sessions of 1.5–2 h in theoretical and practical training, and in the PMR group, training was given in groups of three to four persons. Both groups performed exercises at home for 8 weeks and recorded them in daily report sheets. The general health of all three groups was assessed before and after intervention by using the General Health Questionnaire-28. Results: Differences in the mean (SD) general health scores obtained before and after intervention in the PMR, PA, and control groups were 15.63 (5.73), 19.11 (7.79), and 8.27 (2.14), respectively. One-way analysis of variance test showed a significant difference between the three groups (F = 28.10; p < 0.001). Conclusions: As the study results confirm the positive effects of PMR and PA on the subscales of the general health of pregnant women, the two techniques are recommended to promote the general health of pregnant women.
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Affiliation(s)
- Bita Sadeghi
- Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Masoud Sirati-Nir
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Zahra Hajimini
- Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Matin Ali-Asgari
- Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
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68
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Reasons, Motivational Factors, and Perceived Personal Barriers to Engagement in Physical Activity During Pregnancy Vary Within the BMI Classes: The Prenatal Prevention Project Germany. J Phys Act Health 2017; 15:204-211. [PMID: 28872388 DOI: 10.1123/jpah.2016-0563] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND International data indicate that approximately only 20.0% of pregnant women reach physical activity recommendations (≥150 min/wk). To find ways for increasing physical activity, the reasons for exercising, motivational factors, and barriers need to be determined. The aim of this pilot study was to identify these factors in respect to body mass index classification in German pregnant women. METHODS A total of 61 women [age: 32.7 (4.8) y; 13.3 (3.4) wk of gestation] participated in this study. Before pregnancy, 10.0% of women were underweight, 58.3% were normal weight, 18.3% were overweight, and 13.4% were obese. Standardized questionnaires were used to evaluate the abovementioned factors. RESULTS "Fun" was one of the main reasons for being active in underweight/normal weight compared with overweight/obese women (53.7% vs 10.5%; P = .002), whereas "burning fat" was more important in overweight/obese women (9.8% vs 36.8%; P = .027). According to motivational factors, differences occurred in "calorie burning" (7.3% underweight/normal weight vs 31.6% overweight/obese; P = .025) and "fat burning" (7.3% underweight/normal weight vs 47.4% overweight/obese; P = .001). Regarding barriers for being active, "tiredness" was more often a barrier in overweight/obese (63.2%) compared with normal weight/underweight women (31.7%; P = .022). CONCLUSION Pregnant women should be given tailored advice/motivation according to prepregnancy body mass index. However, larger studies are necessary to evaluate these factors on pregnant women's physical activity level.
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Development and design of an intervention to improve physical activity in pregnant women using Text4baby. Transl Behav Med 2017; 6:285-94. [PMID: 27356999 DOI: 10.1007/s13142-015-0339-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Text4baby is a free, mobile health information service for pregnant and post-partum women. This study aims to understand preferences of physical activity text messages (SMS), sequentially develop prototype SMS, and determine preferred dose of SMS to inform a future study utilizing Text4baby. This study had a user-centered design with three phases: (1) literature review and interviews with pregnant women for development of prototype SMS, (2) interviews with health care professionals and pregnant women for prototype SMS feedback, and (3) survey to determine preferred dose of SMS. Data from interviews identified knowledge and support as major themes. Prototypes were developed (N = 14) and informed 168 SMS. Pregnant women (N = 326) thought three SMS/week were about right (50.2 %) and preferred three SMS/week throughout pregnancy (71.9 %). There is a need for opportunities for behavioral scientists to incorporate evidence-based practices within scalable interventions. As such, this research will inform utilization of Text4baby to potentially improve physical activity participation.
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Fragoso J, Lira ADO, Chagas GS, Lucena Cavalcanti CC, Beserra R, de Santana-Muniz G, Bento-Santos A, Martins G, Pirola L, da Silva Aragão R, Leandro CG. Maternal voluntary physical activity attenuates delayed neurodevelopment in malnourished rats. Exp Physiol 2017; 102:1486-1499. [DOI: 10.1113/ep086400] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 08/17/2017] [Indexed: 12/13/2022]
Affiliation(s)
- Jéssica Fragoso
- Department of Nutrition; Federal University of Pernambuco; 50670-901 Recife PE Brazil
| | | | - Guilherme Souza Chagas
- Department of Physical Education and Sports Science, CAV; Federal University of Pernambuco; 55608-680 Recife PE Brazil
| | | | - Renata Beserra
- Department of Nutrition; Federal University of Pernambuco; 50670-901 Recife PE Brazil
| | | | - Adriano Bento-Santos
- Department of Physical Education and Sports Science, CAV; Federal University of Pernambuco; 55608-680 Recife PE Brazil
| | - Gerffeson Martins
- Department of Physical Education and Sports Science, CAV; Federal University of Pernambuco; 55608-680 Recife PE Brazil
| | - Luciano Pirola
- INSERM U1060, Lyon-1 University; South Lyon Medical Faculty; 69921 Oullins France
| | - Raquel da Silva Aragão
- Department of Physical Education and Sports Science, CAV; Federal University of Pernambuco; 55608-680 Recife PE Brazil
| | - Carol Góis Leandro
- Department of Nutrition; Federal University of Pernambuco; 50670-901 Recife PE Brazil
- Department of Physical Education and Sports Science, CAV; Federal University of Pernambuco; 55608-680 Recife PE Brazil
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Corrêa MDS, Gelaleti RB, Bento GF, Damasceno DC, Peraçoli JC. DNA damage in Wistar Kyoto rats exercised during pregnancy. Acta Cir Bras 2017; 32:388-395. [PMID: 28591368 DOI: 10.1590/s0102-865020170050000008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 04/10/2017] [Indexed: 01/21/2023] Open
Abstract
Purpose: To evaluate DNA damage levels in pregnant rats undergoing a treadmill exercise program. Methods: Wistar Kyoto rats were allocated into two groups (n= 5 animals/group): non-exercise and exercise. The pregnant rats were underwent an exercise protocol on a treadmill throughout pregnancy. Exercise intensity was set at 50% of maximal capacity during maximal exercise testing performed before mating. Body weight, blood pressure and glucose levels, and triglyceride concentration were measured during pregnancy. At day 10 post-natal, the animals were euthanized and maternal blood samples were collected for DNA damage. Results: Blood pressure and glucose levels and biochemical measurements showed no significant differences. Increased DNA damage levels were found in exercise group compared to those of non-exercise group (p<0.05). Conclusion: The exercise intensity protocol used in the study might have been exhaustive leading to maternal increased DNA damage levels, demonstrating the relevance of an adequate protocol of physical exercise.
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Affiliation(s)
- Mikaela da Silva Corrêa
- Fellow Master degree, Postgraduate Program in Ginecology, Obstetrics and Mastology, Department of Gynecology and Obstetrics, Laboratory of Experimental Research in Gynecology and Obstetrics, Botucatu Medical School, Universidade Estadual Paulista (UNESP), Botucatu-SP, Brazil. Scientific, intellectual, conception and design of the study; acquisition, analysis and interpretation of data; technical procedures; manuscript preparation
| | - Rafael Bottaro Gelaleti
- Fellow PhD degree, Postgraduate Program in Ginecology, Obstetrics and Mastology, Department of Gynecology and Obstetrics, Laboratory of Experimental Research in Gynecology and Obstetrics, Botucatu Medical School, UNESP, Botucatu-SP, Brazil. Scientific and intellectual content of the study, analysis and interpretation of data, technical procedures, statistics analysis, manuscript preparation, critical revision
| | - Giovana Fernanda Bento
- Graduate student, Botucatu Medical School, UNESP, Botucatu-SP, Brazil. Scientific and intellectual content of the study, acquisition of data, technical procedures
| | - Débora Cristina Damasceno
- Full Professor, CNPq Researcher Followship 2, Postgraduate Program in Ginecology, Obstetrics and Mastology, Department of Gynecology and Obstetrics, Laboratory of Experimental Research in Gynecology and Obstetrics, Botucatu Medical School, UNESP, Botucatu-SP, Brazil. Scientific, intellectual, conception and design of the study; analysis and interpretation of data; statistics analysis; manuscript preparation; critical revision; final approval
| | - José Carlos Peraçoli
- Full Professor and Head, CNPq Researcher Fellowship 2, Postgraduate Program in Ginecology, Obstetrics and Mastology, Department of Gynecology and Obstetrics, Laboratory of Experimental Research in Gynecology and Obstetrics, Botucatu Medical School, UNESP, Botucatu-SP, Brazil. Scientific, intellectual, conception and design of the study; analysis and interpretation of data; critical revision; final approval
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Exercise during pregnancy and its impact on mothers and offspring in humans and mice. J Dev Orig Health Dis 2017; 9:63-76. [DOI: 10.1017/s2040174417000617] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Exercise during pregnancy has beneficial effects on maternal and offspring’s health in humans and mice. The underlying mechanisms remain unclear. This comparative study aimed to determine the long-term effects of an exercise program on metabolism, weight gain, body composition and changes in hormones [insulin, leptin, brain-derived neurotrophic factor (BDNF)]. Pregnant women (n=34) and mouse dams (n=44) were subjected to an exercise program compared with matched controls (period I). Follow-up in the offspring was performed over 6 months in humans, corresponding to postnatal day (P) 21 in mice (period II). Half of the mouse offspring was challenged with a high-fat diet (HFD) for 6 weeks between P70 and P112 (period III). In period I, exercise during pregnancy led to 6% lower fat content, 40% lower leptin levels and an increase of 50% BDNF levels in humans compared with controls, which was not observed in mice. After period II in humans and mice, offspring body weight did not differ from that of the controls. Further differences were observed in period III. Offspring of exercising mouse dams had significantly lower fat mass and leptin levels compared with controls. In addition, at P112, BDNF levels in offspring were significantly higher from exercising mothers while this effect was completely blunted by HFD feeding. In this study, we found comparable effects on maternal and offspring’s weight gain in humans and mice but different effects in insulin, leptin and BDNF. The long-term potential protective effects of exercise on biomarkers should be examined in human studies.
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Factors affecting perceived change in physical activity in pregnancy. Midwifery 2017; 51:16-23. [DOI: 10.1016/j.midw.2017.05.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 05/07/2017] [Accepted: 05/08/2017] [Indexed: 02/06/2023]
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Ette L. Community-based exercise interventions during pregnancy are perceived as a satisfactory and motivating form of exercise engagement. Evid Based Nurs 2017; 20:77-78. [PMID: 28601803 DOI: 10.1136/eb-2017-102681] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/17/2017] [Accepted: 05/26/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Lizzie Ette
- Faculty of Health Sciences, University of Hull, Hull, United Kingdom
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Schmidt T, Heilmann T, Savelsberg L, Maass N, Weisser B, Eckmann-Scholz C. Physical Exercise During Pregnancy - How Active Are Pregnant Women in Germany and How Well Informed? Geburtshilfe Frauenheilkd 2017; 77:508-515. [PMID: 28579622 DOI: 10.1055/s-0043-107785] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 03/27/2017] [Accepted: 03/28/2017] [Indexed: 10/19/2022] Open
Abstract
INTRODUCTION There is sufficient evidence showing the positive effects of physical exercise on various aspects of pregnancy. This study evaluates knowledge and status of physical exercise among pregnant women. METHODS The standardised paper-pencil questionnaire "Pregnancy Physical Activity Questionnaire" (PPAQ) as well as general demographic questions were used to assess the exercise behaviour of study participants. 83 questionnaires completed by women presenting to the Kiel University Hospital for antenatal assessment were included in the analysis. RESULTS At the time of questionnaire completion 10 women were in the first trimester of pregnancy, 64 in the second, and 9 in the third. Just less than 90% of participants felt they had been informed "sufficiently" on the topic physical exercise during pregnancy, over 50% felt they were "well" or "very well" informed. Just less than half of participants received their information from a doctor (either their gynaecologist or general practitioner) and none of these felt "insufficiently" informed. Almost 80% of participants reported still doing no sport or less exercise than before falling pregnant. The maximum proportional energy expenditure for recreational activity - just under 20% - was in the third trimester. Women who felt they had been well counselled tended to have higher activity levels. CONCLUSION Study participants demonstrated a clear decline in physical exercise during pregnancy despite clear evidence of the benefits of regular exercise for pregnant women, and despite participants feeling they were well informed. Detailed information on the recommendations for physical exertion in pregnancy should form an integral part of antenatal counselling.
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Affiliation(s)
- Thorsten Schmidt
- Supportivangebote Sport- und Bewegungstherapie Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel
| | - Thorsten Heilmann
- Universitätsklinikum Schleswig-Holstein Campus Kiel, Klinik für Gynäkologie und Geburtshilfe, Kiel
| | - Luisa Savelsberg
- Institut für Sportwissenschaft, Christian-Albrechts-Universität Kiel, Kiel
| | - Nicolai Maass
- Universitätsklinikum Schleswig-Holstein Campus Kiel, Klinik für Gynäkologie und Geburtshilfe, Kiel
| | - Burkhard Weisser
- Institut für Sportwissenschaft, Christian-Albrechts-Universität Kiel, Kiel
| | - Christel Eckmann-Scholz
- Universitätsklinikum Schleswig-Holstein Campus Kiel, Klinik für Gynäkologie und Geburtshilfe, Kiel
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Abstract
Studies have found positive correlations between prenatal exposure to testosterone and masculinization of offspring traits, particularly among females. The present study sought to determine if physical or sexual activity by the mother during pregnancy was related to masculinized/defeminized offspring traits in adulthood. Data were obtained from a large sample of North American college students (offspring) and their mothers. Information about maternal activity levels during pregnancy were reported retrospectively by each mother. The offspring provided self-ratings of various sexually dimorphic traits. Several significant correlations were found. By and large, as maternal physical activity increased, feminine mannerisms decreased and masculine mannerisms increased in the offspring, particularly for females. Maternal physical activity was also associated with increased upper- and lower-body strength and especially with adult height among offspring. Sexual activity by the mother was only associated with upper-body strength and adult height, particularly of the female offspring. Several sexually dimorphic physical traits in offspring are associated with maternal activity levels during pregnancy. Prenatal testosterone is almost certainly involved. The associations could either reflect genetic influences (given that prenatal testosterone is highly heritable) or an effect of maternal testosterone being transferred to the developing fetus. More research is needed to assess the relative merit of these two possibilities.
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Perales M, Santos-Lozano A, Sanchis-Gomar F, Luaces M, Pareja-Galeano H, Garatachea N, Barakat R, Lucia A. Maternal Cardiac Adaptations to a Physical Exercise Program during Pregnancy. Med Sci Sports Exerc 2017; 48:896-906. [PMID: 26694848 DOI: 10.1249/mss.0000000000000837] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Scarce evidence exists regarding the effects of regular pregnancy exercise on maternal cardiovascular health. We aimed to study, using a randomized controlled trial design, the effects of pregnancy exercise on echocardiographic indicators of hemodynamics, cardiac remodeling, left ventricular (LV) function, and cardiovascular disease (CVD) risk factors. METHODS Two hundred forty-one healthy pregnant women were assigned to a control (standard care) or intervention (exercise) group (initial n = 121/120). The intervention (weeks 9-11 to 38-39) included three supervised sessions per week (55-60 min, with light-moderate intensity aerobic and strength exercises). RESULTS The main findings were as follows: (i) the proportion of women with excessive weight gain at end pregnancy was lower in the exercise group compared with controls (18% vs 40%, P = 0.005), and (ii) there was a tendency toward lower prevalence of depression at end pregnancy in the former (P = 0.029, threshold P value set at 0.013). No significant exercise training effect was essentially found for echocardiographic variables, CVD risk factors, type/duration of labor, or newborn's outcomes (weight, height, head circumference, Apgar scores, and umbilical cord pH). CONCLUSIONS Light-moderate intensity supervised exercise is safe for healthy pregnant women and does not impose an additional cardiac overload beyond gestation or affect the main pregnancy outcomes. Such intervention might help decrease, at least partly, the risk of two CVD-associated conditions, excessive weight gain and depression.
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Affiliation(s)
- María Perales
- 1Research Institute Hospital 12 de Octubre ('i+12'), Madrid, SPAIN; 2AFIPE Research Group, Faculty of Physical Activity and Sports Sciences INEF, Technical University of Madrid, SPAIN; 3GIDFYS, Department of Health Sciences, European University Miguel de Cervantes, Valladolid, SPAIN; 4Department of Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, SPAIN; 5School of Doctorate Studies and Research, European University, Madrid, SPAIN; and 6Departamento de Fisiatría y Enfermería. Facultad de Ciencias de la Salud y del Deporte. Instituto Agroalimentario de Aragón-IA2, Universidad de Zaragoza-CITA, Zaragoza, SPAIN
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Decision Support to Enhance Prenatal Care Using the Screening, Brief Intervention, and Referral to Treatment Model. J Nurse Pract 2016. [DOI: 10.1016/j.nurpra.2016.07.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Aparicio VA, Ocón O, Padilla-Vinuesa C, Soriano-Maldonado A, Romero-Gallardo L, Borges-Cósic M, Coll-Risco I, Ruiz-Cabello P, Acosta-Manzano P, Estévez-López F, Álvarez-Gallardo IC, Delgado-Fernández M, Ruiz JR, Van Poppel MN, Ochoa-Herrera JJ. Effects of supervised aerobic and strength training in overweight and grade I obese pregnant women on maternal and foetal health markers: the GESTAFIT randomized controlled trial. BMC Pregnancy Childbirth 2016; 16:290. [PMID: 27680325 PMCID: PMC5041398 DOI: 10.1186/s12884-016-1081-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 09/22/2016] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND During pregnancy, a sedentary lifestyle may have negative consequences on maternal and foetal health status. The main objective of this project is to assess the effects of an exercise intervention in overweight and grade I obese pregnant on maternal and foetal health markers. METHODS/DESIGN The present study aims to recruit 60 overweight and grade I obese women interested in participating in an exercise intervention program from the 17th gestational week until delivery. Women will be randomized to either an exercise (three 60-min sessions/week of combined aerobic and strength training and pelvic floor exercises), or usual care (control) group (30 women per group). The primary outcome measures are maternal weight gain, and maternal and neonatal glycaemic profile. Secondary outcome measures are: i) perinatal obstetric records; i) body composition; iii) dietary patterns; iv) physical fitness; v) low-back pain; vi) objectively measured physical activity and sedentary behaviour; vii) haematology and biochemical analyses; viii) oxidative stress; ix) pro- and anti-inflammatory markers; x) bone health biomarkers; xi) sleep quality; xii) mental health, quality of life and positive health. DISCUSSION The findings of this project will help to identify strategies for primary prevention and health promotion based on this exercise-based intervention program among overweight and grade I obese pregnant women. TRIAL REGISTRATION NCT02582567 ; Date of registration: 20/10/2015.
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Affiliation(s)
- Virginia A. Aparicio
- Department of Physiology, Faculty of Pharmacy and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
- Department of Public and Occupational Health, and EMGO+ Institute for Health and Care Research, VU University medical center, Amsterdam, The Netherlands
| | - Olga Ocón
- Department of Obstetrics and Gynecology, University of Granada, Granada, Spain
| | - Carmen Padilla-Vinuesa
- Department of Obstetrics and Gynecology, University of Granada, Granada, Spain
- Obstetrics and Gynecology Service, University Hospital Complex, Granada, Spain
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Lidia Romero-Gallardo
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Milkana Borges-Cósic
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Irene Coll-Risco
- Department of Physiology, Faculty of Pharmacy and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Pilar Ruiz-Cabello
- Department of Physiology, Faculty of Pharmacy and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Fernando Estévez-López
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
- Department of Clinical and Health Psychology, Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, The Netherlands
| | | | - Manuel Delgado-Fernández
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Jonatan R. Ruiz
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Mireille N. Van Poppel
- Department of Public and Occupational Health, and EMGO+ Institute for Health and Care Research, VU University medical center, Amsterdam, The Netherlands
- Institute of Sport Science, University of Graz, Graz, Austria
| | - Julio J. Ochoa-Herrera
- Department of Physiology, Faculty of Pharmacy and Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
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Martínez-Pascual B, Alvarez-Harris S, Fernández-de-Las-Peñas C, Palacios-Ceña D. Pregnancy in Spanish elite sportswomen: A qualitative study. Women Health 2016; 57:741-755. [PMID: 27322112 DOI: 10.1080/03630242.2016.1202883] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Pregnancy and motherhood have been historically considered as reasons why elite sportswomen may end their sport careers. During pregnancy, the safety of both mother and baby has been identified as a key reason for ceasing sport participation. Recent "official" statistics on how many elite athletes are mothers suggest that pregnancy, motherhood, and sport could be no longer mutually exclusive. The aim of this qualitative phenomenological study was to describe the lived pregnancy of Spanish elite sportswomen. Spanish elite sportswomen (n = 20) aged between 18 and 65 years that had been pregnant during their sporting professional career and after the end of their pregnancy had taken up again their professional sporting career for at least one year were included. Data were collected from May 2010 to April 2012 using in-depth personal interviews, investigator's field notes, and extracts from the participants' personal letters. Identified themes included: (1) choosing the right moment; (2) fears and doubts; and (3) justifying physical exercise. By giving voice to these elite Spanish sportswomen, their pregnancy experiences are made visible, which might help to gain a better understanding into their expectations and develop policies and practices focused on elite sportswomen during and after pregnancy.
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Affiliation(s)
| | - Sara Alvarez-Harris
- a Department of Physical Therapy & Podiatry , Universidad Europea de Madrid , Madrid , Spain
| | - César Fernández-de-Las-Peñas
- b Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine , Universidad Rey Juan Carlos , Madrid , Spain
| | - Domingo Palacios-Ceña
- b Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine , Universidad Rey Juan Carlos , Madrid , Spain
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82
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Harrison CL, Brown WJ, Hayman M, Moran LJ, Redman LM. The Role of Physical Activity in Preconception, Pregnancy and Postpartum Health. Semin Reprod Med 2016; 34:e28-37. [PMID: 27169984 DOI: 10.1055/s-0036-1583530] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The rise in obesity and associated morbidity is currently one of our greatest public health challenges. Women represent a high risk group for weight gain with associated metabolic, cardiovascular, reproductive and psychological health impacts. Regular physical activity is fundamental for health and well-being with protective benefits across the spectrum of women's health. Preconception, pregnancy and the early postpartum period represent opportune windows to engage women in regular physical activity to optimize health and prevent weight gain with added potential to transfer behavior change more broadly to children and families. This review summarizes the current evidence for the role of physical activity for women in relation to preconception (infertility, assisted reproductive therapy, polycystic ovary syndrome, weight gain prevention and psychological well-being) pregnancy (prevention of excess gestational weight gain, gestational diabetes and preeclampsia as well as labor and neonatal outcomes) and postpartum (lactation and breastfeeding, postpartum weight retention and depression) health. Beneficial outcomes validate the importance of regular physical activity, yet key methodological gaps highlight the need for large, high-quality studies to clarify the optimal type, frequency, duration and intensity of physical activity required for beneficial health outcomes during preconception, pregnancy and postpartum.
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Affiliation(s)
- Cheryce L Harrison
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Wendy J Brown
- Centre for Research on Exercise Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Melanie Hayman
- School of Medical and Applied Sciences, Central Queensland University, Queensland, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Leanne M Redman
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
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83
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Schröder G, Kundt G, Otte M, Wendig D, Schober HC. Impact of pregnancy on back pain and body posture in women. J Phys Ther Sci 2016; 28:1199-207. [PMID: 27190453 PMCID: PMC4868213 DOI: 10.1589/jpts.28.1199] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 12/26/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this single-center investigation was to study the impact of pregnancy on back pain and body posture. [Subjects] The subjects were 26 pregnant females. [Methods] Data were generated with a spine scanner (Diers(®) formetric 4D), trunk strength measurement (Diers(®) myoline), a numeric pain scale (0 to 10), and a biomechanical model. Parameters were compared during each trimester. [Results] The alteration in pain level at rest and lumbar lordosis angle in the females revealed a statistical trend during pregnancy. Spearman's test showed positive correlations between body weight and trunk inclination during the second trimester, and between body weight and the kyphosis angle in the third trimester. The trunk inclination and the kyphosis angle revealed a negative correlation in the third trimester. Based on our analysis, the highest moments and muscle strength must be expended in the third trimester. The actual muscle strength is greatest in the second trimester. [Conclusion] Pain at rest must be given greater attention in pregnant females, and their increasing lumbar kyphosis must be counteracted. Exercising the deep segmental muscles may serve as a preventive measure.
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Affiliation(s)
- Guido Schröder
- Division of Internal Medicine I, Department of Internal Medicine, Germany
| | - Günther Kundt
- Institute of Biostatistics and Informatics in Medicine and Aging Research, University of Rostock, Germany
| | - Mandy Otte
- Division of Internal Medicine I, Department of Internal Medicine, Germany
| | - Detlef Wendig
- Division of Internal Medicine I, Department of Internal Medicine, Germany
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Abstract
Although the physiology of the heart and vascular system has not changed, there are many things we have learned and are still learning today. Research related to heart adaptations during pregnancy has been performed since the 1930s. Since the mid-1950s, researchers began to look at changes in the maternal cardiovascular system during exercise while pregnant. Research related to exercise during pregnancy and offspring heart development began and has continued since the 1970s. We will review the normal female cardiovascular system adaptations to pregnancy in general. Additionally, topics related to maternal cardiac adaptations to pregnancy during acute exercise, as well as the chronic conditioning response from exercise training will be explored. Since physical activity during pregnancy influences fetal development, the fetal cardiac development will be discussed in regards to acute and chronic maternal exercise. Similarly, the influence of various types of maternal exercise on acute and chronic fetal heart responses will be described. Briefly, the topics related to how and if there is maternal-fetal synchrony will be explained. Lastly, the developmental changes of the fetal cardiovascular system that persist after birth will be explored. Overall, the article will discuss maternal cardiac physiology related to changes with normal pregnancy, and exercise during pregnancy, as well as fetal cardiac physiology related to changes with normal development, and exercise during pregnancy as well as developmental changes in offspring after birth.
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Affiliation(s)
- Linda May
- Assistant Professor, Foundational Sciences and Research, East Carolina University, Greenville, NC
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85
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Potential benefits of physical activity during pregnancy for the reduction of gestational diabetes prevalence and oxidative stress. Early Hum Dev 2016; 94:57-62. [PMID: 26833143 DOI: 10.1016/j.earlhumdev.2016.01.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 01/07/2016] [Indexed: 01/28/2023]
Abstract
Changes in quality of nutrition, habits, and physical activity in modern societies increase susceptibility to obesity, which can deleteriously affect pregnancy outcome. In particular, a sedentary lifestyle causes dysfunction in blood flow, which impacts the cardiovascular function of pregnant women. The main molecular mechanism responsible for this effect is the synthesis and bioavailability of nitric oxide, a phenomenon regulated by the antioxidant capacity of endothelial cells. These alterations affect the vascular health of the mother and vascular performance of the placenta, the key organ responsible for the healthy development of the fetus. In addition to the increases in systemic vascular resistance in the mother, placental oxidative stress also affects the feto-placental blood flow. These changes can be integrated into the proteomics and metabolomics of newborns.
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Santos PC, Abreu S, Moreira C, Santos R, Ferreira M, Alves O, Moreira P, Mota J. Physical Activity Patterns During Pregnancy in a Sample of Portuguese Women: A Longitudinal Prospective Study. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e22455. [PMID: 27247788 PMCID: PMC4884625 DOI: 10.5812/ircmj.22455] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 03/30/2015] [Accepted: 04/16/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Physical activity (PA) patterns during pregnancy have not been explored in depth and most previous studies lack assessment of variables such as type, frequency, duration and intensity of activity. OBJECTIVES This study had two goals: 1) to analyze PA patterns during pregnancy according to weekly time spent on different types of activity; and 2) to determine women's perception about health care providers regarding PA advisement during pregnancy. PATIENTS AND METHODS A longitudinal prospective study was carried out with a 118-pregnant women cohort. Participants were evaluated during all trimesters. Self-reported questionnaires were used to collect personal and obstetric data. Type, duration and frequency of PA were evaluated using the pregnancy physical activity questionnaire (PPAQ) and intensity levels were calculated. Repeated measure analysis of variance was performed to determine differences between trimesters, and Wilcoxon signed-rank test was performed when appropriate. RESULTS A decrease in values of self-reported PA (MET.h.wk(-1)) was found from the first to the second and the first to the third trimester of pregnancy, respectively; total (270.91 vs 220.54 vs 210.35; P < 0.01), light (109.45 vs 95.11vs 92.40; P < 0.01) and moderate intensity (81.99 vs 50.69 vs 62.94; P = 0.002). Time spent on most activities remained fairly stable throughout pregnancy. Women spent most of their weekly time during the entire pregnancy on household and caregiving activities, occupational activities and leisure, except sport activities. Swimming was the most reported organized PA, reaching its highest proportion (12.7%) in the second trimester. Prenatal exercise classes were reported by 39.8% of women during the 3rd trimester. Pregnant women reported that PA was recommended by health professionals: 53.9% in the 1st trimester, 70.4% in the 2nd trimester and 56.8% in the 3rd trimester. CONCLUSIONS Self-reported PA decreased, especially from the first to the second trimester, in total, light and moderate intensity. Women spent most of their weekly time on domestic, occupational and leisure activities, except sport activities. There are some health care providers that do not recommend physical activity during pregnancy.
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Affiliation(s)
- Paula Clara Santos
- Department of Physiotherapy, School of Health Technology of Porto, Polytechnic Institute of Porto, Porto, Portugal
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Sandra Abreu
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Carla Moreira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Rute Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
- Early Start Research Centre, School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - Margarida Ferreira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Odete Alves
- Ponte da Barca Health Unit, Alto Minho Local Health Unit, Porto, Portugal
| | - Pedro Moreira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
- Faculty of Science, Nutrition and Food Science, University of Porto, Porto, Portugal
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
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Jędrzejko M, Nowosielski K, Poręba R, Ulman-Włodarz I, Bobiński R. Physical efficiency and activity energy expenditure in term pregnancy females measured during cardiopulmonary exercise tests with a supine cycle ergometer. J Matern Fetal Neonatal Med 2016; 29:3800-5. [PMID: 26866763 DOI: 10.3109/14767058.2016.1147550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To evaluate physical efficiency and activity energy expenditure (AEE) in term pregnancy females during cardiopulmonary exercise tests with a supine cycle ergometer. MATERIAL AND METHODS The study comprised 22 healthy full-term pregnancy women with uncomplicated pregnancies hospitalized in the Department of Gynecology and Obstetrics, Specialist Teaching Hospital in Tychy, Poland. All subjects underwent cardiopulmonary exercise tests (CPET) on a supine cycle ergometer. The 12-min, three-stage, progressive, symptom-limited submaximal test protocol (up to 80% HRmax) was used. Pulsometry was used to record HR on a beat-to-beat analysis and to calculate AEE. Respiratory responses were measured by ergospirometer and a computer system on a breath-by-breath basis at rest, during exercise and at restitution. RESULTS In the studied population, VO2max was established at the level of 2.19 ± 0.33 L/min in ergospirometry and 2.04 ± 025 L/min in pulsometry. Physical efficiency calculated for sub-maximal exercise by use of the Davis equation was 30.52 ± 0.12%. AEE, based on VO2 in various phases of the CPET, was 0.47, 0.71 and 0.88 L/min for phases 25, 50 and 75 W. Based on ergospirometer readouts, AEE was 10.60, 16.11 and 20.94 kJ/min for phases 25, 50 and 75 W. Overall mean AEE (determined by pulsometry) was 10.59 kJ/min. CPET testing did not have any negative effect upon the health or life of the neonates involved in the study. CONCLUSIONS Submaximal CPET up to 80% HRmax with a supine cycle ergometer is a safe and precise method for assessing work efficiency in term pregnancy women.
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Affiliation(s)
- Maciej Jędrzejko
- a Department of Gynecology and Obstetrics , Specialist Teaching Hospital in Tychy , Tychy , Poland and
| | - Krzysztof Nowosielski
- a Department of Gynecology and Obstetrics , Specialist Teaching Hospital in Tychy , Tychy , Poland and
| | - Ryszard Poręba
- a Department of Gynecology and Obstetrics , Specialist Teaching Hospital in Tychy , Tychy , Poland and
| | - Izabela Ulman-Włodarz
- a Department of Gynecology and Obstetrics , Specialist Teaching Hospital in Tychy , Tychy , Poland and.,b Faculty of Health Sciences , University of Bielsko-Biała , Bielsko-Biała , Poland
| | - Rafał Bobiński
- b Faculty of Health Sciences , University of Bielsko-Biała , Bielsko-Biała , Poland
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Darroch FE, Giles AR. A postcolonial feminist discourse analysis of urban Aboriginal women's description of pregnancy-related weight gain and physical activity. Women Birth 2016; 29:e23-32. [DOI: 10.1016/j.wombi.2015.08.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Revised: 07/23/2015] [Accepted: 08/05/2015] [Indexed: 12/16/2022]
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Kim Y, Chung E. Descriptive Epidemiology of Objectively Measured Walking Among US Pregnant Women: National Health and Nutrition Examination Survey, 2005-2006. Prev Chronic Dis 2015; 12:E217. [PMID: 26652217 PMCID: PMC4676279 DOI: 10.5888/pcd12.150437] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The objective of this study was to examine population-based prevalence of walking in the United States among pregnant women. Objectively measured walking data on 197 pregnant women who participated in the National Health and Nutrition Examination Survey 2005-2006 were analyzed. In general, pregnant women showed a level of walking below the recommendation; most walking was at low-intensity levels. These findings suggest that walking, particularly at higher intensity than usual, should be promoted among pregnant women.
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Affiliation(s)
- Youngdeok Kim
- Box 43011, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX 79409.
| | - Eunhee Chung
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas
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Physical activity during pregnancy: predictors of change, perceived support and barriers among women at increased risk of gestational diabetes. Matern Child Health J 2015; 18:2158-66. [PMID: 24615354 DOI: 10.1007/s10995-014-1464-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The aim of this study was to examine the predictors of change in intensity-specific leisure-time physical activity (LTPA) during pregnancy, and the perceived support and barriers of LTPA in Finnish pregnant women at increased risk of gestational diabetes. The study population consisted of 399 pregnant women who participated in a randomized controlled trial aiming to prevent gestational diabetes. Evaluation of LTPA was based on a self-report at baseline, 26-28, and 36-37 weeks' gestation. Data on predictors of change, perceived support and barriers were collected with questionnaires and from the maternity cards. Multinomial logistic regression was used to assess associations between the variables. The average weekly minutes of light-intensity LTPA were 179 at baseline, 161 at 26-28 weeks' gestation, and 179 at 36-37 weeks' gestation. The corresponding minutes of moderate-to-vigorous-intensity LTPA were 187, 133 and 99. At 26-28 weeks' gestation, the strongest predictors for light-intensity LTPA were meeting the PA recommendations prior to pregnancy, having polytechnic education and working part-time, while having a physically active spouse prior to pregnancy was the strongest predictor for moderate-to-vigorous-intensity LTPA. The people and/or factors that encouraged women to LTPA the most were the spouse, a child, other family members and weather, whereas tiredness, nausea, perceived health, work and lack of time restricted their LTPA the most. The strongest predictors for maintaining LTPA during pregnancy were pre-pregnancy LTPA, education, working part-time and a spouse's LTPA. Most common barriers were perceived health, work and lack of time.
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Songstad NT, Kaspersen KHF, Hafstad AD, Basnet P, Ytrehus K, Acharya G. Effects of High Intensity Interval Training on Pregnant Rats, and the Placenta, Heart and Liver of Their Fetuses. PLoS One 2015; 10:e0143095. [PMID: 26566220 PMCID: PMC4643918 DOI: 10.1371/journal.pone.0143095] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 10/30/2015] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To investigate the effects of high intensity interval training (HIIT) on the maternal heart, fetuses and placentas of pregnant rats. METHODS Female Sprague-Dawley rats were randomly assigned to HIIT or sedentary control groups. The HIIT group was trained for 6 weeks with 10 bouts of high intensity uphill running on a treadmill for four minutes (at 85-90% of maximal oxygen consumption) for five days/week. After three weeks of HIIT, rats were mated. After six weeks (gestational day 20 in pregnant rats), echocardiography was performed to evaluate maternal cardiac function. Real-time PCR was performed for the quantification of gene expression, and oxidative stress and total antioxidant capacity was assessed in the tissue samples. RESULTS Maternal heart weight and systolic function were not affected by HIIT or pregnancy. In the maternal heart, expression of 11 of 22 genes related to cardiac remodeling was influenced by pregnancy but none by HIIT. Litter size, fetal weight and placental weight were not affected by HIIT. Total antioxidant capacity, malondialdehyde content, peroxidase and superoxide dismutase activity measured in the placenta, fetal heart and liver were not influenced by HIIT. HIIT reduced the expression of eNOS (p = 0.03), hypoxia-inducible factor 1α (p = 0.04) and glutathione peroxidase 4.2 (p = 0.02) in the fetal liver and increased the expression of vascular endothelial growth factor-β (p = 0.014), superoxide dismutase 1 (p = 0.001) and tissue inhibitor of metallopeptidase 3 (p = 0.049) in the fetal heart. CONCLUSIONS Maternal cardiac function and gene expression was not affected by HIIT. Although HIIT did not affect fetal growth, level of oxidative stress and total antioxidant capacity in the fetal tissues, some genes related to oxidative stress were altered in the fetal heart and liver indicating that protective mechanisms may be activated.
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Affiliation(s)
- Nils Thomas Songstad
- Women’s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT–The Arctic University of Norway, Tromsø, Norway
- Department of Pediatrics, University Hospital of Northern Norway, Tromsø, Norway
- * E-mail:
| | - Knut-Helge Frostmo Kaspersen
- Department of Pediatrics, University Hospital of Northern Norway, Tromsø, Norway
- Pediatric Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT–The Arctic University of Norway, Tromsø, Norway
| | - Anne Dragøy Hafstad
- Cardiovascular Research Group, Department of Medical Biology, Faculty of Health Science, UiT–The Arctic University of Norway, Tromsø, Norway
| | - Purusotam Basnet
- Women’s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT–The Arctic University of Norway, Tromsø, Norway
- Department of Obstetrics and Gynecology, University Hospital of Northern Norway, Tromsø, Norway
| | - Kirsti Ytrehus
- Cardiovascular Research Group, Department of Medical Biology, Faculty of Health Science, UiT–The Arctic University of Norway, Tromsø, Norway
| | - Ganesh Acharya
- Women’s Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health Sciences, UiT–The Arctic University of Norway, Tromsø, Norway
- Department of Obstetrics and Gynecology, University Hospital of Northern Norway, Tromsø, Norway
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92
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Marcelino TB, de Lemos Rodrigues PI, Miguel PM, Netto CA, Pereira Silva LO, Matté C. Effect of maternal exercise on biochemical parameters in rats submitted to neonatal hypoxia-ischemia. Brain Res 2015; 1622:91-101. [DOI: 10.1016/j.brainres.2015.06.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 06/17/2015] [Accepted: 06/18/2015] [Indexed: 01/25/2023]
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93
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Intrauterine Growth Restricted Rats Exercised before and during Pregnancy: Maternal and Perinatal Repercussions. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:294850. [PMID: 26345406 PMCID: PMC4540985 DOI: 10.1155/2015/294850] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 07/08/2015] [Accepted: 07/12/2015] [Indexed: 01/12/2023]
Abstract
This study aimed at evaluating the effect of swimming before and during pregnancy on rats born with intrauterine growth restriction (IUGR) and their offspring. For this, nondiabetic and streptozotocin-induced severely diabetic (SD) pregnant rats were mated and generated offspring with appropriate (control, C) and small (IUGR) for pregnancy age, respectively. Following that, C and IUGR groups were further distributed into nonexercised control (C), exercised control (Cex), nonexercised IUGR (IUGR), and exercised IUGR (IUGRex). IUGR rats presented lower mating rate than control rats. Regardless of physical exercise IUGR rats presented decreased body weight from birth to lactation. At 90 days of life, IUGR rats presented glucose intolerance. Maternal organ weights were increased and relative adiposity of IUGRex rats was lower than Cex. IUGR and IUGRex offspring presented reduced body weight than C and Cex, respectively. IUGRex dams presented an increased rate of appropriate for pregnancy age newborns. IUGEex male and female offspring relative brain weight was increased compared with Cex. Therefore, swimming before and during pregnancy prevented glucose intolerance, reduced general adiposity, and increased maternal and offspring organ weight in rats, showing the benefit of physical exercise for IUGR rats.
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94
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Poyatos-León R, García-Hermoso A, Sanabria-Martínez G, Álvarez-Bueno C, Sánchez-López M, Martínez-Vizcaíno V. Effects of exercise during pregnancy on mode of delivery: a meta-analysis. Acta Obstet Gynecol Scand 2015; 94:1039-47. [DOI: 10.1111/aogs.12675] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 05/06/2015] [Indexed: 01/16/2023]
Affiliation(s)
| | - Antonio García-Hermoso
- Physical Activity, Sport and Health Sciences Laboratory; University of Santiago de Chile; USACH; Santiago de Chile Chile
| | | | | | - Mairena Sánchez-López
- School of Education; University of Castilla-La Mancha; Ciudad Real Spain
- Health and Social Research Center; University of Castilla-La Mancha; Cuenca Spain
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95
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Tenforde AS, Toth KES, Langen E, Fredericson M, Sainani KL. Running habits of competitive runners during pregnancy and breastfeeding. Sports Health 2015; 7:172-6. [PMID: 25984264 PMCID: PMC4332642 DOI: 10.1177/1941738114549542] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Running is a popular sport that may be performed safely during pregnancy. Few studies have characterized running behavior of competitive female runners during pregnancy and breastfeeding. Hypothesis: Women modify their running behavior during pregnancy and breastfeeding. Study Design: Observational, cross-sectional study. Level of evidence: Level 2. Methods: One hundred ten female long-distance runners who ran competitively prior to pregnancy completed an online survey characterizing training attitudes and behaviors during pregnancy and postpartum. Results: Seventy percent of runners ran some time during their pregnancy (or pregnancies), but only 31% ran during their third trimester. On average, women reduced training during pregnancy, including cutting their intensity to about half of their nonpregnant running effort. Only 3.9% reported sustaining a running injury while pregnant. Fewer than one third (29.9%) selected fetal health as a reason to continue running during pregnancy. Of the women who breastfed, 84.1% reported running during breastfeeding. Most felt that running had no effect on their ability to breastfeed. Women who ran during breastfeeding were less likely to report postpartum depression than those who did not run (6.7% vs 23.5%, P = 0.051), but we did not detect the same association of running during pregnancy (6.5% vs 15.2%, P = 0.16). Conclusion: Women runners reported a reduction in total training while pregnant, and few sustained running injuries during pregnancy. The effect of running on postpartum depression was not clear from our findings. Clinical Relevance: We characterized running behaviors during pregnancy and breastfeeding in competitive runners. Most continue to run during pregnancy but reduce total training effort. Top reasons for running during pregnancy were fitness, health, and maintaining routine; the most common reason for not running was not feeling well. Most competitive runners run during breastfeeding with little perceived impact.
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Affiliation(s)
- Adam S Tenforde
- Division of Physical Medicine and Rehabilitation, Department of Orthopedic Surgery, Stanford University, Stanford, California
| | - Kierann E S Toth
- Mid-Hudson Family Medicine Residency Program, Institute for Family Health, Kingston, New York
| | - Elizabeth Langen
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
| | - Michael Fredericson
- Division of Physical Medicine and Rehabilitation, Department of Orthopedic Surgery, Stanford University, Stanford, California
| | - Kristin L Sainani
- Division of Epidemiology, Department of Health Research and Policy, Stanford University, Stanford, California
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96
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Seneviratne SN, McCowan LME, Cutfield WS, Derraik JGB, Hofman PL. Exercise in pregnancies complicated by obesity: achieving benefits and overcoming barriers. Am J Obstet Gynecol 2015; 212:442-9. [PMID: 24909342 DOI: 10.1016/j.ajog.2014.06.009] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 05/08/2014] [Accepted: 06/03/2014] [Indexed: 01/21/2023]
Abstract
An increasing number of women are entering pregnancy in an overweight or obese state. Obese women and their offspring are at increased risk of adverse perinatal outcomes, which may be improved by regular moderate-intensity antenatal exercise. Current guidelines recommend that all pregnant women without contraindications engage in ≥30 minutes of moderate-intensity exercise on a daily basis. However, obese women are usually less physically active and tend to further reduce activity levels during pregnancy. This commentary summarizes the potential short- and long-term benefits of antenatal exercise in obese pregnant women, highlights the challenges they face, and discusses means of improving their exercise levels. In addition, we make recommendations on exercise prescription for pregnancies complicated by obesity.
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Affiliation(s)
- Sumudu N Seneviratne
- Liggins Institute, University of Auckland, Auckland, New Zealand; Gravida: National Centre for Growth and Development, University of Auckland, Auckland, New Zealand
| | - Lesley M E McCowan
- Gravida: National Centre for Growth and Development, University of Auckland, Auckland, New Zealand; Department of Obstetrics and Gynaecology, Faculty of Medical and Health Science, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand; Gravida: National Centre for Growth and Development, University of Auckland, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand; Gravida: National Centre for Growth and Development, University of Auckland, Auckland, New Zealand.
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97
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The efficacy of physiotherapy for the prevention and treatment of prenatal symptoms: a systematic review. Int Urogynecol J 2015; 26:1575-86. [DOI: 10.1007/s00192-015-2684-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2014] [Accepted: 03/11/2015] [Indexed: 12/16/2022]
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98
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Lashley CJ, Supik DA, Atkinson JT, Murphy RJ, O'Hagan KP. Effect of pregnancy on the uterine vasoconstrictor response to exercise in rats. Physiol Rep 2015; 3:3/3/e12337. [PMID: 25804264 PMCID: PMC4393170 DOI: 10.14814/phy2.12337] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
A major maternal adaptation in pregnancy is the large increase in uteroplacental blood flow that supplies the growing fetus with oxygen and nutrients. The impact of gestation on the dynamic uterine vasoconstrictor response to exercise in the rat, a common model for pathophysiological disorders in pregnancy remains unknown. We hypothesized that rats exhibit a robust uterine vasoconstrictor response to acute exercise that is attenuated in late pregnancy. Pregnant (P, N = 12) and nonpregnant (NP, N = 8) rats were instrumented chronically with a ultrasonic transit-time flowprobe and carotid arterial catheter to directly measure uterine artery blood flow (UtBF) and blood pressure (BP), respectively, at day 20 of gestation for 5 min of treadmill exercise (7 m/min; 6% grade). Preexercise UtBF [P, 2.1 (SD1.6) vs. NP, 0.5 (SD0.3) mL/min P < 0.01) and uterine artery conductance (UtC) [P, 2.1(SD1.7) vs. NP, 0.4 (SD0.2) mL/min × mmHg−1 × 10−2, P < 0.01] were higher in pregnant rats, whereas preexercise BP was lower in the pregnant rats [P, 111 (SD13) vs. NP, 126 (SD13) mmHg, P = 0.02]. Preexercise heart rate was similar [P, 457 (SD30) vs. NP, 454 (SD42), P = 0.3]. Exercise initiated rapid and sustained decreases in UtBF [Δ−47% (SD12)] and UtC [Δ−49% (SD12)] that were attenuated in the pregnant rats [UtBF, Δ−25% (SD20) and UtC, Δ−30% (SD20), P = 0.02]. The BP and heart rate responses to exercise were unaffected in late pregnancy (interaction term, P = 0.3). In rats, dynamic exercise induces a uterine vasoconstrictor response that is blunted during late gestation, a response that we observed previously in pregnant rabbits.
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Affiliation(s)
- Christopher J Lashley
- Program in Biomedical Sciences, College of Health Sciences, Midwestern University, Downers Grove, Illinois, USA Department of Physiology, Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, Illinois, USA
| | - David A Supik
- Program in Biomedical Sciences, College of Health Sciences, Midwestern University, Downers Grove, Illinois, USA
| | - James T Atkinson
- Program in Biomedical Sciences, College of Health Sciences, Midwestern University, Downers Grove, Illinois, USA
| | - Robert J Murphy
- Department of Physiology, Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, Illinois, USA
| | - Kathleen P O'Hagan
- Department of Physiology, Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, Illinois, USA
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99
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Sorbye LM, Klungsoyr K, Samdal O, Owe KM, Morken NH. Pre-pregnant body mass index and recreational physical activity: effects on perinatal mortality in a prospective pregnancy cohort. BJOG 2015; 122:1322-30. [PMID: 25645155 DOI: 10.1111/1471-0528.13290] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the effect of maternal pre-pregnant body mass index (BMI) and recreational physical activity on perinatal mortality. DESIGN A prospective cohort study. SETTING The Norwegian Mother and Child Cohort (MoBa), 1999-2008. POPULATION Singleton pregnancies without congenital anomalies (n = 77 246). METHODS Pre-pregnant BMI was classified as underweight (<18.5), normal weight (18.5-24.9), overweight (25-29.9), obese (30-34.9) or morbidly obese (BMI ≥ 35). Risk estimates were obtained by logistic regression and adjusted for confounders. MAIN OUTCOME MEASURES Perinatal death (stillbirth ≥ 22 weeks plus early neonatal death 0-7 days after birth). RESULTS An increased risk of perinatal death was seen in obese [odds ratio (OR) 2.4, 95% CI (confidence interval) 1.7-3.4] and morbidly obese women (OR 3.3, 95% CI 2.1-5.1) as compared with normal weight women. In the group participating in recreational physical activity during pregnancy, obese women had an OR of 3.2 (95% CI 2.2-4.7) for perinatal death relative to non-obese women. In the non-active group the corresponding OR was 1.8 (95% CI 1.1-2.8) for obese women compared with non-obese women. The difference in perinatal mortality risk related to obesity between the active and non-active groups was statistically significant (P-value for interaction = 0.046, multiplicative model). CONCLUSIONS Maternal obesity was associated with a two- to three-fold increased risk of perinatal death when compared with normal weight. For women with a BMI <30 the lowest perinatal mortality was seen in those performing recreational physical activity at least once a week.
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Affiliation(s)
- L M Sorbye
- Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway.,Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - K Klungsoyr
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Medical Birth Registry of Norway, Norwegian Institute of Public Health, Bergen, Norway
| | - O Samdal
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - K M Owe
- Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Rikshospitalet, Oslo, Norway.,Department of Psychosomatics and Health Behaviour, Norwegian Institute of Public Health, Oslo, Norway
| | - N-H Morken
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Clinical Sciences, University of Bergen, Bergen, Norway
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100
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Chawla S, Anim-Nyame N. Advice on exercise for pregnant women with hypertensive disorders of pregnancy. Int J Gynaecol Obstet 2014; 128:275-9. [DOI: 10.1016/j.ijgo.2014.09.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 09/06/2014] [Accepted: 11/11/2014] [Indexed: 10/24/2022]
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