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Sparks JR, Flanagan EW, Kebbe M, Redman LM. Understanding Barriers and Facilitators to Physical Activity Engagement to Inform a Precision Prescription Approach during Pregnancy. Am J Lifestyle Med 2023; 17:108-122. [PMID: 36636400 PMCID: PMC9830245 DOI: 10.1177/15598276221108669] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Physical activity during pregnancy is an important health behavior. However, many pregnant individuals are provided with little-to-no guidance to adequately engage in physical activity. The purpose of this quantitative and quasi-qualitative study of currently or previously pregnant women was to examine physical activity behaviors in pregnancy and understand barriers and facilitators to achieving physical activity recommendations. Overall, 431 women (18+ years), White/Caucasian (84.5%), married (84.9%), and currently pregnant (66.6%), completed an online survey study. Most women (69.4%) reported engaging in cardio-based physical activity and willing to engage in physical activity to meet guidelines between 2 and 5 days per week (77.4 -88.8%). The most frequently reported barriers were feeling too tired (72.8%) or uncomfortable (71.8%) and childcare needs (57.8%). Being able to choose time of day (96.0%), accessing home workouts (92.9%), and having a personalized prescription (95.6%) were the most reported facilitators. Open comment feedback resulted in additional barriers, such as ensuring proper energy intake, while motivation and support from other pregnant individuals were fundamental facilitators. Individualized physical activity prescription is lacking in routine prenatal care. To support pregnant individuals to achieve physical activity recommendations, developing a prescription with suitable modalities, at-home options, and consideration for physical activity timing are required.
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Affiliation(s)
- Joshua R. Sparks
- Reproductive Endocrinology and Women’s Health Laboratory, Pennington Biomedical Research
Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | | | | | - Leanne M. Redman
- Reproductive Endocrinology and Women’s Health Laboratory, Pennington Biomedical Research
Center, Louisiana State University, Baton Rouge, Louisiana, USA
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Beetham KS, Spathis JG, Hoffmann S, Brown WJ, Clifton V, Mielke GI. Longitudinal association of physical activity during pregnancy with maternal and infant outcomes: Findings from the Australian longitudinal study of women's health. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221142357. [PMID: 36560920 PMCID: PMC9793022 DOI: 10.1177/17455057221142357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Physical activity has known benefits during pregnancy; however, the optimum volume of physical activity through the different stages of pregnancy is not well known. OBJECTIVES The aims of this study were to investigate the associations of physical activity volume in pregnant women in each trimester of pregnancy with maternal and infant outcomes. DESIGN The study involved 1657 pregnant women from the Australian Longitudinal Study on Women's Health, who completed surveys from 2006 to 2012 (aged 28-39 years). METHODS Women reported being in either the first, second or third trimester of pregnancy. Women were grouped into four groups according to their self-reported physical activity during pregnancy: (1) Nil (0-<33.3 MET.min/week), (2) Low (33.3-<500 MET.min/week), (3) Moderate (500-<1000 MET.min/week) and (4) High (⩾1000 MET.min/week). Women who reported their physical activity during pregnancy completed a survey within three years after the birth, relating to outcomes associated with pregnancy and childbirth (gestational diabetes, hypertension, and antenatal depression and anxiety) and infant outcomes (birthweight and prematurity). RESULTS There was no association of physical activity in any trimester with infant birthweight, prematurity, gestational diabetes, hypertension or antenatal depression. Antenatal anxiety was less prevalent in women who reported low (1.7%) or moderate (1.1%) physical activity than in those who reported no activity (4.7%; p = 0.01). CONCLUSION Different amounts of physical activity during pregnancy were not associated with the measured adverse health outcomes. However, low and moderate amounts of physical activity were associated with reduced incidence of antenatal anxiety.
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Affiliation(s)
- Kassia S Beetham
- School of Behavioural and Health
Sciences, Australian Catholic University, Brisbane, QLD, Australia,School of Exercise and Nutrition
Sciences, Deakin University, Geelong, VIC, Australia,Kassia S Beetham, School of Behavioural and
Health Sciences, Australian Catholic University, 1100 Nudgee Road, Banyo,
Brisbane, QLD, 4014, Australia.
| | - Jemima G Spathis
- School of Behavioural and Health
Sciences, Australian Catholic University, Brisbane, QLD, Australia
| | - Samantha Hoffmann
- School of Exercise and Nutrition
Sciences, Deakin University, Geelong, VIC, Australia
| | - Wendy J Brown
- School of Human Movement and Nutrition
Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Vicki Clifton
- Mater Research and Translational
Research Institute, Brisbane, QLD, Australia
| | - Gregore I Mielke
- School of Public Health, The University
of Queensland, Brisbane, QLD, Australia
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103
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Liu X, Wang G, Cao Y. Physical exercise interventions for perinatal depression symptoms in women: A systematic review and meta-analysis. Front Psychol 2022; 13:1022402. [PMID: 36582320 PMCID: PMC9792692 DOI: 10.3389/fpsyg.2022.1022402] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/24/2022] [Indexed: 12/15/2022] Open
Abstract
Background The previous meta-analysis indicated that physical exercise could play a crucially therapeutic role in reducing perinatal depression symptoms in women. However, the efficacy varies across different exercise types, forms, intensities, and duration. Aim The purpose of this study was to review and evaluate the effects of different types, forms, intensities, and duration of exercise for improving perinatal depressive symptoms. Design A systematic review and meta-analysis. Methods Randomized controlled trials until December 2021 were searched from seven databases, including PubMed, EMBASE, Medline, CINAHL, Web of Science, Cochrane Library, and PsycINFO. The risk of bias in eligible trials was evaluated using the Cochrane Risk of Bias tool. When high heterogeneity was tested, we used random-effects models. A funnel plot was used to assess the publication bias. This review was performed under the PRISMA guidelines, Consensus on Exercise Reporting (CERT) checklist and Cochrane Handbook. The certainty of the body of evidence was assessed using the GRADE method. Results Of 1,573 records, 20 trials were identified in this study. The results of this review revealed that women with perinatal depression symptoms gained benefits from physical exercise [OR = 0.62, 95% CI (0.45, 0.86), P = 0.004; MD = -0.57, 95% CI (-0.83, -0.30), P < 0.0001]. Type of walking [SMD = -1.06, 95% CI (-1.92, -0.19), P < 0.00001], form of "Individual + group-based"exercise [SMD = -0.91, 95% CI (-0.80, -0.03), P = 0.04], intensity of ≥150 min per week [SMD = -0.84, 95% CI (-1.53, -0.15), P = 0.02], and ≥12 weeks duration [SMD = -0.53, 95% CI (-0.75, -0.31), P < 0.00001] seemed to generate more prominent improvement on perinatal depression symptoms. Conclusion Physical exercise showed a significant effect on reducing perinatal depressive symptoms. This meta-analysis provides an important update on exercise's efficacy in treating perinatal depression. Further higher quality and large-scale trials are needed to substantiate our findings. Systematic review registration [https://www.crd.york.ac.uk/prospero/], identifier [CRD42022296230].
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Affiliation(s)
- Xueyan Liu
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Guangpeng Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Yingjuan Cao
- Qilu Hospital, Shandong University, Jinan, Shandong, China,*Correspondence: Yingjuan Cao,
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Wilcox S, Liu J, Turner-McGrievy GM, Boutté AK, Wingard E. Effects of a behavioral intervention on physical activity, diet, and health-related quality of life in pregnant women with elevated weight: results of the HIPP randomized controlled trial. Int J Behav Nutr Phys Act 2022; 19:145. [PMID: 36494702 PMCID: PMC9733107 DOI: 10.1186/s12966-022-01387-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/26/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Physical activity (PA), diet, and health-related quality of life (HRQOL) are related to maternal and infant health, but interventions to improve these outcomes are needed in diverse pregnant women with elevated weight. METHODS Health In Pregnancy and Postpartum (HIPP) was a randomized controlled trial. Women who were pregnant (N=219, 44% African American, 56% white) with overweight or obesity but otherwise healthy were randomized to a behavioral intervention grounded in Social Cognitive Theory (n=112) or to standard care (n=107). The intervention group received an in-depth counseling session, a private Facebook group, and 10 content-based counseling calls with accompanying behavioral podcasts followed by weekly or biweekly counseling calls until delivery. The standard care group received monthly mailings and 10 podcasts focused on healthy pregnancy. PA (SenseWear armband), diet (ASA24), and HRQOL (SF-12) measures were obtained from blinded assessors at baseline (<16 weeks) and late pregnancy (32 weeks). Mixed model repeated measures regression models tested treatment (Group x Time) and within-group effects. We hypothesized that intervention participants would have higher levels of PA, a better-quality diet, and higher HRQOL than standard care participants. Exploratory analyses examined whether changes in outcomes over time differed according to whether participants had recommended, excessive, or inadequate weight gain. RESULTS Treatment effects favored intervention participants for vegetable intake (d=0.40, p<0.05) and % whole grains (d=0.60, p<0.01). HRQOL mental component improved in both groups, but less in intervention than standard care participants (d=-0.33, p<0.05). Time effects demonstrated that total PA, steps/day, and HRQOL physical component declined significantly in both groups. Within-group effects showed that diet quality significantly improved in intervention participants. Moderate-intensity PA declined significantly in standard care participants, whereas light-intensity PA declined and sedentary behavior increased significantly in intervention participants. Finally, exploratory analyses showed that total PA and light PA increased whereas sedentary behavior decreased among those meeting guidelines for weight gain, with opposite patterns seen among those with excessive or inadequate weight gain. CONCLUSIONS The intervention improved several dietary outcomes but had modest impacts on PA and HRQOL, underscoring the challenge of behavior change during pregnancy. TRIAL REGISTRATION This trial was registered in ClinicalTrials.gov on 10/09/2014. NCT02260518.
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Affiliation(s)
- Sara Wilcox
- grid.254567.70000 0000 9075 106XPrevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208 USA ,grid.254567.70000 0000 9075 106XDepartment of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Jihong Liu
- grid.254567.70000 0000 9075 106XDepartment of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Gabrielle M. Turner-McGrievy
- grid.254567.70000 0000 9075 106XDepartment of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Alycia K. Boutté
- grid.254567.70000 0000 9075 106XPrevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208 USA ,grid.254567.70000 0000 9075 106XDepartment of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC USA
| | - Ellen Wingard
- grid.254567.70000 0000 9075 106XPrevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29208 USA
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105
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Badon SE, Ferrara A, Gabriel KP, Avalos LA, Hedderson MM. Changes in 24-Hour Movement Behaviors From Early to Late Pregnancy in Individuals With Prepregnancy Overweight or Obesity. J Phys Act Health 2022; 19:842-846. [PMID: 36370700 PMCID: PMC11023622 DOI: 10.1123/jpah.2022-0333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/14/2022] [Accepted: 09/25/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Understanding how sleep, sedentary behavior (SED), and physical activity (PA) (24-h movement profile) changes across pregnancy in individuals with prepregnancy overweight or obesity and how parity (previous births) impacts these changes can help inform interventions. METHODS In 155 participants, movement was measured using wrist-worn accelerometers, and sleep was self-reported in early (8-15 wk) and late (29-38 wk) pregnancy. The 24-hour movement profiles were analyzed using compositional analyses. RESULTS Nulliparous participants (no previous births) spent 33.95%, 38.14%, 25.32%, and 2.58% of the 24-hour day in early pregnancy in sleep, SED, light-intensity PA, and moderate/vigorous-intensity PA, respectively. Multiparous participants (≥1 previous birth) spent 2.50 percentage points less in SED (mean log-ratio difference = -0.068; 95% confidence interval [CI], -0.129 to -0.009) and 2.73 percentage points more in light-intensity PA (mean log-ratio difference = 0.102; 95% CI, 0.035 to 0.180). From early to late pregnancy, participants decreased the proportion of the 24-hour day spent asleep by 1.67 percentage points (mean log-ratio difference = -0.050; 95% CI, -0.092 to -0.011) and increased light-intensity PA by 1.56 percentage points (mean log-ratio difference = 0.057; 95% CI, 0.003 to 0.108), with no change in other behaviors. CONCLUSIONS Nulliparous and multiparous individuals with prepregnancy overweight or obesity both had high levels of SED, with no change across pregnancy, and may require interventions to reduce SED.
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Affiliation(s)
- Sylvia E Badon
- Kaiser Permanente Northern California Division of Research, Oakland, CA,USA
| | - Assiamira Ferrara
- Kaiser Permanente Northern California Division of Research, Oakland, CA,USA
| | | | - Lyndsay A Avalos
- Kaiser Permanente Northern California Division of Research, Oakland, CA,USA
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The prevalence and associated factors of prenatal depression and anxiety in twin pregnancy: a cross-sectional study in Chongqing, China. BMC Pregnancy Childbirth 2022; 22:877. [DOI: 10.1186/s12884-022-05203-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 11/09/2022] [Indexed: 11/28/2022] Open
Abstract
Abstract
Background
Pregnant women expecting twins are more likely to experience stress, which can lead to anxiety and depression. Our aim was to investigate the prevalence of prenatal anxiety and depressive symptoms in women with twin pregnancies and the associated factors.
Methods
In a cross-sectional survey, 210 women with twin pregnancies who satisfied the inclusion and exclusion criteria in two tertiary centers in Southwestern China were asked to complete a basic information form, the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). To compare statistics with normal distribution in distinct characteristic groups, a paired t-test, and one-way ANOVA were utilized. Binary logistic step regression was used to analyze the associated factors of antenatal anxiety and depressive symptoms.
Results
The 210 women with twin pregnancies (age = 30.8 ± 4.2 years) were between 7 and 37 gestational weeks (29.2 ± 1.2 weeks), were typically well-educated (72.4% had a post-high-school degree), and reasonably affluent (88.1% were above the low-income cutoff). Among them, 34.8% had symptoms associated with clinical levels of anxiety, and 37.1% had symptoms indicating possible depression. The prevalence of co-morbid anxiety and depressive symptoms was 24.3%. Binary stepwise logistic regression analysis showed that previous health status and sleep disturbance during pregnancy were the associated factors of anxiety symptoms in women with twin pregnancies (P < 0.05), whereas age, previous health status, negative life events, and physical activity during pregnancy were the associated factors of depressive symptoms in women with twin pregnancies (P < 0.05).
Conclusion
About one-third of women with twin pregnancies had symptoms of anxiety or depression; these were most strongly predicted by some modifiable factors, suggesting that early preventive mind-body interventions may be a promising strategy to protect against mental health issues for women with twin pregnancies.
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107
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Factors associated with meeting the WHO physical activity recommendations in pregnant Colombian women. Sci Rep 2022; 12:19500. [PMID: 36376351 PMCID: PMC9663497 DOI: 10.1038/s41598-022-23947-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
In the absence of medical contraindications, physical activity (PA) can offer health maternal and fetal health outcomes during pregnancy. However, most pregnant women may not consider PA to be feasible, suitable and safe. Hence, it is essential to determine the prevalence of pregnant women who meet the PA recommendations and the possible factors associated with that meeting, since it might be important from the perspective of pregnant women's health. The aim of the present study was to establish the prevalence of meeting the World Health Organization PA recommendations for Colombian pregnant women, as well as possible factors that may be associated with meeting that recommendations. A cross-sectional study including representative data from the National Nutritional Situation Survey (2015) in Colombia was performed. Data were collected in 2015-2016. From an initial sample of 1140 Colombian pregnant women, 702 participants with complete data were included in the final analysis. PA was assessed by self-reported information through the long version of the International Physical Activity Questionnaire. Several potential factors were analysed according to four levels of the socioecological model: the individual, interpersonal, organizational and community levels. The prevalence of Colombian pregnant women who met with the PA recommendations was 7.5%. Indigenous and Mestizo pregnant women showed lower probabilities of meeting the PA recommendations [Indigenous: OR 0.05, 95% CI (0.01-0.18); Mestizo: OR 0.12, 95% CI (0.06-0.22)] than Afro-Colombian participants. Additionally, participants who lived near green and safe spaces for PA were more likely to meet the PA recommendations [OR 2.30, 95% CI (1.06-4.79)] than those who did not live near green areas. In conclusion, a low percentage of Colombian pregnant women met the new PA recommendations. The associations found according to race/ethnicity and living near green and safe areas underline the presence of fundamental disparities associated with meeting PA recommendations.
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108
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Zhao L, Wang L, Wang W, Shi Z, Zhu Y, Li S, Wang T, Su Y, Li Z, Wen Y, Zhang L, Xu Q, Sharma M, Zhao Y. Association between modes of delivery and postpartum dietary patterns: A cross-sectional study in Northwest China. Front Nutr 2022; 9:985941. [DOI: 10.3389/fnut.2022.985941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
ObjectivePuerperae’ dietary patterns (DPs) during the puerperium may be influenced by the mode of delivery, but population studies on this topic are scarce. This study aims to explore the relationship between DPs and different modes of delivery among puerperae.MethodsA cross-sectional study was conducted on 3,345 parturients in Lanzhou, China. The postpartum food intake was measured by a food frequency questionnaire (FFQ). Factor analysis was used to determine the DPs. Multiple linear regression was employed to examine the association between the mode of delivery and DP.ResultsIn this study, two DPs, i.e., traditional and modern DPs, were identified. Traditional DP was characterized by high energy-adjusted intake of tubers, coarse cereals, rice, whole grains, fishery products, and eggs. Modern DP included a high intake of coffee, non-sugary drinks, wine, tea, and fishery products. Compared with participants with vaginal delivery (reference category), cesarean section had an inverse association with modern DP (β: −0.11, 95% CI: −0.36, −0.09). A significant interaction was found between education level, monthly household income, alcohol drinking, and modes of delivery. The inverse association between cesarean section and modern DP or the intake of coffee was significant among puerperae with higher or lower monthly household income. However, the inverse association between cesarean section and traditional DP was only found among puerperae with higher monthly household income. Moreover, among the participants with high education, cesarean section was positively associated with intake of vegetables.ConclusionCesarean puerperae with higher levels of education and those with lower and higher monthly household income had less unhealthy foods intake than those who had vaginal delivery. They need to be accounted for in educational programs and interventions focused on healthy diet recommendations in puerperium.
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Dolatabadi Z, Amiri-Farahani L, Ahmadi K, Pezaro S. Barriers to physical activity in pregnant women living in Iran and its predictors: a cross sectional study. BMC Pregnancy Childbirth 2022; 22:815. [PMID: 36333661 PMCID: PMC9636628 DOI: 10.1186/s12884-022-05124-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND AND AIMS Despite the benefits of physical activity (PA) on maternal and fetal health, the level of PA is low among pregnant women globally. The aim of this study was to determine the barriers to PA and its predictors in Iranian pregnant women specifically. METHODS This cross-sectional study included 300 pregnant women referred to the Ilam health centers of Iran. The sampling strategy used stratified random proportional allocation sampling from both comprehensive health centers and health bases. Data were collected from September to December 2018 in relation to individual characteristics. Data collection tools used included the Pregnancy Physical Activity Questionnaire and the Barriers to Physical Activity during Pregnancy Scale. To analyze the data, descriptive statistics and statistical tests of analysis including variance, independent t-test and multiple linear regression were used. RESULTS The mean and SD of the total score of PA barriers was 88.55 and 19.28, respectively. The highest and lowest mean scores of the subscale of PA barriers were related to interpersonal and environmental barriers, respectively. Among the intrapersonal barriers related to pregnancy; fear of pregnancy complications, drowsiness, and nausea and vomiting, heaviness or swelling barriers scored higher than other barriers. Lack of regular schedule, insufficient time, and lack of motivation received the highest score in terms of intrapersonal barriers non-related to pregnancy. In the interpersonal subscale; lack of knowledge about how to be physically active during pregnancy, forbiddance of PA by friends and family, as well as lack of advice from physicians and midwives scored higher than other barriers. Lack of adequate facilities and air pollution were identified as barriers to PA in the environmental subscale. PA barriers were significantly associated with pre-pregnancy or early pregnancy body mass index (B = - 14.643), level of education (B = 17.215), and habitual exercise pre-pregnancy (B = - 7.15). CONCLUSION Interpersonal barriers were reported to be the most common barriers to PA during pregnancy. Perinatal care providers should encourage, educate and reassure pregnant women, their spouses and their families about the benefits, type and frequency of safe PA in pregnancy. PA interventions focused on women with lower levels of education and income in particular are required.
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Affiliation(s)
- Zari Dolatabadi
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Amiri-Farahani
- Nursing and Midwifery Care Research Center, Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, 1996713883 Iran
| | - Katayon Ahmadi
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Sally Pezaro
- The University of Notre Dame, Fremantle, Australia
- The Centre for Healthcare Research, Coventry University, Coventry, UK
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Boisseau N. Physical Activity During the Perinatal Period: Guidelines for Interventions During the Perinatal Period from the French National College of Midwives. J Midwifery Womens Health 2022; 67 Suppl 1:S158-S171. [PMID: 36480664 DOI: 10.1111/jmwh.13425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 12/12/1912] [Accepted: 05/10/2022] [Indexed: 12/13/2022]
Abstract
The aim of this review is to provide an update on the beneficial effects of regular physical activity and/or less sedentary behavior before, during, and after pregnancy, based on data from the scientific literature and the recommendations of expert committees. In the preconception period, it is recommended that women perform 30 minutes to 1 hour of moderate-to-high intensity physical activity per day, at least 5 days a week, and avoid the absence of any physical activity for 2 consecutive days. Pregnant women should: i) start or continue to perform moderate-intensity physical activity (up to 150 min/wk with at least 3 sessions longer than 30 min), ii) start or continue to do muscle strengthening activity involving the large muscle groups (once or twice a week). In the absence of medical contraindications, it is recommended that they continue physical activity (at least 30 min/d) during the postpartum period. Sedentary time must be limited, if possible, to less than 7 hours a day, regardless of the period.
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Affiliation(s)
- Nathalie Boisseau
- Laboratoire des Adaptations Métaboliques à l'Exercice en conditions Physiologiques et Pathologiques (AME2P), 3 rue de la Chebarde, Aubière Cedex, 63171, France
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111
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Ionescu RF, Enache RM, Cretoiu SM, Gaspar BS. Gut Microbiome Changes in Gestational Diabetes. Int J Mol Sci 2022; 23:12839. [PMID: 36361626 PMCID: PMC9654708 DOI: 10.3390/ijms232112839] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 08/27/2023] Open
Abstract
Gestational diabetes mellitus (GDM), one of the most common endocrine pathologies during pregnancy, is defined as any degree of glucose intolerance with onset or first discovery in the perinatal period. Physiological changes that occur in pregnant women can lead to inflammation, which promotes insulin resistance. In the general context of worldwide increasing obesity in young females of reproductive age, GDM follows the same ascending trend. Changes in the intestinal microbiome play a decisive role in obesity and the development of insulin resistance and chronic inflammation, especially in patients with type 2 diabetes mellitus (T2D). To date, various studies have also associated intestinal dysbiosis with metabolic changes in women with GDM. Although host metabolism in women with GDM has not been fully elucidated, it is of particular importance to analyze the available data and to discuss the actual knowledge regarding microbiome changes with potential impact on the health of pregnant women and newborns. We analyzed peer-reviewed journal articles available in online databases in order to summarize the most recent findings regarding how variations in diet and metabolic status of GDM patients can contribute to alteration of the gut microbiome, in the same way that changes of the gut microbiota can lead to GDM. The most frequently observed alteration in the microbiome of patients with GDM was either an increase of the Firmicutes phylum, respectively, or a decrease of the Bacteroidetes and Actinobacteria phyla. Gut dysbiosis was still present postpartum and can impact the development of the newborn, as shown in several studies. In the evolution of GDM, probiotic supplementation and regular physical activity have the strongest evidence of proper blood glucose control, favoring fetal development and a healthy outcome for the postpartum period. The current review aims to summarize and discuss the most recent findings regarding the correlation between GDM and dysbiosis, and current and future methods for prevention and treatment (lifestyle changes, pre- and probiotics administration). To conclude, by highlighting the role of the gut microbiota, one can change perspectives about the development and progression of GDM and open up new avenues for the development of innovative therapeutic targets in this disease.
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Affiliation(s)
- Ruxandra Florentina Ionescu
- Department of Cardiology I, Central Military Emergency Hospital “Dr Carol Davila”, 030167 Bucharest, Romania
- Department of Morphological Sciences, Cell and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Robert Mihai Enache
- Department of Radiology and Medical Imaging, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Sanda Maria Cretoiu
- Department of Morphological Sciences, Cell and Molecular Biology and Histology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Bogdan Severus Gaspar
- Surgery Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Surgery Clinic, Bucharest Emergency Clinical Hospital, 014461 Bucharest, Romania
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Zhang W, Jin Y, Liu N, Xiang Z, Wang X, Xu P, Guo P, Mao M, Feng S. Predicting Physical Activity in Chinese Pregnant Women Using Multi-Theory Model: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13383. [PMID: 36293962 PMCID: PMC9603386 DOI: 10.3390/ijerph192013383] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/04/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Physical activity (PA) brings many benefits to pregnant women and fetuses; however, the majority of pregnant women do not participate actively in PA during pregnancy. OBJECTIVES This study aimed to: (1) assess the utility of Multi-Theory Model (MTM) to explain the intentions of PA behavior in Chinese pregnant women; (2) analyze the predictors in initiating and maintaining PA behavior based on MTM. METHODS A cross-sectional study including pregnant women was conducted from March to June 2022 at a university hospital in Hangzhou, Zhejiang Province, China. Participants completed measures that included a self-developed demographic questionnaire and a 29-item MTM questionnaire. Descriptive statistics and stepwise multiple regression were used to analyze the data. The reliability was assessed by Cronbach's alpha and test-retest stability. The construct validity was evaluated by using exploratory factor (EFA) analysis and confirmatory factor analysis (CFA). RESULTS A total of 450 pregnant women participated in this study. The score of the magnitude of intention to initiate and maintain PA behavior during pregnancy was 2.30 (1.08) and 2.24 (1.09). The overall Cronbach's alpha value was 0.857. A four-factor structure for initiation model and a three-factor structure for maintenance model were determined. Results of the CFA confirmed construct validity of subscales (initiation model: χ2 = 206.123, df = 140, p < 0.001, χ2/df = 1.472, RMSEA = 0.046, SRMR = 0.0432, GFI = 0.913, CFI = 0.982; maintenance model: χ2 = 49.742, df = 29, p < 0.001, χ2/df = 1.715, RMSEA = 0.057, SRMR = 0.0432, GFI = 0.958, CFI 0.985). The result of regression indicated that participatory dialogue (β = 0.030; p = 0.002), behavioral confidence (β = 0.128; p < 0.001), changes in physical environment (β = 0.041; p = 0.005), trimester (β = -0.192; p = 0.001), and Gestational Diabetes Mellitus (GDM) (β = 0.408; p < 0.001) explained 52.1% variance in initiating PA behavior. Emotional transformation (β = 0.197; p < 0.001), practice for change (β = 0.083; p = 0.001), changes in social environment (β = 0.063; p < 0.001), pre-pregnancy exercise habit (β = -0.251; p = 0.001), and GDM (β = 0.298; p = 0.003) were significantly associated with pregnant women's intentions to maintain PA behavior and explained 49.1% variance. CONCLUSIONS The constructs of MTM were effective in explaining the intention to initiate and maintain PA behavior among Chinese pregnant women.
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Affiliation(s)
- Wei Zhang
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
- Faculty of Nursing, School of Medicine Zhejiang University, Hangzhou 310052, China
| | - Ying Jin
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
| | - Ningning Liu
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
| | - Zhenzhen Xiang
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
| | - Xiaojuan Wang
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
- Faculty of Nursing, School of Medicine Zhejiang University, Hangzhou 310052, China
| | - Ping Xu
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
- Faculty of Nursing, School of Medicine Zhejiang University, Hangzhou 310052, China
| | - Pingping Guo
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
- Faculty of Nursing, School of Medicine Zhejiang University, Hangzhou 310052, China
| | - Minna Mao
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
- Faculty of Nursing, School of Medicine Zhejiang University, Hangzhou 310052, China
| | - Suwen Feng
- Women’s Hospital, School of Medicine Zhejiang University, Hangzhou 310006, China
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113
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Souza Leite Vieira A, Nascimento SL, Souza Silva L, Mendes Pedroso Chainça T, Costa Machado H, Surita FG. Self-reported exercise or physical activity level: what matters to a better quality of life in the third trimester of pregnancy? Women Health 2022; 62:799-808. [PMID: 36404410 DOI: 10.1080/03630242.2022.2146833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study evaluated the relationship of self-reported exercise, physical activity (PA) level, and Quality of Life (QoL) among women in their third trimester of pregnancy and verified which factors are associated with physical exercise (PE) and QoL. A cross-sectional study was performed with women who have been pregnant for at least 28 weeks and who can engage in PE. Data on self-reported exercise, sociodemographic characteristics, PA level, and QoL were collected through the International Physical Activity Questionnaire (IPAQ) and the World Health Organization Quality of Life Questionnaire BREF version (WHOQOL-BREF). Frequencies, bivariate analyses, and logistic and linear regression were performed. Among 405 pregnant women, 103 (25.43 percent) reported practicing PE. The self-reported PE was associated with better scores in the physical and environmental domains of the WHOQOL-BREF. Several IPAQ variables and the WHOQOL-BREF environmental score were associated with self-reported exercise. The majority classified as "active" by the IPAQ was due to employment and not the PE practice. A correct conceptual approach to PA and PE during antenatal care has a different impact on health and QoL during pregnancy.
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Affiliation(s)
- André Souza Leite Vieira
- Department of Obstetrics and Gynecology, School of Medical Science, University of Campinas, Sao Paulo, Brazil
| | | | - Luana Souza Silva
- Department of Obstetrics and Gynecology, School of Medical Science, University of Campinas, Sao Paulo, Brazil
| | | | - Helymar Costa Machado
- Department of Obstetrics and Gynecology, School of Medical Science, University of Campinas, Sao Paulo, Brazil
| | - Fernanda G Surita
- Department of Obstetrics and Gynecology, School of Medical Science, University of Campinas, Sao Paulo, Brazil
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114
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LeBlanc ES, Boisvert C, Catlin C, Lee MH, Smith N, Vesco KK, Savage J, Mitchell DC, Gruß I, Stevens VJ. Prepare randomized clinical trial: Acceptability, engagement, and lifestyle effects of a weight loss intervention beginning in pre-pregnancy. Obes Sci Pract 2022; 8:603-616. [PMID: 36238226 PMCID: PMC9535669 DOI: 10.1002/osp4.596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/25/2022] [Accepted: 01/30/2022] [Indexed: 12/05/2022] Open
Abstract
Background Healthier lifestyles in early pregnancy are associated with lower rates of pregnancy complications, childhood adiposity, and maternal and child cardiovascular risks. However, it is not known whether lifestyle coaching initiated prior to pregnancy can affect behavior and attitudes during pregnancy. Methods Three hundred and twenty six women planning pregnancy within 2 years with BMI ≥27 kg/m2 were randomized to a behavioral weight loss intervention or to usual care. Analyses reported here examined the intervention's impact on mid-pregnancy diet quality and activity levels; program acceptability; and effects of pregnancy on intervention engagement. Results One hundred and sixty eight participants experienced pregnancy during the study (intervention: 91; usual care: 77). From randomization to mid-pregnancy, participants who received the intervention had larger increases in fruit intake than usual care participants (+0.67 vs. +0.06 cups; p = 0.02) and engaged in more vigorous-intensity activity (3.9 [5.5] vs. 1.2 [3.0] Met-hr/week p = 0.002) and sports/exercise (17.0 [14.1] vs. 11.0 [9.5] Met-hr/week; p = 0.03); the groups also differed in changes in sedentary time (-4.9 [15.0] vs. +0.5 [7.6] Met-hr/week; p = 0.02). Intervention satisfaction was high (>80%), and experiencing pregnancy during the intervention was associated with higher engagement. Conclusion A coaching-based intervention beginning in pre-pregnancy successfully helped women attain healthier diet and exercise habits in mid-pregnancy. Clinical trials registration Registered with ClinicalTrials.gov, NCT02346162, first registered on January 26, 2015, before date of initial participant enrollment (May 2015), https://clinicaltrials.gov/ct2/show/NCT02346162.
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Affiliation(s)
- Erin S. LeBlanc
- Kaiser PermanenteCenter for Health ResearchPortlandOregonUSA
| | | | - Chris Catlin
- Kaiser PermanenteCenter for Health ResearchPortlandOregonUSA
| | - Mi H. Lee
- Kaiser PermanenteCenter for Health ResearchPortlandOregonUSA
| | - Ning Smith
- Kaiser PermanenteCenter for Health ResearchPortlandOregonUSA
| | | | - Jennifer Savage
- Center for Childhood Obesity ResearchThe Pennsylvania State UniversityUniversity ParkPennsylvaniaUSA
| | - Diane C. Mitchell
- Department of Nutritional SciencesThe Pennsylvania State UniversityUniversity ParkPennsylvaniaUSA
| | - Inga Gruß
- Kaiser PermanenteCenter for Health ResearchPortlandOregonUSA
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115
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Santos-Rocha R, Pajaujiene S, Szumilewicz A. ACTIVE PREGNANCY: Workshop on Promotion of Physical Activity in Pregnancy for Exercise Professionals. J Multidiscip Healthc 2022; 15:2077-2089. [PMID: 36128597 PMCID: PMC9482785 DOI: 10.2147/jmdh.s370453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/14/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction A one-day workshop on promotion of physical activity in pregnancy for exercise professionals was delivered during 2021, to 137 participants. The main aim of this workshop was to motivate and prepare exercise professionals for promoting physical activity and implementing prenatal exercise programs, in their respective private or public fitness centers or other physical activity settings. Methods The contents of the workshop were focused on six topics based on the "Pregnancy and Postpartum Exercise Specialist" educational standards by EuropeActive and the "Exercise and Physical Activity during Pregnancy and Postpartum" textbook published by Springer. Participants provided feedback on the effectiveness and satisfaction with the workshop. Results Overall evaluations from the feedback forms showed that majority of the participants agreed that the workshop achieved its objectives with a major recommendation as to the organization of more short duration workshops, the inclusion of practical sessions, and the separation of the contents addressing the postpartum period. Discussion The workshop on promotion of physical activity in pregnancy for exercise professionals was successfully organized and the participants are looking forward for future ones.
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Affiliation(s)
- Rita Santos-Rocha
- Department of Physical Activity and Health, Sport Sciences School of Rio Maior (ESDRM), Polytechnic Institute of Santarém (IPSANTAREM), Rio Maior, Portugal
- Interdisciplinary Centre for the Study of Human Performance (CIPER), Faculty of Human Kinetics (FMH), University of Lisbon, Cruz Quebrada, Portugal
| | - Simona Pajaujiene
- Department of Coaching Science, Lituanian Sport University, Kaunas, Lithuania
| | - Anna Szumilewicz
- Department of Fitness, Faculty of Physical Culture, Gdansk University of Physical Education and Sport, Gdansk, Poland
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116
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Cabrera-Domínguez G, de la Calle M, Herranz Carrillo G, Ruvira S, Rodríguez-Rodríguez P, Arribas SM, Ramiro-Cortijo D. Women during Lactation Reduce Their Physical Activity and Sleep Duration Compared to Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11199. [PMID: 36141479 PMCID: PMC9517522 DOI: 10.3390/ijerph191811199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 06/16/2023]
Abstract
Sleep, mental health and physical activity are fundamental for wellbeing, and some of these factors are interrelated. However, these aspects are not usually considered during pregnancy and lactation, which are particularly vulnerable periods. Therefore, our aims were to conduct a cross sectional study to assess the psychological capital, quality of life, sleep hygiene and physical activity in a cohort of women during pregnancy and lactation periods. Women were recruited from Spanish maternity and lactation non-profit associations and social networks through an online platform with the following inclusion criteria: pregnancy (in any period of gestation) or breastfeeding period (≤6 months postpartum). The cohort was categorized into ≤12 weeks of gestation (n = 32), >12 weeks of gestation (n = 119) and lactation (n = 60). The women self-reported the sociodemographic data, obstetric complications and full breastfeeding or mixed practices. In addition, women responded to the psychological capital instrument, the health survey form, the Pittsburg sleep quality index and the pregnancy physical activity questionnaire. Overall, the groups were similar in sociodemographic variables. Women in the lactation period perceived lower social support compared to the gestation period. No statistically differences were found between groups in the psychological capital nor in the general health survey form. However, the models adjusted by employment and civil and economic status and perceived social support, demonstrated that the sleep duration negatively associated with the lactation period (β = 1.13 ± 0.56; p-Value = 0.016), and the household tasks were associated with this period (β = 2147.3 ± 480.7; p-Value < 0.001). A decrease in physical daily activities were associated with both the end of gestation and the lactation periods. In addition, the decreasing total activity was associated with the lactation period (β = 1683.67 ± 688.05; p-Value = 0.016). In conclusion, during lactation, the poorer sleep and physical activity, together with a lower social support of the woman, may lead to deficient mental health adjustment. Our data suggest that women are at higher risk of vulnerability in lactation compared to the gestation period.
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Affiliation(s)
- Gema Cabrera-Domínguez
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
| | - María de la Calle
- Department of Obstetric and Gynecology, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain
| | - Gloria Herranz Carrillo
- Division of Neonatology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), C/Profesor Martin Lagos s/n, 28040 Madrid, Spain
| | - Santiago Ruvira
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
- Food, Oxidative Stress and Cardiovascular Health (FOSCH) Research Group, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain
- PhD Programme in Pharmacology and Physiology, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Pilar Rodríguez-Rodríguez
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
- Food, Oxidative Stress and Cardiovascular Health (FOSCH) Research Group, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain
| | - Silvia M. Arribas
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
- Food, Oxidative Stress and Cardiovascular Health (FOSCH) Research Group, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain
| | - David Ramiro-Cortijo
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
- Food, Oxidative Stress and Cardiovascular Health (FOSCH) Research Group, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain
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117
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Baattaiah BA, Zedan HS, Almasaudi AS, Alashmali S, Aldhahi MI. Physical activity patterns among women during the postpartum period: an insight into the potential impact of perceived fatigue. BMC Pregnancy Childbirth 2022; 22:678. [PMID: 36057543 PMCID: PMC9440528 DOI: 10.1186/s12884-022-05015-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
Background Regular participation in physical activity (PA) improves physical well-being and reduces the risk of contracting noncommunicable diseases. However, fatigue could negatively impact the PA participation of women in their postpartum period. This study delineated the levels of perceived fatigue and characterized the association between fatigue and the PA patterns of postpartum women. Methods A cross-sectional study was conducted using an online questionnaire distributed to postpartum women living in Saudi Arabia. Their perceived postpartum fatigue (PPF) was assessed using the fatigue severity scale; their PA, using the short form of the International Physical Activity Questionnaires; and their postpartum depression, using the Edinburgh Postnatal Depression Scale. Descriptive statistics were expressed as the mean ± standard deviation for normally distributed variables and as the median (interquartile range) for non-normally distributed variables. Between-group differences were tested using the Mann–Whitney U test for independent samples. To determine the relationship between the study variables, Spearman’s rho correlation coefficient was calculated. Multiple linear regression analysis was performed to explain the role of fatigue severity as an independent predictor of the variance of the PA level. Results A total of 499 postpartum women were divided into the PPF group (43%), who self-reported fatigue, and the non-PPF group (57%), who self-reported no fatigue. There was a significant difference in the median of vigorous PA, and moderate PA which were significantly higher in the non-PPF group than in the PPF group. The women with PPF reported less engagement in walking and a longer sitting duration than the women without PPF. High fatigue severity was associated with lower moderate PA (β = -10.90; p = .005; R2 = .21) and vigorous PA (β = -04; p < .001; R2 = .13). These associations remained significant in the regression model after adjustment for the mother’s depression score; age; number of children; body mass index (kg/m2); employment status; intake of vitamins B1 (thiamin), C, and D and of Omega-3; and walking metabolic equivalent. Conclusion PPF may reduce the PA of postpartum women. Strategies targeting PPF may buffer its harmful impacts, and thus, improve postpartum women’s health.
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Affiliation(s)
- Baian A Baattaiah
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Haya S Zedan
- Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Arwa S Almasaudi
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Shoug Alashmali
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Monira I Aldhahi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia.
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118
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Santos PC, Leirós-Rodríguez R, Abreu S, Ferreira M, Alves O, Mota J. Physical activity during pregnancy and its effects on neonatal outcomes. Placenta 2022; 128:9-17. [PMID: 36037665 DOI: 10.1016/j.placenta.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/11/2022] [Accepted: 08/19/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION Despite the acknowledgement that physical activity is beneficial during pregnancy and may result in positive health outcomes for the newborn child few studies have examined this issue. This research was deemed necessary with the primary objective of identifying possible associations between adherence to American College of Sports Medicine recommendations on neonatal outcome variables at birth. METHODS An observational, longitudinal and prospective study focused on a sample of 70 pregnant women (the power score achieved was estimated to be 0.3). Data was collected in three stages (1st and 2nd trimester of pregnancy and 48 h after delivery). The variables analyzed included the physical activity measurement (with accelerometry), neonatal outcomes at birth and the mother's anxiety, dietary intake, anthropometric measures and socio-demographic and lifestyle. RESULTS 21.4% women were active according to physical activity recommendations. There were no significant differences in neonatal outcomes at birth when comparing adherence to physical activity recommendations and the overall activity levels of the mothers. There were also no statistically significant differences in the birth weights of babies born to active and inactive mothers. Mother's anxiety level, weight gained and dietary intake were not statistically different according to compliance with physical activity behaviour or recommendations. DISCUSSION There is no relationship between adherence to physical activity recommendations on neonatal outcome variables at birth. There were also no significant associations with sociodemographic and lifestyle variables. There is a need to identify attitudes associated with negative physical activity behavior to reduce the incidence of comorbidities associated with sedentary lifestyles during pregnancy.
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Affiliation(s)
- Paula C Santos
- Department of Physiotherapy, Center for Research in Rehabilitation, School of Health, Polytechnic of Porto, Dr. António Bernardino de Almeida St., 400, 4200-072, Porto, Portugal; Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports-University of Porto (FADEUP) and Laboratory for Integrative and Translational Research in Population Health (ITR), Dr. Plácido da Costa St., 91, 4200-450 Porto, Portugal.
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Nursing and Physical Therapy Department, University of Leon, Astorga Ave, 15, 24401, Ponferrada, Spain.
| | - Sandra Abreu
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports-University of Porto (FADEUP) and Laboratory for Integrative and Translational Research in Population Health (ITR), Dr. Plácido da Costa St., 91, 4200-450 Porto, Portugal; Faculty of Psychology, Education and Sports, Lusófona University of Porto, Augusto Rosa St., 24, 4000-098, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health, Portugal.
| | - Margarida Ferreira
- Department of Physiotherapy. School of Health Vale do Sousa. Central de Gandra St., 1317, 4585-116, Gandra, Portugal.
| | - Odete Alves
- Health Unit of Alto Minho, Dr. Francisco Sá Carneiro St., 4980-633, Ponte da Barca, Portugal.
| | - Jorge Mota
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports-University of Porto (FADEUP) and Laboratory for Integrative and Translational Research in Population Health (ITR), Dr. Plácido da Costa St., 91, 4200-450 Porto, Portugal.
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Silva-Jose C, Sánchez-Polán M, Barakat R, Gil-Ares J, Refoyo I. Level of Physical Activity in Pregnant Populations from Different Geographic Regions: A Systematic Review. J Clin Med 2022; 11:jcm11154638. [PMID: 35956253 PMCID: PMC9369818 DOI: 10.3390/jcm11154638] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/23/2022] [Accepted: 08/05/2022] [Indexed: 12/05/2022] Open
Abstract
The aim of this study was to examine the level of physical activity during pregnancy in different populations worldwide. An intensive search was carried out from February until May 2021. The inclusion criteria were original studies of healthy pregnant women, and the main study variable was the assessment of physical activity. A total of 110 out of 1451 studies were assessed for inclusion, using the Newcastle–Ottawa Scale for quality, and for the risk of bias. The 44 analyzed articles were divided into 5 tables according to the characteristics of the intervention and the validated instrument used to measure physical activity (PA). A total of 59.09% of the studies indicated that participants had a low level of physical activity during pregnancy. In addition, the median quality score of the studies was 7.12, and 77.27% of the studies were cataloged as having a high-quality score. Although international guidelines recommend that women without a contraindication engage in prenatal physical activity, the results of the present study show that the level of PA is too low for women to achieve scientifically proven maternal-fetal benefits. Failure to achieve the recommended levels of weekly physical activity could pose significant risks to maternal well-being.
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Affiliation(s)
- Cristina Silva-Jose
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-913364120
| | - Rubén Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Javier Gil-Ares
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Ignacio Refoyo
- Sports Department, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
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120
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Wang Y, Liu H, Zhang C, Li C, Xu JJ, Duan CC, Chen L, Liu ZW, Jin L, Lin XH, Zhang CJ, Zhang HQ, Yu JL, Li T, Dennis CL, Li H, Wu YT. Antepartum sleep quality, mental status, and postpartum depressive symptoms: a mediation analysis. BMC Psychiatry 2022; 22:521. [PMID: 35918689 PMCID: PMC9344627 DOI: 10.1186/s12888-022-04164-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor sleep quality and maternal mood disturbances are common during pregnancy and may play pivotal roles in the development of postpartum depression. We aim to examine the trajectories of sleep quality and mental health in women from early pregnancy to delivery and explore the mediating effects of sleep quality and mental status on the link between antepartum depressive symptoms and postpartum depressive symptoms. METHODS In an ongoing prospective birth cohort, 1301 women completed questionnaires in the first, second and third trimesters and at 6 weeks postpartum. In each trimester, sleep quality was measured utilizing the Pittsburgh Sleep Quality Index (PSQI), and mental health was assessed with the Center for Epidemiologic Studies Depression Scale (CES-D), the Self-Rating Anxiety Scale (SAS) and the Perceived Stress Scale (PSS). Postpartum depressive symptoms were evaluated by the Edinburgh Postnatal Depression Scale (EPDS). The bootstrap method was used to test the mediation effect. RESULTS The PSQI, CES-D, and SAS scores presented U-shaped curves across the antenatal period while the PSS score followed a descending trend. Antenatal sleep quality, depressive symptoms, anxiety symptoms and perceived stress all predicted depressive symptoms at 6 weeks postpartum. The influence of antepartum depressive symptoms on postpartum depressive symptoms was mediated by antepartum sleep quality and anxiety symptoms, which accounted for 32.14%, 39.25% and 31.25% in the first, second and third trimesters (P = 0.002, P = 0.001, P = 0.001, respectively). CONCLUSIONS Poor sleep quality and anxiety symptoms in pregnancy mediated the relationship between antepartum depressive symptoms and postpartum depressive symptoms. Interventions aimed at detecting and managing sleep quality and elevated anxiety among depressed women in pregnancy warrant further investigation as preventative strategies for postpartum depression.
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Affiliation(s)
- Yu Wang
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Han Liu
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China
| | - Chen Zhang
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.8547.e0000 0001 0125 2443Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, 200011 China
| | - Cheng Li
- grid.8547.e0000 0001 0125 2443Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, 200011 China
| | - Jing-Jing Xu
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Chen-Chi Duan
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Lei Chen
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China
| | - Zhi-Wei Liu
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China
| | - Li Jin
- grid.8547.e0000 0001 0125 2443Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, 200011 China
| | - Xian-Hua Lin
- grid.8547.e0000 0001 0125 2443Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, 200011 China
| | - Chen-Jie Zhang
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Han-Qiu Zhang
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Jia-Le Yu
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Tao Li
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Cindy-Lee Dennis
- grid.17063.330000 0001 2157 2938Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Hong Li
- School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030, China.
| | - Yan-Ting Wu
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, 200011, China. .,Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China.
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Shen X, Lin S, Li H, Amaerjiang N, Shu W, Li M, Xiao H, Segura-Pérez S, Pérez-Escamilla R, Fan X, Hu Y. Timing of Breastfeeding Initiation Mediates the Association between Delivery Mode, Source of Breastfeeding Education, and Postpartum Depression Symptoms. Nutrients 2022; 14:2959. [PMID: 35889915 PMCID: PMC9324203 DOI: 10.3390/nu14142959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/08/2022] [Accepted: 07/14/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Emergency cesarean section (EMCS) and breastfeeding difficulties increase the risk of postpartum depressive (PPD) symptoms. Early initiation of breastfeeding (EIBF) may not only alleviate PPD symptoms but also facilitate subsequent breastfeeding success. EMCS is a risk factor for not practicing EIBF. Therefore, it is important to understand the relationship between EMCS, EIBF, and PPD symptoms. Methods: We conducted a prospective cohort study in three areas of China. At baseline, a total of 965 mothers completed electronic questionnaires within 72 h postpartum. Women were screened for PPD symptoms using the Edinburgh Postpartum Depression Scale (EPDS). Multivariate logistic regression was used to identify the determinants of PPD symptoms. Mediation analysis was used to determine if EIBF mediated the relationship between delivery mode or breastfeeding education source and PPD symptoms. Results: The prevalence of EIBF was 40.6%; 14% of 965 mothers experienced EMCS, and 20.4% had PPD symptoms. The risk factors for developing PPD symptoms were excessive gestational weight gain (adjusted odds ratio [aOR] = 1.55, confidence interval [95% CI]: 1.03−2.33, p = 0.037) and EMCS (aOR = 2.05, 95% CI: 1.30−3.25, p = 0.002). The protective factors for developing PPD symptoms were monthly household income over CNY 10000 (aOR = 0.68, 95% CI: 0.47−0.97, p = 0.034), EIBF (aOR = 0.49, 95% CI: 0.34−0.72, p < 0.001), and prenatal breastfeeding education from nurses (aOR = 0.46, 95% CI: 0.29−0.73, p = 0.001). EIBF indirectly affected PPD symptoms in patients who had undergone EMCS (percentage mediated [PM] = 16.69, 95% CI: 7.85−25.25, p < 0.001). The source of breastfeeding education through EIBF also affected PPD symptoms (PM = 17.29, 95% CI: 3.80−30.78, p = 0.012). Conclusion: The association between EMCS on PPD symptoms was mediated by EIBF. By providing breastfeeding education, nurses could also help alleviate PPD symptoms.
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Affiliation(s)
- Xinran Shen
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No. 10 You’anmenwai Xitoutiao, Fengtai District, Beijing 100069, China; (X.S.); (H.L.); (N.A.); (W.S.); (M.L.); (H.X.)
| | - Shunna Lin
- Department of Pediatrics, Tianhe District Maternal and Child Hospital of Guangzhou, Guangzhou 510620, China;
| | - Hui Li
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No. 10 You’anmenwai Xitoutiao, Fengtai District, Beijing 100069, China; (X.S.); (H.L.); (N.A.); (W.S.); (M.L.); (H.X.)
| | - Nubiya Amaerjiang
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No. 10 You’anmenwai Xitoutiao, Fengtai District, Beijing 100069, China; (X.S.); (H.L.); (N.A.); (W.S.); (M.L.); (H.X.)
| | - Wen Shu
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No. 10 You’anmenwai Xitoutiao, Fengtai District, Beijing 100069, China; (X.S.); (H.L.); (N.A.); (W.S.); (M.L.); (H.X.)
| | - Menglong Li
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No. 10 You’anmenwai Xitoutiao, Fengtai District, Beijing 100069, China; (X.S.); (H.L.); (N.A.); (W.S.); (M.L.); (H.X.)
| | - Huidi Xiao
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No. 10 You’anmenwai Xitoutiao, Fengtai District, Beijing 100069, China; (X.S.); (H.L.); (N.A.); (W.S.); (M.L.); (H.X.)
| | - Sofia Segura-Pérez
- Chief Program Officer, Hispanic Health Council, 175 Main St., Hartford, CT 06106, USA;
| | | | - Xin Fan
- Department of Pediatrics, Women and Children’s Hospital of Chongqing Medical University, No. 120, Longshan Road, Yubei District, Chongqin 400042, China
| | - Yifei Hu
- Department of Child and Adolescent Health and Maternal Care, School of Public Health, Capital Medical University, No. 10 You’anmenwai Xitoutiao, Fengtai District, Beijing 100069, China; (X.S.); (H.L.); (N.A.); (W.S.); (M.L.); (H.X.)
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Cilar Budler L, Budler M. Physical activity during pregnancy: a systematic review for the assessment of current evidence with future recommendations. BMC Sports Sci Med Rehabil 2022; 14:133. [PMID: 35842718 PMCID: PMC9288689 DOI: 10.1186/s13102-022-00524-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Physical activity is essential to maternal and infant health. Healthcare professionals should inform pregnant women about benefits of physical activity to prevent possible health issues. Those recommendations should elaborate on relevant contemporary evidence. The aim of this study was to review evidence-based recommendations for physical activity during pregnancy. METHODS A systematic search, analysis and synthesis of conducted randomised controlled trials (RCTs) was conducted from October 2021 to June 2022 in following databases: PubMed, CINAHL, ScienceDirect and Web of Science. Literature was searched using inclusion and exclusion criteria and following PRISMA recommendations. RESULTS Benefits for pregnant-women health and well-being were reported while performing aerobic exercise, lumbar stabilization and stretching exercise, water exercise, nerve and tendon-slip exercise, resistance training and strength training. For all exercise modalities it is recommended to perform moderate intensity activities during the whole time of pregnancy. CONCLUSIONS This systematic literature review supplements current knowledge on physical activity of pregnant women. Exercise interventions are listed and suggested in an integrative model with physical-fitness components to contextualize and promote physical activity among pregnant women.
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Affiliation(s)
- Leona Cilar Budler
- Faculty of Health Sciences, University of Maribor, Zitna ulica 15, 2000, Maribor, Slovenia.
| | - Marko Budler
- School of Economics and Business, University of Ljubljana, Kardeljeva ploscad 17, 1000, Ljubljana, Slovenia
- Fitness Association of Slovenia, Cesta 24. junija 23, 1231, Ljubljana, Slovenia
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123
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Choong SYX, Tan XYJ, Cheng LJ, Lau Y. Effectiveness of Exercise in Improving Sleep Outcomes among Perinatal Women: A Systematic Review and Meta-analysis of randomised Controlled Trials. Behav Sleep Med 2022; 20:410-428. [PMID: 34081551 DOI: 10.1080/15402002.2021.1931221] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Sleep problems are prevalent among perinatal women, contributing to the poor overall well-being of mother and child. Exercise is an inexpensive and sustainable intervention to improve sleep outcomes and can be personalized accordingly to individuals. This systematic review and meta-analysis aim to consolidate available evidence to evaluate the effectiveness of exercise on improving sleep outcomes among perinatal women. METHODS Eight databases (CINAHL, Cochrane, EMBASE, PsycINFO, PubMed, Scopus, Web of Science and ProQuest) were used to perform a systematic search for studies in the English language from the inception of each database to 7 December 2019. The quality of studies was assessed using the risk of bias and GRADE. Review Manager was used for meta-analyses. Heterogeneity was determined by Cochran's Q (chi-square) and I2 values. The overall effect was evaluated using effect size and Z-statistics. RESULTS A total of 2,139 records were identified. Ten randomized controlled trials were included, with seven in the meta-analysis, involving 998 pregnant and postpartum women across eight countries. With medium to very large effect sizes, the results favored exercise interventions on sleep quality, sleep efficiency, sleep duration, sleep latency, insomnia, diurnal tiredness and daytime dysfunction. CONCLUSION Exercise interventions produced significant effects on improving sleep among perinatal women. This can increase advocacy for exercise among perinatal women to improve sleep and general health. Future randomized controlled trial designs should adhere to the Consolidated Standards of Reporting Trials and Template to ensure reliability when conducting and reporting such studies.
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Affiliation(s)
- Shanise Yi Xin Choong
- Department of Nursing, Khoo Teck Puat Hospital, Yishun Health Campus, National Healthcare Group, Singapore, Singapore
| | - Xing Yee Jolyn Tan
- Department of Nursing, Khoo Teck Puat Hospital, Yishun Health Campus, National Healthcare Group, Singapore, Singapore
| | - Ling Jie Cheng
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Davis JW, Hyer S, Xie R, Martinez VC, Wheeler JM, Misra DP, Giurgescu C. Physical activity changes among non-Hispanic Black pregnant women. Public Health Nurs 2022; 39:744-751. [PMID: 35037297 PMCID: PMC10476508 DOI: 10.1111/phn.13051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/17/2021] [Accepted: 01/02/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine aerobic physical activity (PA) among non-Hispanic Black pregnant women. DESIGN Longitudinal prospective cohort study. SAMPLE A subset of 161 non-Hispanic Black pregnant women from the Midwestern US participating in a larger study completed questionnaires about aerobic physical activity (PA) before pregnancy (reported at 24.46±2.13 weeks gestation), mid-pregnancy (24.46±2.13 weeks gestation), and late pregnancy (31.78±1.95 weeks gestation). MEASUREMENTS Aerobic PA was measured using the Rapid Assessment of Physical Activity (RAPA). RESULTS Most participants reported being active prior to pregnancy (n = 101, 63%), with 60 (37%) underactive/sedentary. Aerobic RAPA scores were highest pre-pregnancy (3.29±1.11, median = 4, interquartile range [IQR] = 1) compared with mid-pregnancy (3.05±1.26, median = 4, IQR = 2) and late pregnancy (3.05±1.24, median = 4, IQR = 2). Pre-pregnancy scores were significantly higher than mid-pregnancy scores (Wilcoxon test = 1472, p = .008) and late pregnancy scores (Wilcoxon test = 1854, p = .01). CONCLUSION Most Black pregnant participants reported high levels of aerobic PA both before pregnancy and during pregnancy. However, many were underactive or sedentary. Aerobic PA decreased during pregnancy compared with pre-pregnancy, without the drop in third trimester PA found in other populations. Providers should assess PA across pregnancy and promote adequate PA for maternal and infant health, particularly among Black women.
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Affiliation(s)
- Jean W. Davis
- University of Central Florida College of Nursing, Orlando, FL, USA
| | - Suzanne Hyer
- University of Central Florida College of Nursing, Orlando, FL, USA
| | - Rui Xie
- Assistant Professor University of Central Florida Department of Statistics and Data Science, Orlando, FL, USA
| | - Valerie C. Martinez
- Clinical Assistant Professor and Director of Family Nurse Practitioner and Adult Gerontology Primary Care Nurse Practitioner Programs, University of Central Florida College of Nursing, Orlando, FL, USA
| | - Jenna M. Wheeler
- University of Central Florida College of Nursing, Orlando, FL, USA
| | - Dawn P. Misra
- Professor and Department Chair of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
| | - Carmen Giurgescu
- Associate Dean of Research, and Chatlos Endowed Chair in Nursing, University of Central Florida College of Nursing, Orlando, FL, USA
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125
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S.V M, Nitin K, Sambit D, Nishant R, Sanjay K. ESI Clinical Practice Guidelines for the Evaluation and Management of Obesity In India. Indian J Endocrinol Metab 2022; 26:295-318. [PMID: 36185955 PMCID: PMC9519829 DOI: 10.4103/2230-8210.356236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Madhu S.V
- Department of Endocrinology, Centre for Diabetes, Endocrinology and Metabolism, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India
| | - Kapoor Nitin
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
| | - Das Sambit
- Department of Endocrinology, Hi Tech Medical College and Hospital, Bhubaneshwar, Odisha, India
| | - Raizada Nishant
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
| | - Kalra Sanjay
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
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Physical Activity during Pregnancy: Comparisons between Objective Measures and Self-Reports in Relation to Blood Glucose Levels. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138064. [PMID: 35805717 PMCID: PMC9266138 DOI: 10.3390/ijerph19138064] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/05/2022] [Accepted: 06/21/2022] [Indexed: 11/23/2022]
Abstract
Objective: to quantify pregnant women’s physical activity during pregnancy using wearable accelerometers and a self-reported scale and to examine the variation in these two physical activity measures in relation to fasting plasma glucose (FPG) levels and presence of gestational diabetes mellitus (GDM). Methods: this prospective observational study included 197 pregnant women from one of the largest regional hospitals in South China. Women with singleton pregnancy, absence of pre-existing comorbidities and pre-specified contraindications, wore an accelerometer on their waist for 7 consecutive days to objectively record their physical activity, followed by completing a past-7-day physical activity questionnaire, three times, respectively, in three trimesters. GDM was determined by 2-h 75 g oral glucose tolerance test (OGTT) in 24–28th week’s gestation and FPG was obtained in both 1st and 2nd trimesters following standard practice. Results: pregnant women engaged highest levels of various physical activity types in 2nd trimester, except accelerometer-based moderate-to-vigorous physical activity which gradually decreased in pregnancy. Pregnant women were more likely to walk in 3rd trimester. The relationship between objective total physical activity and self-reported total physical activity was non-linear. Increased trend of FPG from 1st trimester to 2nd trimester disappeared when adjusting for accelerometer-based light physical activity and attenuated when including walking. Self-reported moderate physical activity was surprisingly positively associated with GDM. Conclusions: different patterns in physical activity between objective measure and self-report in relation to gestational glucose levels were observed. Short-term increase in moderate physical activity prior to OGTT may not be necessary for reducing presence of GDM. Future glucose management for pregnant women may be targeted at lower intensity physical activity.
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127
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Thomas T, Xu F, Sridhar S, Sedgwick T, Nkemere L, Badon SE, Quesenberry C, Ferrara A, Mandel S, Brown SD, Hedderson M. A Web-Based mHealth Intervention With Telephone Support to Increase Physical Activity Among Pregnant Patients With Overweight or Obesity: Feasibility Randomized Controlled Trial. JMIR Form Res 2022; 6:e33929. [PMID: 35731565 PMCID: PMC9260523 DOI: 10.2196/33929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 03/29/2022] [Accepted: 04/22/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Pregnant patients with overweight or obesity are at high risk for perinatal complications. Excess gestational weight gain (GWG) further exacerbates this risk. Mobile health (mHealth) lifestyle interventions that leverage technology to facilitate self-monitoring and provide just-in-time feedback may motivate behavior change to reduce excess GWG, reduce intervention costs, and increase scalability by improving access. OBJECTIVE This study aimed to test the acceptability and feasibility of a pilot mHealth lifestyle intervention for pregnant patients with overweight or obesity to promote moderate intensity physical activity (PA), encourage guideline-concordant GWG, and inform the design of a larger pragmatic cluster randomized controlled trial. METHODS We conducted a mixed methods acceptability and feasibility randomized controlled trial among pregnant patients with a prepregnancy BMI of 25 to 40 kg/m2. Patients with singletons at 8 to 15 weeks of gestation who were aged ≥21 years and had Wi-Fi access were recruited via email from 2 clinics within Kaiser Permanente Northern California and randomized to receive usual prenatal care or an mHealth lifestyle intervention. Participants in the intervention arm received wireless scales, access to an intervention website, activity trackers to receive automated feedback on weight gain and activity goals, and monthly calls from a lifestyle coach. Surveys and focus groups with intervention participants assessed intervention satisfaction and ways to improve the intervention. PA outcomes were self-assessed using the Pregnancy Physical Activity Questionnaire, and GWG was assessed using electronic health record data for both arms. RESULTS Overall, 33 patients were randomly assigned to the intervention arm, and 35 patients were randomly assigned to the usual care arm. All participants in the intervention arm weighed themselves at least once a week, compared with 20% (7/35) of the participants in the usual care arm. Participants in the intervention arm wore the activity tracker 6.4 days per week and weighed themselves 5.3 times per week, and 88% (29/33) of them rated the program "good to excellent." Focus groups found that participants desired more nutrition-related support to help them manage GWG and would have preferred an app instead of a website. Participants in the intervention arm had a 23.46 metabolic equivalent of task hours greater change in total PA per week and a 247.2-minute greater change in moderate intensity PA per week in unadjusted models, but these effects were attenuated in adjusted models (change in total PA: 15.55 metabolic equivalent of task hours per week; change in moderate intensity PA: 199.6 minutes per week). We found no difference in total GWG (mean difference 1.14 kg) compared with usual care. CONCLUSIONS The pilot mHealth lifestyle intervention was feasible, highly acceptable, and promoted self-monitoring. Refined interventions are needed to effectively affect PA and GWG among pregnant patients with overweight or obesity. TRIAL REGISTRATION ClinicalTrials.gov NCT03936283; https://clinicaltrials.gov/ct2/show/NCT03936283.
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Affiliation(s)
- Tainayah Thomas
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Fei Xu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Sneha Sridhar
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Tali Sedgwick
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Linda Nkemere
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Sylvia E Badon
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Charles Quesenberry
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Sarah Mandel
- The Permanente Medical Group, San Francisco, CA, United States
| | - Susan D Brown
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
- School of Medicine, University of California, Davis, Sacramento, CA, United States
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States
| | - Monique Hedderson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
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Yang X, Zhang J, Wang X, Xu Y, Sun L, Song Y, Bai R, Huang H, Zhang J, Zhang R, Guo E, Gao L. A self-efficacy-enhancing physical activity intervention in women with high-risk factors for gestational diabetes mellitus: study protocol for a randomized clinical trial. Trials 2022; 23:461. [PMID: 35668430 PMCID: PMC9169409 DOI: 10.1186/s13063-022-06379-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/04/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is one of the most common medical disorders in pregnancy. Evidence has demonstrated that moderate-intensity physical activity may reduce the risk of gestational diabetes. However, women at risk of GDM spend most of their time performing sedentary behaviors. Although researchers identified self-efficacy as a mediator to overcome physical activity barriers, exercise intervention during pregnancy based on self-efficacy theory has not been discussed so far. Furthermore, there is conflicting evidence regarding the effects of a physical exercise intervention on the incidence of GDM and other maternal or neonatal outcomes in women at higher risk for GDM. METHODS/DESIGN A single-center, parallel, randomized controlled trial will be conducted in a maternal-child health care center. A total of 244 pregnant women at high risk for GDM will be randomized into a study group receiving a self-efficacy-enhancing physical activity intervention or a control group receiving the usual care. The intervention will consist of four group sessions and everyday reminders by WeChat (Tencent, Shenzhen, China). The program will begin at approximately 13-14+6 gestational weeks and end at 36+6 gestational weeks. The primary outcomes will include the incidence of GDM, blood sugar values, and physical activity. The secondary outcomes will include physical activity self-efficacy, gestational weight gain, maternal outcomes, and neonatal outcomes. DISCUSSION The findings of this research will contribute toward understanding the effects of a self-efficacy theory-oriented physical activity program on the incidence of GDM, blood sugar values, physical activity level, gestational weight gain, physical activity self-efficacy, maternal outcomes, and neonatal outcomes. TRIAL REGISTRATION Chinese Clinical Trial Registry (CHiCTR) ChiCTR2200056355 . Registered on February 4, 2022.
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Affiliation(s)
- Xiao Yang
- School of Nursing, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, Guangdong Province 510080 P.R. China
| | - Ji Zhang
- Women and Infants Hospital of Zhengzhou, Zhengzhou, China
| | - Xiangzhi Wang
- Women and Infants Hospital of Zhengzhou, Zhengzhou, China
| | - Yi Xu
- Women and Infants Hospital of Zhengzhou, Zhengzhou, China
| | - Li Sun
- Women and Infants Hospital of Zhengzhou, Zhengzhou, China
| | - Yingli Song
- Women and Infants Hospital of Zhengzhou, Zhengzhou, China
| | - Ruijuan Bai
- Women and Infants Hospital of Zhengzhou, Zhengzhou, China
| | - Hui Huang
- Women and Infants Hospital of Zhengzhou, Zhengzhou, China
| | - Jing Zhang
- Women and Infants Hospital of Zhengzhou, Zhengzhou, China
| | - Ruixing Zhang
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Erfeng Guo
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Lingling Gao
- School of Nursing, Sun Yat-Sen University, No. 74 Zhongshan Road 2, Yuexiu District, Guangzhou, Guangdong Province 510080 P.R. China
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Uphoff EP, Zamperoni V, Yap J, Simmonds R, Rodgers M, Dawson S, Seymour C, Kousoulis A, Churchill R. Mental health promotion and protection relating to key life events and transitions in adulthood: a rapid systematic review of systematic reviews. J Ment Health 2022:1-14. [PMID: 35658814 DOI: 10.1080/09638237.2022.2069724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/04/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND During the decades representing working-age adulthood, most people will experience one or several significant life events or transitions. These may present a challenge to mental health. AIM The primary aim of this rapid systematic review of systematic reviews was to summarise available evidence on the effectiveness of interventions to promote and protect mental health relating to four key life events and transitions: pregnancy and early parenthood, bereavement, unemployment, and housing problems. This review was conducted to inform UK national policy on mental health support. METHODS We searched key databases for systematic reviews of interventions for working-age adults (19 to 64 years old) who had experienced or were at risk of experiencing one of four key life events. Titles and abstracts were screened by two reviewers in duplicate, as were full-text manuscripts of relevant records. We assessed the quality of included reviews and extracted data on the characteristics of each literature review. We prioritised high quality, recent systematic reviews for more detailed data extraction and synthesis. RESULTS The search and screening of 3997 titles/abstracts and 239 full-text papers resulted in 134 relevant studies, 68 of which were included in a narrative synthesis. Evidence was strongest and of the highest quality for interventions to support women during pregnancy and after childbirth. For example, we found benefits of physical activity and psychological therapy for outcomes relating to mental health after birth. There was high quality evidence of positive effects of online bereavement interventions and psychological interventions on symptoms of grief, post-traumatic stress, and depression. Evidence was inconclusive and of lower quality for a range of other bereavement interventions, unemployment support interventions, and housing interventions. CONCLUSIONS Whilst evidence based mental health prevention and promotion is available during pregnancy and early parenthood and for bereavement, it is unclear how best to support adults experiencing job loss, unemployment, and housing problems.
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Affiliation(s)
| | | | - Jade Yap
- Mental Health Foundation, London, UK
| | | | - Mark Rodgers
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Sarah Dawson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | | | - Rachel Churchill
- Centre for Reviews and Dissemination, University of York, York, UK
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Elliott-Sale KJ, Bostock EL, Jackson T, Wardle SL, O'Leary TJ, Greeves JP, Sale C. Investigating the Efficacy of an 18-Week Postpartum Rehabilitation and Physical Development Intervention on Occupational Physical Performance and Musculoskeletal Health in UK Servicewomen: Protocol for an Independent Group Study Design. JMIR Res Protoc 2022; 11:e32315. [PMID: 35648463 PMCID: PMC9201705 DOI: 10.2196/32315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 03/08/2022] [Accepted: 03/18/2022] [Indexed: 11/20/2022] Open
Abstract
Background Postpartum women are at an increased risk of pelvic floor dysfunction, musculoskeletal injury, and poor psychological health and have reduced physical fitness compared to before pregnancy. There is no formal, evidence-based rehabilitation and physical development program for returning UK servicewomen to work following childbirth. Objective This study aims to examine the efficacy of a rehabilitation and physical development intervention for returning postpartum UK servicewomen to occupational fitness. Methods Eligible servicewomen will be assigned to a training or control group in a nonrandomized controlled trial 6 weeks after childbirth. Group allocation will be based on the location of standard pregnancy and postpartum care. The control group will receive standard care, with no prescribed intervention. The training group will start an 18-week core and pelvic health rehabilitation program 6 weeks post partum and a 12-week resistance and high-intensity interval training program 12 weeks post partum. All participants will attend 4 testing sessions at 6, 12, 18, and 24 weeks post partum for the assessment of occupational physical performance, pelvic health, psychological well-being, quality of life, and musculoskeletal health outcomes. Occupational physical performance tests will include vertical jump, mid-thigh pull, seated medicine ball throw, and a timed 2-km run. Pelvic health tests will include the Pelvic Organ Prolapse Quantification system, the PERFECT (power, endurance, repetitions, fast, every contraction timed) scheme for pelvic floor strength, musculoskeletal physiotherapy assessment, the Pelvic Floor Distress Inventory–20 questionnaire, and the International Consultation on Incontinence Questionnaire–Vaginal Symptoms. Psychological well-being and quality of life tests will include the World Health Organization Quality of Life questionnaire and the Edinburgh Postnatal Depression Scale. Musculoskeletal health outcomes will include body composition; whole-body areal bone mineral density; tibial volumetric bone mineral density, geometry, and microarchitecture; patella tendon properties; muscle architecture; muscle protein and collagen turnover; and muscle mass and muscle breakdown. Data will be analyzed using linear mixed-effects models, with participants included as random effects, and group and time as fixed effects to assess within- and between-group differences over time. Results This study received ethical approval in April 2019 and recruitment started in July 2019. The study was paused in March 2020 owing to the COVID-19 pandemic. Recruitment restarted in May 2021. The results are expected in September 2022. Conclusions This study will inform the best practice for the safe and optimal return of postpartum servicewomen to physically and mentally demanding jobs. Trial Registration ClinicalTrials.gov NCT04332757; https://clinicaltrials.gov/ct2/show/NCT04332757 International Registered Report Identifier (IRRID) DERR1-10.2196/32315
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Affiliation(s)
- Kirsty Jayne Elliott-Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom.,Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
| | - Emma Louise Bostock
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Thea Jackson
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Sophie Louise Wardle
- Army Health and Performance Research, Army Headquarters, Andover, United Kingdom
| | - Thomas James O'Leary
- Army Health and Performance Research, Army Headquarters, Andover, United Kingdom
| | | | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom.,Institute of Sport, Manchester Metropolitan University, Manchester, United Kingdom
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Santos-Rocha R, Fernandes de Carvalho M, Prior de Freitas J, Wegrzyk J, Szumilewicz A. Active Pregnancy: A Physical Exercise Program Promoting Fitness and Health during Pregnancy-Development and Validation of a Complex Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4902. [PMID: 35457769 PMCID: PMC9028999 DOI: 10.3390/ijerph19084902] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/11/2022] [Accepted: 04/15/2022] [Indexed: 12/13/2022]
Abstract
Physical activity during pregnancy is a public health issue. In the view of reproducibility and the successful implementation of exercise interventions, reporting the quality of such study design must be ensured. The objective of this study was to develop and validate a physical exercise program promoting fitness and health during pregnancy. A qualitative methodological study was carried out. For the description of the exercise program, the Consensus on Exercise Reporting Template (CERT) was used. For the validation of the program, the revised guideline of the Criteria for Reporting the Development and Evaluation of Complex Interventions in Health Care (CReDECI2) was followed and went through three stages of development, piloting, and evaluation. The customizable exercise program was designed and validated by exercise and health specialists based on evidence-based, international recommendations and supported by different educational tools to be implemented by qualified exercise professionals in health and fitness settings. A 12-week testing intervention addressing a group of 29 pregnant women was carried out. The program's feasibility was subsequently evaluated by all the pregnant women. The CReDECI2 process guides practitioners and researchers in developing and evaluating complex educational interventions. The presented intervention may assist exercise specialists, health professionals, and researchers in planning, promoting, and implementing a prenatal exercise program.
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Affiliation(s)
- Rita Santos-Rocha
- ESDRM Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal; (M.F.d.C.); (J.P.d.F.)
- CIPER Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics (FMH), University of Lisbon, 1499-002 Cruz Quebrada, Portugal
| | - Marta Fernandes de Carvalho
- ESDRM Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal; (M.F.d.C.); (J.P.d.F.)
| | - Joana Prior de Freitas
- ESDRM Sport Sciences School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal; (M.F.d.C.); (J.P.d.F.)
| | - Jennifer Wegrzyk
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, 1011 Lausanne, Switzerland;
| | - Anna Szumilewicz
- Department of Fitness, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland;
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de Castro R, Antunes R, Mendes D, Szumilewicz A, Santos-Rocha R. Can Group Exercise Programs Improve Health Outcomes in Pregnant Women? An Updated Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4875. [PMID: 35457743 PMCID: PMC9024782 DOI: 10.3390/ijerph19084875] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/09/2022] [Accepted: 04/15/2022] [Indexed: 02/06/2023]
Abstract
Current scientific evidence supports the recommendation to initiate or continue physical exercise in healthy pregnant women. Group exercise programs have positive effects on improving health, well-being, and social support. In 2015, a systematic review was provided to evaluate the evidence on the effectiveness of group exercise programs in improving pregnant women's and newborns' health outcomes and to assess the content of the programs. This review aims to update this knowledge between 2015 and 2020. The exercise program designs were analyzed with the Consensus of Exercise Reporting Template (CERT) model, the compliance with the current guidelines, and effectiveness in the maternal health and fitness parameters. Three databases were used to conduct literature searches. Thirty-one randomized control trials were selected for analysis. All studies followed a supervised group exercise program including aerobic, resistance, pelvic floor training, stretching, and relaxation sections. Group interventions during pregnancy improved health and fitness outcomes for the women and newborns, although some gaps were identified in the interventions. Multidisciplinary teams of exercise and health professionals should advise pregnant women that group exercise improves a wide range of health outcomes for them and their newborns.
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Affiliation(s)
- Rebeca de Castro
- ESECS—Polytechnic Institute of Leiria, 2411-901 Leiria, Portugal; (R.d.C.); (D.M.)
| | - Raul Antunes
- ESECS—Polytechnic Institute of Leiria, 2411-901 Leiria, Portugal; (R.d.C.); (D.M.)
- Life Quality Research Centre (CIEQV), 2040-413 Leiria, Portugal
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2410-541 Leiria, Portugal
| | - Diogo Mendes
- ESECS—Polytechnic Institute of Leiria, 2411-901 Leiria, Portugal; (R.d.C.); (D.M.)
- Life Quality Research Centre (CIEQV), 2040-413 Leiria, Portugal
| | - Anna Szumilewicz
- Department of Fitness, Faculty of Physical Culture, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland;
| | - Rita Santos-Rocha
- ESDRM Sport Sciences School of Rio Maior—Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal;
- CIPER Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics (FMH), University of Lisbon, 1499-002 Cruz Quebrada, Portugal
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Beyond the Calorie Paradigm: Taking into Account in Practice the Balance of Fat and Carbohydrate Oxidation during Exercise? Nutrients 2022; 14:nu14081605. [PMID: 35458167 PMCID: PMC9027421 DOI: 10.3390/nu14081605] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 02/04/2023] Open
Abstract
Recent literature shows that exercise is not simply a way to generate a calorie deficit as an add-on to restrictive diets but exerts powerful additional biological effects via its impact on mitochondrial function, the release of chemical messengers induced by muscular activity, and its ability to reverse epigenetic alterations. This review aims to summarize the current literature dealing with the hypothesis that some of these effects of exercise unexplained by an energy deficit are related to the balance of substrates used as fuel by the exercising muscle. This balance of substrates can be measured with reliable techniques, which provide information about metabolic disturbances associated with sedentarity and obesity, as well as adaptations of fuel metabolism in trained individuals. The exercise intensity that elicits maximal oxidation of lipids, termed LIPOXmax, FATOXmax, or FATmax, provides a marker of the mitochondrial ability to oxidize fatty acids and predicts how much fat will be oxidized over 45–60 min of low- to moderate-intensity training performed at the corresponding intensity. LIPOXmax is a reproducible parameter that can be modified by many physiological and lifestyle influences (exercise, diet, gender, age, hormones such as catecholamines, and the growth hormone-Insulin-like growth factor I axis). Individuals told to select an exercise intensity to maintain for 45 min or more spontaneously select a level close to this intensity. There is increasing evidence that training targeted at this level is efficient for reducing fat mass, sparing muscle mass, increasing the ability to oxidize lipids during exercise, lowering blood pressure and low-grade inflammation, improving insulin secretion and insulin sensitivity, reducing blood glucose and HbA1c in type 2 diabetes, and decreasing the circulating cholesterol level. Training protocols based on this concept are easy to implement and accept in very sedentary patients and have shown an unexpected efficacy over the long term. They also represent a useful add-on to bariatric surgery in order to maintain and improve its weight-lowering effect. Additional studies are required to confirm and more precisely analyze the determinants of LIPOXmax and the long-term effects of training at this level on body composition, metabolism, and health.
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Ehrhardt C, Deibert C, Flöck A, Merz WM, Gembruch U, Bockler A, Dötsch J, Joisten C, Ferrari N. Impact of Diet Quality during Pregnancy on Gestational Weight Gain and Selected Adipokines-Results of a German Cross-Sectional Study. Nutrients 2022; 14:nu14071515. [PMID: 35406128 PMCID: PMC9003101 DOI: 10.3390/nu14071515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/28/2022] [Accepted: 04/02/2022] [Indexed: 11/16/2022] Open
Abstract
While nutrition during pregnancy is critical for the health of both mother and child, little is known about the diet quality of women during pregnancy, its correlation with gestational weight gain (GWG)/body composition, and chosen maternal adipokines. Therefore, we evaluated the Healthy Eating Index (HEI) of 110 pregnant women and analyzed its correlation with GWG/body composition, physical activity, leptin, resistin, adiponectin, and interleukin 6 (IL-6), respectively. Diet quality was medium in 63% of women, characterized by a high intake of animal-based products. HEI was negatively influenced by pre-pregnancy obesity (β = −0.335, p = 0.004), and positively influenced by higher age (>35 yrs., β = 0.365, p ≤ 0.001), upper arm circumference (β = 0.222, p = 0.052), and total activity during the third trimester (β = 0.258, p = 0.008). GWG was associated with pre-pregnancy obesity (β = −0.512, p ≤ 0.001), thigh circumference (β = 0.342, p = 0.007), upper arm fat area (β = 0.208, p = 0.092), and maternal age group (>35 yrs. β = −0.166, p = 0.082), but not with HEI. Leptin and IL-6 displayed associations with variables representative of body composition, such as pre-pregnancy BMI, thigh circumference, upper arm fat area, and upper arm circumference, but were not influenced by HEI. Neither were adiponectin and resistin. IL-6 was also associated with total activity. In conclusion, GWG, leptin, and IL-6 were influenced by nutritional status (body composition/pre-pregnancy BMI), not by maternal diet. Physical activity level also had an impact on IL-6. Thus, efforts should be intensified to improve diet quality and participation in sports before and during pregnancy, particularly in overweight or obese women.
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Affiliation(s)
- Christina Ehrhardt
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany;
- Correspondence:
| | - Clara Deibert
- Department of Pediatric, DRK Hospital Kirchen, Bahnhofstraße 24, 57548 Kirchen, Germany;
| | - Anne Flöck
- Department of Obstetrics and Prenatal Medicine, Venusberg-Campus 1, University Bonn Medical School, 53127 Bonn, Germany; (A.F.); (W.M.M.); (U.G.)
| | - Waltraut M. Merz
- Department of Obstetrics and Prenatal Medicine, Venusberg-Campus 1, University Bonn Medical School, 53127 Bonn, Germany; (A.F.); (W.M.M.); (U.G.)
| | - Ulrich Gembruch
- Department of Obstetrics and Prenatal Medicine, Venusberg-Campus 1, University Bonn Medical School, 53127 Bonn, Germany; (A.F.); (W.M.M.); (U.G.)
| | - Adeline Bockler
- Department of General Internal Medicine/Cardiology, Marienhof Hospital, Rudolf-Virchow-Str. 7–9, 56073 Koblenz, Germany;
| | - Jörg Dötsch
- Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, University Hospital Cologne and University of Cologne, Robert-Koch-Str. 16, 50931 Cologne, Germany;
| | - Christine Joisten
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany;
| | - Nina Ferrari
- Cologne Center for Prevention in Childhood and Youth/Heart Center Cologne, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany;
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Miranda LA, de Moura ACR, Kasawara KT, Surita FG, Moreira MA, do Nascimento SL. Exercise and Physical Activity Levels and Associated Factors Among High-Risk Pregnant Women. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2022; 44:360-368. [PMID: 35276747 PMCID: PMC10032053 DOI: 10.1055/s-0042-1743099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/17/2021] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To assess the levels of physical activity and exercise practice, and examine the associated maternal characteristics; as well as the anxiety levels of high-risk pregnant women. METHODS A cross-sectional study conducted with pregnant women at a High-risk Prenatal Clinic (HRPC) in a tertiary maternity. Pregnant women of 18 to 40-years-old, with a single fetus, and with gestational age up to 38 weeks were included. The level of physical activity and exercise practice of the study's participants were investigated using the Pregnancy Physical Activity Questionnaire (PPAQ). Maternal sociodemographic, anthropometric, and medical data were investigated using a specific form. For anxiety levels, the short version of the State-Trait Anxiety Inventory (STAI) was applied. We used the Student t-test, chi-square test, odds ratio (OR) with 95% confidence interval (95% CI) and multiple logistic regression. The significance level was 5%. RESULTS Among the 109 pregnant women included, 82 (75.2%) were classified as sedentary/little active. The higher energy expenditure were for domestic activities (133.81 ± 81.84 METs), followed by work-related activities (40.77 ± 84.71 METs). Only 19.3% women exercised during pregnancy (4.76 ± 12.47 METs), with slow walking being the most reported exercise. A higher level of education was the most important factor associated with women being moderately or vigorously active (OR = 29.8; 95% CI 4.9-117.8). Nulliparity (OR = 3.1; 95% CI 1.0-9.1), low levels of anxiety (OR = 3.6; 95% CI 1.2-10.7), and unemployment (OR = 4.8; 95% CI 1.1-19.6) were associated with the practice of exercise during pregnancy. CONCLUSION Most women with high-risk pregnancies exhibited a sedentary pattern, with low prevalence of physical exercise practice. Recognizing factors that hinder the adoption of a more physically active lifestyle is essential for an individualized guidance regarding exercise during pregnancy.
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Effects of Regular Exercise During Pregnancy on Early Childhood Neurodevelopment: The Physical Activity for Mothers Enrolled in Longitudinal Analysis Randomized Controlled Trial. J Phys Act Health 2022; 19:203-210. [PMID: 35168196 DOI: 10.1123/jpah.2021-0477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/10/2021] [Accepted: 01/17/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND The aim of this study was to investigate the effect of exercise during pregnancy on early childhood neurodevelopment (cognitive, motor, and language domains). METHODS A randomized controlled trial nested into the 2015 Pelotas (Brazil) Birth Cohort was conducted. Healthy pregnant women were enrolled between 16 and 20 weeks of gestation; 424 women and their children (intervention [n = 141]; control [n = 283]) were analyzed. An exercise-based intervention 3 times per week was delivered over 16 weeks. Child neurodevelopment and its domains were assessed at 1, 2, and 4 years. Standardized mean differences and 95% confidence intervals are presented. RESULTS No effects of exercise during pregnancy on child neurodevelopment and its domains at age 1 year were observed. Compared with the control group, children from women in the exercise group had higher language score at age 2 years (standardized mean differences = 0.23; 95% confidence intervals, 0.02 to 0.44) and higher cognitive score (standardized mean differences = 0.22; 95% confidence intervals, 0.03 to 0.41) at age 4 years. No effects of exercise during pregnancy were observed in the motor domain at 1, 2, and 4 years. CONCLUSIONS No detrimental effects of exercise during pregnancy on child neurodevelopment were observed. In addition, these findings suggest that exercise during pregnancy can result in small benefits for language and cognitive development.
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Nulty AK, Bovbjerg ML, Savitz DA, Herring AH, Bradley CB, Evenson KR. Maternal Physical Activity at Term and Spontaneous Labor: A Case-Crossover Study. J Phys Act Health 2022; 19:99-107. [PMID: 34998275 PMCID: PMC9364698 DOI: 10.1123/jpah.2021-0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 10/01/2021] [Accepted: 12/10/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND This study assessed associations between antenatal physical activity and the onset of spontaneous labor (SL). METHODS Data were taken from 541 participants in the third pregnancy, infection, and nutrition study who had no contraindications to antenatal physical activity. An interviewer-administered questionnaire assessed labor triggers, gestational age at birth, and physical activity within the week (24 h to 7 d) and the 24-hour period (0-24 h) prior to SL. A case-crossover design examined the association between physical activity (recreational, occupational, or any) and the risk of onset of SL within the subsequent 24 hours. RESULTS Overall, 21% (any), 26% (recreational), and 14% (occupational) of participants reported physical activity during the week; whereas 5% (any), 7% (recreational), and 3% (occupational) reported physical activity during the 24-hour period, prior to SL onset. Participants who reported any or occupational physical activity during the 24-hour period had a decreased likelihood of SL within the subsequent 24 hours, while participants who reported at least 30 minutes of recreational physical activity had an increased likelihood. Results remained consistent among early, full, or postterm participants. CONCLUSION Recreational, but not occupational, physical activity at term may increase the likelihood of SL; however, the authors cannot rule out reverse causality.
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Danielli M, Gillies C, Thomas RC, Melford SE, Baker PN, Yates T, Khunti K, Tan BK. Effects of Supervised Exercise on the Development of Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:793. [PMID: 35160245 PMCID: PMC8836524 DOI: 10.3390/jcm11030793] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 01/28/2022] [Indexed: 01/14/2023] Open
Abstract
Hypertensive disorders of pregnancy (HDP) are the most common medical complication in pregnancy, affecting approximately 10-15% of pregnancies worldwide. HDP are a major cause of maternal and perinatal morbidity and mortality, and each year, worldwide, around 70,000 mothers and 500,000 babies die because of HDP. Up-to-date high-quality systematic reviews quantifying the role of exercise and the risks of developing HDP are currently lacking. Physical exercise is considered to be safe and beneficial to pregnant women. Supervised exercise has been shown to be safe and to be more beneficial than unsupervised exercise in the general population, as well as during pregnancy in women with obesity and diabetes. Therefore, we undertook a systematic review and meta-analysis to investigate the effects of women performing supervised exercise during pregnancy compared to a control group (standard antenatal care or unsupervised exercise) on the development of HDP. We searched Medline, Embase, CINHAL, and the Cochrane Library, which were searched from inception to December 2021. We included only randomized controlled trials (RCTs) investigating the development of HDP compared to a control group (standard antenatal care or unsupervised exercise) in pregnant women performing supervised exercise. Two independent reviewers selected eligible trials for meta-analysis. Data collection and analyses were performed by two independent reviewers. The PROSPERO registration number is CRD42020176814. Of 6332 articles retrieved, 16 RCTs met the eligibility criteria, comparing a total of 5939 pregnant women (2904 pregnant women in the intervention group and 3035 controls). The risk for pregnant women to develop HDP was significantly reduced in the intervention compared to the control groups, with an estimated pooled cumulative incidence of developing HDP of 3% in the intervention groups (95% CI: 3 to 4) and of 5% in the control groups (95% CI: 5 to 6), and a pooled odds ratio (OR) comparing intervention to control of 0.54 (95% CI:0.40 to 0.72, p < 0.001). A combination of aerobic and anaerobic exercise, or yoga alone, had a greater beneficial effect compared to performing aerobic exercise only (mixed-OR = 0.50, 95% CI:0.33 to 0.75, p = 0.001; yoga-OR = 0.28, 95% CI:0.13 to 0.58, p = 0.001); aerobic exercise only-OR = 0.87, 95% CI:0.55 to 1.37, p = 0.539). Pregnancy is an opportunity for healthcare providers to promote positive health activities, thus optimizing the health of pregnant women with potential short- and long-term benefits for both mother and child. This systematic review and meta-analysis support a beneficial effect of either structured exercise (combination of aerobic, strength, and flexibility workouts) or yoga for preventing the onset of HDP. Yoga, considered a low-impact physical activity, could be more acceptable and safer for women in pregnancy in reducing the risk of developing HDP.
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Affiliation(s)
- Marianna Danielli
- Department of Cardiovascular Sciences, University of Leicester, Leicester LE1 7RH, UK; (M.D.); (R.C.T.); (S.E.M.); (P.N.B.)
| | - Clare Gillies
- Diabetes Research Centre, Leicester General Hospital, Leicester LE5 4PW, UK; (C.G.); (T.Y.); (K.K.)
| | - Roisin Clare Thomas
- Department of Cardiovascular Sciences, University of Leicester, Leicester LE1 7RH, UK; (M.D.); (R.C.T.); (S.E.M.); (P.N.B.)
| | - Sarah Emily Melford
- Department of Cardiovascular Sciences, University of Leicester, Leicester LE1 7RH, UK; (M.D.); (R.C.T.); (S.E.M.); (P.N.B.)
| | - Philip Newton Baker
- Department of Cardiovascular Sciences, University of Leicester, Leicester LE1 7RH, UK; (M.D.); (R.C.T.); (S.E.M.); (P.N.B.)
| | - Thomas Yates
- Diabetes Research Centre, Leicester General Hospital, Leicester LE5 4PW, UK; (C.G.); (T.Y.); (K.K.)
- National Institute for Health Research (NIHR) Leicester Biomedical Research Centre (BRC), Leicester General Hospital, Leicester LE5 4PW, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, Leicester General Hospital, Leicester LE5 4PW, UK; (C.G.); (T.Y.); (K.K.)
- NIHR Applied Research Collaboration—East Midlands (ARC-EM), Leicester General Hospital, Leicester LE5 4PW, UK
| | - Bee Kang Tan
- Department of Cardiovascular Sciences, University of Leicester, Leicester LE1 7RH, UK; (M.D.); (R.C.T.); (S.E.M.); (P.N.B.)
- Diabetes Research Centre, Leicester General Hospital, Leicester LE5 4PW, UK; (C.G.); (T.Y.); (K.K.)
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139
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Morres ID, Tzouma NA, Hatzigeorgiadis A, Krommidas C, Kotronis KV, Dafopoulos K, Theodorakis Y, Comoutos N. Exercise for perinatal depressive symptoms: A systematic review and meta-analysis of randomized controlled trials in perinatal health services. J Affect Disord 2022; 298:26-42. [PMID: 34728280 DOI: 10.1016/j.jad.2021.10.124] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 09/14/2021] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Exercise improves perinatal depressive (PD) symptoms, but reports call for more robust evidence. This systematic review and meta-analysis aimed at synthesizing evidence exclusively from randomized controlled trials (RCTs) examining the effects of exercise on PD symptoms in women recruited through perinatal health services. METHODS Nine e-databases and fifteen systematic reviews were searched for relevant RCTs. Exercise-specific tools extracted/coded data. A meta-analysis using a random effects model (Standardized Mean Difference [SMD]) investigated the effects of exercise on PD scores post-intervention. RESULTS From 285 records, 14 RCTs (2.025 participants) were considered eligible including two RCTs with clinically diagnosed PD women. Exercise showed a statistically significant, small, overall antidepressant effect (SMD = -0.21, 95% CI = -0.31, -0.11, p = 0.0001) with low/non-significant heterogeneity (Q = 17.82, I 2 = 16%, p = 0.27). Only the fail-safe criterion recorded marginally significant publication bias, but trim-fill analysis added no study. Sensitivity analyses increased the overall effect in RCTs showing lower risk of bias or delivering ≥150 min/week moderate intensity aerobic exercise. Subgroup analyses revealed significant antidepressant effects for exercise across various settings, delivery formats, depressive symptoms severities and outcome measures used. Heterogeneity was low/non-significant in all analyses (I 2 ≤ 50%). Hedges' g corrections did not influence the results. LIMITATIONS Study limitations include the small number of available trials and clinically diagnosed PD samples and the variety of exercise modalities. CONCLUSIONS Exercise improved PD symptoms, especially in RCTs with lower risk of bias or with ≥150 min/day moderate intensity aerobic exercise interventions. Findings are clinically useful but more RCTs for clinically diagnosed PD women are needed for firmer conclusions.
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Affiliation(s)
- Ioannis D Morres
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece.
| | - Natalia-Antigoni Tzouma
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece
| | - Antonis Hatzigeorgiadis
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece
| | - Charalampos Krommidas
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece
| | | | - Konstantinos Dafopoulos
- Department of Obstetrics and Gynecology, School of Health Sciences, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Yannis Theodorakis
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece
| | - Nikolaos Comoutos
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece
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de Borja C, Chang CJ, Watkins R, Senter C. Optimizing Health and Athletic Performance for Women. Curr Rev Musculoskelet Med 2022; 15:10-20. [PMID: 35023069 PMCID: PMC8804053 DOI: 10.1007/s12178-021-09735-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW The exponential growth of women participating in competitive sports throughout the years was made possible through several initiatives by the International Olympic Committee and the passage and implementation of Title IX as a federal law in the United States. However, this positive trend towards gender equity in sports has not transpired for women in medicine, especially in fields that care for elite athletes. This current review will discuss specific areas that can be tailored to help female athletes prevent injuries and optimize their athletic performance. We will also highlight how increased female team physician representation in sports may help optimize care for female athletes. RECENT FINDINGS Female athletes are considered high risk for certain conditions such as ACL tears, patellofemoral pain syndrome, bone stress injuries, sport-related concussions, and sexual violence in sport. Addressing factors specific to female athletes has been found to be valuable in preventing injuries. Strength and conditioning can optimize athletic performance but remains underutilized among female athletes. Although diversity in healthcare workforce has been found to be beneficial for multiple reasons, women remain underrepresented in sports medicine. Increasing female team physician representation may positively impact care for female athletes. Team physicians must understand the physiologic, biomechanical, and anatomic factors that are unique to female athletes in order to tailor injury prevention programs and optimize their athletic performance. Advocating for gender equity in sports medicine to advance representation of women in the field will increase workforce diversity and promote excellence in sports medicine care.
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Affiliation(s)
- Celina de Borja
- Department of Orthopaedic Surgery, Division of Pediatric Orthopaedics, University of California, San Francisco, 1825 4th Street, 5th Floor, San Francisco, CA, 94158, USA.
| | - Cindy J Chang
- Department of Orthopaedic Surgery, Primary Care Sports Medicine, University of California, San Francisco, San Francisco, CA, 94158, USA
| | - Rhonda Watkins
- Department of Orthopaedic Surgery, Division of Pediatric Orthopaedics, University of California, San Francisco, 1825 4th Street, 5th Floor, San Francisco, CA, 94158, USA
| | - Carlin Senter
- Department of Orthopaedic Surgery, Primary Care Sports Medicine, University of California, San Francisco, San Francisco, CA, 94158, USA
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Sitzberger C, Hansl J, Felberbaum R, Brössner A, Oberhoffer-Fritz R, Wacker-Gussmann A. Physical Activity in High-Risk Pregnancies. J Clin Med 2022; 11:jcm11030703. [PMID: 35160151 PMCID: PMC8836910 DOI: 10.3390/jcm11030703] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/07/2022] [Accepted: 01/24/2022] [Indexed: 01/11/2023] Open
Abstract
It is known that physical activity before and during pregnancy is associated with health benefits for both the mother and fetus. The WHO recommends a minimum of 150 min per week of moderate-intensity aerobic physical activity for pregnant women. However, the majority of pregnant woman seem not to be physically active in pregnancy as recommended. In addition, the WHO recommendations do not include information on physical activity (PA) for specific target groups. This might be particularly problematic in women with assisted reproduction technologies (ART) or those who have received the fetal diagnosis of congenital heart defects (CHD). The aim of our study was to elaborate on whether assisted reproduction technologies (ART) and/or the diagnosis of fetal congenital heart defects (CHD) influence the level of PA in pregnant women, and to determine if there is a difference between PA behavior before and during pregnancy. In addition, we will evaluate whether high-risk pregnant women also reach the WHO recommendations. A non-interventional, cross-sectional, monocentric study based on two standardized questionnaires on physical activity was conducted. In total, n = 158 pregnant women were included. All of the participants were recruited from the outpatient clinics of the German Heart Center, Munich, and the Klinikverbund Kempten-Oberallgäu, Germany. Pregnant women after ART (n = 18), with fetal CHD (n = 25) and with both ART and CHD (n = 8) could be included. A total of 107 pregnant women served as healthy controls. Women, after ART, showed a significantly reduced level of physical activity (p = 0.014) during pregnancy compared to women who became pregnant naturally. Additionally, less (p < 0.001) and lighter (p = 0.002) physical activity was observed in all groups during pregnancy compared to those before pregnancy. An increase in maternal age increases the likelihood of CHD (p < 0.001) and decreases the level of physical activity before pregnancy (p = 0.012). The overall level of physical activity decreased in healthy and high-risk pregnancies, and only a quarter (26.49%) of all pregnant women reached the WHO recommendations. Further research for the specific target groups is highly recommended in order to promote and increase physical activity in ART and CHD pregnancies.
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Affiliation(s)
- Christina Sitzberger
- Institute of Preventive Pediatrics, Faculty of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany; (J.H.); (R.O.-F.); (A.W.-G.)
- Correspondence:
| | - Juliane Hansl
- Institute of Preventive Pediatrics, Faculty of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany; (J.H.); (R.O.-F.); (A.W.-G.)
| | - Ricardo Felberbaum
- Klinikverbund Kempten(Allgäu), Kinderwunschzentrum, 87439 Kempten (Allgäu), Germany; (R.F.); (A.B.)
| | - Anke Brössner
- Klinikverbund Kempten(Allgäu), Kinderwunschzentrum, 87439 Kempten (Allgäu), Germany; (R.F.); (A.B.)
| | - Renate Oberhoffer-Fritz
- Institute of Preventive Pediatrics, Faculty of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany; (J.H.); (R.O.-F.); (A.W.-G.)
- German Heart Centre, Department of Paediatric Cardiology and Congenital Heart Defects, 80636 Munich, Germany
| | - Annette Wacker-Gussmann
- Institute of Preventive Pediatrics, Faculty of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany; (J.H.); (R.O.-F.); (A.W.-G.)
- German Heart Centre, Department of Paediatric Cardiology and Congenital Heart Defects, 80636 Munich, Germany
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142
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Syed Nor SF, Idris IB, Md Isa Z. Physical inactivity in early pregnancy and the determinants in an urban city setting of Kuala Lumpur, Malaysia. BMC Public Health 2022; 22:93. [PMID: 35027033 PMCID: PMC8758214 DOI: 10.1186/s12889-022-12513-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 01/05/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Physical inactivity in pregnancy has been associated with excessive gestational weight gain, hypertensive disorders, gestational diabetes mellitus and postpartum depression. Despite these risks, physical inactivity level remains high especially in higher income countries. The prevalence of physical inactivity among women in Malaysia aged ≥16 years was 28.2% in 2019 exceeding men by 6.1%. However, little is known regarding the subpopulation of pregnant women especially in Kuala Lumpur which is the most urbanized and highly populated city in Malaysia. Therefore, the aim of this study is to measure the physical inactivity prevalence among first trimester pregnant women in Kuala Lumpur and to identify its determining factors. METHODS This was a cross-sectional study in which 339 first trimester pregnant women were sampled from 13 maternal and child health clinics located in all four parliament districts of Kuala Lumpur. Self-administered questionnaires which contained the Malay version of the pregnancy physical activity questionnaire (PPAQ) were used. Descriptive analysis was conducted to determine the physical inactivity prevalence followed by simple and multiple logistic regression to identify the determinants of physical inactivity with significant level of 5%. RESULTS The prevalence of physical inactivity was 38.3%. The highest activity was seen in the household activity domain, despite only 24.8% of the respondents were housewives/unemployed. There was little to no participation observed in the vigorous intensity category. The determinants of physical inactivity were primigravida (aOR 3.54 95% CI 1.40, 8.97), education level (aOR 3.77 95% CI 1.35, 10.52) and body mass index (aOR 0.88 95% CI 0.80, 0.97) which explained 22.6% variation of physical inactivity in the final adjusted model. CONCLUSION The prevalence of physical inactivity among first trimester pregnant mothers in this study was 38.3%, and the highest activity was seen in the household category. Health education on physical activity in pregnancy should be focused on those who are primigravida and have no tertiary education. The educational content should be updated and tailored to current pandemic situation where self-isolation is the new norm, by advocating for home-based, moderate to vigorous intensity physical activities.
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Affiliation(s)
- Sharifah Fazlinda Syed Nor
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Batu 9 Cheras, 56000, Wilayah Persekutuan Kuala Lumpur, Malaysia
- Training Management Division, Ministry of Health Malaysia, Kompleks E, Pusat Pentadbiran Kerajaan Persekutuan, 62590, Wilayah Persekutuan Putrajaya, Malaysia
| | - Idayu Badilla Idris
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Batu 9 Cheras, 56000, Wilayah Persekutuan Kuala Lumpur, Malaysia.
| | - Zaleha Md Isa
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Batu 9 Cheras, 56000, Wilayah Persekutuan Kuala Lumpur, Malaysia
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143
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Sánchez-Polán M, Nagpal TS, Barakat R. Call to Action for Promoting Exercise Is Medicine in Pregnancy—Collaboration Is Key. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2022. [DOI: 10.1249/tjx.0000000000000222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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144
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Yang X, Li H, Zhao Q, Han R, Xiang Z, Gao L. Clinical Practice Guidelines That Address Physical Activity and Exercise During Pregnancy: A Systematic Review. J Midwifery Womens Health 2022; 67:53-68. [PMID: 34841649 DOI: 10.1111/jmwh.13286] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 08/11/2021] [Accepted: 08/12/2021] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Physical activity is recommended for healthy pregnant women. Clinical practice guidelines vary with regard to initial time, duration, or type of physical activity that is recommended, which is confusing for health care professionals and pregnant women alike. This study aimed to appraise clinical guidelines relevant to physical activity for pregnant women and summarize consensus and discrepant recommendations. METHODS The websites of organizations that develop guidelines including those of obstetricians, gynecologists, midwives, and medical sports associations were searched in addition to 9 literature databases for the period from January 2010 through November 2020. Guidelines were included if they were published in a journal or on a website in English or Chinese; were labeled as a recommendation guideline, position paper, practice parameter, or consensus statement; and addressed physical activity for pregnant women. Two authors independently extracted recommendations. Four reviewers independently assessed guideline quality using the AGREE II instrument. RESULTS Thirteen guidelines met the inclusion criteria. The guidelines developed by the World Health Organization and the National Institute for Health and Clinical Excellence were deemed to have the highest methodological quality. The recommendations were consistent with regard to recommended exercise duration, frequency, intensity, and type of physical activity. The main discrepant recommendations included best tools for conducting pre-exercise screening and assessing intensity of exertion. Guidelines also differ on optimal heart rate during exercise, when in pregnancy to initiate an exercise regimen, and duration or frequency of strengthening exercises. DISCUSSION Of the 13 guidelines, 2 were found to have good methodological quality. The recommendations that were consistent across the differing guidelines can support health care providers in counseling women about physical activity during pregnancy. The recommendations that are discrepant among these guidelines may contribute to confusion and a reluctance to recommend exercise during pregnancy. Research is needed to clarify discrepant recommendations.
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Affiliation(s)
- Xiao Yang
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Hanbing Li
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Qian Zhao
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Rongrong Han
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Zhixuan Xiang
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Lingling Gao
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
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Benítez-Andrades JA, García-Ordás MT, Álvarez-González M, Leirós-Rodríguez R, López Rodríguez AF. Detection of the most influential variables for preventing postpartum urinary incontinence using machine learning techniques. Digit Health 2022; 8:20552076221111289. [PMID: 35832475 PMCID: PMC9272055 DOI: 10.1177/20552076221111289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 06/09/2022] [Indexed: 11/15/2022] Open
Abstract
Background Postpartum urinary incontinence is a fairly widespread health problem in today’s society among women who have given birth. Recent studies analysing the different variables that may be related to Postpartum urinary incontinence have brought to light some variables that may be related to Postpartum urinary incontinence in order to try to prevent it. However, no studies have been found that analyse some of the intrinsic and extrinsic variables of patients during pregnancy that could give rise to this pathology. Objective The objective of this study is to assess the most influential variables in Postpartum urinary incontinence by means of machine learning techniques, starting from a group of intrinsic variables, another group of extrinsic variables and a mixed group that combines both types. Methods Information was collected on 93 patients, pregnant women who gave birth. Experiments were conducted using different machine learning classification techniques combined with oversampling techniques to predict four variables: urinary incontinence, urinary incontinence frequency, urinary incontinence intensity and stress urinary incontinence. Results The results showed that the most accurate predictive models were those trained with extrinsic variables, obtaining accuracy values of 70% for urinary incontinence, 77% for urinary incontinence frequency, 71% for urinary incontinence intensity and 93% for stress urinary incontinence. Conclusions This research has shown that extrinsic variables are more important than intrinsic variables in predicting problems related to postpartum urinary incontinence. Therefore, although not conclusive, it opens a line of research that could confirm that the prevention of Postpartum urinary incontinence could be achieved by following healthy habits in pregnant women.
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Affiliation(s)
| | - María Teresa García-Ordás
- SECOMUCI Research Group, Escuela de Ingenierías Industrial e Informática, Universidad de León, León, Spain
| | | | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Nursing and Physical Therapy Department, Universidad de León, Ponferrada, Spain
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146
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Skjold I, Benvenuti MB, Haakstad LAH. Why do so many pregnant women give up exercise? An Italian cross-sectional study. WOMEN'S HEALTH 2022; 18:17455057221117967. [PMID: 36124367 PMCID: PMC9490457 DOI: 10.1177/17455057221117967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: Current exercise guidelines recommend women to exercise throughout pregnancy, and the benefits are well documented. Still, there is an increasing decline of exercise levels during pregnancy and a high percentage of them are sedentary. It is well established that individual attitudes and perception of barriers may influence the ability to engage in sufficient amount of exercise. This has, however, not been examined in an Italian pregnant population. Hence, the aims of the present study were to increase knowledge of facilitators and barriers to regular exercise in Italian pregnant women and to report their social support in regard to maternal exercise. Methods: Healthy, pregnant women (n = 513) were allocated from Fatebenefratelli San Giovanni Calibita, a public hospital in Rome, and four antenatal clinics in Rome and Modena. The participants completed a validated self-administrated questionnaire, the Physical Activity Pregnancy Questionnaire, in gestational week 36. In line with current American College of Obstetricians and Gynecologists guidelines (2020), participants were categorized as “regular exercisers” (⩾150 min/week) and “not regular exercisers” (< 150 min/week). Results: Only 4.6% of the women engaged in regular physical activity/exercise in the third trimester. “Insufficient time” (54%) were the only barrier negatively associated with exercise. The facilitators “relaxation/recreation” (18%), “prevention of health complaints” (15%), “enjoyment” (10%), and “prevention of gestational weight gain” (4%) were associated with achieving the recommendations of exercise. This study found no association between achieving the recommendations and childhood exercise/having social modeling, or exercising network/milieu (p = 0.294 and p = 0.123). Nevertheless, exercising together with others was a significant predictor for regular maternal exercise (p < 0.001). Most women did not receive any advice on exercise during pregnancy from their doctor or midwife (60.0 %). Yet, those who received such advice were significantly more likely to exercise regularly compared to those who did not (75.0% vs 38.2%; p < 0.001). Conclusion: Italian pregnant women mainly reported internal facilitators for their willingness to participate in regular maternal exercise, while barriers were primarily related to inconveniences (such as insufficient time and difficulty combining with work/studies). The study addresses the positive association between achieving the recommended amount of exercise and social support in terms of exercising with others and getting advice from health professions. Because women respect their doctor and have regular prenatal checkups, this health care setting can play a pivotal role in the initiation and maintenance of exercise behavior during pregnancy.
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Affiliation(s)
| | | | - Lene AH Haakstad
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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147
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Adeoye IA. Pattern and correlates of physical activity and sedentary behaviours of pregnant women in Ibadan, Nigeria: Findings from Ibadan pregnancy cohort study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001153. [PMID: 36962637 PMCID: PMC10021993 DOI: 10.1371/journal.pgph.0001153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/14/2022] [Indexed: 11/07/2022]
Abstract
Globally, physical inactivity is the fourth leading risk factor for premature death. Pregnancy is associated with reduced physical activity because of physiological and anatomical changes and socio-cultural barriers. Even though physical activity provides many benefits, such as improved insulin sensitivity and reduced cardiometabolic risk, it is not emphasized among pregnant women in Nigeria. This study described the pattern of physical activity and sedentary behaviours of pregnant women from the Ibadan Pregnancy Cohort Study in Ibadan, Nigeria. The Ibadan Pregnancy Cohort Study (IbPCS) is a prospective cohort study investigating the associations between maternal obesity, lifestyle factors on glycaemia control, gestational weight gain, pregnancy and postpartum outcomes among pregnant women in Ibadan. The Pregnancy Physical Activity Questionnaire (PPAQ) was used to assess physical activity and sedentary behaviour. Sedentary time was estimated from the time spent watching television, sitting at work and the computer. Bivariate and multivariate logistic regression analyses were done to investigate associations at a 5% level of statistical significance. None of the pregnant women met the WHO recommendation of 150mins of moderate-intensity activity per week. The average time spent engaged in moderate-intensity activity was 26.3 ± 22.9 mins. The mean daily sedentary time was 6.5 ± 4.2 hours. High parity para ≥ 4: [AOR 0.57 95% CI: (0.36-0.89) p = 0.014] and being employed [AOR 0.23 95% CI: (0.15-0.33) p <0.001] reduced the odds of having inadequate physical activity. Correlates of sedentary behavior after adjusting for confounders were high parity: para 1-3 AOR 0.73, 95% CI: (0.58-0.91) p = 0.004], tertiary education: AOR 2.39 95% CI: (1.16-4.91) p = 0.018] and earning a higher income: AOR 1.40: 95% CI: (1.11-1.78) p = 0.005]. Pregnant women's physical activity and sedentary behaviours are emerging public health issues, especially in Nigeria. The level of physical activity was inadequate among pregnant women, while the sedentary time was high. There is a need to implement programmes that promote physical activity and discourage sedentary behaviour among pregnant women in Nigeria.
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Affiliation(s)
- Ikeola A Adeoye
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Consortium for Advanced Research in Africa (CARTA), Nairobi, Kenya
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148
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Gamble A, Beech BM, Blackshear C, Herring SJ, Welsch MA, Moore JB. Changes in Physical Activity and Television Viewing From Pre-pregnancy Through Postpartum Among a Socioeconomically Disadvantaged Perinatal Adolescent Population. J Pediatr Adolesc Gynecol 2021; 34:832-838. [PMID: 34271198 PMCID: PMC8578293 DOI: 10.1016/j.jpag.2021.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/16/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE Adolescent pregnancy contributes to accelerated trajectories of adiposity and cardiometabolic diseases. Two potentially low-cost prevention strategies include promoting physical activity (PA) and limiting television (TV) viewing. Few studies have explored these behavior patterns in perinatal adolescents. This study sought to characterize PA and TV viewing in a socioeconomically disadvantaged perinatal adolescent population. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS A cross-sectional, retrospective, 10-item survey was used to explore behavior patterns in 79 predominantly Black (86%) postpartum adolescents. MAIN OUTCOME MEASURES Outcomes included self-reported changes in PA from pre-pregnancy through pregnancy, and 7-day recall of PA and TV viewing in postpartum. RESULTS The majority of adolescents (66%) reported being active on ≥3 days/week in pre-pregnancy; however, many reported low PA (≤2 days/wk) in their first (59%), second (66%), and third (54%) trimesters. Adolescents who reported being active on ≥5 days/wk in pre-pregnancy (19%) experienced first trimester PA decline, which subsequently plateaued. This group remained the most active throughout pregnancy. In postpartum, over half (54%) of all adolescents reported low PA and irrespective of PA, spent considerable time watching TV (median = 1680.0 minutes, inerquartile range = 2940). CONCLUSION Interventions promoting PA coupled with reducing TV viewing during pregnancy and in postpartum may benefit perinatal adolescents. The findings from this study suggest that PA history is a predictor of gestational PA, and low PA and high TV viewing in postpartum underscore the need for behavioral intervention. Conducting a brief assessment of PA history in early gestation may offer important insight.
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Affiliation(s)
- A Gamble
- Department of Preventive Medicine, University of Mississippi Medical Center, Jackson, Mississippi; Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi.
| | - B M Beech
- Office of the Provost, University of Houston, Houston, Texas; College of Medicine, University of Houston, Houston, Texas
| | - C Blackshear
- Department of Data Science, University of Mississippi Medical Center, Jackson, Mississippi
| | - S J Herring
- Program for Maternal Health Equity, Center for Urban Bioethics, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - M A Welsch
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, Mississippi
| | - J B Moore
- Department of Implementation Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina
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149
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McDonald SM, May LE, Hinkle SN, Grantz KL, Zhang C. Maternal Moderate-to-Vigorous Physical Activity before and during Pregnancy and Maternal Glucose Tolerance: Does Timing Matter? Med Sci Sports Exerc 2021; 53:2520-2527. [PMID: 34138816 PMCID: PMC8865218 DOI: 10.1249/mss.0000000000002730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE To assess prospective associations between moderate-to-vigorous physical activity (MVPA) from preconception through pregnancy and glucose metabolism. METHODS The sample consisted of 2388 women from the NICHD Fetal Growth Studies-Singletons, which enrolled US pregnant women between 8 and 13 wk of gestation. Women recalled their MVPA in periconception (past 12 months, inclusive of first trimester), early-to-mid (13-20 wk of gestation), and mid-to-late second trimester (20-29 wk). These data were obtained at study visits that occurred at enrollment (8-13 wk) and at follow-up visits at 16 to 22 wk and 24 to 29 wk. Moderate-to-vigorous physical activity was recalled using the Pregnancy Physical Activity Questionnaire. Glucose challenge test and oral glucose tolerance test results and gestational diabetes diagnosis (defined by the Carpenter-Coustan criteria) were extracted from medical records. ANCOVA and Poisson regression with robust error variance were performed to estimate associations between MVPA and glucose concentrations and gestational diabetes risk, respectively, controlling for age, race/ethnicity, and prepregnancy body mass index. RESULTS Women achieving higher levels of MVPA (≥75th percentile; 760.5 MET·min·wk-1) in early-to-mid second trimester had lower glucose concentrations (β = -3.9 mg·dL-1, 95% CI, -7.4 to -0.5) compared with their least-active counterparts (≤25th percentile; ≤117.0 MET·min·wk-1). Women maintaining recommended levels of MVPA from preconception and first trimester through second trimester (early-to-mid: β = -3.0 mg·dL-1; -5.9 to -0.1; mid-to-late: β = -4.2 mg·dL-1; -8.4 to -0.1) or maintaining sufficient activity throughout second trimester exhibited lower glucose levels (β = -5.6 mg·dL-1; -9.8 to -1.4) compared with their inactive counterparts. No statistically significant associations with gestational diabetes were observed. CONCLUSIONS These findings demonstrate that achieving MVPA of at least 760.0 MET·min·wk-1 in early-to-mid second trimester or maintaining at least 500 MET·min·wk-1 from preconception through second trimester may be related to improved maternal glucose metabolism in the second trimester.
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Affiliation(s)
- Samantha M McDonald
- Department of Foundational Sciences and Research, East Carolina University, Greenville, NC
| | | | - Stefanie N Hinkle
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Katherine L Grantz
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
| | - Cuilin Zhang
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD
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Abstract
For apparently healthy pregnant women, regular physical activity is recommended. The American College of Obstetricians and Gynecologists (ACOG) created recommendations for physical activity and exercise during pregnancy in 1985. At that time, pregnant women were advised to not exceed a heart rate of 140 beats per minute with physical activity. The heart rate recommendation was subsequently removed with the recommendations published in 1994, 2002, and 2015. In 2020, the ACOG updated its recommendations on physical activity for pregnant and postpartum women. The recommendation included exercising at a "fairly light to somewhat hard" perceived intensity and at less than 60-80% of age-predicted maximum heart rate, usually not exceeding a heart rate of 140 beats per minute. Women often seek advice from healthcare providers on physical activity during pregnancy, yet providers report concern about giving appropriate physical activity guidance. This paper summarizes the key scientific literature on monitoring absolute and relative exercise intensity in relation to the current ACOG recommendations, providing background on intensity-related concepts used in the recommendation. This paper also provides practical guidance to assist healthcare providers in relaying this information to pregnant women.
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Affiliation(s)
- Kelly R. Evenson
- Kelly R. Evenson, Department of
Epidemiology, University of NC, Gillings School of Global Public Health, 123 W
Franklin Street, Building C, Suite 410, Chapel Hill, NC, USA; e-mail:
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