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Seneviratne SN, Rajindrajith S. Fetal programming of obesity and type 2 diabetes. World J Diabetes 2022; 13:482-497. [PMID: 36051425 PMCID: PMC9329845 DOI: 10.4239/wjd.v13.i7.482] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/18/2021] [Accepted: 06/03/2022] [Indexed: 02/06/2023] Open
Abstract
The prevalence of obesity and type 2 diabetes mellitus has increased rapidly over the past few decades, and prevention efforts have not been successful. Fetal programming involves the earliest stage of obesity development, and provides a novel concept to complement other strategies for lifelong prevention of obesity and type 2 diabetes mellitus. The World Health Organization now advocates a life-course approach to prevent/control obesity, starting with pre-conceptional and antenatal maternal health. Maternal overnutrition, gestational diabetes mellitus and excessive gestational weight gain lead to fetal overgrowth, and “programs” the offspring with an increased risk of obesity and type 2 diabetes mellitus in childhood and adulthood. This review summarizes current data on fetal programming of obesity and type 2 diabetes mellitus including potential causative factors, mechanisms and interventions to reduce its impact.
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Affiliation(s)
| | - Shaman Rajindrajith
- Department of Paediatrics, Faculty of Medicine, University of Colombo, Colombo 08, Sri Lanka
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Rubens M, Ramamoorthy V, Saxena A, McGranaghan P, Veledar E, Hernandez A. Obstetric outcomes during delivery hospitalizations among obese pregnant women in the United States. Sci Rep 2022; 12:6862. [PMID: 35477949 PMCID: PMC9046286 DOI: 10.1038/s41598-022-10786-9] [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: 01/04/2022] [Accepted: 03/29/2022] [Indexed: 11/14/2022] Open
Abstract
The rates of both maternal and fetal adverse outcomes increase significantly with higher body mass index. The aim of this study was to calculate national estimates of adverse maternal and fetal outcomes and associated hospitalization cost among obese pregnant women using a national database. This study was a retrospective analysis of data retrieved from Nationwide Inpatient Sample database, collected during 2010–2014. The primary outcomes of this study were adverse maternal and fetal outcomes, hospital length of stay, and hospitalization cost. There was a total of 18,687,217 delivery-related hospitalizations, of which 1,048,323 were among obese women. Obese women were more likely to have cesarean deliveries (aOR 1.70, 95% CI 1.62–1.79) and labor inductions (aOR 1.51, 95% CI 1.42–1.60), greater length of stay after cesarean deliveries (aOR 1.14, 95% CI 1.08–1.36) and vaginal deliveries (aOR 1.48, 95% CI 1.23–1.77). They were also more likely to have pregnancy-related hypertension, preeclampsia, gestational diabetes, premature rupture of membranes, chorioamnionitis, venous thromboembolism, excessive fetal growth, and fetal distress. Obese pregnant women had significantly greater risk for adverse obstetrical outcomes, which substantially increased the hospital and economic burden. Risk stratification of pregnant patients based on obesity could also help obstetricians to make better clinical decisions and improve patient outcomes.
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Affiliation(s)
| | | | | | - Peter McGranaghan
- Miami Cancer Institute, Miami, FL, USA. .,Department of Internal Medicine and Cardiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität Zu Berlin, 10117, Berlin, Germany.
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Salmon VE, Rodgers LR, Rouse P, Williams O, Cockcroft E, Boddy K, De Giorgio L, Thomas C, Foster C, Davies R, Morgan K, Jarvie R, Weis C, Pulsford RM. Moving through Motherhood: Involving the Public in Research to Inform Physical Activity Promotion throughout Pregnancy and Beyond. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4482. [PMID: 33922547 PMCID: PMC8122923 DOI: 10.3390/ijerph18094482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/08/2021] [Accepted: 04/14/2021] [Indexed: 12/14/2022]
Abstract
Information received by women regarding physical activity during and after pregnancy often lacks clarity and may be conflicting and confusing. Without clear, engaging, accessible guidance centred on the experiences of pregnancy and parenting, the benefits of physical activity can be lost. We describe a collaborative process to inform the design of evidence-based, user-centred physical activity resources which reflect diverse experiences of pregnancy and early parenthood. Two iterative, collaborative phases involving patient and public involvement (PPI) workshops, a scoping survey (n = 553) and stakeholder events engaged women and maternity, policy and physical activity stakeholders to inform pilot resource development. These activities shaped understanding of challenges experienced by maternity and physical activity service providers, pregnant women and new mothers in relation to supporting physical activity. Working collaboratively with women and stakeholders, we co-designed pilot resources and identified important considerations for future resource development. Outcomes and lessons learned from this process will inform further work to support physical activity during pregnancy and beyond, but also wider health research where such collaborative approaches are important. We hope that drawing on our experiences and sharing outcomes from this work provide useful information for researchers, healthcare professionals, policy makers and those involved in supporting physical activity behaviour.
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Affiliation(s)
- Victoria E. Salmon
- College of Medicine and Health, St. Luke’s Campus, University of Exeter, Heavitree Road, Exeter EX1 2LU, UK; (V.E.S.); (L.R.R.); (E.C.); (K.B.); (L.D.G.); (C.T.); (R.J.)
| | - Lauren R. Rodgers
- College of Medicine and Health, St. Luke’s Campus, University of Exeter, Heavitree Road, Exeter EX1 2LU, UK; (V.E.S.); (L.R.R.); (E.C.); (K.B.); (L.D.G.); (C.T.); (R.J.)
| | - Peter Rouse
- College of Life and Environmental Sciences, St. Luke’s Campus, University of Exeter, Heavitree Road, Exeter EX1 2LU, UK
| | - Oli Williams
- Department for Health, University of Bath, Claverton Down, Bath BA2 7AY, UK;
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King’s College London, 57 Waterloo Road, London SE1 8WA, UK;
| | - Emma Cockcroft
- College of Medicine and Health, St. Luke’s Campus, University of Exeter, Heavitree Road, Exeter EX1 2LU, UK; (V.E.S.); (L.R.R.); (E.C.); (K.B.); (L.D.G.); (C.T.); (R.J.)
- The Healthcare Improvement Studies Institute, Clifford Allbutt Building, Cambridge Biomedical Campus, University of Cambridge, Cambridge CB2 0AH, UK
| | - Kate Boddy
- College of Medicine and Health, St. Luke’s Campus, University of Exeter, Heavitree Road, Exeter EX1 2LU, UK; (V.E.S.); (L.R.R.); (E.C.); (K.B.); (L.D.G.); (C.T.); (R.J.)
- The Healthcare Improvement Studies Institute, Clifford Allbutt Building, Cambridge Biomedical Campus, University of Cambridge, Cambridge CB2 0AH, UK
| | - Luana De Giorgio
- College of Medicine and Health, St. Luke’s Campus, University of Exeter, Heavitree Road, Exeter EX1 2LU, UK; (V.E.S.); (L.R.R.); (E.C.); (K.B.); (L.D.G.); (C.T.); (R.J.)
| | - Ciara Thomas
- College of Medicine and Health, St. Luke’s Campus, University of Exeter, Heavitree Road, Exeter EX1 2LU, UK; (V.E.S.); (L.R.R.); (E.C.); (K.B.); (L.D.G.); (C.T.); (R.J.)
| | - Charlie Foster
- National Institute for Health Research Applied Research Collaboration South West Peninsula (PenARC), South Cloisters, St. Luke’s Campus, Exeter EX1 2LU, UK
| | - Rosie Davies
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK;
| | - Kelly Morgan
- National Institute for Health Research Applied Research Collaboration West of England (ARC West), University Hospitals Bristol NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol BS1 2NT, UK;
| | - Rachel Jarvie
- College of Medicine and Health, St. Luke’s Campus, University of Exeter, Heavitree Road, Exeter EX1 2LU, UK; (V.E.S.); (L.R.R.); (E.C.); (K.B.); (L.D.G.); (C.T.); (R.J.)
| | - Christina Weis
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff CF10 3BD, UK;
| | - Richard M. Pulsford
- Centre for Reproduction Research, De Montfort University, The Gateway, Leicester LE1 9BH, UK;
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Okafor UB, Goon DT. Physical activity and exercise during pregnancy in Africa: a review of the literature. BMC Pregnancy Childbirth 2020; 20:732. [PMID: 33238920 PMCID: PMC7691114 DOI: 10.1186/s12884-020-03439-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 11/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pregnancy is an important phase in a woman's life, with health status at this stage affecting both the woman and her child's life. Global evidence suggests that many women engage in low levels of physical activity (PA) and exercise during pregnancy despite its beneficial effects. This is particularly the case in Africa. METHODS This article reviews the literature on levels of PA and exercise among pregnant women in Africa, highlighting the level of PA or exercise participation during pregnancy in Africa, including types of PA, factors affecting PA, beliefs about and benefits of prenatal activity, advice or counselling on PA during pregnancy in Africa, and PA interventions proposed to promote the uptake of prenatal PA. Electronic search databases used were Google Scholar, Science Direct, Scopus, EMBASE, ERIC, Medline, Web of Science, EBSCOhost, PubMed, BIOMED Central, and African Journal Online. The basic search terms were: 'Physical activity', 'Exercise', 'Pregnancy', 'Pregnant women' and 'Africa'. A total of 40 references were found. On the basis of an analysis of titles, abstracts and the language of publication (other than English), 11 articles were rejected, and 29 articles were fully read, although two had to be rejected due to a lack of access to the full version. Finally, 27 references were included in the review. RESULTS Few studies exist on PA during pregnancy in Africa. The limited data available suggests that, compared to the Western world, pregnant women in Africa do not adhere to the recommendations for PA during pregnancy. Levels of participation in PA during pregnancy are low and decline as the pregnancy progresses. The majority of the studies used direct, objective measures to assess PA during pregnancy. Personal and environmental factors such as lack of time, lack of knowledge, inadequate information from healthcare providers, feelings of tiredness and an absence of social support constituted the main barriers to PA during pregnancy. The types of PA participation among pregnant women varied across studies and geographical settings. CONCLUSIONS While published data is limited, it seems clear that the participation of pregnant women in PA during pregnancy in Africa is low and declines with advancing pregnancy. There is a need for more studies to examine the dynamics of PA during pregnancy in Africa to guide contextual interventions to improve and promote maternal health on the continent.
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Affiliation(s)
- Uchenna Benedine Okafor
- Department of Nursing Science, University of Fort Hare, 50 Church Street, 5201, East London, South Africa.
| | - Daniel Ter Goon
- Department of Public Health, University of Fort Hare, 05 Oxford Street, East London, South Africa
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Determinants of Maternal Behavior of Mobile Phone Use during Pregnancy. JOURNAL OF HEALTHCARE ENGINEERING 2020; 2020:9465019. [PMID: 33149872 PMCID: PMC7603607 DOI: 10.1155/2020/9465019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 09/20/2020] [Accepted: 09/27/2020] [Indexed: 11/17/2022]
Abstract
Excessive use of mobile phones might bring negative physical and psychological consequences to pregnant women. This study aims to explore the potential determinants of pregnant women's mobile phone use behavior to assist healthcare providers in the development of guideline programs. In order to explain the behavior, we developed a theoretical model based on the widely applied theory of planned behavior (TPB) by incorporating two additional constructs of personal habit and perceived risk. Structural equation modeling technique is employed to estimate the model based on questionnaire survey. Research results clearly show that behavior attitude and perceived behavior control play dominant roles in determining the intention and behavior. It is interesting to find that perceived risk and personal habit are less important in determining pregnant women's behavior of mobile phone use. Finally, suggestions are put forward to reduce the risk of mobile phone use during pregnancy.
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Abstract
Importance The pandemic of obesity during pregnancy now afflicts 1 out of every 2 pregnant women in the United States. Even though unintended pregnancy has decreased to 45% of all pregnancies, 50% of those unintended pregnancies occur in obese women. Objective This study aims to identify why current lifestyle interventions for obese pregnancy are not effective and what the newer complications are for obesity during pregnancy. Evidence Acquisition Available literatures on current treatments for maternal obesity were reviewed for effectiveness. Emerging maternal and infant complications from obesity during pregnancy were examined for significance. Results Limitations in successful interventions fell into 3 basic categories to include the following: (1) preconception weight loss; (2) bariatric surgery before pregnancy; and (3) prevention of excessive gestational weight gain during pregnancy. Emerging significant physiological changes from maternal obesity is composed of inflammation (placenta and human milk), metabolism (hormones, microbiome, fatty acids), and offspring outcomes (body composition, congenital malformations, chronic kidney disease, asthma, neurodevelopment, and behavior). Conclusions and Relevance Are current prepregnancy lifestyle and behavioral interventions feasible to prevent maternal obesity complications? Epigenetic and metabolomic research will be critical to determine what is needed to blunt the effects of maternal obesity and to discover successful treatment.
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Maxwell C, Gaudet L, Cassir G, Nowik C, McLeod NL, Jacob CÉ, Walker M. Guideline No. 391-Pregnancy and Maternal Obesity Part 1: Pre-conception and Prenatal Care. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 41:1623-1640. [PMID: 31640864 DOI: 10.1016/j.jogc.2019.03.026] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This guideline will review key aspects in the pregnancy care of women with obesity. Part I will focus on pre-conception and pregnancy care. Part II will focus on team planning for delivery and Postpartum Care. INTENDED USERS All health care providers (obstetricians, family doctors, midwives, nurses, anaesthesiologists) who provide pregnancy-related care to women with obesity. TARGET POPULATION Women with obesity who are pregnant or planning pregnancies. EVIDENCE Literature was retrieved through searches of Statistics Canada, Medline, and The Cochrane Library on the impact of obesity in pregnancy on antepartum and intrapartum care, maternal morbidity and mortality, obstetrical anaesthesia, and perinatal morbidity and mortality. Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to September 2018. Grey (unpublished) literature was identified through searching the websites of health technology assessment and related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. VALIDATION METHODS The content and recommendations were drafted and agreed upon by the authors. Then the Maternal-Fetal Medicine Committee peer reviewed the content and submitted comments for consideration, and the Board of the Society of Obstetricians and Gynaecologists of Canada (SOGC) approved the final draft for publication. Areas of disagreement were discussed during meetings, at which time consensus was reached. The level of evidence and quality of the recommendation made were described using the Evaluation of Evidence criteria of the Canadian Task Force on Preventive Health Care. BENEFITS, HARMS, AND COSTS Implementation of the recommendations in these guidelines may increase obstetrical provider recognition of the issues affected pregnant individuals with obesity, including clinical prevention strategies, communication between the health care team, the patient and family as well as equipment and human resource planning. It is hoped that regional, provincial and federal agencies will assist in the education and support of coordinated care for pregnant individuals with obesity. GUIDELINE UPDATE SOGC guidelines will be automatically reviewed 5 years after publication. However, authors can propose another review date if they feel that 5 years is too short/long based on their expert knowledge of the subject matter. SPONSORS This guideline was developed with resources funded by the SOGC. SUMMARY STATEMENTS RECOMMENDATIONS.
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Dow ML, Szymanski LM. Effects of Overweight and Obesity in Pregnancy on Health of the Offspring. Endocrinol Metab Clin North Am 2020; 49:251-263. [PMID: 32418588 DOI: 10.1016/j.ecl.2020.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Overweight and obesity in pregnancy confer a wide range of risks on mother, fetus, and offspring throughout their lives. In addition to compounding many common pregnancy complications, including both iatrogenic preterm delivery and cesarean delivery, obesity is associated with multiple fetal anomalies, metabolic sequelae including diabetes and obesity, allergy and asthma, attention-deficit disorder, and likely many other challenges for the offspring. As targeted interventions are being developed, encouraging solid nutrition and exercise in women of childbearing age may stave off risks and mitigate obesity in the next generation.
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Affiliation(s)
- Margaret L Dow
- Mayo Clinic, 200 First Street Southwest, Rochester, MN 59505, USA.
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Yan W, Wang X, Kuang H, Chen Y, Baktash MB, Eskenazi B, Ye L, Fang K, Xia Y. Physical activity and blood pressure during pregnancy: Mediation by anxiety symptoms. J Affect Disord 2020; 264:376-382. [PMID: 31759664 DOI: 10.1016/j.jad.2019.11.056] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/04/2019] [Accepted: 11/10/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND During pregnancy, physiological systems and psychological perceptions vary across individuals. Prenatal physical activity has been linked to reduced anxiety symptoms and lower blood pressure values. However, whether anxiety symptoms can mediate the relationship between physical activity and blood pressure during pregnancy remains unclear. METHODS In this prospective cohort study, 1275 pregnant women enrolled in Nanjing, China. Life behaviours and anxiety symptoms were investigated during the first trimester. Anxiety symptoms were measured by the Self-Rating Anxiety Scale. Blood pressure values were taken during the third trimester. Multivariate linear regression models were used to estimate the associations of physical activity with anxiety symptoms and blood pressure, and mediating effect models were used to detect the regulating effect by anxiety. RESULTS The participants were assigned to 3 groups based on their frequency and intensity of physical activity, and those who engaged in regular physical activity had lower blood pressure values. Anxiety symptoms were milder in the regular group than in the insufficient group. Partial mediating effect of anxiety on the association between regular physical activity and systolic blood pressure was significant after accounting for some confounders. LIMITATIONS The participants' physical activity and anxiety symptoms were self-reported, as well as the lack of details of physical activity during pregnancy may restrict the power of our findings. CONCLUSIONS Regular physical activity might be beneficial for anxiety and blood pressure. Physical activity likely stabilises systolic blood pressure by alleviating anxiety symptoms. Our research could provide a positive theoretical reference for guiding prenatal care.
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Affiliation(s)
- Wu Yan
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
| | - Xu Wang
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
| | - Hualong Kuang
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
| | - Ying Chen
- Central Laboratory, Nanjing Medical University Affiliated Wuxi Maternity and Child Health Care Hospital, Wuxi, Jiangsu 214002, China.
| | - Mohammad Basir Baktash
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
| | - Brenda Eskenazi
- Center for Environmental Research on Children's Health, University of California, Berkeley, CA, USA.
| | - Lin Ye
- Taizhou Maternal and Child Health Care Center, Taizhou, Jiangsu 225300, China.
| | - Kacey Fang
- Department of Cognitive Science, Yale University, New Haven, CT, USA.
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine, Institute of Toxicology, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
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Maxwell C, Gaudet L, Cassir G, Nowik C, McLeod NL, Jacob CÉ, Walker M. Directive clinique N o 391 - Grossesse et obésité maternelle Partie 1 : Préconception et soins prénataux. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019; 41:1641-1659. [PMID: 31640865 DOI: 10.1016/j.jogc.2019.08.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Garland M, Wilbur J, Semanik P, Fogg L. Correlates of Physical Activity During Pregnancy: A Systematic Review with Implications for Evidence‐based Practice. Worldviews Evid Based Nurs 2019; 16:310-318. [DOI: 10.1111/wvn.12391] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Louis Fogg
- Rush University College of Nursing Chicago IL USA
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12
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Shahnazi H, Abdolalian N, Kazemi A, Hassanzadeh A. Designing an educational intervention to prevent excessive gestational weight gain: a protocol for a randomized controlled trial. Reprod Health 2019; 16:31. [PMID: 30866980 PMCID: PMC6417265 DOI: 10.1186/s12978-019-0696-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 03/05/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pregnancy as one of the critical stages of life carries a high risk to the health of pregnant women. The amount of weight gained during pregnancy can affect the woman and her infant health immediately or in the future. The present study is conducted to design and explore the effectiveness of an educational intervention based on health belief model (HBM) to preventing excessive gestational weight gain (GWG). METHODS This research-based planning is designed in three phases and will be conducted on pregnant women in first trimester. In the first phase of this randomized controlled trial study, body mass index (BMI), the level of knowledge and the level of the HBM constructs will be measured using a questionnaire. The HBM questionnaire is designed based on a literature review and experts opinions. In the next phase the educational program content will be designed based on the results of the first phase of the study on the level of women's knowledge, and HBM constructs as well as a literature review and experts opinions. The intervention will be designed in four training sessions about the importance of behaviors, especially physical activity and nutrition, in the prevention of excessive weight gain during pregnancy. The tired phase includes the implementation of educational intervention with two intervention and control groups. The efficacy of the program will be evaluated by measuring the level of the knowledge, HBM constructs and women's weight gain during pregnancy in the second and third trimesters. Appreciate weight gain will be considered according to the BMI in first trimester. DISCUSSION The present study will provide strong information regarding the effetiness of the HBM and appropriate framework to develop educational interventions together with enhancing pregnant women's knowledge and belief toward weight management behaviors. TRIAL REGISTRATION Registration of this randomized control trial has been completed with the Iranian Registry of Clinical Trials, IRCT20180703040325N1 . Date of registration: 2018-08-20.
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Affiliation(s)
- Hossein Shahnazi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nafiseh Abdolalian
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Science, Isfahan, Iran.
| | - Akbar Hassanzadeh
- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Snyder K, Dinkel D. Mental and physical support (MAPS) for moms: preliminary findings from a prenatal health support program. Integr Med Res 2019; 8:8-14. [PMID: 30596013 PMCID: PMC6309116 DOI: 10.1016/j.imr.2018.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 10/18/2018] [Accepted: 10/23/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The low incidence of exercise during pregnancy and the high rates of prenatal depression indicate more opportunities are needed for mothers to engage in exercise and obtain health-related support and education. MAPS (mental & physical support) was developed to support mothers' psychological and physical health during pregnancy. MAPS consisted of physical activity classes 2×/week followed by either a speaker or group discussion regarding a parenting or health-related topic. The primary purpose of this study was to determine if the format was feasible prior to developing a main scale randomized trial. METHODS Program measurements included a pre/post survey, post-program focus group, attendance logs and scales for exercise, self-efficacy, and social support. RESULTS Findings indicated the program format is well-received by participants; however, issues in attendance warrant program format alterations. Further, larger scale studies and the addition of a control group are needed. CONCLUSION This format offers practitioners an effective strategy for supporting pregnant women's physical and psychological health.
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Affiliation(s)
- Kailey Snyder
- School of Health & Kinesiology, University of Nebraska at Omaha, Omaha, United States
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Rodríguez-González GL, Castro-Rodríguez DC, Zambrano E. Pregnancy and Lactation: A Window of Opportunity to Improve Individual Health. Methods Mol Biol 2018; 1735:115-144. [PMID: 29380310 DOI: 10.1007/978-1-4939-7614-0_7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Human and animal studies indicate that obesity during pregnancy adversely impacts both maternal health and offspring phenotype predisposing them to chronic diseases later in life including obesity, dyslipidemia, type 2 diabetes mellitus, and hypertension. Effective interventions during human pregnancy and/or lactation are needed to improve both maternal and offspring health. This review addresses the relationship between adverse perinatal insults and its negative impact on offspring development and presents some maternal intervention studies such as diet modification, probiotic consumption, or maternal exercise, to prevent or alleviate the negative outcomes in both the mother and her child.
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Affiliation(s)
- Guadalupe L Rodríguez-González
- Reproductive Biology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Diana C Castro-Rodríguez
- Reproductive Biology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Elena Zambrano
- Reproductive Biology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
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Chiavaroli V, Hopkins SA, Derraik JGB, Biggs JB, Rodrigues RO, Brennan CH, Seneviratne SN, Higgins C, Baldi JC, McCowan LME, Cutfield WS, Hofman PL. Exercise in pregnancy: 1-year and 7-year follow-ups of mothers and offspring after a randomized controlled trial. Sci Rep 2018; 8:12915. [PMID: 30150651 PMCID: PMC6110723 DOI: 10.1038/s41598-018-30925-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 07/20/2018] [Indexed: 01/21/2023] Open
Abstract
There are limited data on long-term outcomes of mothers or their offspring following exercise interventions during pregnancy. We assessed long-term effects of an exercise intervention (home-based stationary cycling) between 20–36 weeks of gestation on anthropometry and body composition in mothers and offspring after 1 and 7 years. 84 women were randomised to intervention or usual activity, with follow-up data available for 61 mother-child pairs (38 exercisers) at 1 year and 57 (33 exercisers) at 7 years. At 1 year, there were no observed differences in measured outcomes between mothers and offspring in the two groups. At the 7-year follow-up, mothers were mostly similar, except that exercisers had lower systolic blood pressure (−6.2 mmHg; p = 0.049). However, offspring of mothers who exercised during pregnancy had increased total body fat (+3.2%; p = 0.034) and greater abdominal (+4.1% android fat; p = 0.040) and gynoid (+3.5% gynoid fat; p = 0.042) adiposity compared with controls. Exercise interventions beginning during pregnancy may be beneficial to long-term maternal health. However, the initiation of exercise during pregnancy amongst sedentary mothers may be associated with adverse effects in the offspring during childhood. Larger follow-up studies are required to investigate long-term effects of exercise in pregnancy.
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Affiliation(s)
| | - Sarah A Hopkins
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Janene B Biggs
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | | | | | - Sumudu N Seneviratne
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Department of Paediatrics, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Chelsea Higgins
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - James C Baldi
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Lesley M E McCowan
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand.
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16
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Wang C, Wei Y, Yang H. Reply. Am J Obstet Gynecol 2017; 217:380-381. [PMID: 28502756 DOI: 10.1016/j.ajog.2017.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 05/04/2017] [Indexed: 11/27/2022]
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17
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van der Pligt P, Bick D, Furber C. Tackling maternal obesity: Building an evidence base to reflect the complexity of lifestyle behaviour change. Midwifery 2017; 49:1-3. [PMID: 28215699 DOI: 10.1016/j.midw.2017.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Paige van der Pligt
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Australia.
| | - Debra Bick
- King's College London, Florence Nightingale Faculty of Nursing and Midwifery/Women's Health Division, London, UK
| | - Christine Furber
- Faculty of Biology, Medicine and Health, University of Manchester, UK
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18
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19
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Seneviratne SN, Jiang Y, Derraik JGB, McCowan LME, Parry GK, Biggs JB, Craigie S, Gusso S, Peres G, Rodrigues RO, Ekeroma A, Cutfield WS, Hofman PL. Effects of antenatal exercise in overweight and obese pregnant women on maternal and perinatal outcomes: a randomised controlled trial. BJOG 2015; 123:588-97. [DOI: 10.1111/1471-0528.13738] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2015] [Indexed: 01/30/2023]
Affiliation(s)
- SN Seneviratne
- Liggins Institute; University of Auckland; Auckland New Zealand
- Gravida: National Centre for Growth and Development; Auckland New Zealand
| | - Y Jiang
- Department of Statistics; University of Auckland; Auckland New Zealand
| | - JGB Derraik
- Liggins Institute; University of Auckland; Auckland New Zealand
| | - LME McCowan
- Gravida: National Centre for Growth and Development; Auckland New Zealand
- Department of Obstetrics and Gynaecology; Faculty of Medical and Health Science; University of Auckland; Auckland New Zealand
| | - GK Parry
- Department of Obstetrics and Gynaecology; Faculty of Medical and Health Science; University of Auckland; Auckland New Zealand
| | - JB Biggs
- Liggins Institute; University of Auckland; Auckland New Zealand
| | - S Craigie
- Liggins Institute; University of Auckland; Auckland New Zealand
| | - S Gusso
- Liggins Institute; University of Auckland; Auckland New Zealand
| | - G Peres
- Liggins Institute; University of Auckland; Auckland New Zealand
| | - RO Rodrigues
- Liggins Institute; University of Auckland; Auckland New Zealand
| | - A Ekeroma
- Department of Obstetrics and Gynaecology; Faculty of Medical and Health Science; University of Auckland; Auckland New Zealand
| | - WS Cutfield
- Liggins Institute; University of Auckland; Auckland New Zealand
- Gravida: National Centre for Growth and Development; Auckland New Zealand
| | - PL Hofman
- Liggins Institute; University of Auckland; Auckland New Zealand
- Gravida: National Centre for Growth and Development; Auckland New Zealand
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