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Aktaş Reyhan F. Determination of exercise attitudes of women of reproductive age in pregnancy. Eur J Obstet Gynecol Reprod Biol X 2024; 21:100294. [PMID: 38495928 PMCID: PMC10940935 DOI: 10.1016/j.eurox.2024.100294] [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: 12/29/2023] [Revised: 02/16/2024] [Accepted: 02/28/2024] [Indexed: 03/19/2024] Open
Abstract
Objective This study was conducted to evaluate the exercise attitudes of women of reproductive age during pregnancy. Method The descriptive study was conducted with 326 women who applied to the gynecology outpatient clinics of a state hospital between September and November 2023. Data were collected with the "Personal Information Form" and "Exercise Attitudes in Pregnant Women Scale". Statistical analyses were analyzed at p < .05 significance level with the independent samples t test method. Results Most of the participants (85.6%) stated that they did not know the benefits of exercise during pregnancy and did not exercise during pregnancy (89.6%). The mean exercise attitude scale score of the participants was 135.42 ± 25.90. A significant difference was found between the participants' education level, exercising outside pregnancy, attending a pregnancy school, knowing the benefits of exercise during pregnancy and exercising during pregnancy and all sub-dimension scores (p < .05). Conclusion In the study, it was observed that the participants had positive attitudes towards exercise during pregnancy, although their knowledge and behaviors were insufficient. Women's attitudes towards exercise should be determined by health professionals and women's positive attitudes, knowledge and behaviors should be improved by organizing trainings and exercise programs starting from pre-pregnancy.
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Fernández-Buhigas I, Martin Arias A, Vargas-Terrones M, Brik M, Rolle V, Barakat R, Muñoz-Gonzalez MD, Refoyo I, Gil MM, Santacruz B. Fetal and maternal Doppler adaptation to maternal exercise during pregnancy: a randomized controlled trial. J Matern Fetal Neonatal Med 2023; 36:2183759. [PMID: 36889747 DOI: 10.1080/14767058.2023.2183759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
BACKGROUND Regular and supervised exercise during pregnancy is worldwide recommended due to its proven benefits, but, during exercise, maternal blood flow is redirected from the viscera to the muscles and how fetal wellbeing may be affected by this redistribution is still not well known. OBJECTIVE To analyze the longitudinal effect of a supervised moderate physical exercise program during pregnancy on uteroplacental and fetal Doppler parameters. METHODS This is a planned secondary analysis of an randomized controlled trial (RCT), performed at Hospital Universitario de Torrejón, Madrid, Spain, including 124 women randomized from 12+0 to 15+6 weeks of gestation to exercise vs. control group. Fetal umbilical artery (UA), middle cerebral artery, and uterine artery pulsatility index (PI), were longitudinally collected by Doppler ultrasound assessment throughout gestation, and derived cerebroplacental ratio (normalized by z-score), and maternal mean PI in the uterine arteries (normalized by multiplies of the median). Obstetric appointments were scheduled at 12 (baseline, 12+0 to 13+5), 20 (19+0 to 24+2), 28 (26+3 to 31+3) and 35 weeks (32+6 to 38+6) of gestation. Generalized estimating equations were adjusted to assess longitudinal changes in the Doppler measurements according to the randomization group. RESULTS No significant differences in the fetal or maternal Doppler measurements were found at any of the different checkup time points studied. The only variable that consistently affected the Doppler standardized values was gestational age at the time of assessment. The evolution of the UA PI z-score during the pregnancy was different in the two study groups, with a higher z-score in the exercise group at 20 weeks and a subsequent decrease until delivery while in the control group it remained stable at around zero. CONCLUSIONS A regular supervised moderate exercise program during pregnancy does not deteriorate fetal or maternal ultrasound Doppler parameters along the pregnancy, suggesting that the fetal well-being is not compromised by the exercise intervention. Fetal UA PI z-score decreases during pregnancy to lower levels in the exercise group compared with the control group.
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Affiliation(s)
- Irene Fernández-Buhigas
- Obstetrics and Gynecology Department, Hospital Universitario de Torrejón, Madrid, Spain.,School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Aranzazu Martin Arias
- Obstetrics and Gynecology Department, Hospital Universitario de Torrejón, Madrid, Spain.,School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Marina Vargas-Terrones
- AFIPE Research Group, Faculty of Sciences for Physical Activity and Sport, INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Maia Brik
- Obstetrics and Gynecology Department, Hospital Universitario de Torrejón, Madrid, Spain.,School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Valeria Rolle
- Biostatistics and Epidemiology Platform at Fundación para la Investigación e Innovación Biosanitaria del Principado de Asturias, Oviedo, Spain
| | - Rubén Barakat
- AFIPE Research Group, Faculty of Sciences for Physical Activity and Sport, INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - María D Muñoz-Gonzalez
- Obstetrics and Gynecology Department, Hospital Universitario de Torrejón, Madrid, Spain.,School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Ignacio Refoyo
- AFIPE Research Group, Faculty of Sciences for Physical Activity and Sport, INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Maria M Gil
- Obstetrics and Gynecology Department, Hospital Universitario de Torrejón, Madrid, Spain.,School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Belén Santacruz
- Obstetrics and Gynecology Department, Hospital Universitario de Torrejón, Madrid, Spain.,School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
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Chatzakis C, Mastorakos G, Demertzidou E, Theodoridou A, Dinas K, Sotiriadis A. The Impact of a Single Supervised Exercise Session in the Third Trimester of Pregnancy on the Physical Activity Levels of Pregnant Women-A Pilot Study. Clin Pract 2023; 13:1227-1235. [PMID: 37887086 PMCID: PMC10605668 DOI: 10.3390/clinpract13050110] [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: 07/29/2023] [Revised: 09/16/2023] [Accepted: 09/28/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Despite the numerous beneficial effects of physical exercise during pregnancy, the levels of physical activity remain low. The aim of the study is to investigate the impact of a single supervised physical exercise session on the overall physical activity levels of pregnant women. METHODS During the third trimester, pregnant women attending our outpatient clinic were requested to assess their physical activity levels using the International Physical Activity Questionnaire (IPAQ). Additionally, they were invited to participate in a supervised 30 min mild-moderate-intensity aerobic exercise session (stationary bike ergometer) under the guidance of medical personnel. Subsequently, physical activity levels were reevaluated at the time of delivery. RESULTS Prior to the intervention, 3 out of 50 (6%) women engaged in mild-moderate physical activity for 150 min per week, while 20 out of 50 (40%) women participated in mild-moderate activity for 15-30 min, twice a week. Following the intervention, these percentages increased to 10 out of 50 (20%) and 31 out of 50 (62%), respectively (p < 0.05). CONCLUSIONS This pilot study suggests that a single exercise session supervised by medical personnel may significantly improve the low physical activity levels observed in pregnant women.
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Affiliation(s)
- Christos Chatzakis
- Second Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece; (C.C.)
| | - George Mastorakos
- Endocrine Unit of Aretaieion Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Eleftheria Demertzidou
- Second Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece; (C.C.)
| | - Anatoli Theodoridou
- Midwifery Department, School of Health Sciences, International Hellenic University, 65404 Thessaloniki, Greece
| | - Konstantinos Dinas
- Second Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece; (C.C.)
| | - Alexandros Sotiriadis
- Second Department of Obstetrics and Gynecology, School of Medicine, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece; (C.C.)
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Brown JY, Drakeley S, Duncan M, Knapp WP, Schefter ZJ, Barker N, Rouse CE, Maron B, Edelman ER, Valente AM, Economy KE. Moderate intensity exercise in pregnant patients with cardiovascular disease: A pilot study. Am Heart J 2023; 262:66-74. [PMID: 37072104 DOI: 10.1016/j.ahj.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/06/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Exercise in pregnancy has proven health benefits, yet the safety of exercise in patients with pre-existing cardiovascular disease (CVD) has not been established. Our aim was to determine the feasibility and safety profile of moderate intensity exercise during pregnancy in patients with CVD, compared with those without CVD. METHODS This is a prospective single center pilot study of a moderate intensity exercise regimen, with data collection through wearable fitness trackers and personal exercise logs in pregnant patients with and without pre-existing CVD. The primary outcome was Doppler umbilical artery systolic to diastolic (S/D) ratio measured between 32 and 34 weeks' gestation. The secondary outcomes were adverse maternal and fetal events, trends in wearable fitness tracker data, C-reactive protein levels, and weight changes. RESULTS At baseline, the CVD group (62% congenital heart disease) took part in more prepregnancy walking, less weightlifting, and had a higher body mass index compared to the control group, and on average walked 539 fewer steps per day during pregnancy than the control group. Resting heart rate (HR) was found to increase in both groups up to 30 weeks' gestation. The cardiovascular disease group displayed an overall lower exercise intensity, as measured by the ability to increase HR with exercise over resting heart rate 1 hour prior to exercise at study baseline (45% vs 59% P < .001). Umbilical artery S/D ratio was normal in both groups. No differences were seen in adverse events between groups. CONCLUSIONS This pilot study of moderate intensity exercise in pregnant individuals with pre-existing CVD demonstrated that patients with CVD were not able to increase their HR during exercise throughout pregnancy compared to those in the control group. Although a small study group, this data supports the hypothesis that exercise interventions during pregnancy for patients with CVD are feasible without evidence abnormal fetal Doppler profiles. Further studies using wearable fitness trackers may provide the opportunity to understand how to safely tailor exercise programs to pregnant individuals with CVD.
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Affiliation(s)
- Jonathan Y Brown
- Harvard-MIT Biomedical Engineering Center, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA.
| | - Sheila Drakeley
- Department of Cardiology, Boston Children's Hospital, Boston, MA
| | - Madeline Duncan
- Department of Cardiology, Boston Children's Hospital, Boston, MA
| | - William P Knapp
- Department of Cardiology, Boston Children's Hospital, Boston, MA
| | - Zoë J Schefter
- Department of Cardiology, Boston Children's Hospital, Boston, MA
| | - Nancy Barker
- Department of Cardiology, Boston Children's Hospital, Boston, MA
| | | | - Bradley Maron
- Department of Medicine, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA
| | - Elazer R Edelman
- Harvard-MIT Biomedical Engineering Center, Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, MA; Department of Medicine, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA
| | - Anne M Valente
- Department of Cardiology, Boston Children's Hospital, Boston, MA; Department of Medicine, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA; Department of Medicine, Harvard Medical School, Boston, MA
| | - Katherine E Economy
- Department of Medicine, Harvard Medical School, Boston, MA; Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Brigham and Women's Hospital, Boston, MA
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Priviero F. Epigenetic modifications and fetal programming: Molecular mechanisms to control hypertension inheritance. Biochem Pharmacol 2023; 208:115412. [PMID: 36632959 PMCID: PMC10012045 DOI: 10.1016/j.bcp.2023.115412] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023]
Abstract
Cardiovascular diseases (CVD) are the number 1 cause of death in the United States and hypertension is a highly prevalent risk factor for CVD. It is estimated that up to 50 % of the hypertensive trait is genetically inherited while the other 50 % is determined by modifiable factors involving lifestyle, behaviors, and the environment. Interestingly, the hypertensive trait is induced or inhibited by epigenetic modifications modulated by modifiable factors. This review focused on the underlying mechanisms of stress, sleep deprivation, obesity and sedentarism as key players for epigenetic modifications contributing to the development of the hypertensive trait and, on the other hand, how epigenetic modifications induced by physical exercise and healthier habits may contribute to overturn and prevent the inheritance of hypertension trait. Furthermore, adversities during gestation and perinatal life also increase the risk for hypertension and CVD later in life, which can perpetuate the inheritance of the hypertensive trait whereas healthier habits during gestation and lactation may counteract fetal programming to improve the cardiovascular health of the progeny. Therefore, it is promising that a healthier lifestyle causes long-lasting epigenetic modifications and is transmitted to the next generation, strengthening the fight against the inheritance of hypertension.
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Affiliation(s)
- Fernanda Priviero
- Department of Cell Biology and Anatomy - School of Medicine, University of South Carolina, Columbia, SC, United States; Cardiovascular Translational Research Center - School of Medicine, University of South Carolina, Columbia, SC, United States; College of Engineering and Computing, Biomedical Engineering Program, University of South Carolina, Columbia, SC, United States.
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Hyvärinen M, Schläppy F, de Labrusse C, Wegrzyk J. Pedagogical innovation to promote physical activity in pregnancy: Interprofessional and real-life settings on the example of the educational program Move Your Baby. Eur J Midwifery 2022; 6:32. [PMID: 35664014 PMCID: PMC9132109 DOI: 10.18332/ejm/146629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/18/2022] [Accepted: 02/10/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Despite scientific evidence on health benefits of an active lifestyle during and after pregnancy, a gap still exists between current and recommended practice in physical activity counselling. Undergraduate education in midwifery is fundamental for physical activity promotion in professional practice. The aim of this article is to present pedagogical aspects, preliminary results and discuss the relevance of the educational program Move Your Baby. METHODS Between 2018 and 2020, 23 midwifery students (BSc) participated in the program at the School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western, Lausanne, Switzerland. Theoretical and practical workshops as well as adapted physical activity sessions, in direct contact with pregnant women, were offered and supervised by professional midwives and one expert in adapted physical activity. Data analysis based on an exploratory self-administered questionnaire was performed to rate pedagogical effectiveness, perceived skill level and identify barriers and facilitators to promote physical activity in their future profession. RESULTS Midwifery students perceived improvement in their knowledge, skills and confidence to promote physical activity during pregnancy. They rated the program as pedagogically effective. However, several barriers were identified such as lack of time and material resources to promote physical activity in professional practice. CONCLUSIONS This community-oriented educational program based on interplay of theory, hands-on experience and interprofessional collaboration was rated successful. Teaching physical activity in real-life settings facilitates midwifery students to identify with their professional role in the field of health promotion. Midwifery students require more opportunities to promote physical activity in their professional practice.
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Affiliation(s)
- Mathilde Hyvärinen
- Department of Research, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
- Department of Health Promotion and Prevention, University Center for Primary Care and Public Health (Unisanté), Lausanne, Switzerland
| | - Franziska Schläppy
- Department of Midwifery, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Claire de Labrusse
- Department of Midwifery, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Jennifer Wegrzyk
- Department of Research, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
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Iobst SE, Phillips AK, Foster G, Wasserman J, Wilson C. Integrative Review of Racial Disparities in Perinatal Outcomes Among Beneficiaries of the Military Health System. J Obstet Gynecol Neonatal Nurs 2022; 51:16-28. [PMID: 34626568 DOI: 10.1016/j.jogn.2021.09.002] [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] [Accepted: 09/14/2021] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To examine the extent to which racial disparities exist in the perinatal outcomes of beneficiaries of the Military Health System (MHS). DATA SOURCES We searched the PubMed, CINAHL, and Embase databases. STUDY SELECTION We selected articles published in English in peer-reviewed journals in which the authors examined race in relation to perinatal outcomes among beneficiaries of the MHS. Date of publication was unrestricted through March 2021. DATA EXTRACTION Twenty-six articles met the inclusion criteria. We extracted data about study design, purpose, sample, setting, and results. We also assigned quality appraisal ratings to each article. DATA SYNTHESIS In most of the included articles, researchers observed differences in perinatal outcomes between Black and White women. Compared to White women, Black women had greater rates of cesarean birth, preterm birth, low birth weight, and small for gestational age neonates. White women had greater rates of postpartum depression than Black women. CONCLUSION Racial disparities in very low birth weight newborns and preterm birth may be smaller in the MHS than in the general population of the United States. The overall rates of preterm birth, cesarean birth, and neonatal mortality were lower for beneficiaries of the MHS than in the general population of the United States.
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Iobst SE, Phillips AK, Wilson C. Shared Decision-Making During Labor and Birth Among Low-Risk, Active Duty Women in the U.S. Military. Mil Med 2021; 187:e747-e756. [PMID: 34850083 DOI: 10.1093/milmed/usab486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/30/2021] [Accepted: 11/10/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION The cesarean birth rate of 24.7% in the Military Health System (MHS) is lower than the national rate of 31.7%. However, the MHS rate remains higher than the 15-19% threshold associated with optimal maternal and neonatal outcomes. For active duty servicewomen, increased morbidity associated with cesarean birth is likely to affect the ability to meet the demands of assigned missions. Several decision-points occur during pregnancy and after the onset of labor that can affect the likelihood of cesarean birth including choice of provider, choice of hospital, timing of admission, and type of fetal monitoring. Evidence suggests the overuse of labor interventions may be associated with cesarean birth. Shared decision-making (SDM) is a strategy that can be used to carefully consider the risks, benefits, and alternatives of each labor intervention and is shown to be associated with positive patient outcomes. Most existing evidence explores SDM as an interaction that occurs between women and their providers. Few studies have explored the role of stakeholders such as spouses, family members, friends, labor and delivery nurses, and doulas. Furthermore, little is known about the process of SDM during labor and childbirth in the hospital setting, particularly for active duty women in the U.S. military. The purpose of this study was to propose a framework that explains the process of SDM during labor and childbirth in the hospital setting for active duty women in the U.S. military. MATERIALS AND METHODS A qualitatively driven mixed-methods approach was conducted to propose a framework that explains the process of SDM during labor and childbirth in the hospital setting for active duty women in the U.S. military. Servicewomen were recruited from September 2019 to April 2020. Semi-structured interviews were analyzed using a constructivist grounded theory approach. Participants also completed the SDM Questionnaire (SDM-Q-9). RESULTS Interviews were conducted with 14 participants. The sample included servicewomen from the Air Force (n = 7), Army (n = 4), and Navy (n = 3). Two participants were enlisted and the remainder were officers. Ten births occurred at military treatment facilities (MTFs) and six births took place at civilian facilities. The mean score on the SDM Questionnaire was 86.7 (±11.6), indicating a high level of SDM. Various stakeholders (e.g., providers, labor and delivery nurses, doulas, spouses, family members, and friends) were involved in SDM at different points during labor and birth. The four stages of SDM included gathering information, identifying preferences, discussing options, and making decisions. Events that most often involved SDM were deciding when to travel to the hospital, deciding when to be admitted, and selecting a strategy for pain management. Military factors involved in SDM included sources of information, selecting and working with civilian providers, and delaying labor interventions to allow time for an active duty spouse to travel to the hospital. CONCLUSIONS SDM during labor and birth in the hospital setting is a multi-stage process that involves a variety of stakeholders, including the woman, members of her social and support network, and healthcare professionals. Future research is needed to explore perspectives of other stakeholders involved in SDM.
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Affiliation(s)
- Stacey E Iobst
- Department of Nursing, Towson University, Towson, MD 21252, USA
| | - Angela K Phillips
- Daniel K. Inouye Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.,Malcolm Grow Medical Clinics and Surgery Center, Joint Base Andrews, MD 20762, USA
| | - Candy Wilson
- Daniel K. Inouye Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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Integrative Review of Exercise at Altitude during Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179272. [PMID: 34501869 PMCID: PMC8430622 DOI: 10.3390/ijerph18179272] [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] [Received: 06/07/2021] [Revised: 08/19/2021] [Accepted: 08/29/2021] [Indexed: 11/17/2022]
Abstract
Many competitive and elite athletes continue to train throughout their pregnancies and many visit or live at altitude. The purpose of this integrative review is to synthesize, analyze and critique published studies regarding the safety of serious recreational or elite athletes exercising at altitude while pregnant. Seven databases were searched, and 157 documents were located, which were screened for appropriateness and reduced to seven articles that met the criteria. The studies were analyzed based on maternal and fetal outcomes. Current recommendations for exercising at altitude were based on sedentary individuals who frequently did not have the expected physiological responses based on research on pregnancy and altitude. It is unknown whether competitive and elite athletes would have similar responses to exercise at altitude. More research on exercise at altitude on individuals with a variety of fitness levels is needed.
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Díaz-Burrueco JR, Cano-Ibáñez N, Martín-Peláez S, Khan KS, Amezcua-Prieto C. Effects on the maternal-fetal health outcomes of various physical activity types in healthy pregnant women. A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2021; 262:203-215. [PMID: 34058612 DOI: 10.1016/j.ejogrb.2021.05.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 05/11/2021] [Accepted: 05/16/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Physical activity (PA) promotes health in pregnancy. OBJECTIVE To collate the recent randomized controlled trial (RCT) on the effects of various types of PA during pregnancy on maternal-fetal health outcomes, among healthy mothers, and to report the variability in the outcomes reported. SEARCH STRATEGY Registered in PROSPERO (CRD42019143522). Systematic search conducted in EMBASE, CENTRAL, MEDLINE and CINAHL, from 2015-2020. SELECTION CRITERIA RCT examining PA interventions and maternal-fetal outcomes. DATA COLLECTION AND ANALYSIS Were independently extracted by two reviewers. Quality of studies was assessed with Cochrane Collaboration's risk of bias tool. RESULTS 37 studies (6857 women) were included. PA had a protective effect on gestational weight gain (overall SMD -0.32, 95 % CI -0.46, -0.17, I2 77 %; supervised exercise SMD -0.15, 95 % CI -0.28, -0.02, I2 51 %; static cycling SMD -0.32, 95 % CI -0.59, -0.05; I2 49 %), gestational diabetes (overall OR 0.65, 95 % CI: 0.43, 0.98, I2 48 %), and hypertensive disorders (overall OR 0.51, 95 % CI: 0.31, 0.83, I2 0%). CONCLUSIONS PA in pregnancy had a preventive effect on weight gain, gestational diabetes, and hypertensive disorders. Supervised exercise and static cycling had a protective effect on gestational weight gain. Variation in outcomes reported suggest establishing a core outcome set.
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Affiliation(s)
- Javier Ramón Díaz-Burrueco
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
| | - Naomi Cano-Ibáñez
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain; CIBER de Epidemiología y Salud Pública, (CIBERESP), Granada, Spain; Instituto de Investigación Biosanitaria ibs, GRANADA, Granada, Spain.
| | - Sandra Martín-Peláez
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria ibs, GRANADA, Granada, Spain
| | - Khalid S Khan
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain; CIBER de Epidemiología y Salud Pública, (CIBERESP), Granada, Spain
| | - Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain; CIBER de Epidemiología y Salud Pública, (CIBERESP), Granada, Spain; Instituto de Investigación Biosanitaria ibs, GRANADA, Granada, Spain
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