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Almasaudi AS, Alashmali S, Zedan HS, Kutbi HA, Alharbi MD, Baattaiah BA. The associations between dairy product intake, fatigue status, and physical activity among postpartum women in Saudi Arabia: a cross-sectional study. BMC Public Health 2024; 24:2759. [PMID: 39385137 PMCID: PMC11465780 DOI: 10.1186/s12889-024-20294-2] [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: 10/17/2023] [Accepted: 10/04/2024] [Indexed: 10/11/2024] Open
Abstract
BACKGROUND Fatigue is a major issue that affects women during the postpartum period. A healthy dietary pattern and increased physical activity (PA) are commonly recommended lifestyle modifications to promote health during this time. However, little is known about the interrelationship between dairy product intake, PA level, and postpartum fatigue (PPF) among women. The aim of this study was to evaluate whether PPF is associated with dairy product intake in relation to PA level. METHODS A total of 242 women were included in this cross-sectional study. Data related to dairy product intake and PA were collected using a food frequency questionnaire and the International Physical Activity Questionnaire-Short Form, respectively. PPF was assessed using the Fatigue Severity Scale. Logistic regression models were used to examine associations between the intake of dairy products and PPF among women engaged in low, moderate, and high levels of PA while controlling for potential confounders. RESULTS Higher consumption rates of yogurt and total dairy predicted lower odds of PPF in women engaged in moderate levels of PA (aOR = 0.24 [95% CI = 0.07, 0.86] and 0.70 [95% CI = 0.53, 0.93], respectively). In women engaged in high levels of PA, lower odds of experiencing PPF were predicted by higher consumption rates of milk (aOR = 0.24 [95% CI = 0.07, 0.89]), yogurt (aOR = 0.21 [95% CI = 0.05, 0.83]), laban (aOR = 0.16 [95% CI = 0.03, 0.86]), and total dairy (aOR = 0.66 [95% CI = 0.47, 0.92]). However, no association was observed between dairy product intake and PPF in women with low levels of PA. CONCLUSIONS Higher consumption rates of dairy products were associated with lower odds for experiencing PPF, particularly for women engaged in moderate to high levels of PA. These findings support nutritional and PA promotion programs to moderate issues with PPF. However, the cross-sectional design of this study could limit the ability to infer causality between dairy intake, PA, and PPF. Further longitudinal studies are needed to establish causality and explore the mechanisms underlying these associations.
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Affiliation(s)
- Arwa S Almasaudi
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Shoug Alashmali
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Haya S Zedan
- Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh, 13316, Saudi Arabia
| | - Hebah A Kutbi
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Mutasim D Alharbi
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, P.O. Box 80324, Jeddah, 21589, Saudi Arabia
| | - Baian A Baattaiah
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, P.O. Box 80324, Jeddah, 21589, Saudi Arabia.
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Shuai Y, Wu J, Li C, Li D. Effect of different physical activity interventions on perinatal depression: a systematic review and network meta-analysis. BMC Public Health 2024; 24:2076. [PMID: 39085828 PMCID: PMC11293035 DOI: 10.1186/s12889-024-19564-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: 12/07/2023] [Accepted: 07/23/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Perinatal depression can have profound impacts on both families and society. Exercise therapy is gradually becoming a widely used adjunct treatment for perinatal depression. Some studies have already focused on the relationship between physical activity and perinatal depression (PND). However, there is currently a lack of systematic and comprehensive evidence to address the crucial question of making optimal choices among different forms of physical activity. This study aims to compare and rank different physical activity intervention strategies and identify the most effective one for perinatal depression. METHODS Four databases, namely PubMed, Cochrane Library, Embase, and Web of Science, were searched for randomized controlled trials assessing the impact of physical activity interventions on perinatal depression. The search covered the period from the inception of the databases until May 2024. Two researchers independently conducted literature screening, data extraction, and quality assessment. Network meta-analysis was performed using Stata 15.1. RESULTS A total of 48 studies were included in the analysis. The results indicate that relaxation therapy has the most effective outcome in reducing perinatal depression (SUCRA = 99.4%). Following that is mind-body exercise (SUCRA = 80.6%). Traditional aerobics and aquatic sports were also effective interventions (SUCRA = 70.9% and 67.1%, respectively). CONCLUSION Our study suggests that integrated mental and physical (MAP) training such as relaxation therapy and mind-body exercise show better performance in reducing perinatal depression. Additionally, while exercise has proven to be effective, the challenge lies in finding ways to encourage people to maintain a consistent exercise routine. TRIAL REGISTRATION This study has been registered on PROSPERO (CRD 42,023,469,537).
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Affiliation(s)
- Yu Shuai
- Hanjiang Normal University, Shiyan, China
- Chodang University, Muan, Republic of Korea
| | - Jinlong Wu
- College of physical education, Southwest University, Chongqing, China
| | - Chenmu Li
- Guangzhou Sport University, Guangzhou, China
| | - Dong Li
- Chodang University, Muan, Republic of Korea.
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Baattaiah BA, Alharbi MD, Aldhahi MI, Khan F. Factors associated with postpartum fatigue: an exploration of the moderating role of resilience. Front Public Health 2024; 12:1394380. [PMID: 38947349 PMCID: PMC11211369 DOI: 10.3389/fpubh.2024.1394380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 06/04/2024] [Indexed: 07/02/2024] Open
Abstract
Background Postpartum fatigue (PPF) can impair the physical and mental well-being of women. The aims of this study were to assess the associations between fatigue and maternal health-related variables, specifically, sleep quality, depression symptoms, and resilience, and to explore the moderating role of resilience in the relationships between sleep quality, depression symptoms, and fatigue. Methods This cross-sectional study used data collected from mothers during the postpartum period via an online platform. PPF was assessed using the Fatigue Severity Scale, whereas sleep quality and depression symptoms were assessed using the Pittsburgh Sleep Quality Index and Edinburgh Postnatal Depression Scale, respectively. The Brief Resilience Scale was used to assess resilience. Simple and multiple binary logistic regression analyses were performed to examine the association of each independent variable with PPF and to determine the most significant predictors of PFF. The data were analyzed using SPSS, and structural equation modeling was performed using AMOS 23. A moderation analysis was performed to explore the moderating role of resilience using the Hayes PROCESS macro. Results A total of 1,443 postpartum mothers were included in the analysis. The simple binary logistic regression analysis showed that having chronic disease (odds: 1.52; p = 0.02), mother's age (odds: 0.97; p = 0.03), mother's body mass index (BMI; odds: 1.03; p = 0.01), depression symptoms (odds: 1.09; p ≤ 0.0001), sleep quality (odds: 1.17; p ≤ 0.0001), and resilience (odds: 0.42; p ≤ 0.0001) all contributed to fatigue during postpartum. Multivariate logistic regression showed that the mother's BMI, sleep quality, depression symptoms, and resilience were significant predictors of PPF. Moderation analyses showed that resilience was not a significant moderator between the main effects of sleep quality and fatigue (interaction effect: β = 0.01, p = 0.31, 95% CI: -0.01 to 0.04) or between the main effects of depression symptoms and fatigue during postpartum (interaction effect: β = 0.01, p = 0.82, 95% CI: -0.01 to 0.02). Conclusion Given the deleterious effects of PPF on maternal health outcomes, factors associated with PPF should be assessed regularly. In addition to mothers' BMI, sleep quality, and depression symptoms, resilience could also be a crucial factor in predicting fatigue severity during this critical time for mothers even though it was not a significant moderator among this sample.
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Affiliation(s)
- Baian A. Baattaiah
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mutasim D. Alharbi
- Department of Physical Therapy, Faculty of Medical Rehabilitation 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, Riyadh, Saudi Arabia
| | - Fayaz Khan
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
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4
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Yang Z, Zhai H, Yang Z, Ning B. Comparing the efficacy of traditional Chinese exercises and general aerobic exercises in university students with sleep disorders: A systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e38521. [PMID: 38847687 PMCID: PMC11155542 DOI: 10.1097/md.0000000000038521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 05/17/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND The objective of this study was to compare the impact of traditional Chinese exercise (TCEs) and general aerobic exercise (GAEs) on the sleep quality of university students and to determine which exercise is more effective in improving sleep quality in this specific population. METHODS We utilized Review Manager 5.3 to analyze data from 21 randomized controlled trials (RCTs), which included a total of 1252 participants. Effect sizes of TCEs and GAEs were compared using a random-effects model. Subgroup analyses were conducted on 3 modulating variables: times per session, frequency per week, and period. RESULTS A Meta-analysis of 14 RCTs showed that both TCEs (standard mean difference [SMD] = -0.89, 95% CI: -1.18 to -0.61; P < .00001) and GAEs (SMD = -1.53, 95% CI: -2.10 to -0.97; P < .00001) can significantly improve the sleep of university students, with a significant difference between TCEs and GAEs (P = .05). Both GAEs and TCEs had positive effects on various aspects of sleep quality, including subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleep medication, and daytime dysfunction. A subgroup analysis of aerobic exercise showed that the effect size was larger in the 40 to 60 minutes group compared to the 60 to 90 minutes group (SMD = -1.89; 95% CI: -2.19 to -1.59; P < .00001). Furthermore, the effect size was larger in the 3 to 5 times per week group compared to the 2 times per week group (SMD = -1.56; 95% CI: -2.33 to -0.80; P < .0001). The effect size was also found to be larger in a period of 2 to 4 weeks compared to 6 to 18 weeks (SMD = -1.85; 95% CI: -2.17 to -1.54; P < .00001). CONCLUSION GAEs is more effective than TCEs in improving the sleep quality of university students. An optimal aerobic exercise regimen for enhancing sleep quality among university students involves engaging in sessions lasting 40~60 minutes, 3~5 times per week, over a duration of 4 weeks.
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Affiliation(s)
| | - Haiting Zhai
- Sports Coaching College, Beijing Sport University, Beijing, China
- School of Basic Sciences for Aviation, Naval Aviation University, Yantai, China
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5
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Ji M, Li R, Xu Y. Meta-analysis of the effect of different exercise modalities in the prevention and treatment of perinatal depression. J Affect Disord 2024; 350:442-451. [PMID: 38228277 DOI: 10.1016/j.jad.2024.01.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 12/24/2023] [Accepted: 01/04/2024] [Indexed: 01/18/2024]
Abstract
BACKGROUND The incidence of perinatal depression is increasing and has become a global public health problem to be addressed. OBJECTIVE To explore the prevention and treatment effects of different exercise methods on perinatal depression. METHODS A meta-analysis was conducted by searching databases for published "exercise interventions for perinatal depression "related randomized controlled trials, up to July 20, 2022. RESULTS 48 randomized controlled trials were included, with a total of 5282 pregnant women. (1) Exercise prevention of prenatal depression has a low effective stress intervention effect, ranking from high to low as yoga, aerobic+resistance. (2) Exercise therapy for prenatal depression has a significant intervention effect, followed by gymnastics, pelvic floor muscle training, aerobic exercise, aerobic+resistance, and yoga. (3) Exercise prevention of postpartum depression has a low effective intervention effect, followed by yoga, aerobic exercise, aerobic+resistance, and gymnastics. (4) Exercise has a moderate equivalent stress intervention effect on treating postpartum depression, followed by aerobic exercise, water exercise, yoga, fertility dance, and stroller walking. LIMITATIONS Due to the small number of included literature on single exercise modalities, and maternity is a special population, most of the trial procedures included in the text were not blinded, which has a certain risk of bias and affects the accuracy of the Meta-analysis results. CONCLUSIONS The therapeutic effect of exercise in the prevention and treatment of perinatal depression is superior to the preventive effect, and the effect of prenatal prevention and treatment is better than that of postpartum, with a moderate effect.
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Affiliation(s)
- Moufang Ji
- Postdoctoral Station of Physical Education, Central China Normal University, Wuhan, China; School of Physical Education, Hunan Institute of Science and Technology, Yueyang, China
| | - Ruobing Li
- School of Physical Education, Hunan Institute of Science and Technology, Yueyang, China
| | - Yizhe Xu
- School of Physical Education, Jianghan University, Wuhan, China.
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Witkowska-Zimny M, Zhyvotovska A, Isakov R, Boiko DI, Nieradko-Iwanicka B. Maternal Sleeping Problems Before and After Childbirth - A Systematic Review. Int J Womens Health 2024; 16:345-371. [PMID: 38455339 PMCID: PMC10918694 DOI: 10.2147/ijwh.s446490] [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: 10/25/2023] [Accepted: 01/22/2024] [Indexed: 03/09/2024] Open
Abstract
The perinatal and postpartum period is of great significance for women due to physiological changes, shifts in circadian rhythms, social setting, and psychological well-being, all of which affect the quality and quantity of their sleep. A mixed-studies systematic review was undertaken to enhance our understanding of sleep disturbances and mood disorders in women in late pregnancy and the postpartum period, their connection with breastfeeding, and the assessment of interventions for sleep disturbance. Three electronic databases (PUBMED, EMBASE and Google Scholar) were searched for qualitative, observational, and mixed-method studies from the year 2016 to June 2023. Twenty-nine articles were included in the analysis. The results were synthesized into four overarching themes: (і) the sleep quality of women in the perinatal period; (ii) the relationship between sleep and breastfeeding; (iii) the relationship between sleep quality and emotional disturbance in the perinatal period; (iv) sleep interventions in the researched group. The subjective nature of the perception of sleep disturbances, along with the absence of an objective measurement tool is clearly an inconvenience. It is advisable to include the assessment of maternal sleep hygiene and family sleep patterns during postpartum healthcare provider appointments to develop strategies not only for women's sleep quality but also for their mental well-being.
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Affiliation(s)
| | - Anastasiia Zhyvotovska
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
| | - Rustam Isakov
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
| | - Dmytro I Boiko
- Department of Psychiatry, Narcology and Medical Psychology, Poltava State Medical University, Poltava, Ukraine
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Sun J, Cui N, Shao D, Li J, Zhang H, Li J, Zhang X, Cao F. Association between trajectories of maternal depressive symptoms and length of hospital stay, hospitalization costs, and adverse maternal and infantile outcomes: A longitudinal observational study. Stress Health 2024; 40:e3291. [PMID: 37439545 DOI: 10.1002/smi.3291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 06/23/2023] [Accepted: 07/05/2023] [Indexed: 07/14/2023]
Abstract
This study aimed to determine the trajectories of perinatal depression and their relationship with length of hospital stay (LOS), hospitalization costs, and adverse maternal and infantile outcomes. This longitudinal observational study included 525 participants. Perinatal depressive symptoms were assessed at four waves (from the first trimester to the postpartum period). LOS, hospitalization costs, and adverse maternal (sleep, fatigue, anxiety, perceived stress, and memory problems) and infantile outcomes of participants were obtained from medical records and self-reported questionnaires. Trajectories of perinatal depressive symptoms were explored with latent class growth analysis. Associations between trajectories and adverse maternal and infant outcomes were explored with multiple linear regression and binary logistic regression models. The participants' average age was 29.6 ± 3.9 years. Five heterogeneous developmental trajectories of perinatal depressive symptoms were identified as follows: high-level (7.05%), moderate-increasing (12%), remission (15.05%), moderate-level (37.14%), and low-level (28.76%). The average LOS was 5.78 ± 2.13 days, and the average hospitalization costs were 12,695.27 ± 5457.51 yuan. Compared with the trajectory of low-level depressive symptoms, the LOS, hospitalization costs, and likelihood of adverse outcomes of women with high-level and moderate-increasing depressive symptom trajectories increased. The findings capture the heterogeneity of perinatal depression in Chinese women. Women in the moderate-increasing and high-level trajectory groups had longer LOS, more hospitalization costs, and poor birth outcomes. Elucidating the trajectories of perinatal depression and their relationship with maternal and infant health outcomes provides important insights into the development of person-centred care planning for women during pregnancy and postpartum.
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Affiliation(s)
- Jiwei Sun
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Naixue Cui
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Di Shao
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Jie Li
- School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Huihui Zhang
- Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Jiahuan Li
- School of Health and Nursing, Zhenjiang College, Zhenjiang, Jiangsu, China
| | - Xuan Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Fenglin Cao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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8
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Shehata MA, Basyouny SES, Atef H, Hussien HED, Botla AM. The SAFE study: Stress and fatigue control by exercise: Acute and long-term effects of aerobic exercise in lactating employed mothers. Work 2024; 77:641-649. [PMID: 37742675 DOI: 10.3233/wor-220677] [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] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Stress and fatigue experienced by lactating employed mothers can affect mothers' and babies' mental and physical health detrimentally. Aerobic exercise is known to control stress and fatigue, but the dosages of the exercises needed to maintain long-term effects are still under investigation. OBJECTIVE This study aimed to investigate the acute and long-term effects of aerobic exercise on controlling stress and fatigue in lactating, employed mothers. METHODS This randomized control study involved sixty lactating, employed mothers suffering from stress and fatigue. They were divided into two groups: Group A received five sessions of 30-minute aerobic training on a treadmill per week, in addition to lifestyle modification advice for six weeks. Group B received the same lifestyle routine advice for the same duration without being trained. Assessments of stress and fatigue levels were done before, after 6 weeks, and after 6 months from the baseline assessments using the Perceived Stress Scale (PSS-10) and Fatigue Assessment Scale (FAS), respectively. RESULTS Post-six-week comparisons within and between both groups showed a significant decline in PSS-10 and FAS in group A compared with group B (p < 0.001); however, after six months of follow-up, there were statistically significant effects within groups only (p < 0.05) and no statistically significant difference between groups at both variables (p > 0.05). CONCLUSION Aerobic exercises for 6 weeks can induce an acute but not long-term effect on stress and fatigue control in lactating-employed mothers. Future research is needed to tailor the exercise prescription needed to maintain training's long-term benefits.
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Affiliation(s)
- Mai Ali Shehata
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Sara El-Sayed Basyouny
- Department of Physiotherapy, Family Medicine Unit, Health Affairs Directorate, 10th of Ramadan (Ministry of Health), Al-Sharqiya, Egypt
| | - Hady Atef
- Department of Physical Therapy for Internal Medicine, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Hossam El-Dien Hussien
- Department of Gynecology and Obstetrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Afaf M Botla
- Department of Physical Therapy for Women's Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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Florkiewicz-Danel M, Zaręba K, Ciebiera M, Jakiel G. Quality of Life and Sexual Satisfaction in the Early Period of Motherhood-A Cross-Sectional Preliminary Study. J Clin Med 2023; 12:7597. [PMID: 38137665 PMCID: PMC10744264 DOI: 10.3390/jcm12247597] [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: 09/26/2023] [Revised: 12/07/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
The aim of the study was to assess the impact of breastfeeding-related fatigue and family support on the sexuality and quality of life of mothers during early motherhood. A cross-sectional preliminary study was conducted between 1 October 2021 and 15 May 2022 in 65 women being in early postpartum period. We used the authors' questionnaire developed for the purposes of the study; the Sexual Satisfaction Scale for Women-SSS-W; the Mell-Krat scale for women; and the General Health Questionnaire-GHQ28. A significant negative correlation was found between the age of the patients and the reduction in somatic symptoms (GHQ28 questionnaire) (r = -0.315, p = 0.011). Women working professionally achieved significantly higher results in the SSS-W contentment category (r = 0.313, p = 0.014). Frequent sexual activity reduced disorders in social functioning (the GHQ28 questionnaire) (r = -0.107, p = 0.283). Women who breastfed up to 5 times a day (p = 0.033) reached significantly higher SSS-W scores in terms of communication. The partner's help significantly contributed to higher sexual satisfaction in the aspect of compatibility (p = 0.004) and the overall level of satisfaction determined with the SSS-W questionnaire (p = 0.016). The presented study suggests that older mothers who are employed and supported by a partner have a higher level of contentment, sexual satisfaction and quality of life.
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Affiliation(s)
- Maria Florkiewicz-Danel
- Department of Nursing, Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, 00-968 Warszawa, Poland;
| | - Kornelia Zaręba
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences (CMHS), United Arab Emirates University (UAEU), Al Ain 17666, United Arab Emirates
| | - Michał Ciebiera
- 2nd Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education in Warsaw, 01-809 Warsaw, Poland;
- Warsaw Institute of Women’s Health, 00-189 Warsaw, Poland
| | - Grzegorz Jakiel
- 1st Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education in Warsaw, 01-004 Warsaw, Poland;
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Xu H, Liu R, Wang X, Yang J. Effectiveness of aerobic exercise in the prevention and treatment of postpartum depression: Meta-analysis and network meta-analysis. PLoS One 2023; 18:e0287650. [PMID: 38019729 PMCID: PMC10686497 DOI: 10.1371/journal.pone.0287650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Aerobic exercise is widely recognized for improving mental health and reducing negative emotions, including anxiety. However, research on its role in preventing and treating postpartum depression (PPD) has yielded inconsistent results. Some studies show positive effects on PPD symptoms, while others find limited impact, suggesting various factors at play, such as exercise type, intensity, and individual differences. To address this gap, our study aims to comprehensively gather evidence on the preventive and therapeutic effects of aerobic exercise for PPD. We'll focus on differences in exercise program design and implementation, exploring how these factors impact intervention outcomes. By identifying effective exercise approaches, we aim to provide more comprehensive exercise prescription recommendations for this vulnerable population. METHODS We conducted a quantitative systematic review of the study in 5 representative databases for the effect of aerobic exercise on PPD. Meta-analysis and network meta-analysis were performed with Review-Manager.5.4 and Stata.16.0 software, respectively. This study has been registered on the official Prospero website, and the registration code is CRD42023398221. RESULTS Twenty-six studies with 2,867 participants were eventually included and the efficacy of aerobic exercise in preventing and treating postpartum depression is significant compared to standard care. (MD = -1.90; 95%CL: -2.58 to -1.21; I2 = 86%). Subgroup analysis suggests that the intervention objective (prevention vs. treatment) of exercise could potentially be a source of heterogeneity in this study, as the "Test for subgroup difference" revealed the presence of significant distinctions (p = 0.02<0.05). The "Test for subgroup difference" yielded non-significant results for both the supervised vs. unsupervised subgroup comparison (p = 0.55 > 0.05) and the individual vs. team subgroup comparison (p = 0.78 > 0.05). Nonetheless, when assessing their effect sizes [Subtotal (95%CL)], the supervised exercise group [-1.66 (-2.48, -0.85)] exhibited a slightly better performance than the unsupervised exercise group [-1.37 (-1.86, -0.88)], while the team exercise group [-1.43 (-1.94, -0.93)] slightly outperformed the individual exercise group [-1.28 (-2.23, -0.33)]. Network meta-analysis indicated that moderate intensity (35~45 min) group demonstrated a more pronounced intervention effect compared to low intensity (50~60 min) group [-2.63 (-4.05, -1.21)] and high intensity (20~30 min) group [-2.96 (-4.51, -1.41)], while the 3~4 times/week group had a more significant intervention effect compared to 1~2 times/week groups [-2.91 (-3.99, -1.83)] and 5~6 times/week groups [-3.28 (-4.75, -1.81)]. No significant differences were observed in pairwise comparisons of intervention effects among the five common types of aerobic exercises. (95%CL including 0). The Surface Under the Cumulative Ranking curve (SUCRA) results align with the findings mentioned above and will not be reiterated here. CONCLUSION The efficacy of aerobic exercise in preventing and treating postpartum depression is significant compared to standard care, with a greater emphasis on prevention. The optimal prescribed exercise volume for intervention comprises a frequency of 3~4 exercise sessions per week, moderate intensity (35~45 minutes). Currently, several uncharted internal factors influence the optimal intervention effect of aerobic exercise, such as the potential enhancement brought by team-based and supervised exercise. Given the absence of significant differences in certain results and the limitations of the study, it is essential to exercise caution when interpreting the outcomes. Further research is needed in the future to provide a more comprehensive understanding.
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Affiliation(s)
- Hao Xu
- School of Physical Education, China University of Geosciences (Wuhan), Wuhan, China
| | - Renyi Liu
- School of Physical Education, China University of Geosciences (Wuhan), Wuhan, China
| | - Xiubing Wang
- School of Physical Education, China University of Geosciences (Wuhan), Wuhan, China
| | - Jiahui Yang
- School of Physical Education, China University of Geosciences (Wuhan), Wuhan, China
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Brites-Lagos C, Ramos L, Szumilewicz A, Santos-Rocha R. Feasibility of a Supervised Postpartum Exercise Program and Effects on Maternal Health and Fitness Parameters-Pilot Study. Healthcare (Basel) 2023; 11:2801. [PMID: 37893875 PMCID: PMC10606677 DOI: 10.3390/healthcare11202801] [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: 09/05/2023] [Revised: 09/27/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
The postpartum period is marked by profound changes in women at physical, psychological, and physiological levels. Many of these changes persist after four to six weeks postpartum, and most women do not resume their levels of physical activity, which increases the risk of remaining inactive for many years. It is crucial to implement effective programs that promote exercise during the postpartum period. The objective of this study was to test the feasibility and analyze the effects of a structured and supervised postpartum exercise program on maternal health and fitness parameters. To analyze the potential effects of the intervention, the level of physical activity, quality of life, pelvic girdle and low back pain, fatigue, depression, and the level of functional and physical fitness were assessed at baseline, after 8 weeks, and after 16 weeks of intervention. Feedback on the exercise program was collected after the final assessment. The results showed that a structured and supervised postpartum exercise program was feasible and safe and produced positive effects on selected maternal health and fitness parameters. These results will encourage a study protocol with a larger sample in order to prove its effectiveness, improve the guidelines for postpartum exercise, and incorporate this program into a routine healthcare setting.
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Affiliation(s)
- Carla Brites-Lagos
- ESDRM, Department of Physical Activity and Health, Sport Sciences School of Rio Maior, Polytechnic Institute of Santarem, 2040-413 Rio Maior, Portugal; (C.B.-L.); (L.R.)
| | - Liliana Ramos
- ESDRM, Department of Physical Activity and Health, Sport Sciences School of Rio Maior, Polytechnic Institute of Santarem, 2040-413 Rio Maior, Portugal; (C.B.-L.); (L.R.)
- CIEQV, Life Quality Research Center, Polytechnic Institute of Santarem, 2040-413 Rio Maior, 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, Department of Physical Activity and Health, Sport Sciences School of Rio Maior, Polytechnic Institute of Santarem, 2040-413 Rio Maior, Portugal; (C.B.-L.); (L.R.)
- CIPER, Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, 1499-002 Cruz Quebrada, Portugal
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12
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Zedan HS, Baattaiah BA, Alashmali S, Almasaudi AS. Risk of Postpartum Depression: The Considerable Role of Maternal Health Status and Lifestyle. Healthcare (Basel) 2023; 11:2074. [PMID: 37510515 PMCID: PMC10380076 DOI: 10.3390/healthcare11142074] [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: 06/05/2023] [Revised: 06/27/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Women's health issues are complex and require collaborative efforts to unravel some of these complexities. This study aims to identify the incidence risk of Postpartum Depression (PPD) in a national sample of women in Saudi Arabia and the relationship with several health status, lifestyle, and sociodemographic factors. A cross-sectional study with an online questionnaire format assessed the risk of postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS) and included several questions on postpartum health status and lifestyle factors. Of the 550 women who responded to the survey 75% scored within range of risk for PPD (≥12). We found significant associations between family income, younger baby age, birth difficulty, having family support, level of physical activity, and the risk for PPD (p < 0.05). Urgent attention and resources should be directed towards screening and treatment for PPD in the healthcare system. The development of programs for awareness, education, and support of postpartum mothers in the Kingdom of Saudi Arabia is also required.
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Affiliation(s)
- Haya S Zedan
- Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh 13316, Saudi Arabia
| | - Baian A Baattaiah
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Shoug Alashmali
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Arwa S Almasaudi
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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13
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Qian J, Sun S, Wang M, Sun Y, Sun X, Jevitt C, Yu X. The effect of exercise intervention on improving sleep in menopausal women: a systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1092294. [PMID: 37181372 PMCID: PMC10167708 DOI: 10.3389/fmed.2023.1092294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/30/2023] [Indexed: 05/16/2023] Open
Abstract
Background Sleep disturbance is common in menopausal women and negatively affects their quality of life and could cause increased risks of other menopause-related diseases. Objective This systematic review aims to synthesize evidence regarding the effects of exercise interventions on improving sleep in menopausal women. Methods A comprehensive search in seven electronic databases for randomized controlled trials (RCTs) was performed on June 3, 2022. The systematic review included seventeen trials, ten of which provided data for the meta-analysis. The effects on outcomes were presented as mean differences (MDs) or standard mean differences (SMDs) and their 95% confidence intervals (CI). Cochrane risk-of-bias tool was used in quality assessment. Results The results suggest that exercise intervention significantly reduces insomnia severity (SMD = -0.91, 95% CI = -1.45 to -0.36, Z = 3.27, P = 0.001) and alleviates sleep problems (MD = -0.09, 95% CI = -0.17 to -0.01, Z = 2.20, P = 0.03). For sleep quality, the results showed that insignificant differences were found between the exercise intervention and the control groups (MD = -0.93, 95% CI = -2.73 to 0.87, Z = 1.01, P = 0.31). The results of the subgroup analysis indicated that more apparent effects of exercise intervention were found among women with sleep disorders than among women without sleep disorders. Which exercise intervention duration was more beneficial to sleep outcomes could not be judged. Overall, there was a moderate risk of bias in the primary studies. Conclusion According to this meta-analysis, exercise interventions can be recommended for menopausal women to improve their sleep. High-quality RCTs applying different types of exercise (e.g., walking, yoga, meditative exercise and so on) with different intervention durations as well as subjective and objective sleep assessment are warranted. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022342277, identifier: CRD42022342277.
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Affiliation(s)
- Jialu Qian
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
- Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Shiwen Sun
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Man Wang
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Yaping Sun
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiangyu Sun
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
| | - Cecilia Jevitt
- Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Xiaoyan Yu
- Department of Obstetrics, Women's Hospital School of Medicine, Zhejiang University, Hangzhou, China
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He L, Soh KL, Huang F, Khaza'ai H, Geok SK, Vorasiha P, Chen A, Ma J. The impact of physical activity intervention on perinatal depression: A systematic review and meta-analysis. J Affect Disord 2023; 321:304-319. [PMID: 36374719 DOI: 10.1016/j.jad.2022.10.026] [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: 05/30/2022] [Revised: 09/23/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND No meta-analysis has analyzed the effect of physical activity level, period of physical activity intervention, and duration of intervention, on perinatal depression. This study was to evaluate the impact of physical activity intensity, dose, period, and duration on perinatal depression. METHODS The literature was searched via the PubMed, Embase, Cochrane Library, and Web of Science databases. Weighted mean difference (WMD) or the risk ratio (RR) was used as the effect indicator, and the effect size was represented by the 95 % confidence interval (CI). Subgroup analysis based on the perinatal stage, physical activity intensity, physical activity equivalent, and intervention duration was performed. RESULTS Totally, 35 studies including 5084 women were included. Physical activity could reduce the incidence and severity of depression in perinatal women. Among depressed women with prenatal depression, low-intensity physical activity, with metabolic equivalents (METs)-min/week being <450, was associated with lower levels of depression. In the general population, the risk of postpartum depression was lower in the physical activity group when the duration of intervention was ≥12 weeks, being II, III stage, and ≥450 METs-min/week. Both low and moderate-intensity physical activity were beneficial to an improved depression severity among depressed women with postpartum depression, and moderate exercise intervention could decrease the risk of postpartum depression in general pregnant women. LIMITATIONS Different types of physical activities may affect the effectiveness of interventions. CONCLUSION Our study indicated physical activity specifically targeted at pregnant women could reduce depression risk and severity.
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Affiliation(s)
- Liping He
- Department of Nursing and Rehabilitations, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia; Department of Nursing, Chang Zhi Medical College, Changzhi 046000, PR China.
| | - Kim Lam Soh
- Department of Nursing and Rehabilitations, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
| | - Feifei Huang
- School of nursing, Fujian Medical University, Fuzhou 350000, PR China
| | - Huzwah Khaza'ai
- Department of Biomedical Science, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Soh Kim Geok
- Department of Sport Studies, Faculty of Education, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Ponpun Vorasiha
- College of Nursing and Health, Suan Sunandha Rajabhat University, Bangkok 10300, Thailand
| | - Aixiang Chen
- Department of Nursing, Chang Zhi Medical College, Changzhi 046000, PR China
| | - Jiangping Ma
- Department of Nursing, Chang Zhi Medical College, Changzhi 046000, PR China
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Baattaiah BA, Alharbi MD, Babteen NM, Al-Maqbool HM, Babgi FA, Albatati AA. The relationship between fatigue, sleep quality, resilience, and the risk of postpartum depression: an emphasis on maternal mental health. BMC Psychol 2023; 11:10. [PMID: 36635743 PMCID: PMC9836926 DOI: 10.1186/s40359-023-01043-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 01/06/2023] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Several factors can contribute to the development of postpartum depression (PPD) and negatively affect mothers' mental and physical well-being. The objective of this study was to determine the relationship between fatigue, sleep quality, resilience, and the risk of PPD development. METHODS A cross-sectional study was conducted using an online questionnaire distributed to mothers during their postpartum period. The risk of PPD was assessed using the Edinburgh Postnatal Depression Scale (EPDS), postpartum fatigue (PPF) was assessed using the Fatigue Severity Scale (FSS), sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and resilience was assessed using the Brief Resilience Scale (BRS). The Pearson correlation coefficient was calculated to determine the relationship between the study variables. Simple and multiple linear regression analyses were performed to explain the contributions of PPF, sleep quality, and resilience as independent predictors of PPD development. RESULTS A total of 1409 postpartum women were included in the analysis, with 75% of the participants reporting a risk of PPD, 61% reporting PPF, 97% reporting having sleep problems, and 36% being in the "low resilience level" category. In terms of correlations, the scores of FSS and the PSQI showed moderate positive relationships with the EPDS scores (r = 0.344 and r = 0.447, respectively, p = .000). The BRS scores were negatively associated with the EPDS scores (r = -0.530, p = 0.000). Fatigue, sleep quality, and resilience were predictors of depressive symptoms (β = 0.127, β = 0.262, and β = -0.393, respectively, R2 = 0.37, p = 0.000). The association remained significant in the regression model after adjusting for mother's age, mother's BMI, child's age, smoking status, full-term pregnancy, having a chronic disease, and taking anti-depressant. CONCLUSIONS Mothers with higher levels of fatigue, poor sleep quality, and low resilience levels were at high risk of developing PPD. Healthcare providers should identify these factors and thus set better rehabilitation goals to improve overall maternal health.
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Affiliation(s)
- Baian A. Baattaiah
- grid.412125.10000 0001 0619 1117Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, P.O. Box 80200, Jeddah, 21589 Saudi Arabia
| | - Mutasim D. Alharbi
- grid.412125.10000 0001 0619 1117Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, P.O. Box 80200, Jeddah, 21589 Saudi Arabia
| | - Nouf M. Babteen
- grid.412125.10000 0001 0619 1117Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, P.O. Box 80200, Jeddah, 21589 Saudi Arabia
| | - Haneen M. Al-Maqbool
- grid.412125.10000 0001 0619 1117Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, P.O. Box 80200, Jeddah, 21589 Saudi Arabia
| | - Faten A. Babgi
- grid.412125.10000 0001 0619 1117Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, P.O. Box 80200, Jeddah, 21589 Saudi Arabia
| | - Ashar A. Albatati
- grid.412125.10000 0001 0619 1117Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, P.O. Box 80200, Jeddah, 21589 Saudi Arabia
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16
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Odabas RK, Sökmen Y, Taspinar A. The effect of acupressure on postpartum fatigue in women delivering by caesarean section: A randomized controlled study. Explore (NY) 2022; 19:293-299. [PMID: 36535860 DOI: 10.1016/j.explore.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 11/07/2022] [Accepted: 12/04/2022] [Indexed: 12/14/2022]
Abstract
AIM The aim of this study was to determine the effect of acupressure on postpartum fatigue in women who gave birth by cesarean section. METHOD This study is a randomized controlled experimental study. The study was conducted between August 2021 and January 2022 in the maternity wards of hospitals in Turkey. Multiparous women who gave birth by cesarean section were randomly assigned to acupressure (n = 60) and control (n = 62) groups. Acupressure was applied to the acupressure group for a total of four sessions on the points of LI4, ST36, and SP6, for an average of 15 min for each session. The application sessions continued for 48 h after the cesarean section. The data were collected with a Descriptive Information Form and the VAS-F. RESULTS It was determined that the mean posttest score of the fatigue dimension of the VAS-F was found to be significantly lower in the acupressure group (p = 0.023). Additionally, in the acupressure group, while the differences between the pretest and posttest results of the both fatigue and energy dimensions of the VAS-F were statistically highly significant in the acupressure group (p = 0.000), only the difference in the energy dimension was found to be statistically significant in the control group (p = 0.016). CONCLUSIONS As a result, acupressure was found to be effective in reducing postpartum fatigue in women who gave birth by cesarean section, and its usability for healthcare professionals was demonstrated.
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Affiliation(s)
- Resmiye Kaya Odabas
- Kocaeli University Faculty of Health Sciences, Midwifery Department, Kocaeli, Turkey.
| | - Yasemin Sökmen
- Ondokuz Mayıs University, Faculty of Health Sciences, Department of Midwifery, Samsun, Turkey
| | - Ayten Taspinar
- Aydın Adnan Menderes University, Faculty of Health Sciences, Department of Midwifery, Aydın, Turkey
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17
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Sanchez-Garcia JC, Aguilar-Cordero MJ, Montiel-Troya M, Marín-Jiménez AE, Cortes-Martin J, Rodriguez-Blanque R. Quality of Life in the Postpartum Recovery of Women Who Practice Hypopressive Exercise: Randomized Clinical Trial. J Clin Med 2022; 11:jcm11195592. [PMID: 36233462 PMCID: PMC9572625 DOI: 10.3390/jcm11195592] [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: 07/10/2022] [Revised: 09/11/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Practicing physical exercise is a way of maintaining a healthy lifestyle and it has been demonstrated to provide benefits and improve quality of life after labour. Aim: The objective of this study is to determine if performing a moderate hypopressive exercise program after childbirth improves the HRQoL of women. Materials and Methods: A 12-week randomized clinical trial was carried out. The women in the exercise group followed a training program based on the hypopressive method, which comprises postural and respiratory exercises of moderate intensity. We used the SF-36v2 questionnaire to assess the Health-Related Quality of Life in women. Results: We found statistically significant differences (p < 0.05) in general health components, vitality, emotional role, and mental health in the sample group of exercise group of women, who obtained a higher score. We found statistically significant differences in all aspects between the groups. The interaction between time and group affect in general health components, vitality, emotional role and the score of mental components. In all of them, the score was higher at the end of the programme and in the exercise group. Conclusions: The training program with hypopressive physical exercise improves the quality of life after childbirth. According to the guidelines recommended by the ACOG, the hypopressive method is valid for the improvement of HRQoL in women who perform this method at 16 weeks of delivery. Further studies are recommended to start such exercises one week after delivery in postpartum women.
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Affiliation(s)
- Juan Carlos Sanchez-Garcia
- Andalusian Plan for Research, Development and Innovation, CTS 1068, 18014 Granada, Spain
- Andalusian Plan for Research, Development and Innovation, CTS 367, 18014 Granada, Spain
| | - María José Aguilar-Cordero
- Andalusian Plan for Research, Development and Innovation, CTS 367, 18014 Granada, Spain
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
| | - Maria Montiel-Troya
- Andalusian Plan for Research, Development and Innovation, CTS 1068, 18014 Granada, Spain
- Department of Nursing Ceuta Campus, Faculty of Health Sciences, University of Granada, 51001 Ceuta, Spain
- Correspondence:
| | - Ana Eugenia Marín-Jiménez
- Andalusian Plan for Research, Development and Innovation, CTS 1068, 18014 Granada, Spain
- Quantitative Methods for the Economics and Enterprise, Faculty of Economics and Business Sciences, University of Granada, 18071 Granada, Spain
| | - Jonathan Cortes-Martin
- Andalusian Plan for Research, Development and Innovation, CTS 1068, 18014 Granada, Spain
- Andalusian Plan for Research, Development and Innovation, CTS 367, 18014 Granada, Spain
| | - Raquel Rodriguez-Blanque
- Andalusian Plan for Research, Development and Innovation, CTS 1068, 18014 Granada, Spain
- Andalusian Plan for Research, Development and Innovation, CTS 367, 18014 Granada, Spain
- San Cecilio Clinical Hospital, 18071 Granada, Spain
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Ladyman C, Sweeney B, Sharkey K, Bei B, Wright T, Mooney H, Huthwaite M, Cunningham C, Firestone R, Signal TL. A scoping review of non-pharmacological perinatal interventions impacting maternal sleep and maternal mental health. BMC Pregnancy Childbirth 2022; 22:659. [PMID: 35999501 PMCID: PMC9395885 DOI: 10.1186/s12884-022-04844-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 06/15/2022] [Indexed: 01/24/2023] Open
Abstract
Background A woman’s vulnerability to sleep disruption and mood disturbance is heightened during the perinatal period and there is a strong bidirectional relationship between them. Both sleep disruption and mood disturbance can result in significant adverse outcomes for women and their infant. Thus, supporting and improving sleep in the perinatal period is not only an important outcome in and of itself, but also a pathway through which future mental health outcomes may be altered. Methods Using scoping review methodology, we investigated the nature, extent and characteristics of intervention studies conducted during the perinatal period (pregnancy to one-year post-birth) that reported on both maternal sleep and maternal mental health. Numerical and descriptive results are presented on the types of studies, settings, sample characteristics, intervention design (including timeframes, facilitation and delivery), sleep and mood measures and findings. Results Thirty-seven perinatal interventions were identified and further described according to their primary focus (psychological (n = 9), educational (n = 15), lifestyle (n = 10), chronotherapeutic (n = 3)). Most studies were conducted in developed Western countries and published in the last 9 years. The majority of study samples were women with existing sleep or mental health problems, and participants were predominantly well-educated, not socio-economically disadvantaged, in stable relationships, primiparous and of White race/ethnicity. Interventions were generally delivered across a relatively short period of time, in either the second trimester of pregnancy or the early postnatal period and used the Pittsburgh Sleep Quality Index (PSQI) to measure sleep and the Edinburgh Postnatal Depression Scale (EPDS) to measure mood. Retention rates were high (mean 89%) and where reported, interventions were well accepted by women. Cognitive Behavioural Therapies (CBT) and educational interventions were largely delivered by trained personnel in person, whereas other interventions were often self-delivered after initial explanation. Conclusions Future perinatal interventions should consider spanning the perinatal period and using a stepped-care model. Women may be better supported by providing access to a range of information, services and treatment specific to their needs and maternal stage. The development of these interventions must involve and consider the needs of women experiencing disadvantage who are predominantly affected by poor sleep health and poor mental health.
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Affiliation(s)
- Clare Ladyman
- Sleep/Wake Research Centre, School of Health Sciences, College of Health, Massey University, PO Box 756, Wellington, 6140, New Zealand
| | - Bronwyn Sweeney
- Sleep/Wake Research Centre, School of Health Sciences, College of Health, Massey University, PO Box 756, Wellington, 6140, New Zealand
| | - Katherine Sharkey
- The Warren Alpert Medical School, Brown University, 222 Richmond St, Providence, RI, 02903, USA
| | - Bei Bei
- Turner Institute for Brain and Mental Health, Monash University, 18 Innovation Walk Clayton Campus, Clayton, Victoria, 3800, Australia
| | - Tanya Wright
- School of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Hannah Mooney
- Ngāti Raukawa, Te Atiawa, Ngā Rauru, Te Āti Haunui-a-Pāpārangi, School of Social Work, College of Health, Massey University, Private Bag 11-222, Palmerston North, 4442, New Zealand
| | - Mark Huthwaite
- Department of Psychological Medicine, University of Otago, 23 Mein St, Newtown, Wellington, 6242, New Zealand
| | - Chris Cunningham
- Ngāti Raukawa; Ngāti Toarangatira; Te Atiawa; Te Ati Haunui-a-Pāpārangi, Research Centre for Hauora & Health, College of Health, Massey University, PO Box 756, Wellington, 6140, New Zealand
| | - Ridvan Firestone
- Research Centre for Hauora & Health, College of Health, Massey University, PO Box 756, Wellington, 6140, New Zealand
| | - T Leigh Signal
- Sleep/Wake Research Centre, School of Health Sciences, College of Health, Massey University, PO Box 756, Wellington, 6140, New Zealand.
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Kazeminia M, Salari N, Shohaimi S, Akbari H, Khaleghi AA, Bazrafshan MR, Mohammadi M. Assessing the effects of exercise on post-partum fatigue symptoms: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol X 2022; 15:100155. [PMID: 35647520 PMCID: PMC9136263 DOI: 10.1016/j.eurox.2022.100155] [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: 03/07/2022] [Revised: 04/18/2022] [Accepted: 05/16/2022] [Indexed: 11/30/2022] Open
Abstract
Background The level of activity in women who have given birth is very low despite the great benefits of exercise on their physical and mental health. There are some contradictories between the results of several preliminary studies on the effects of exercise on post-partum fatigue reduction. Therefore, the aim of this study was to assess the effects of exercise on decreasing postpartum fatigue in general and, specifically, in Iran using meta-analysis. Methods In this study, the articles printed in international and national centres of SID, MagIran, IranMedex, IranDoc, Cochrane, Embase, ScienceDirect, Scopus, PubMed and Web of Science (WoS), were used to find the studies electronically published up to 2021. The studies' heterogeneity was examined using the I2 index, and subsequently, a random-effects model was applied. Data analysis was performed within the Comprehensive Meta-Analysis software (version 2). Results Finally, nine articles met the inclusion criteria in this systematic and meta-analysis review. The included samples were 456 patients in the intervention group and 446 in the control group. The mean score of fatigue after the intervention was 8.1 ± 1.1 lower than before intervention in the experimental group, and this difference was statistically significant (p ≤ 0.001). Conclusion The results of this study indicate that exercise reduces postpartum fatigue, which can be used for counseling and treatment by gynecologists. Reduce postpartum problems in women and increase the quality of life after childbirth.
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Affiliation(s)
- Mohsen Kazeminia
- Student research committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Hakimeh Akbari
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran
| | - Ali Asghar Khaleghi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran
| | - Mohammad-Rafi Bazrafshan
- Department of Nursing, School of Nursing, Larestan University of Medical Sciences, Larestan, Iran
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran
- Corresponding author.
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20
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Zuchatti BV, Ferreira RC, Ribeiro E, Duran ECM. Clinical validation of nursing diagnosis fatigue (00093) in women in the immediate hospital postpartum period. Rev Esc Enferm USP 2022; 56:e20210530. [PMID: 35776946 PMCID: PMC10081645 DOI: 10.1590/1980-220x-reeusp-2021-0530en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 04/27/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To perform clinical validation of nursing diagnosis fatigue (00093) in women in the immediate postpartum hospital. METHOD This is a methodological and clinical validation study of the diagnostic accuracy of nursing diagnosis fatigue (00093) components in women in the immediate postpartum hospital period. Data were collected with women in the immediate postpartum hospital. Sensitivity and specificity accuracy measures, positive and negative predictive values of the aforementioned nursing diagnosis were investigated. RESULTS The sample consisted of 153 women in the immediate postpartum period hospitalized in the rooming-in ward, with a mean age of 27 years, whose defining characteristic with statistical significance was tiredness. CONCLUSION The defining characteristics of tiredness and pain and related factor sleep deprivation presented high prevalence and high values of fatigue (00093) accuracy measures, being validated. Thus, it is believed that this study will contribute to clinical practice nurses in the correct identification of postpartum hospital fatigue, a frequent phenomenon in this population that causes much damage throughout the puerperium period. Additionally, it will corroborate the immediate conduct aiming at good outcome.
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Affiliation(s)
| | | | - Elaine Ribeiro
- Universidade Estadual de Campinas, Faculdade de Enfermagem, Campinas, SP, Brazil
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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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22
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Zhang H, Li A, Zhu B, Niu Y, Ruan Z, Liu L, Gao X, Wang K, Yin L, Peng M, Xue Q, Leng H, Min B, Tian Q, Wang C, Yang Y, Zhu Z, Si T, Li W, Shangguan F, Hong X, Chang H, Song H, Li D, Jia L, Dong H, Wang Y, Cosci F, Wang H. COVID-19 pandemic: study on simple, easy, and practical relaxation techniques while wearing medical protective equipment. Psychol Med 2022; 52:1386-1392. [PMID: 32829730 PMCID: PMC7484302 DOI: 10.1017/s0033291720003220] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND No studies have reported on how to relieve distress or relax in medical health workers while wearing medical protective equipment in coronavirus disease 2019 (COVID-19) pandemic. The study aimed to establish which relaxation technique, among six, is the most feasible in first-line medical health workers wearing medical protective equipment. METHODS This was a two-step study collecting data with online surveys. Step 1: 15 first-line medical health workers were trained to use six different relaxation techniques and reported the two most feasible techniques while wearing medical protective equipment. Step 2: the most two feasible relaxation techniques revealed by step 1 were quantitatively tested in a sample of 65 medical health workers in terms of efficacy, no space limitation, no time limitation, no body position requirement, no environment limitation to be done, easiness to learn, simplicity, convenience, practicality, and acceptance. RESULTS Kegel exercise and autogenic relaxation were the most feasible techniques according to step 1. In step 2, Kegel exercise outperformed autogenic relaxation on all the 10 dimensions among the 65 participants while wearing medical protective equipment (efficacy: 24 v. 15, no space limitation: 30 v. 4, no time limitation: 31 v. 4, no body position requirement: 26 v. 4, no environment limitation: 30 v. 11, easiness to learn: 28 v. 5, simplicity: 29 v. 7, convenience: 29 v. 4, practicality: 30 v. 14, acceptance: 32 v. 6). CONCLUSION Kegel exercise seems a promising self-relaxation technique for first-line medical health workers while wearing medical protective equipment among COVID-19 pandemic.
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Affiliation(s)
- Huiqin Zhang
- Department of Ultrasound, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Aimin Li
- Department of Respiratory and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Boheng Zhu
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Yanyan Niu
- Department of Orthopedics, Jincheng People's Hospital, Shanxi Medical University, Jincheng, China
| | - Zheng Ruan
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Lihong Liu
- Department of Neurology, Ningcheng Center Hospital, Ningcheng, Inner Mongolia, China
| | - Xiaoling Gao
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Kun Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Puren Hospital, Beijing, China
| | - Lu Yin
- Medical Research & Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China
| | - Mao Peng
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qing Xue
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Haixia Leng
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Baoquan Min
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qing Tian
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
| | - Chunxue Wang
- Department of Neuropsychiatry and Behavioral Neurology and Clinical Psychology Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yuan Yang
- Department of Psychiatry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhou Zhu
- Department of Psychiatry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tianmei Si
- Peking University Sixth Hospital, Institute of Mental Health, National Clinical Research Center for Mental Health Disorders & Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, China
| | - Wei Li
- Department of Neurology, The Third People's Hospital of Chengdu, Chengdu, China
| | | | - Xia Hong
- Department of Neurology, Xiyuan Hospital, China Academy of Chinese Medical Science, Beijing, China
| | - Hong Chang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Haiqing Song
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Dongning Li
- Department of Neurology, Ningcheng Center Hospital, Ningcheng, Inner Mongolia, China
| | - Longbin Jia
- Department of Neurology, Jincheng People's Hospital, Shanxi Medical University, Jincheng, China
| | - Huiqing Dong
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yuping Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Hongxing Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Beijing Psychosomatic Disease Consultation Center, Xuanwu Hospital, Capital Medical University, Beijing, China
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Yan S, Chen J, Zhang F. Infant sleep patterns and maternal postpartum fatigue: A cross-sectional study. J Obstet Gynaecol Res 2022; 48:1193-1201. [PMID: 35179264 DOI: 10.1111/jog.15191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/31/2022] [Accepted: 02/04/2022] [Indexed: 01/15/2023]
Abstract
AIM Unpredictable nature of infant sleep-wake cycles go against that of the adult sleep. Maternal sleep quality is acknowledged as a main factor to postpartum fatigue. This study explored the effects of infant sleep patterns on maternal postpartum fatigue. METHODS A total of 319 mothers of infants from two teaching hospitals in the Nantong City were enrolled. Maternal fatigue status and infant sleep patterns were assessed by the Fatigue Scale (FS-14) and the Brief Infant Sleep Questionnaire (BISQ). Generalized estimating equation analyses were perform to explored the effect of infant sleep patterns on maternal fatigue. RESULTS Sleep-onset time later than 10 p.m., and nocturnal wakefulness more than 60 min were risk factors of postpartum fatigue. After controlling the confounding variables, infant sleep patterns were still the determinant factors of postpartum fatigue. CONCLUSION Infant sleep pattern is a factor of maternal postpartum fatigue. It is recommended to promote infant sleep so as to improve maternal sleep quality and finally alleviate postpartum fatigue.
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Affiliation(s)
- Shuhan Yan
- Medical College, Nantong University, Nantong City, China
| | - Jing Chen
- School of Nursing, Soochow University, Soochow City, China
| | - Feng Zhang
- Medical College, Nantong University, Nantong City, China
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24
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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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Zuchatti BV, Ferreira RC, Ribeiro E, Duran ECM. Validação clínica do diagnóstico de enfermagem fadiga (00093) em mulheres no pós-parto hospitalar imediato. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2021-0530pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: Realizar a validação clínica do diagnóstico de enfermagem fadiga (00093) em mulheres no pós-parto hospitalar imediato. Método: Trata-se de estudo metodológico, do tipo validação clínica, de acurácia diagnóstica dos componentes do diagnóstico de enfermagem fadiga (00093) em mulheres no pós-parto hospitalar imediato. A coleta de dados foi realizada junto a mulheres no pós-parto imediato hospitalar. Foram investigadas as medidas de acurácias de sensibilidade e especificidade, valores preditivos positivos e negativos do referido diagnóstico de enfermagem. Resultados: A amostra foi composta por 153 mulheres no pós-parto imediato internadas na enfermaria de alojamento conjunto, com idade média de 27 anos, cuja característica definidora com significância estatística foi cansaço. Conclusão: As características definidoras cansaço e dor e o fator relacionado privação de sono apresentaram alta prevalência e altos valores de medidas de acurácia para fadiga (00093), sendo validadas. Assim, acredita-se que este estudo contribuirá para os enfermeiros da prática clínica na identificação correta da fadiga pós-parto hospitalar, um fenômeno frequente nesta população que causa muitos prejuízos em todo período do puerpério. Além disso, corroborará na condução imediata visando bom desfecho.
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26
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Lewis BA, Schuver K, Dunsiger S, Samson L, Frayeh AL, Terrell CA, Ciccolo JT, Fischer J, Avery MD. Randomized trial examining the effect of exercise and wellness interventions on preventing postpartum depression and perceived stress. BMC Pregnancy Childbirth 2021; 21:785. [PMID: 34802425 PMCID: PMC8607568 DOI: 10.1186/s12884-021-04257-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 11/03/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Approximately 13-19% of postpartum women experience postpartum depression and a majority report at least some stress during the postpartum phase. Traditional interventions such as psychotherapy and antidepressant medications are often not feasible or desirable. The purpose of this study was to examine two low cost, brief, accessible interventions designed to prevent postpartum depression and perceived stress among women at high risk. METHODS Participants (n = 450) who were on average four weeks postpartum, had a history of depression before pregnancy, and exercised less than 60 min per week were randomly assigned to one of the following three conditions: (1) 6-month telephone-based exercise intervention; (2) 6-month telephone-based wellness/support intervention (e.g., healthy eating, sleep, and perceived stress); or (3) usual care. RESULTS Overall, 2.4% of participants met criteria for depression at 6 months and 3.6% at 9 months with no differences between groups. At 6 months following randomization, median symptoms of depression were significantly lower among wellness participants compared to usual care participants (b = - 1.00, SE = 0.46, p = .03). Perceived stress at 6 months post-randomization was significantly lower among exercise vs. usual care participants (b = - 2.00, SE = .98, p = .04) and exercise vs. wellness participants (b = - 2.20, SE = 1.11, p = .04). CONCLUSIONS The wellness intervention was efficacious for preventing symptoms of depression; however, postpartum depression that met the diagnostic criteria was surprisingly low in all conditions among this at risk sample of postpartum women. Exercise interventions may have a protective effect on perceived stress among women at risk for postpartum depression. Practitioners should consider integrating exercise and wellness interventions into postpartum care. TRIAL REGISTRATION Clinical Trials Number: NCT01883479 (06/21/2013).
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Affiliation(s)
- Beth A Lewis
- University of Minnesota, School of Kinesiology, 1900 University Ave SE, Minneapolis, MN, 55455, USA.
| | - Katie Schuver
- University of Minnesota, School of Kinesiology, 1900 University Ave SE, Minneapolis, MN, 55455, USA
| | - Shira Dunsiger
- Center for Health Promotion and Health Equity in the Department of Behavioral and Social Sciences, Brown University, Box G-S121-4, Providence, RI, 02912, USA
| | - Lauren Samson
- University of Minnesota, School of Kinesiology, 1900 University Ave SE, Minneapolis, MN, 55455, USA
| | - Amanda L Frayeh
- University of Minnesota, School of Kinesiology, 1900 University Ave SE, Minneapolis, MN, 55455, USA
| | - Carrie A Terrell
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, 604 24th Ave S, Ste 300, Minneapolis, MN, 55454, USA
| | - Joseph T Ciccolo
- Department of Biobehavioral Sciences, Teachers College Columbia University, 525 West 120th St., New York, NY, USA
| | - John Fischer
- Department of Obstetrics, Gynecology and Women's Health, University of Minnesota, 604 24th Ave S, Ste 300, Minneapolis, MN, 55454, USA
| | - Melissa D Avery
- University of Minnesota, School of Nursing, 308 Harvard St. SE, Minneapolis, MN, 55455, USA
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Qian J, Sun S, Liu L, Yu X. Effectiveness of non-pharmacological interventions for reducing postpartum fatigue: a systematic review protocol. BMJ Open 2021; 11:e051136. [PMID: 34697115 PMCID: PMC8547358 DOI: 10.1136/bmjopen-2021-051136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Postpartum fatigue is a common symptom among new mothers after their pregnancy. It has a considerable negative impact on women's functional and mental status as well as the development of babies. Identifying effective interventions to prevent or reduce postpartum fatigue is meaningful to improve the quality of life and avoid adverse outcomes of this vulnerable population. This systematic review aims to synthesise non-pharmacological evidence and evaluate the effectiveness of interventions for reducing postpartum fatigue among puerperas. METHODS AND ANALYSIS This review will be conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. We will systematically search the Cochrane Library, PubMed, Embase, Web of Science, PsycINFO, CINAHL and ProQuest databases to identify clinical trials implementing non-pharmacological interventions conducted during 0-78 weeks postpartum for fatigue reduction. An additional search of OpenGrey will be conducted to identify grey literature. The search will be performed on 30 March 2021 without restrictions on time and language. Two independent reviewers will be responsible for study selection, data extraction and study quality assessment. The Cochrane risk-of-bias tool will be adopted to evaluate the risk biases of the included randomised controlled trials, and the Risk of Bias in Non-randomised Studies of Interventions will be applied to evaluate non-randomised controlled trials. Any disagreements will be referred to a third reviewer to reach a consensus. Findings will be qualitatively synthesised, and a meta-analysis will be conducted for the statistical combination if outcome data are sufficient and available. ETHICS AND DISSEMINATION This systematic review will not involve the collection of primary data and will be based on published data. Therefore, ethics approval is not required. The final findings will be disseminated through peer-reviewed journals and academic conferences. PROSPERO REGISTRATION NUMBER CRD42021234869.
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Affiliation(s)
- Jialu Qian
- School of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Department of Obstetrics, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang, China
| | - Shiwen Sun
- Department of Obstetrics, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang, China
| | - Lu Liu
- School of Nursing, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Department of Obstetrics, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang, China
| | - Xiaoyan Yu
- Department of Obstetrics, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang, China
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Paz Fernández N, González González Y, Alonso Calvete A, Da Cuña Carrera I. Efectos del ejercicio en la depresión durante el embarazo y el posparto. Una revisión sistemática. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2021. [DOI: 10.1016/j.gine.2021.100683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Qian J, Sun S, Liu L, Yu X. Effectiveness of nonpharmacological interventions for reducing postpartum fatigue: a meta-analysis. BMC Pregnancy Childbirth 2021; 21:622. [PMID: 34521386 PMCID: PMC8442348 DOI: 10.1186/s12884-021-04096-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/31/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Postpartum fatigue is the most common issue among postnatal women and it could not only seriously affect the health of mothers but also bring about adverse impacts on their offspring. This meta-analysis aims to synthesize nonpharmacological evidence and evaluate the effectiveness of interventions for reducing postpartum fatigue among puerperae. METHODS The Cochrane Library, PubMed, Embase, Web of Science, PsycINFO, CINAHL and ProQuest databases were searched for papers published from inception until June 2021. Grey literature was searched using OpenGrey. Randomized controlled trials (RCTs) or controlled clinical trials (CCTs) evaluating nonpharmacological interventions conducted during 0 ~ 78 weeks postpartum for fatigue reduction were eligible for inclusion. The methodological quality of the included studies was independently assessed by two reviewers using the Cochrane risk-of-bias tool and the risk of bias in nonrandomized studies of interventions. Cohen's kappa coefficient was used to measure inter-rater agreement. The meta-analysis was conducted using Review Manager 5.3. RESULTS Seventeen published clinical trials matched the eligibility criteria and ten studies involving 1194 participants were included in this meta-analysis. The intervention start time varied from immediately postpartum care to 1 year after delivery, and duration ranged from 1 day to 3 months. The results revealed that exercise (SMD = - 1.74, 95% CI = -2.61 to - 0.88) and drinking tea (MD = - 3.12, 95% CI = -5.44 to - 0.80) resulted in significant improvements in women's postpartum fatigue at postintervention. Drinking tea may have beneficial effects on depression (MD = - 2.89, 95% CI = -4.30 to - 1.49). Positive effects of psychoeducational interventions on postpartum fatigue or depression were not observed. Physical therapies including mother-infant skin-to-skin contact, taking warm showers and breathing lavender oil aroma were used for reducing postpartum fatigue. No significant risk of publication bias was found. Small number of included studies and sample sizes, not time-matched conditions of control groups, high heterogeneity and the risk of bias within the included studies were the main limitations of our review. CONCLUSIONS This review provides evidence that exercise and drinking tea may be effective nonpharmacological interventions for relieving postpartum fatigue. More effective and targeted exercise programs need to be further studied. Rigorous RCTs of drinking tea are needed. Caution is required when interpreting the findings due to the limitations of our study. Further studies are still needed to validate our findings and increase confidence in the results.
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Affiliation(s)
- Jialu Qian
- Zhejiang University School of Medicine, Zhejiang, Hangzhou, China
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang Province, China
| | - Shiwen Sun
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang Province, China
| | - Lu Liu
- Zhejiang University School of Medicine, Zhejiang, Hangzhou, China
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang Province, China
| | - Xiaoyan Yu
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang Province, China.
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Hawkins M, Marcus B, Pekow P, Rosal MC, Tucker KL, Spencer RMC, Chasan-Taber L. The Impact of a Randomized Controlled Trial of a Lifestyle Intervention on Sleep Among Latina Postpartum Women. Ann Behav Med 2021; 55:892-903. [PMID: 33580651 DOI: 10.1093/abm/kaaa118] [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: 11/13/2022] Open
Abstract
BACKGROUND Poor sleep is associated with adverse outcomes among postpartum women. Exercise may improve sleep, but this has not been well examined in the postpartum period. PURPOSE To examine the impact of a culturally modified, individually tailored lifestyle intervention on sleep outcomes among postpartum Latina women. METHODS Estudio PARTO was a randomized controlled trial aimed at reducing Type 2 diabetes among Latina women with abnormal glucose tolerance in pregnancy. Participants were randomized to a lifestyle (i.e., diet and exercise; n = 70) or a health and wellness control intervention (n = 78) in late pregnancy (baseline). The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality (PSQI score), onset latency (minutes per night), duration (hours per night), efficiency (percentage of the time in bed asleep), and daytime dysfunction at baseline, 6 weeks, 6 months, and 12 months postpartum. RESULTS Mean PSQI score (6.56 ± 3.87), sleep duration (6.84 ± 1.75 hr/night), and sleep efficiency (79.70% ± 18.10%) did not differ between the arms at baseline. Mixed-effects models indicated a greater decrease of 1.29 in PSQI score (i.e., improved sleep quality) in the lifestyle versus health and wellness arm (95% confidence interval [CI] = -2.50 to -0.08, p = .04) over follow-up. There was the suggestion of a smaller decrease in sleep duration (mean = 0.48 hr/night, 95% CI = -0.10 to 1.06, p = .10) in the lifestyle versus health and wellness arm. There were no statistically significant differences in other sleep outcomes between arms. CONCLUSIONS Findings suggest that lifestyle interventions improve sleep quality but not sleep duration, sleep onset latency, sleep efficiency, or daytime dysfunction in postpartum Latina women and, therefore, may hold promise for improving subsequent mental and physical health in this population. CLINICAL TRIALS REGISTRATION NCT01679210.
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Affiliation(s)
- Marquis Hawkins
- Department of Epidemiology, University of Pittsburgh, Public Health, Pittsburgh, PA, USA
| | - Bess Marcus
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Penelope Pekow
- Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst, MA, USA
| | - Milagros C Rosal
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Rebecca M C Spencer
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, USA
| | - Lisa Chasan-Taber
- Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst, MA, USA
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Campos MDSB, Buglia S, Colombo CSSDS, Buchler RDD, Brito ASXD, Mizzaci CC, Feitosa RHF, Leite DB, Hossri CAC, Albuquerque LCAD, Freitas OGAD, Grossman GB, Mastrocola LE. Position Statement on Exercise During Pregnancy and the Post-Partum Period - 2021. Arq Bras Cardiol 2021; 117:160-180. [PMID: 34320089 PMCID: PMC8294738 DOI: 10.36660/abc.20210408] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
| | - Susimeire Buglia
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil.,Hospital do Coração (HCOR), São Paulo, SP - Brasil
| | | | - Rica Dodo Delmar Buchler
- Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil.,Ergometria DASA, São Paulo, SP - Brasil
| | | | | | | | - Danielle Batista Leite
- Real Hospital Português, Recife, PE - Brasil.,Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Recife, PE - Brasil
| | | | | | | | - Gabriel Blacher Grossman
- Hospital Moinhos de Vento, Porto Alegre, RS - Brasil.,Clínica Cardionuclear, Porto Alegre, RS - Brasil
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32
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Maestro-Gonzalez A, Sánchez-Zaballos M, Mosteiro-Díaz MP, Zuazua-Rico D. Quality of sleep among social media users during the lockdown period due to COVID-19 in Spain. Sleep Med 2021; 80:210-215. [PMID: 33607556 PMCID: PMC9188780 DOI: 10.1016/j.sleep.2021.01.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/01/2020] [Accepted: 01/26/2021] [Indexed: 11/06/2022]
Abstract
Aims To analyse the quality of sleep of the Spanish population during the lockdown due to COVID-19. Design Cross-sectional descriptive study using a web based survey design. Methods Pittsburgh Sleep Quality Index questionnaire and sociodemographic, occupational, health and sleep quality variables were used to collect data during the first month of the lockdown period due to COVID-19 (March–April 2020). A snowball sampling was carried out, where participants were asked to disseminate and distribute the questionnaire among their own profiles in social networks. Results A representative sample of 5220 participants aged ≥18 years old took part in the study. The global PSQI score was 8.17 points (SD 4.43). A statistical association was found between the global PSQI score and several of the variables collected. Findings show that the quality of sleep was worse among women (p < 0.001), single participants (p 0.02), those working in rotating shifts (p < 0.001), on-site workers (p < 0.001), and people diagnosed with COVID-19 or who had someone in their environment diagnosed with the virus (p < 0.001). Conclusion Findings show that the Spanish population has experienced poor quality of sleep during the lockdown period. Being a woman, working in rotating shifts, having suffered from COVID-19 or having someone close suffering from COVID-19, being unemployed or being affected by a Temporary Redundancy Scheme, as well as spending long hours in bed were associated with poorer sleep quality. On the contrary, being older and sleeping longer hours were associated with a better sleep quality.
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Affiliation(s)
- Alba Maestro-Gonzalez
- Faculty of Medicine and Health Sciences, University of Oviedo, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Marta Sánchez-Zaballos
- Faculty of Medicine and Health Sciences, University of Oviedo, Hospital Universitario Central de Asturias, Oviedo, Spain.
| | | | - David Zuazua-Rico
- Faculty of Medicine and Health Sciences, University of Oviedo, Hospital Universitario Central de Asturias, Oviedo, Spain
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33
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Raspovic AM, Prichard I, Yager Z, Hart LM. Mothers' experiences of the relationship between body image and exercise, 0-5 years postpartum: A qualitative study. Body Image 2020; 35:41-52. [PMID: 32892146 DOI: 10.1016/j.bodyim.2020.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 07/31/2020] [Accepted: 08/02/2020] [Indexed: 01/29/2023]
Abstract
The relationship between body image and exercise in early motherhood is an important yet understudied determinant of mother and infant wellbeing. To address this, we report on a qualitative study of early mothers' lived experiences of the relationship between body image and exercise in the first five years post-birth. Twenty-one mothers (0-5 years postpartum) completed individual, semi-structured online/phone interviews (M interview time =47.25 min), to elicit narratives about peripartum body image and its relationship with exercise. Thematic analysis was conducted according to the Braun and Clarke framework. Three key themes, and several subthemes, were identified: 1.body image in early motherhood is diverse, dynamic and individual, 2.postpartum exercise forms part of early motherhood adjustment, and 3.body image and exercise form an important, intricate relationship in early motherhood. Women's narratives indicated three body image/exercise patterns, each characterised by different behaviours and motivations. Mothers who reported exercising, or avoiding exercising, for reasons related to body dissatisfaction appeared at greatest risk of negative outcomes from body-related distress and maladaptive exercise patterns. Conversely, mothers reporting higher body appreciation described more adaptive exercise behaviours. This research provides important information for the development of interventions to support positive body image and healthful exercise in early motherhood.
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Affiliation(s)
- Anita M Raspovic
- School of Psychology and Public Health, La Trobe University, Melbourne, 3086, Australia.
| | - Ivanka Prichard
- Health and Exercise Science, College of Nursing and Health Sciences, Flinders University, Adelaide, 5001, Australia; SHAPE Research Centre, Flinders University, Adelaide, 5001, Australia; Caring Futures Institute, Flinders University, Adelaide, 5001, Australia.
| | - Zali Yager
- Institute for Health and Sport, Victoria University, Melbourne, 3011, Australia.
| | - Laura M Hart
- School of Psychology and Public Health, La Trobe University, Melbourne, 3086, Australia; Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, 3010, Australia.
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34
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Liu N, Wang J, Chen DD, Sun WJ, Li P, Zhang W. Effects of exercise on pregnancy and postpartum fatigue: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol 2020; 253:285-295. [PMID: 32916639 DOI: 10.1016/j.ejogrb.2020.08.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/28/2020] [Accepted: 08/21/2020] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Fatigue is a common adverse experience in pregnant and postpartum women and is associated with poor outcomes and can seriously affect maternal and infant health and quality of life. However, data from existing studies are inconsistent, and no studies have examined the effects of exercise on pregnancy and postpartum fatigue. The aim of this review is to evaluate the effects of exercise on pregnancy and postpartum fatigue. STUDY DESIGN PubMed, EMBASE, Web of Science and the Cochrane Library database were used to retrieve literature. Eligible studies were clinical trials that reported the effects of exercise on pregnancy and postpartum fatigue in women. The methodological quality of the included studies was assessed using the Cochrane Collaboration Risk of Bias Assessment Tool. A fixed-effect model was used to analyse the pooled results. Subgroup analyses were used to explore sources of heterogeneity. Sensitivity analysis was used to validate the robustness of the pooled results. RESULTS Seven studies were included. The results of meta-analysis of five studies showed that exercise during pregnancy and the postpartum period may have beneficial effects on women's fatigue ([SMD = 0.29, 95 % CI (0.10, 0.47), P = 0.003]). Subgroup analyses reported that compared with the control, long exercise programmes, postpartum exercise and supervised exercise significantly improved fatigue levels. CONCLUSIONS Postpartum exercise in a supervised programme lasting more than eight weeks may be beneficial for reducing postpartum fatigue. More available data from large-scale and high-quality trials are needed to demonstrate the effects of exercise on pregnant and postpartum fatigue.
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Affiliation(s)
- Na Liu
- Nursing School of Jilin University, Changchun, Jilin Province, China.
| | - Jie Wang
- Nursing School of Jilin University, Changchun, Jilin Province, China.
| | - Dan-Dan Chen
- Nursing School of Jilin University, Changchun, Jilin Province, China.
| | - Wei-Jia Sun
- Nursing School of Jilin University, Changchun, Jilin Province, China.
| | - Ping Li
- Department of Developmental Pediatrics, the Second Hospital of Jilin University, Changchun, Jilin Province, China
| | - Wei Zhang
- Nursing School of Jilin University, Changchun, Jilin Province, China.
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35
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Loewen B, Collum C, Ryan GA. Exercise Benefits and Recommendations for the 6-Week Postpartum Period. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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36
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Analysis of status quo and research progress in nursing of postpartum fatigue: a literature review. FRONTIERS OF NURSING 2020. [DOI: 10.2478/fon-2020-0002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Postpartum fatigue is an important issue that threatens women’s health. The incidence of postpartum fatigue is high. Failure to intervene in time may lead to adverse outcomes such as postpartum depression, premature termination of breastfeeding, child abuse, and low infant development. This article reviews the concepts, characteristics, related factors, adverse effects, and interventions of postpartum fatigue. The aim is to improve doctors’ and nurses’ awareness of on postpartum fatigue in pregnant women, enrich the research content and methods, stimulate the interest of nurses, and actively carry out targeted intervention research to prevent or reduce the occurrence of adverse outcomes.
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37
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Chen SL, Chang SM, Kuo PL, Chen CH. Stress, anxiety and depression perceived by couples with recurrent miscarriage. Int J Nurs Pract 2019; 26:e12796. [PMID: 31713284 DOI: 10.1111/ijn.12796] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 06/25/2019] [Accepted: 09/22/2019] [Indexed: 11/29/2022]
Abstract
AIM Recurrent miscarriage is considered a major life event. The main purposes of this study were to compare the differences in stress, anxiety, social support, sleep quality and depressive symptoms in couples experiencing recurrent miscarriage compared to peers who experience full-term normal childbirth in southern Taiwan. METHODS Convenience sampling and snowball sampling were used respectively to recruit 78 couples with and 80 couples without recurrent miscarriage from October 2014 to July 2015. Five structured questionnaires including Perceived Stress Scale, State- Anxiety Inventory, Interpersonal Support Evaluation List, Pittsburgh Sleep Quality Index and Edinburgh Depression Scale were administered. RESULTS Women who experienced recurrent miscarriage perceived significantly higher levels of stress, anxiety and depressive symptoms than their husbands. Women in the recurrent miscarriage group reported significantly greater depressive symptoms than women of the other group. A stepwise multiple regression analysis indicated key predictors of depressive symptoms among women of childbearing age, accounting for 62.9% of the variance, were anxiety, stress, social support and history of recurrent miscarriage. CONCLUSION Women with recurrent miscarriage suffer mild to moderate depressive symptoms and a greater incidence of depression than their peers who experienced normal childbirth. Health professionals can use the knowledge gained from these findings to evaluate women with recurrent miscarriage for stress, anxiety and depressive symptoms and develop supportive interventions.
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Affiliation(s)
- Shu-Lan Chen
- Department of Nursing, Fooyin University, Kaohsiung, Taiwan
| | - Shao-Min Chang
- Department of Nursing, Fooyin University, Kaohsiung, Taiwan
| | - Pao-Lin Kuo
- Department of Obstetrics and Gynecology, College of Medicine, National Cheng-Kung University, Tainan, Taiwan
| | - Chung-Hey Chen
- Department of Nursing, HungKuang University, Taichung, Taiwan.,Department of Nursing & Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
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38
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Association between sleep quality and physical activity in postpartum women. Sleep Health 2019; 5:598-605. [PMID: 31521562 DOI: 10.1016/j.sleh.2019.07.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/08/2019] [Accepted: 07/10/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To describe sleep quality and sleep duration in primiparous women 6 months postpartum and to determine whether sleep quality is associated with 24-hour physical activity assessed using triaxial wrist accelerometry and a novel analytic technique, functional data analysis (FDA). METHODS Six months postpartum, participants wore a triaxial wrist accelerometer for 7 days and completed the Pittsburgh Sleep Quality Index (PSQI). We categorized sleep quality as good (score ≤5) or poor (>5). Data were summarized as vector magnitude of accelerations net of local gravity, or "Euclidean Norm Minus One" (ENMO, mg), in 5-second epochs. Using FDA, we modeled ENMO as a continuously changing, functional outcome predicted by sleep quality. We also compared mean total ENMO per 24-hour day, mean minutes of moderate to vigorous physical activity (MVPA) and of light activity/day, and mean minutes of MVPA in 10-minute bouts/day by sleep quality. RESULTS Of 365 women that completed the PSQI, 215 (59%) reported poor sleep quality. Two hundred ninety-six women completed both the PSQI and valid accelerometry. With the exception of one brief period around noon, sleep quality was not significantly associated with 24-hour physical activity according to FDA. Women with poor sleep quality had slightly greater total mean activity, minutes of light activity, and minutes of MVPA per day, but no difference in minutes of MVPA in at least 10-minute bouts. CONCLUSION Poor sleep quality is common 6 months postpartum. We identified no clinically significant differences in physical activity metrics between women with good and poor quality sleep.
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39
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Kołomańska-Bogucka D, Mazur-Bialy AI. Physical Activity and the Occurrence of Postnatal Depression-A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E560. [PMID: 31480778 PMCID: PMC6780177 DOI: 10.3390/medicina55090560] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 08/12/2019] [Accepted: 08/29/2019] [Indexed: 12/20/2022]
Abstract
Background and Objectives: During pregnancy and the postnatal period many changes occur in a woman's body, both in mental and physical spheres. The birth of a child and a new role-of a mother-can sometimes be associated with numerous negative emotions, uncertainty, fear, anxiety, disgust, depression, or sadness. In the puerperium period, the development of baby blues or postpartum depression may occur. Postpartum depression develops within one month of childbirth and may last up to one year. Depressive disorders that may develop in a young mother affect both her and the newborn's health. That is why it is so important to try to search for factors that could significantly reduce the likelihood of developing depression in this period. The study aims at assessing the relationship between physical activity during pregnancy and puerperium or in the postpartum and the development of postnatal depression. Materials and Methods: A review of the literature was carried out in the Medline-PubMed database. The search terms were "pregnancy" AND "physical activity AND postpartum depression". The study included only English-language publications published in the period 2000-2018. Results: A total of 216 references were found. After establishing the inclusion and exclusion criteria based on the analysis of titles and abstracts, 173 articles were excluded from the review. A total of 43 publications were read in full. Finally, 16 articles were included in the review. It was shown that regular physical activity during pregnancy, pregnancy, and puerperium, or in the postnatal period itself as compared to inactivity, reduces the risk of developing depression in pregnant women and after the birth of a child. Conclusions: Physical activity can be an essential factor in the prevention of depressive disorders of women in the postnatal period.
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Affiliation(s)
- Daria Kołomańska-Bogucka
- Department of Ergonomics and Exercise Physiology, Faculty of Health Science, Jagiellonian University Medical College, Grzegorzecka 20, 31-531 Krakow, Poland
| | - Agnieszka Irena Mazur-Bialy
- Department of Ergonomics and Exercise Physiology, Faculty of Health Science, Jagiellonian University Medical College, Grzegorzecka 20, 31-531 Krakow, Poland.
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40
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Hawkins M, Marcus B, Pekow P, Rosal MC, Tucker KL, Spencer RMC, Chasan-Taber L. Physical activity and sleep quality and duration among Hispanic postpartum women at risk for type 2 diabetes: Estudio PARTO. Sleep Health 2019; 5:479-486. [PMID: 31171492 DOI: 10.1016/j.sleh.2019.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 03/05/2019] [Accepted: 04/12/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVES Poor sleep among postpartum women is associated with adverse maternal outcomes. Physical activity (PA) is associated with better sleep. However, few studies have been conducted among postpartum Hispanic women. The objective of this study was to examine the association between PA and sleep quality and duration among postpartum Hispanic women. DESIGN A cross-sectional analysis using baseline data from Estudio PARTO, an ongoing randomized controlled trial aimed at reducing type 2 diabetes risk among Hispanic women. SETTING Baystate Medical Center, in Western Massachusetts, which serves an ethnically and socioeconomically diverse population. PARTICIPANTS Hispanic women, at elevated risk for type 2 diabetes, at a mean of 11 weeks (SD = 4.5) postpartum. MEASUREMENTS PA was measured with the Pregnancy Physical Activity Questionnaire (PPAQ), and sleep was measured with the Pittsburgh Sleep Quality Index (PSQI). RESULTS Mean sleep duration was 5.9 hour/night (SD = 1.7) and PSQI score was 6.5 (SD = 3.9). In multivariable logistic models, sports/exercise was associated with lower odds of very poor sleep quality (PSQI >10) (OR = 0.18, 95% CI = 0.05 to 0.69). Sports/exercise (OR = 0.05, 95% CI = 0.01 to 0.26) and vigorous intensity PA (OR = 0.13, 95% CI = 0.04 to 0.42) were associated with lower odds of short (vs normal) sleep duration. There were no statistically significant relationships between PA in any other domain or intensity and sleep quality or duration CONCLUSIONS: Findings can inform interventions designed to improve postpartum sleep via increasing opportunities for exercise among postpartum women.
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Affiliation(s)
- Marquis Hawkins
- University of Massachusetts, Department of Biostatistics and Epidemiology, Amherst, MA 01003.
| | - Bess Marcus
- Brown University School of Public Health, Department of Behavioral and Social Sciences, Providence, Providence, Rhode Island
| | - Penelope Pekow
- University of Massachusetts, Department of Biostatistics and Epidemiology, Amherst, MA 01003
| | - Milagros C Rosal
- University of Massachusetts Medical School, 55 Lake Avenue North, S7-755, Division of Preventive and Behavioral Medicine, Department of Medicine, Worcester, MA 01655
| | - Katherine L Tucker
- University of Massachusetts Lowell, Dugan Hall - 110-O, Department of Biomedical and Nutritional Sciences, Lowell, MA 01854
| | - Rebecca M C Spencer
- University of Massachusetts, Tobin 419, Department of Psychological and Brain Sciences, Amherst, MA 01003
| | - Lisa Chasan-Taber
- University of Massachusetts, Department of Biostatistics and Epidemiology, Amherst, MA 01003
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41
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Yuvaci HU, Yazici E, Yazici AB, Cevrioglu S. How often do women use non-drug treatment methods for psyschiatric symptoms during pregnancy and postpartum periods? Ment Illn 2019; 11:7988. [PMID: 31007882 PMCID: PMC6452226 DOI: 10.4081/mi.2019.7988] [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: 01/14/2019] [Accepted: 01/24/2019] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to determine the prevalence of complementary and alternative medical applications (CAM) and non-drug treatments of women during their pregnancies, postpartum periods and the changes between these periods. The Screening Form for Non-pharmacologic Methods Used during Pregnancy and Postpartum period was administered to the participants. Passiflora (Incarnata), Hypericum perforatum (St. John's Wort), omega 3 supplements, bright light treatment, transmagnetic stimulation, S-adenosyl- methionine, herbal teas, biofeedback/neurofeedback, amulets, exercise, acupuncture and psychotherapy were investigated. The ratio of the use of one of the CAM methods for psychiatric complaints during people's lifetime was found to be 33.3% (n=162). Herbal teas were the main practice used during pregnancy (58.8%) and the postpartum. The use of CAM according to the utilization periods of the participants statistically significantly decreased in those who were currently pregnant (Cochran's Q=298.007; P<0.05). The use of participants' non-drug treatments in the periodical follow-up decreased in those who are currently pregnant and increased during the postpartum period.
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Affiliation(s)
| | - Esra Yazici
- Department of Psychiatry, Faculty of Medicine, Sakarya University, Turkey
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42
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Padulo J, Bragazzi NL, De Giorgio A, Grgantov Z, Prato S, Ardigò LP. The Effect of Physical Activity on Cognitive Performance in an Italian Elementary School: Insights From a Pilot Study Using Structural Equation Modeling. Front Physiol 2019; 10:202. [PMID: 30890960 PMCID: PMC6412095 DOI: 10.3389/fphys.2019.00202] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 02/15/2019] [Indexed: 01/11/2023] Open
Abstract
When compared to the previous generations, younger generations have become sedentary on a global level. Physical activity positively contributes to human growth and development, causing, indeed, both physiological and psychological benefits. The aim of the current study was examining the relationship between physical activity and school achievement in a sample of 80 Italian elementary (viz. primary) school last year responding children (11.0 ± 0.3 years, 1.46 ± 0.09 m, 39.5 ± 7.9 kg). Such an aim was fulfilled by investigating eventual correlations between physical tests results and school marks and by disclosing eventual mutual relationships between socio-demographics, family context, lifestyle (including physical activity), and school performance information using a structural modeling approach. Children were assessed for lower/upper limbs muscle strength and running/agility performance. Pearson's correlation between physical tests and school performance was studied. We found that agility correlated with English, Italian, mathematics, music, and sport marks, whereas jump correlated with English, mathematics, sport, and technologies marks. Sprint correlated with mathematics, sport, and technologies marks. All correlation coefficients were moderate, except for correlations between sport marks and physical tests (strong correlation). From the structural model, we found that socio-demographics and lifestyle significantly impacted on school achievement. In particular, lifestyle was found to fully moderate the impact of the family context on school achievement. Schools and households represent important settings for improving children physical and psychological-cognitive health and status, offering physical activities opportunities.
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Affiliation(s)
- Johnny Padulo
- Department of Psychology, eCampus University, Novedrate, Italy
- Faculty of Kinesiology, University of Split, Split, Croatia
- Sport Performance Laboratory, University of Split, Split, Croatia
- Research Laboratory “Sport Performance Optimization”, National Center of Medicine and Sciences in Sport (CNMSS), Tunis, Tunisia
| | - Nicola Luigi Bragazzi
- Faculty of Kinesiology, University of Split, Split, Croatia
- Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | | | - Zoran Grgantov
- Faculty of Kinesiology, University of Split, Split, Croatia
| | | | - Luca Paolo Ardigò
- School of Exercise and Sport Science, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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Wilson N, Lee JJ, Bei B. Postpartum fatigue and depression: A systematic review and meta-analysis. J Affect Disord 2019; 246:224-233. [PMID: 30584956 DOI: 10.1016/j.jad.2018.12.032] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 11/04/2018] [Accepted: 12/16/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND New parents are vulnerable to fatigue and depressive symptoms. Many studies have reported significant positive correlations between the two in postpartum parents, but the size of correlations varies considerably between studies. The relationship between postpartum fatigue and depression is yet to be systematically synthesized and meta-analyzed. METHODS A PROSPERO registered systematic review and meta-analysis (CRD42017065240) was conducted on the correlation between fatigue and depression within the first two years postpartum in parents. Moderation analysis was used to examine the influence of demographic and measurement factors on the effect sizes. RESULTS Thirty-five eligible papers were identified (34 on mothers, 1 on fathers). The meta-analytic summary effect size for simultaneously measured fatigue and depressive symptoms among women in the postpartum period was r = 0.52, 95% CI [0.45, 0.59], p < .001. There was a high degree of heterogeneity in the strength of the correlation between studies. This heterogeneity was not accounted for by demographic (e.g., infant age, maternal age, population type) or methodology (e.g., measurement) related moderators. LIMITATIONS Studies not reporting or providing correlation between fatigue and depression were not included. Unable to assess some moderators due to limited sample size. CONCLUSIONS There is a strong correlation between fatigue and depressive symptoms among women in the first two years after child-birth, but a high degree of heterogeneity in correlation strength exists between studies. Careful assessment of both fatigue and depression when either symptom is reported could facilitate accurate differential diagnosis and prioritizing treatment in postpartum women. Further implications for assessment, treatment, and future research are discussed.
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Affiliation(s)
- Nathan Wilson
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Victoria 3800, Australia
| | - Jin Joo Lee
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Victoria 3800, Australia
| | - Bei Bei
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, 18 Innovation Walk, Clayton Campus, Victoria 3800, Australia.
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The effectiveness of exercise-based interventions for preventing or treating postpartum depression: a systematic review and meta-analysis. Arch Womens Ment Health 2019; 22:37-53. [PMID: 29882074 DOI: 10.1007/s00737-018-0869-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 05/24/2018] [Indexed: 12/17/2022]
Abstract
Postpartum depression can have detrimental effects on both a mother's physical and mental health and on her child's growth and emotional development. The aim of this study is to assess the effectiveness of exercise/physical activity-based interventions in preventing and treating postpartum depressive symptoms in primiparous and multiparous women to the end of the postnatal period at 52 weeks postpartum. Electronic databases were searched for published and unpublished randomised controlled trials of exercise/physical activity-based interventions in preventing and treating depressive symptoms and increasing health-related quality of life in women from 4 to 52 weeks postpartum. The results of the studies were meta-analysed and effect sizes with confidence intervals were calculated. The Grading of Recommendations Assessment and Development and Evaluation (GRADE) system was used to determine the confidence in the effect estimates. Eighteen trials conducted across a range of countries met the inclusion criteria. Most of the exercise interventions were aerobic and coaching compared to usual care, non-intervention and active controls. Small effect sizes of exercise-based interventions in reducing depressive symptoms were observed collectively and the quality of evidence was low across the individual studies. Although exercise-based interventions could create an alternative therapeutic approach for preventing major depression in postpartum women who experience subthreshold elevated depressive symptoms, the clinical effectiveness and the cost-effectiveness of exercise-based and physical activity interventions need to be better established. There is a need for further more rigorous testing of such interventions in high-quality randomised controlled trials against active control conditions before large-scale roll-out of these interventions in clinical practice is proposed.
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A Pilot Study Providing Evidence for a Relationship between a Composite Lifestyle Score and Risk of Higher Carotid Intima-Media Thickness: Is There a Link to Oxidative Stress? OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:4504079. [PMID: 29854082 PMCID: PMC5944202 DOI: 10.1155/2018/4504079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/04/2018] [Accepted: 03/28/2018] [Indexed: 11/17/2022]
Abstract
Lifestyle behaviours have been closely linked to the progressive cell damage associated with oxidative stress (OS) and the development of cardiovascular disease (CVD). Early detection of lifestyle-linked OS may therefore be useful in the early identification of prodromal disease. To test this hypothesis, this study assessed the relationship between a comprehensive redox balance lifestyle score (RBLS) and carotid intima-media thickness (CIMT), a recognized marker for CVD, and plasma biomarkers of OS. In a cross-sectional study design, 100 apparently healthy middle-aged participants were asked to complete a comprehensive lifestyle questionnaire, followed by DXA scanning, CIMT ultrasonography, and blood collection. The RBLS was composed of lifestyle components with pro- and antioxidant properties with a higher score indicative of lower oxidative activity. Multiple linear regression and logistic regression analysis were performed for statistical analysis. The RBLS was significantly associated with the risk for increased CIMT that was independent of conventional CVD risk factors (χ2(9) = 35.60, P ≤ 0.001). The adjusted model explained 42.4% of the variance in CIMT. Participants with RBLS below the median were at significantly increased risk of higher CIMT compared to participants with RBLS above the median (OR = 3.60, 95% CI: 1.19–10.88, P = 0.023). Significant associations were also observed between the RBLS, plasma total antioxidant capacity (TAC) (r(99) = 0.28, P = 0.006), hydroperoxide (HPX) (rs(99) = −0.28, P = 0.005), TAC/HPX ratio (r(98) = 0.41, P ≤ 0.001), γ-glutamyltransferase (r(97) = −0.23, P = 0.024), uric acid (r(98) = −0.20, P = 0.045), and inflammatory C-reactive protein (rs(97) = −0.25, P = 0.012) and interleukin-1β (r(97) = −0.21, P = 0.040). These findings highlight the importance of identifying the collective influence of lifestyle behaviours on OS activity and its potential to remodel the vascular endothelium.
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