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Bucciarelli V, Moscucci F, Dei Cas A, Coppi F, Angeli F, Pizzi C, Renda G, Nodari S, Maffei S, Montisci R, Pedrinelli R, Sciomer S, Perrone Filardi P, Mattioli AV, Gallina S. Maternal-fetal dyad beyond the phenomenology of pregnancy: from primordial cardiovascular prevention on out, do not miss this boat! Curr Probl Cardiol 2024; 49:102695. [PMID: 38852910 DOI: 10.1016/j.cpcardiol.2024.102695] [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: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/11/2024]
Abstract
Pregnancy represents a stress test for every woman's cardiovascular (CV) system, and a pre-existing maternal unfavorable cardio-metabolic phenotype can uncover both adverse pregnancy outcomes and the subsequent development of cardiovascular disease (CVD) risk factors during and after pregnancy. Moreover, the maternal cardiac and extracardiac environment can affect offspring's cardiovascular health through a complex mechanism called developmental programming, in which fetal growth can be influenced by maternal conditions. This interaction continues later in life, as adverse developmental programming, along with lifestyle risk factors and genetic predisposition, can exacerbate and accelerate the development of CV risk factors and CVD in childhood and adolescence. The aim of this narrative review is to summarize the latest evidences regarding maternal-fetal dyad and its role on primordial, primary and secondary CV prevention.
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Affiliation(s)
- Valentina Bucciarelli
- Cardiovascular Sciences Department, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy
| | - Federica Moscucci
- Department of Internal Medicine and Medical Specialties, Policlinico Umberto I, Viale del Policlinico n. 155, Rome 00161, Italy
| | - Alessandra Dei Cas
- Department of Medicine and Surgery, Università di Parma, Parma, Italy; Division of Endocrinology and Metabolic Diseases, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Francesca Coppi
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena 41121, Italy
| | - Francesco Angeli
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda, Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences- DIMEC, University of Bologna, Via Giuseppe Massarenti 9, Bologna 40138, Italy
| | - Carmine Pizzi
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda, Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences- DIMEC, University of Bologna, Via Giuseppe Massarenti 9, Bologna 40138, Italy
| | - Giulia Renda
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Savina Nodari
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia 25123, Italy
| | - Silvia Maffei
- Department of Cardiovascular Endocrinology and Metabolism, Gynaecological and Cardiovascular Endocrinology and Osteoporosis Unit, "Gabriele Monasterio" Foundation and Italian National Research Council (CNR) Pisa, Pisa 56124 Italy
| | - Roberta Montisci
- Clinical Cardiology, AOU Cagliari, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Susanna Sciomer
- Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, 'Sapienza', Rome University, Viale dell'Università, 37, Rome 00185, Italy
| | | | - Anna Vittoria Mattioli
- Department of Quality of Life Sciences, University of Bologna-Alma Mater Studiorum, Bologna 40126, Italy.
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
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Wang W, Yang F, Bai Y, Lu Y, Mao X. Association between domain-specific physical activity and mental health status after embryo transfer in IVF-ET-assisted pregnancy patients. Sci Rep 2024; 14:4928. [PMID: 38418518 PMCID: PMC10902343 DOI: 10.1038/s41598-024-55097-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/20/2024] [Indexed: 03/01/2024] Open
Abstract
Physical activity has been shown to impact mental health in in vitro fertilization-embryo transfer (IVF-ET) patients, but the relationship between domain-specific physical activity and mental health in this population remains unclear. In a cross-sectional observational study, 208 patients undergoing IVF-ET with long-term ovulation induction cycles were recruited from a reproductive center. The International Physical Activity Questionnaire and the symptom checklist 90 (SCL-90) were used to assess physical activity levels and mental health status, respectively. Analyses of variance and linear regression analyses were conducted to identify the relationship between physical activity and mental health. There were differences between different physical activity level in times of transfers, years of infertility, and times of abortions. Patients with high levels of physical activity had fewer symptoms than those with low levels of physical activity. Occupation, transport and household physical activity had significant negative correlations with the respective SCL-90 factor scores. Linear regression analysis revealed that occupation physical activity was associated with lower depression and anxiety, and transport physical activity and household physical activity were associated with lower obsessive-compulsive, interpersonal sensitivity, depression, anxiety, and psychoticism scores. The study indicates that increased engagement in physical activity, specifically activities related to occupation, transportation, and household, may be associated with improved mental health among IVF-ET patients.
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Affiliation(s)
- Wei Wang
- Department of Psychology, Qilu Hospital of Shandong University, Wenhuaxi Road 107, Jinan, 250012, Shandong, China
| | - Fang Yang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, China
| | - Yunfeng Bai
- Department of Anesthesiology, Linyi People's Hospital, Linyi, China
| | - Yanxia Lu
- Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, 250012, Shandong, China.
| | - Xueqin Mao
- Department of Psychology, Qilu Hospital of Shandong University, Wenhuaxi Road 107, Jinan, 250012, Shandong, China.
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Zhang R, Byrd T, Qiao S, Torres ME, Li X, Liu J. Is It Safe for Me to Get It? Factors Influencing COVID-19 Vaccination Decision-Making among Postpartum Women Who Are Black and Hispanic in Deep South. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01931-3. [PMID: 38356011 DOI: 10.1007/s40615-024-01931-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 01/22/2024] [Accepted: 01/31/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND COVID-19 vaccination is vital for ending the pandemic, yet safety concerns persist among pregnant and postpartum women, especially those who are Black and Hispanic. This study aims to explore factors that influence postpartum women's vaccination decision-making during pregnancy and postpartum through women's lived experiences and maternal care providers' (MCPs) observations. METHODS From January to August 2022, we conducted semi-structured interviews with postpartum women who are Black and Hispanic and with MCPs. Participants were recruited from obstetric and pediatric clinics in South Carolina and had given birth in 2021. Thematic analysis was employed for data analysis. RESULTS The study involved 19 Black and 20 Hispanic women, along with 9 MCPs, and revealed both barriers and facilitators to COVID-19 vaccination. The factors that influence pregnant and postpartum women's decision about COVID-19 vaccine uptake included: 1) awareness of health threats associated with COVID-19 vaccines, 2) vaccine availability and accessibility, 3) vaccine-related knowledge and exposure to misinformation, 4) concerns regarding pre-existing health conditions and potential side effects of COVID-19 vaccines, 5) emotional factors associated with vaccination decision-making processes, 6) concerns about the well-being of infants, 7) cultural perspectives, and 8) encouragement by trusted supporters. CONCLUSION The findings suggest that reliable information, social support, and trusted MCPs' advice can motivate COVID-19 vaccination among pregnant and postpartum women who are Black and Hispanic. However, barriers such as misinformation, mistrust in the health care system, and fears of potential side effects impede vaccination uptake. Future interventions should address these barriers, consider health disparities, involve trusted MCPs, and initiate conversations about vaccines to promote vaccination among these populations.
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Affiliation(s)
- Ran Zhang
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Tiffany Byrd
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shan Qiao
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Myriam E Torres
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Lv Y, Hu R, Liang Y, Zhou Y, Lian Y, He T. Effect of daily physical activity on ambulatory blood pressure in pregnant women with chronic hypertension: A prospective cohort study protocol. PLoS One 2024; 19:e0296023. [PMID: 38198464 PMCID: PMC10781089 DOI: 10.1371/journal.pone.0296023] [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: 05/08/2023] [Accepted: 11/23/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Physical activity, a first-line approach for the treatment of non-gestational hypertension globally, has been shown to benefit most pregnant women in many respects. The benefits and risks of prenatal physical activity in complicated pregnancies, such as preeclampsia and chronic hypertension, require further investigation. It is worth conducting studies to address questions about physical activity during pregnancy in women with chronic hypertension, such as the benefits and risks, frequency, duration, and intensity. This prospective cohort study aims to investigate whether moderate-intensity daily physical activity reduces ambulatory blood pressure in pregnant women with chronic hypertension. METHODS Pregnant women with chronic hypertension at 11+0 to 13+6 gestational weeks will be recruited from the outpatient clinic and divided into moderate- and light-intensity physical activity groups according to the intensity of the 7-day physical activity monitored using the model wGT3X-BT accelerometer. 24-h ambulatory blood pressure monitoring will be performed at enrollment as a baseline and will be repeated in the second and third trimesters. The primary outcome is the difference in the change in 24-h ambulatory systolic blood pressure from the first to the third trimester between the groups. Secondary outcomes include the difference of change in other ambulatory (24-h diastolic, daytime, and nighttime) and office blood pressure variables from the first to the second and third trimesters, the incidence of severe hypertension (≥160/110 mmHg), and changes in the type and dosage of antihypertensive medication. The primary and secondary outcomes related to changes in blood pressure from baseline to the second and third trimesters between the groups will be analyzed using Student's independent t-test or the Mann-Whitney U test. DISCUSSION This cohort study will provide a basis for randomized controlled trials and verify an easily achieved, economical, and non-fetotoxic approach for adjuvant blood pressure management in pregnant women with chronic hypertension. REGISTRY This study is registered with the Chinese Clinical Trials Registry (NO. ChiCTR2200062094). Date Registered: 21/07/2022.
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Affiliation(s)
- Yanxiang Lv
- Department of Obstetrics and Gynecology Intensive Care Unit, Northwest Women’s and Children’s Hospital, Xi’an City, Shaanxi Prov, China
| | - Rui Hu
- Department of Obstetrics and Gynecology Intensive Care Unit, Northwest Women’s and Children’s Hospital, Xi’an City, Shaanxi Prov, China
| | - Yan Liang
- Department of Obstetrics and Gynecology Intensive Care Unit, Northwest Women’s and Children’s Hospital, Xi’an City, Shaanxi Prov, China
| | - Ying Zhou
- Department of Obstetrics and Gynecology Intensive Care Unit, Northwest Women’s and Children’s Hospital, Xi’an City, Shaanxi Prov, China
| | - Yanan Lian
- Department of Obstetrics and Gynecology Intensive Care Unit, Northwest Women’s and Children’s Hospital, Xi’an City, Shaanxi Prov, China
| | - Tongqiang He
- Department of Obstetrics and Gynecology Intensive Care Unit, Northwest Women’s and Children’s Hospital, Xi’an City, Shaanxi Prov, China
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Mattioli AV, Coppi F, Bucciarelli V, Gallina S. Cardiovascular risk stratification in young women: the pivotal role of pregnancy. J Cardiovasc Med (Hagerstown) 2023; 24:793-797. [PMID: 37773880 DOI: 10.2459/jcm.0000000000001557] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Affiliation(s)
- Anna Vittoria Mattioli
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena
| | - Francesca Coppi
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena
| | - Valentina Bucciarelli
- Cardiovascular Sciences Department-Azienda Ospedaliero-Universitaria delle Marche, Ancona
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
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Yeh CY, Chien LY, Hwang FM, Huang JP, Lee CF, Chang CW. Evidence-based trends and association between symptom disturbance and physical activity among pregnant women: A longitudinal study. Worldviews Evid Based Nurs 2023; 20:465-475. [PMID: 37140131 DOI: 10.1111/wvn.12647] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/19/2023] [Accepted: 03/13/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Women usually decrease their physical activity (PA) after becoming pregnant. The change in PA may influence their symptom distress (SD). The changes and correlations between SD and PA throughout pregnancy remain unclear. AIMS The aims of this study were to describe PA and SD trajectories across all three trimesters and examine their correlations during pregnancy. METHODS A repeated-measure longitudinal study with convenience sampling at a hospital in Northern Taiwan was performed. Participants were recruited at 8-16 weeks of gestation, and two follow-up visits were performed at 24-28 weeks of gestation (second trimester) and after 36 weeks of gestation (third trimester). A total of 225 participants completed the study. The participants completed the Pregnancy Physical Activity Questionnaire (PPAQ) and Pregnancy-related Symptom Disturbance Scale (PSD), and sociodemographic and prenatal variables were recorded. RESULTS Throughout pregnancy, SD decreased then increased, showing an overall upward trend, whereas PA showed the opposite pattern, increasing then decreasing, with an overall downward trend. Sedentary activity was positively correlated with both physical and psychological SD during the second and third trimesters. Exceeding the Institute of Medicine's recommendations for gestational weight gain, having childcare support, sport/exercise-type, and light-intensity PA were negatively associated with the physical and psychological SD, while a history of miscarriage and sedentary-intensity PA were positively associated with the physical and psychological SD. LINKING EVIDENCE TO ACTION While several factors, including light-intensity PA, were found negatively associated with the physical and psychological SD, sedentary-intensity PA were positively associated with the physical and psychological SD, our findings shed light on future intervention strategies to relieve SD and decrease sedentary behavior among pregnant women.
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Affiliation(s)
- Chen-Yu Yeh
- Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Li-Yin Chien
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Yang Ming Campus, Taipei, Taiwan
| | - Fang-Ming Hwang
- Department of Education, National Chiayi University, Chiayi, Taiwan
| | - Jian-Pei Huang
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan
| | - Ching-Fang Lee
- Department of Nursing, Mackay Medical College, New Taipei City, Taiwan
| | - Chun-Wei Chang
- Department of Psychiatry, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan
- School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan
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Zhang R, Byrd T, Qiao S, Torres ME, Li X, Liu J. Factors influencing COVID-19 vaccination decision-making among African American and Hispanic pregnant and postpartum women in Deep South. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.07.20.23292951. [PMID: 37546980 PMCID: PMC10402215 DOI: 10.1101/2023.07.20.23292951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Background COVID-19 vaccination is vital for ending the pandemic but concerns about its safety among pregnant and postpartum women, especially among African American (AA) and Hispanic women, persist. This study aims to explore factors that influence vaccination decision-making among AA and Hispanic pregnant and postpartum women through women's experiences and maternal care providers' (MCPs) observations. Methods From January and August 2022, we conducted semi-structured interviews with AA and Hispanic women and MCPs. Participants were recruited from obstetric and pediatric clinics in South Carolina, and all births took place after March 2020. Thematic analysis was employed for data analysis. Results The study involved 19 AA and 20 Hispanic women, along with 9 MCPs, and revealed both barriers and facilitators to COVID-19 vaccination. The factors that influence pregnant and postpartum women's decision about COVID-19 vaccine uptake included: 1) awareness of health threats associated with COVID-19 vaccines, 2) vaccine availability and accessibility, 3) vaccine-related knowledge and exposure to misinformation, 4) concerns regarding pre-existing health conditions and potential side effects of COVID-19 vaccines, 5) emotional factors associated with vaccination decision-making processes, 6) concerns about the well-being of infants, 7) cultural perspectives, and 8) encouragement by trusted supporters. Conclusion Findings suggest that reliable information, social support, and trusted doctors' advice can motivate COVID-19 vaccination. However, barriers such as misinformation, mistrust in the health care system, and fears related to potential side effects impede vaccination uptake among AA and Hispanic pregnant and postpartum women. Future interventions should target these barriers, along with health disparities, involve trusted doctors in outreach, and initiate vaccine conversations to promote vaccination among this population.
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Affiliation(s)
- Ran Zhang
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Tiffany Byrd
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Shan Qiao
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Myriam E. Torres
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Xiaoming Li
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
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Li H, Zhang Y. Effects of Physical Activity and Circadian Rhythm on SCL-90 Scores by Factors among College Students. Behav Sci (Basel) 2023; 13:606. [PMID: 37504053 PMCID: PMC10376651 DOI: 10.3390/bs13070606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/08/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE A study was conducted to investigate the effects of different levels of physical activity and circadian rhythm differences on the nine factors of obsessive-compulsive disorder, interpersonal sensitivity, depression, anxiety, hostility, phobia, paranoia, and psychoticism on the SCL-90 scale. METHODS A questionnaire and mathematical and statistical methods were used to conduct the study. Data were collected through a web-based cross-sectional survey of college students from three universities in Anhui. A statistical analysis of the collected data was conducted using mathematical and statistical methods. RESULTS A total of 1248 students were included in the statistics of this study. Binary logistic regression analysis revealed that low physical activity levels were associated with somatization (OR = 1.36, 95% CI = 0.95-1.94), obsessive-compulsive disorder (OR = 1.85, 95% CI = 1.25-2.75), interpersonal sensitivity (OR = 1.94, 95% CI = 1.30-2.88), depression (OR = 2.03, 95% CI = 1.31-3.16), anxiety (OR = 1.67, 95% CI = 1.03-2.69), hostility (OR = 1.80, 95% CI = 1.12-2.89), phobia (OR = 1.88, 95% CI = 1.20-2.94), and paranoia (OR = 2.23, 95% CI = 1.43-3.46). Circadian rhythm differences were associated with somatization (OR = 0.91, 95% CI = 0.87-0.96), obsessive-compulsive disorder (OR = 0.93, p < 0.01, 95% CI = 0.89-0.98), interpersonal sensitivity (OR = 0.90, 95% CI = 0.85-0.94), depression (OR = 0.92, 95% CI = 0.87-0.97), anxiety (OR = 0.89, 95% CI = 0.83-0.95), hostility (OR = 0.91, 95% CI = 0.86-0.97), phobia (OR = 0.87, 95% CI = 0.82-0.93), and paranoia (OR = 0.90, 95% CI = 0.85-0.95) were all negatively associated. In addition, gender was associated with somatization and obsessive-compulsive disorder (OR = 0.75, 95% CI = 0.57-0.98), depression (OR = 0.92, 95% CI = 0.87-0.97), and paranoia (OR = 0.55, 95% CI = 0.40-0.76). CONCLUSIONS Low-intensity physical activity was more likely to be associated with somatization, obsessive-compulsive disorder, relationship sensitivity, depression, anxiety, hostility, terror, and paranoia than high-intensity and moderate-intensity physical activity, and circadian rhythm differences showed that people who slept later (known as nocturnal) were more likely to have these problems.
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Affiliation(s)
- Huimin Li
- Department of Physical Education, College of Physical Education, Anhui Polytechnic University, Wuhu 241000, China
| | - Yong Zhang
- Department of Physical Education, College of Physical Education, Anhui Polytechnic University, Wuhu 241000, China
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Bucciarelli V, Mattioli AV, Sciomer S, Moscucci F, Renda G, Gallina S. The Impact of Physical Activity and Inactivity on Cardiovascular Risk across Women's Lifespan: An Updated Review. J Clin Med 2023; 12:4347. [PMID: 37445383 DOI: 10.3390/jcm12134347] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/08/2023] [Accepted: 06/25/2023] [Indexed: 07/15/2023] Open
Abstract
Physical inactivity (PI) represents a significant, modifiable risk factor that is more frequent and severe in the female population worldwide for all age groups. The physical activity (PA) gender gap begins early in life and leads to considerable short-term and long-term adverse effects on health outcomes, especially cardiovascular (CV) health. Our review aims to highlight the prevalence and mechanisms of PI across women's lifespan, describing the beneficial effects of PA in many physiological and pathological clinical scenarios and underlining the need for more awareness and global commitment to promote strategies to bridge the PA gender gap and limit PI in current and future female generations.
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Affiliation(s)
- Valentina Bucciarelli
- Cardiovascular Sciences Department, Azienda Ospedaliero-Universitaria delle Marche, 60126 Ancona, Italy
| | - Anna Vittoria Mattioli
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
- National Institute for Cardiovascular Research-INRC, 40126 Bologna, Italy
| | - Susanna Sciomer
- Department of Clinical and Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome 'Sapienza', Policlinico Umberto I, 49971 Rome, Italy
| | - Federica Moscucci
- Department of Clinical and Internal Medicine, Anesthesiology and Cardiovascular Sciences, University of Rome 'Sapienza', Policlinico Umberto I, 49971 Rome, Italy
| | - Giulia Renda
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
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Marini S, Messina R, Masini A, Scognamiglio F, Caravita I, Leccese V, Soldà G, Parma D, Bertini V, Scheier LM, Dallolio L. Application of the COM-B Framework to Understand Facilitators and Barriers for Practising Physical Activity among Pregnant Women and Midwives Participating in the WELL-DONE! Study. Behav Sci (Basel) 2023; 13:bs13020114. [PMID: 36829343 PMCID: PMC9952666 DOI: 10.3390/bs13020114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
Regular physical activity (PA) is protective and reduces disease burden but remains a challenge for pregnant women (PW). According to the World Health Organization (WHO) guidelines, PW without contraindications should practice 150 min of moderate PA per week. Nonetheless, PA levels are concerningly low among PW. The aim of this study was to investigate PW's and midwives' perceptions regarding PA and recommended guidelines, and use this information to inform future health promotion strategies. We recruited 10 PW and 10 midwives to participate in online focus groups conducted between July 2020 and April 2021. Focus group probes and data analysis were guided by the COM-B (capability, opportunity, motivation-behaviour) framework. The majority of the sample had already practised PA, recognized the importance of PA during pregnancy, and considered the WHO guidelines reasonable. Notwithstanding, PW wanted more specific instruction on PA and desired opportunities to practice. Additional barriers reported by PW included low self-efficacy and lack of motivation. Midwives considered the lack of specific knowledge and confidence in managing PA as the main obstacles. The current findings suggest that PW and midwives need specific training in PA to overcome both psychological and physical barriers. Midwives play a vital role in educating and encouraging PA among PW.
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Affiliation(s)
- Sofia Marini
- Department for Life Quality Studies, University of Bologna, 47921 Rimini, Italy
| | - Rossella Messina
- Department of Biomedical and Neuromotor Science, University of Bologna, Visa San Giacomo 12, 40126 Bologna, Italy
| | - Alice Masini
- Department of Biomedical and Neuromotor Science, University of Bologna, Visa San Giacomo 12, 40126 Bologna, Italy
- Correspondence:
| | - Francesca Scognamiglio
- Department of Biomedical and Neuromotor Science, University of Bologna, Visa San Giacomo 12, 40126 Bologna, Italy
| | - Isotta Caravita
- Department of Medical and Surgical Sciences, University of Bologna, Bologna Via Massarenti 9, 40138 Bologna, Italy
| | - Vincenza Leccese
- Department of Medical and Surgical Sciences, University of Bologna, Bologna Via Massarenti 9, 40138 Bologna, Italy
| | - Giorgia Soldà
- Department of Biomedical and Neuromotor Science, University of Bologna, Visa San Giacomo 12, 40126 Bologna, Italy
| | - Dila Parma
- Department of Medical and Surgical Sciences, University of Bologna, Bologna Via Massarenti 9, 40138 Bologna, Italy
| | - Virginia Bertini
- Department of Medical and Surgical Sciences, University of Bologna, Bologna Via Massarenti 9, 40138 Bologna, Italy
| | - Lawrence Matthew Scheier
- LARS Research Institute, Inc., Sun City, AZ 85351, USA
- Prevention Strategies, Greensboro, NC 27410, USA
| | - Laura Dallolio
- Department of Biomedical and Neuromotor Science, University of Bologna, Visa San Giacomo 12, 40126 Bologna, Italy
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Villar-Alises O, Martinez-Miranda P, Martinez-Calderon J. Prenatal Yoga-Based Interventions May Improve Mental Health during Pregnancy: An Overview of Systematic Reviews with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1556. [PMID: 36674309 PMCID: PMC9863076 DOI: 10.3390/ijerph20021556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 05/13/2023]
Abstract
An overview of systematic reviews with meta-analysis was developed to summarize evidence on the effectiveness of prenatal yoga-based interventions on pain, psychological symptoms, and quality of life during pregnancy. CINAHL (via EBSCOhost), Embase, PubMed, SPORTDiscus (via EBSCOhost), and the Cochrane Library were searched from inception to 15 December 2022. The intervention of interest was any prenatal yoga-based intervention. Pain, psychological symptoms, and quality of life were considered as outcome measures. The methodological quality of systematic reviews was judged using AMSTAR 2. The primary study overlap among systematic reviews was evaluated, building a citation matrix and calculating the corrected covered area (CCA). A total of ten systematic reviews, including fifteen meta-analyses of interest and comprising 32 distinct primary clinical trials, were included. Meta-analyses on pain and quality of life were not found. Most meta-analyses (93%) showed that prenatal yoga-based interventions are more effective than control interventions in reducing anxiety, depression, and stress symptoms. However, the overall methodological quality of systematic reviews was judged as critically low, and primary study overlap among systematic reviews was very high (CCA = 16%). Altogether, prenatal yoga-based interventions could improve the mental health of pregnant women, although due to the important methodological flaws that were detected, future systematic reviews should improve their methodological quality before drawing firm conclusions on this topic.
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Affiliation(s)
- Olga Villar-Alises
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, 41009 Sevilla, Spain
| | - Patricia Martinez-Miranda
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, 41009 Sevilla, Spain
| | - Javier Martinez-Calderon
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain
- Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, 41009 Sevilla, Spain
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Palacio M, Mottola MF. Activity Restriction and Hospitalization in Pregnancy: Can Bed-Rest Exercise Prevent Deconditioning? A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1454. [PMID: 36674214 PMCID: PMC9859130 DOI: 10.3390/ijerph20021454] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/16/2022] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Evidence suggests that exercise during pregnancy is beneficial to both parent and fetus. However, there are high-risk pregnancy conditions that may warrant hospitalization. In our narrative review, we first describe the clinical implications for activity restriction in pregnancy, the effects of hospitalization, and the impact of bed rest on non-pregnant individuals. We provide examples of a 30 min bed-rest exercise program for hospitalized pregnant patients using the principal of suggested frequency, intensity, time (duration) of activity, and type of activity (FITT) using a resistance tool while in bed. If the individual is able to ambulate, we recommend short walks around the ward. Every minute counts and activity should be incorporated into a program at least 3 times per week, or every day if possible. As in all exercise programs, motivation and accountability are essential. Flexibility in timing of the exercise intervention is important due to the scheduling of medical assessments that may occur throughout the day for these hospitalized patients. Evidence suggests that by improving physical and emotional health through a bed-rest exercise program during a hospitalized pregnancy may help the individual resume demanding daily activity in the postpartum period and improve quality of life once birth has occurred. More research is necessary to improve the health of those individuals who are hospitalized during pregnancy, with follow up and support into the postpartum period.
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Affiliation(s)
- Montse Palacio
- Senior Consultant, Maternal-Fetal Medicine, Hospital Clínic Barcelona (BCNatal Fetal Medicine Research Center), Universitat de Barcelona, 08028 Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi I Sunyer, 08036 Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBERER), 08001 Barcelona, Spain
| | - Michelle F. Mottola
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Children’s Health Research Institute, The University of Western Ontario, London, ON N6A 3K7, Canada
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Asante DO, Osei F, Abdul-Samed F, Nanevie VD. Knowledge and participation in exercise and physical activity among pregnant women in Ho, Ghana. Front Public Health 2022; 10:927191. [PMID: 36466468 PMCID: PMC9709326 DOI: 10.3389/fpubh.2022.927191] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 10/21/2022] [Indexed: 11/18/2022] Open
Abstract
Background Physical activity (PA) and exercise have been identified to improve the general fitness and health. Although, the Pregnancy Physical Activity Questionnaire (PPAQ) has been validated for use in assessing PA in pregnant women. However, understanding the knowledge and participation levels of PA in pregnant women in the underdeveloped regions of Ghana is of clinical relevance to foster education and promotion of PA. In Ghana, pregnant women believe the "myth" (mostly in rural areas and underdeveloped regions) that exercising in the first trimester might lead to miscarriage. Thus, the main objective of this study was to investigate the extent of knowledge and participation levels in PA among pregnant women in Ho, Ghana using a self-developed questionnaire which consisted of some questions adapted from the PPAQ. Methods Seventy-seven (n = 77) pregnant women between the ages of 18-50 years were recruited from three hospitals across the Ho municipality of Ghana. A self-developed questionnaire which consisted of some questions taken from the PPAQ was administered to participants under the researchers' supervision. Spearman's correlation analysis was used to find the association between the level of participation in PA, knowledge of PA and gestational age among pregnant women. Results From the total participants (n = 77) recruited, 57 (74%) of the participants scored high in PA knowledge. Most of the participants 48 (62.3%) answered that PA promotes healthy pregnancy. Participants who reported barriers to PA during pregnancy were no exercise habits 51 (66.2%), having no time 17 (22.1%) and fear of miscarriage 9 (11.7%). There was a significant (p < 0.05) association between the level of participation and gestational age. No significant (p > 0.05) association between the level of participation and knowledge of PA was observed. Conclusion There is a high level of knowledge of PA among pregnant women in Ho, Ghana. However, most pregnant women rather engage in PA as their gestational age increases. Thus, to foster sustainable exercise participation during pregnancy, all healthcare providers saddled with the responsibility of providing maternal healthcare must strengthen the education and promotion of exercise and PA among pregnant women in Ho, Ghana.
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Affiliation(s)
- Drusilla Obenewaa Asante
- Department of Sports and Exercise Medical Sciences, School of Sports and Exercise Medicine, University of Health and Allied Science, Ho, Ghana,*Correspondence: Drusilla Obenewaa Asante
| | - Francis Osei
- Medical Sociology and Psychobiology, Department of Health and Physical Activity, University of Potsdam, Potsdam, Germany
| | - Fridaus Abdul-Samed
- Department of Sports and Exercise Medical Sciences, School of Sports and Exercise Medicine, University of Health and Allied Science, Ho, Ghana
| | - Victoria Dzifa Nanevie
- Department of Sports and Exercise Medical Sciences, School of Sports and Exercise Medicine, University of Health and Allied Science, Ho, Ghana
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