1
|
Grau González A, Sánchez Del Pino A, Amezcua-Prieto C, Møller Luef B, Anne Vinter C, Stener Jorgensen J, García-Valdés L. An umbrella review of systematic reviews on interventions of physical activity before pregnancy, during pregnancy, and postpartum to control and/or reduce weight gain. Int J Gynaecol Obstet 2024; 166:915-931. [PMID: 38466033 DOI: 10.1002/ijgo.15453] [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: 11/21/2023] [Revised: 02/13/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND The increasing prevalence of overweight and obesity worldwide represents a (chronic) complex public health problem. This is also seen among women of childbearing age despite increased efforts to promote physical activity (PA) interventions. Excessive gestational weight gain (GWG) is associated with negative health outcomes for both mothers and offspring. OBJECTIVES To summarize current systematic reviews (SRs) on PA interventions during pregnancy and postpartum to prevent excessive GWG and identify the most effective approaches. SEARCH STRATEGY A literature search was conducted on major electronic databases (MEDLINE/Pubmed, Cochrane, Web of Science, Epistemonikos) from inception to March 2023. SELECTION CRITERIA This study included SRs and meta-analyses of studies involving women aged 18 years or older from diverse ethnic backgrounds, who were either in the preconception period, pregnant, or within 1 year postpartum and who had no contraindications for exercise. Women with chronic diseases, such as pre-existing diabetes (type 1 or type 2) were excluded. DATA COLLECTION AND ANALYSIS Two reviewers extracted data from selected studies assessing the impact of PA in preconception, pregnancy, and postpartum. Methodologic quality was assessed with the AMSTAR-2 tool. A narrative summary of results addresses relationships between PA and weight before, during, and after pregnancy, informing future research priorities for preventing excessive weight gain. This study is registered on PROSPERO (CRD420233946666). MAIN RESULTS Out of 892 identified articles, 25 studies were included after removing duplicates, unrelated titles, and screening titles and abstracts for eligibility. The results demonstrate that PA can help prevent excessive GWG and postpartum weight retention. Structured and supervised moderate-intensity exercise, at least twice a week, and each session lasting a minimum of 35 min seems to provide the greatest benefits. CONCLUSIONS Women who comply with the PA program and recommendations are more likely to achieve adequate GWG and return to their pre-pregnancy body mass index after delivery. Further research is warranted to explore how preconception PA influences pregnancy and postpartum outcomes given the absence of identified preconception-focused interventions.
Collapse
Affiliation(s)
- Andrea Grau González
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
| | - Ana Sánchez Del Pino
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
| | - Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
- CIBER of Epidemiology and Public Health, Carlos III Health Institute, Madrid, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Birgitte Møller Luef
- University of Southern Denmark, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Christina Anne Vinter
- University of Southern Denmark, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | - Jan Stener Jorgensen
- University of Southern Denmark, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Luz García-Valdés
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
| |
Collapse
|
2
|
Evenson KR, Brown WJ, Brinson AK, Budzynski-Seymour E, Hayman M. A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:472-483. [PMID: 38158180 PMCID: PMC11184298 DOI: 10.1016/j.jshs.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The period following pregnancy is a critical time window when future habits with respect to physical activity (PA) and sedentary behavior (SB) are established; therefore, it warrants guidance. The purpose of this scoping review was to summarize public health-oriented country-specific postpartum PA and SB guidelines worldwide. METHODS To identify guidelines published since 2010, we performed a (a) systematic search of 4 databases (CINAHL, Global Health, PubMed, and SPORTDiscus), (b) structured repeatable web-based search separately for 194 countries, and (c) separate web-based search. Only the most recent guideline was included for each country. RESULTS We identified 22 countries with public health-oriented postpartum guidelines for PA and 11 countries with SB guidelines. The continents with guidelines included Europe (n = 12), Asia (n = 5), Oceania (n = 2), Africa (n = 1), North America (n = 1), and South America (n = 1). The most common benefits recorded for PA included weight control/management (n = 10), reducing the risk of postpartum depression or depressive symptoms (n = 9), and improving mood/well-being (n = 8). Postpartum guidelines specified exercises to engage in, including pelvic floor exercises (n = 17); muscle strengthening, weight training, or resistance exercises (n = 13); aerobics/general aerobic activity (n = 13); walking (n = 11); cycling (n = 9); and swimming (n = 9). Eleven guidelines remarked on the interaction between PA and breastfeeding; several guidelines stated that PA did not impact breast milk quantity (n = 7), breast milk quality (n = 6), or infant growth (n = 3). For SB, suggestions included limiting long-term sitting and interrupting sitting with PA. CONCLUSION Country-specific postpartum guidelines for PA and SB can help promote healthy behaviors using a culturally appropriate context while providing specific guidance to public health practitioners.
Collapse
Affiliation(s)
- Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8050, USA.
| | - Wendy J Brown
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Alison K Brinson
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3115, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8120, USA
| | | | - Melanie Hayman
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
| |
Collapse
|
3
|
McLarnan SM, Bramer LM, Dixon HM, Scott RP, Calero L, Holmes D, Gibson EA, Cavalier HM, Rohlman D, Miller RL, Kincl L, Waters KM, Anderson KA, Herbstman JB. Predicting personal PAH exposure using high dimensional questionnaire and wristband data. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024; 34:679-687. [PMID: 38177333 DOI: 10.1038/s41370-023-00617-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 11/13/2023] [Accepted: 11/21/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Polycyclic aromatic hydrocarbons (PAHs) are a class of pervasive environmental pollutants with a variety of known health effects. While significant work has been completed to estimate personal exposure to PAHs, less has been done to identify sources of these exposures. Comprehensive characterization of reported sources of personal PAH exposure is a critical step to more easily identify individuals at risk of high levels of exposure and for developing targeted interventions based on source of exposure. OBJECTIVE In this study, we leverage data from a New York (NY)-based birth cohort to identify personal characteristics or behaviors associated with personal PAH exposure and develop models for the prediction of PAH exposure. METHODS We quantified 61 PAHs measured using silicone wristband samplers in association with 75 questionnaire variables from 177 pregnant individuals. We evaluated univariate associations between each compound and questionnaire variable, conducted regression tree analysis for each PAH compound and completed a principal component analysis of for each participant's entire PAH exposure profile to determine the predictors of PAH levels. RESULTS Regression tree analyses of individual compounds and exposure mixture identified income, time spent outdoors, maternal age, country of birth, transportation type, and season as the variables most frequently predictive of exposure.
Collapse
Affiliation(s)
- Sarah M McLarnan
- Department of Environmental Health Sciences, Columbia University, Columbia Center for Children's Environmental Health, Mailman School of Public Health, New York City, NY, USA.
| | - Lisa M Bramer
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA, USA
| | - Holly M Dixon
- Environmental and Molecular Toxicology, Food Safety and Environmental Stewardship Program, Oregon State University, Corvallis, OR, USA
| | - Richard P Scott
- Environmental and Molecular Toxicology, Food Safety and Environmental Stewardship Program, Oregon State University, Corvallis, OR, USA
| | - Lehyla Calero
- Department of Environmental Health Sciences, Columbia University, Columbia Center for Children's Environmental Health, Mailman School of Public Health, New York City, NY, USA
| | - Darrell Holmes
- Department of Environmental Health Sciences, Columbia University, Columbia Center for Children's Environmental Health, Mailman School of Public Health, New York City, NY, USA
| | - Elizabeth A Gibson
- Department of Environmental Health Sciences, Columbia University, Columbia Center for Children's Environmental Health, Mailman School of Public Health, New York City, NY, USA
| | - Haleigh M Cavalier
- Department of Environmental Health Sciences, Columbia University, Columbia Center for Children's Environmental Health, Mailman School of Public Health, New York City, NY, USA
| | - Diana Rohlman
- Oregon State University, College of Public Health and Human Sciences, Corvallis, OR, USA
| | - Rachel L Miller
- Division of Clinical Immunology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Laurel Kincl
- Oregon State University, College of Public Health and Human Sciences, Corvallis, OR, USA
| | - Katrina M Waters
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA, USA
- Environmental and Molecular Toxicology, Food Safety and Environmental Stewardship Program, Oregon State University, Corvallis, OR, USA
| | - Kim A Anderson
- Environmental and Molecular Toxicology, Food Safety and Environmental Stewardship Program, Oregon State University, Corvallis, OR, USA
| | - Julie B Herbstman
- Department of Environmental Health Sciences, Columbia University, Columbia Center for Children's Environmental Health, Mailman School of Public Health, New York City, NY, USA
| |
Collapse
|
4
|
O'Connor H, Willcox JC, de Jersey S, Wright C, Wilkinson SA. Digital preconception interventions targeting weight, diet and physical activity: A systematic review. Nutr Diet 2024; 81:244-260. [PMID: 37845187 DOI: 10.1111/1747-0080.12842] [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: 05/30/2023] [Revised: 08/14/2023] [Accepted: 08/31/2023] [Indexed: 10/18/2023]
Abstract
AIM Optimising preconception health increases the likelihood of conception, positively influences short- and long-term pregnancy outcomes and reduces intergenerational chronic disease risk. Our aim was to synthesise study characteristics and maternal outcomes of digital or blended (combining face to face and digital modalities) interventions in the preconception period. METHODS We searched six databases (PubMed, Cochrane, Embase, Web of Science, CINHAL and PsycINFO) from 1990 to November 2022 according to the PRISMA guidelines for randomised control trials, quasi-experimental trials, observation studies with historical control group. Studies were included if they targeted women of childbearing age, older than 18 years, who were not currently pregnant and were between pregnancies or/and actively trying to conceive. Interventions had to be delivered digitally or via digital health in combination with face-to-face delivery and aimed to improve modifiable behaviours, including dietary intake, physical activity, weight and supplementation. Studies that included women diagnosed with type 1 or 2 diabetes were excluded. Risk of bias was assessed using the Academy of Nutrition and Dietetics quality criteria checklist. Study characteristics, intervention characteristics and outcome data were extracted. RESULTS Ten studies (total participants n=4,461) were included, consisting of nine randomised control trials and one pre-post cohort study. Seven studies received a low risk of bias and two received a neutral risk of bias. Four were digitally delivered and six were delivered using blended modalities. A wide range of digital delivery modalities were employed, with the most common being email and text messaging. Other digital delivery methods included web-based educational materials, social media, phone applications, online forums and online conversational agents. Studies with longer engagement that utilised blended delivery showed greater weight loss. CONCLUSION More effective interventions appear to combine both traditional and digital delivery methods. More research is needed to adequately test effective delivery modalities across a diverse range of digital delivery methods, as high heterogeneity was observed across the small number of included studies.
Collapse
Affiliation(s)
- Hannah O'Connor
- Centre for Clinical Research and Perinatal Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Butterfield Street Herston, Brisbane, Queensland, Australia
| | - Jane C Willcox
- Faculty of Health, Charles Darwin University, Darwin, Northwest Territories, Australia
| | - Susan de Jersey
- Centre for Clinical Research and Perinatal Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Butterfield Street Herston, Brisbane, Queensland, Australia
| | - Charlotte Wright
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia
| | - Shelley A Wilkinson
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia
- Lifestyle Maternity, Brisbane, Queensland, Australia
- Department of Obstetric Medicine, Mater Mothers' Hospitals, Brisbane, Queensland, Australia
| |
Collapse
|
5
|
Yan S, Jiang H, Yang Z, Tang X, Chen Z, Chen Z, Liu H, Zhang F. Physical activity trajectory during pregnancy and associations with maternal fatigue using a growth mixture modeling approach. Sci Rep 2024; 14:1020. [PMID: 38200232 PMCID: PMC10781982 DOI: 10.1038/s41598-024-51648-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/08/2024] [Indexed: 01/12/2024] Open
Abstract
The purpose of this study was to investigate the associations of physical activity trajectories with maternal fatigue. Pregnant women provided objectively assessed physical activity data by Pregnancy Physical Activity Questionnaire four times. Fatigue scale-14 was used to assess fatigue during pregnancy. Growth mixture modelling characterized physical activity trajectories across pregnancy. The generalized estimating equations was used to analyze the relationship between different physical activity profiles and fatigue in pregnant women. A total of 626 pregnant women were included in analysis in a teaching hospital in Nantong city. Fatigue (total, mental and physical) was not different between two groups based on total energy expenditure of PA (constantly high vs. constantly low). The pregnant women in "constantly high household PA" group had the higher fatigue compared to "constantly low household PA" (P < 0.05) and "constantly medium household PA" (P < 0.05). The pregnant women in "constantly high sport PA" group had lower fatigue compared to "constantly low sport PA" (P < 0.05). Household PA and sport PA were still an independent influencing factor for fatigue after controlling for confounding variables. Specifically, we observed that higher household PA and lower sport PA were associated with higher fatigue during pregnancy.
Collapse
Affiliation(s)
- Shuhan Yan
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China
- Health School attached to Shanghai University of Medicine & Health Sciences, 200237, Shanghai, China
| | - Hui Jiang
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China
- Affiliated hospital of Nantong university, Nantong, China
| | - Ziyi Yang
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China
| | - Xinyan Tang
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China
| | - Zihang Chen
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China
| | - Zhifang Chen
- Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong City, Jiangsu Province, China
| | - Huahua Liu
- Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong City, Jiangsu Province, China
| | - Feng Zhang
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China.
| |
Collapse
|
6
|
Kandel P, Lim S, Dever M, Lamichhane P, Skouteris H, Currie S, Hill B. Enablers and Barriers Related to Preconception Physical Activity: Insights from Women of Reproductive Age Using Mixed Methods. Nutrients 2023; 15:4939. [PMID: 38068798 PMCID: PMC10707946 DOI: 10.3390/nu15234939] [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: 10/30/2023] [Revised: 11/22/2023] [Accepted: 11/26/2023] [Indexed: 12/18/2023] Open
Abstract
Engaging in regular preconception physical activity (PA) is associated with benefits, including improved cardiovascular health and mental well-being. However, most women do not meet PA recommendations in the preconception period. This study aimed to investigate enablers and barriers related to PA in preconception women using a sequential mixed method design. An online survey was followed by Zoom interviews with women of reproductive age (aged 18-45 years). A weaving approach and the Capability Opportunity Motivation Behaviour (COM-B) model were used to integrate and present the data. Seven hundred and eighty-eight non-pregnant women from Australia, India, and the US completed the quantitative survey, and 13 Australian-based women participated in a qualitative interview. Physical activity levels were associated with having social support, a desire to improve body image, and becoming a healthier person. Women encountered barriers such as misconceptions about PA, competing priorities, financial constraints, and a lack of accessibility. Enablers for participation in PA included knowledge of its importance, a desire to be healthier, weight loss, social support, and having goals. The multifaceted and intricate nature of enablers and barriers for preconception PA lays the groundwork for developing tailored interventions and policies aimed at promoting preconception PA among women.
Collapse
Affiliation(s)
- Pragya Kandel
- Health and Social Care Unit, Monash University, Melbourne, VIC 3004, Australia; (P.K.); (M.D.); (H.S.)
| | - Siew Lim
- Health Systems and Equity, Eastern Health Clinical School, Monash University, Melbourne, VIC 3004, Australia;
| | - Michelle Dever
- Health and Social Care Unit, Monash University, Melbourne, VIC 3004, Australia; (P.K.); (M.D.); (H.S.)
| | - Prabhat Lamichhane
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3086, Australia;
| | - Helen Skouteris
- Health and Social Care Unit, Monash University, Melbourne, VIC 3004, Australia; (P.K.); (M.D.); (H.S.)
- Warwick Business School, University of Warwick, Coventry CV4 7AL, UK
| | - Sinead Currie
- Division of Psychology, University of Stirling, Stirling FK9 4LA, UK;
| | - Briony Hill
- Health and Social Care Unit, Monash University, Melbourne, VIC 3004, Australia; (P.K.); (M.D.); (H.S.)
| |
Collapse
|
7
|
Sustarsic A, Hadzic V, Meulenberg CJW, Abazovic E, Videmsek M, Burnik Papler T, Paravlic AH. The influence of lifestyle interventions and overweight on infertility: a systematic review, meta-analysis, and meta-regression of randomized controlled trials. Front Med (Lausanne) 2023; 10:1264947. [PMID: 38020109 PMCID: PMC10646477 DOI: 10.3389/fmed.2023.1264947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/25/2023] [Indexed: 12/01/2023] Open
Abstract
This study aimed to investigate the effect of lifestyle intervention (LSI) on diagnosed infertility in overweight and obese women. A systematic review and meta-analysis were conducted. A literature search was performed on the following databases from September 2022 to December 2022: PubMed, Web of Science, and SPORTDiscus. The inclusion criteria were the following: women between 18 and 45 years of age, BMI over 25.0 kg/m2, diagnosed with infertility, a weight loss intervention, and control group part of RCTs. In total, 15 studies were identified and included. The meta-analysis shows a beneficial effect of LSI on reducing weight, waist circumference, and BMI and increasing infertility. A significantly beneficial effect of lifestyle intervention on weight reduction was observed for participants who initially had a higher BMI, while a non-significant effect was observed for individuals with a BMI above 35 kg/m2. The meta-analysis showed a beneficial effect of lifestyle intervention on ovulation incidence and sex hormone-binding globulin. The lifestyle intervention group had 11.23 times more ovulatory incidence than the control group, which in turn increased the ability to conceive. As robust evidence for the effect of lifestyle interventions on infertility in obese and overweight women was found, it is advised to integrate similar interventions into future infertility treatment processes.
Collapse
Affiliation(s)
- Ana Sustarsic
- Faculty of Sports, University of Ljubljana, Ljubljana, Slovenia
| | - Vedran Hadzic
- Faculty of Sports, University of Ljubljana, Ljubljana, Slovenia
| | | | - Ensar Abazovic
- Faculty of Sport and Physical Education, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Mateja Videmsek
- Faculty of Sports, University of Ljubljana, Ljubljana, Slovenia
| | - Tanja Burnik Papler
- Division of Gynecology, Department of Human Reproduction, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Armin H. Paravlic
- Faculty of Sports, University of Ljubljana, Ljubljana, Slovenia
- Faculty of Sports Studies, Masaryk University, Brno, Czechia
| |
Collapse
|
8
|
Chu AHY, Padmapriya N, Tan SL, Goh CMJL, Chong YS, Shek LP, Tan KH, Gluckman PD, Yap FKP, Lee YS, Loy SL, Chan JKY, Godfrey KM, Eriksson JG, Chan SY, Bernard JY, Müller-Riemenschneider F. Longitudinal Analysis of Patterns and Correlates of Physical Activity and Sedentary Behavior in Women From Preconception to Postpartum: The Singapore Preconception Study of Long-Term Maternal and Child Outcomes Cohort. J Phys Act Health 2023; 20:850-859. [PMID: 37146982 DOI: 10.1123/jpah.2022-0642] [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: 12/07/2022] [Revised: 02/24/2023] [Accepted: 03/20/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVE Longitudinal changes in physical activity (PA) and sedentary behavior patterns from preconception to postpartum are not fully characterized. We examined changes and baseline sociodemographic/clinical correlates of PA and sedentary behavior in women from preconception to postpartum. METHODS The Singapore Preconception Study of Long-Term Maternal and Child Outcomes cohort recruited 1032 women planning pregnancy. Participants completed questionnaires at preconception, 34 to 36 weeks gestation, and 12 months postpartum. Repeated-measures linear regression models were used to analyze changes in walking, moderate to vigorous PA (MVPA), screen time, and total sedentary time, and to identify sociodemographic/clinical correlates associated with these changes. RESULTS Of the 373 women who delivered singleton live births, 281 provided questionnaires for all time points. Walking time increased from preconception to late pregnancy but decreased postpartum (adjusted means [95% CI]: 454 [333-575], 542 [433-651], and 434 [320-547] min/wk, respectively). Vigorous-intensity PA and MVPA decreased from preconception to late pregnancy but increased postpartum (vigorous-intensity PA: 44 [11-76], 1 [-3-5], and 11 [4-19] min/wk, MVPA: 273 [174-372], 165 [95-234], and 226 [126-325] min/wk, respectively). Screen time and total sedentary time remained consistent from preconception to pregnancy but decreased postpartum (screen: 238 [199-277], 244 [211-277], and 162 [136-189] min/d, total: 552 [506-598], 555 [514-596], and 454 [410-498] min/d, respectively). Individual characteristics of ethnicity, body mass index, employment, parity, and self-rated general health significantly influenced women's activity patterns. CONCLUSION During late pregnancy, walking time increased, while MVPA declined significantly, and partially returned to preconception levels postpartum. Sedentary time remained stable during pregnancy but decreased postpartum. The identified set of sociodemographic/clinical correlates underscores need for targeted strategies.
Collapse
Affiliation(s)
- Anne H Y Chu
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Singapore
| | - Natarajan Padmapriya
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore
| | - Shuen Lin Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Singapore
| | - Claire Marie J L Goh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore
| | - Lynette P Shek
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore,Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Singapore
- Liggins Institute, University of Auckland, Auckland,New Zealand
| | - Fabian K P Yap
- Duke-NUS Medical School, Singapore,Singapore
- Department of Pediatrics, KK Women's and Children's Hospital, Singapore,Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore,Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore
| | - See Ling Loy
- Duke-NUS Medical School, Singapore,Singapore
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore,Singapore
| | - Jerry K Y Chan
- Duke-NUS Medical School, Singapore,Singapore
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore,Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton,UK
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki,Finland
- Folkhälsan Research Center, Helsinki,Finland
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore
| | - Jonathan Y Bernard
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and Statistics, Paris,France
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,Singapore
- Berlin Institute of Health, Charite University Medical Centre, Berlin,Germany
| |
Collapse
|
9
|
Hesketh KR, Baird J, Crozier SR, Godfrey KM, Harvey NC, Cooper C, van Sluijs EM. Activity Behaviors Before and During Pregnancy Are Associated With Women's Device-Measured Physical Activity and Sedentary Time in Later Parenthood: A Longitudinal Cohort Analysis. J Phys Act Health 2023; 20:803-811. [PMID: 37573030 PMCID: PMC7615174 DOI: 10.1123/jpah.2022-0630] [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: 11/30/2022] [Revised: 07/03/2023] [Accepted: 07/10/2023] [Indexed: 08/14/2023]
Abstract
PURPOSE To explore how activity behaviors before/during pregnancy relate to those in later parenthood, we assessed associations between sitting and moderate-/strenuous exercise before/during pregnancy, and sedentary time (SED) and moderate to vigorous physical activity (MVPA) 4-7 years postpartum ("later parenthood"). METHODS Longitudinal data were from the Southampton Women's Survey, United Kingdom. Women reported time spent sitting (in hours per day), in moderate-strenuous exercise (hours per week), and in strenuous exercise (hours per week) at 3 time points before/during pregnancy (ie, preconception, at ∼12-wk and ∼34-wk gestation). From this, we derived 3 behavior trajectories for each woman. In later parenthood, women wore an accelerometer for ≤7 days (mean: 5.4 [SD: 1.8] d), which we used to derive 2 outcomes: minutes per day SED and in MVPA. Multilevel linear regression was used to explore associations between trajectories before/during pregnancy and device-measured SED/MVPA in later parenthood. RESULTS A total of 780 women provided valid data before/during pregnancy and in later parenthood. Consistent high sitters (vs low) were more sedentary 4-7 years postpartum (β = 39.5 min/d [95% confidence interval, 23.26 to 55.82]), as were women in groups who sat more in later pregnancy. Consistently high moderate/-strenuous exercisers (vs low) were 22% (95% confidence interval, 2%-47%) more active in later parenthood; those engaging in strenuous activity preconception tended to have higher MVPA as parents. CONCLUSIONS Trajectories of sitting and exercise before/during pregnancy are associated with SED and MVPA, respectively, in later parenthood. Interventions to reduce sitting in pregnancy and to encourage higher intensity activity preconception may benefit maternal and child health.
Collapse
Affiliation(s)
- Kathryn R. Hesketh
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Janis Baird
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Southampton, United Kingdom
| | - Sarah R. Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Applied Research Collaboration Wessex, Southampton Science Park, Southampton, United Kingdom
| | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Nicholas C. Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Esther M.F. van Sluijs
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| |
Collapse
|
10
|
Leiferman JA, Lacy R, Walls J, Farewell CV, Dinger MK, Downs DS, Farrabi SS, Huberty JL, Paulson JF. My Baby, My Move+: feasibility of a community prenatal wellbeing intervention. Pilot Feasibility Stud 2023; 9:134. [PMID: 37507732 PMCID: PMC10375613 DOI: 10.1186/s40814-023-01368-1] [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: 12/16/2022] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Excessive gestational weight gain (EGWG), insufficient prenatal physical activity and sleep, and poor psychological wellbeing independently increase risks for adverse maternal and infant outcomes. A novel approach to mitigate these risks is utilizing peer support in a community-based prenatal intervention. This study assessed the feasibility (acceptability, demand, implementation, and practicality) of a remotely delivered prenatal physical activity intervention called My Baby, My Move + (MBMM +) that aims to increase prenatal physical activity, enhance mood and sleep hygiene, and reduce EGWG. METHODS Participants were recruited through community organizations, local clinics, and social media platforms in the Fall of 2020 and Spring of 2021. Eligible pregnant women were randomized to either the MBMM + intervention or the control group. Each group met over Zoom for 16 sessions (twice weekly for 60 min over 8 weeks) to learn either behavioral change and wellbeing knowledge and skills (MBMM +) or knowledge and skills related to parenting (control group). Multiple methods of evaluation to better understand the feasibility of the intervention were conducted. RESULTS A total of 49 women (25 MBMM + intervention, 24 control) completed both pre- and post-survey assessments and were included in the analyses. A subsample of 19 (39%) intervention participants completed a combination of semi-structured interviews/surveys to assess acceptability, demand, implementation, and practicality. Participants expressed positive feedback regarding acceptability (satisfaction and intent to continue use) and were extremely likely or likely to recommend the program to a friend (demand). Implementation metrics were assessed by observation and feedback forms completed by peer leaders and demonstrated high-quality control. Findings suggest that the intervention was practical due to remote sessions and cost-effectiveness. CONCLUSION The MBMM + intervention was deemed to be a feasible intervention with high acceptability, demand, implementation, and practicality. These findings can be used to inform the scalability of the intervention and implementation of a larger efficacy trial. TRIAL REGISTRATION 19-1366, initial date is on January 23, 2020.
Collapse
Affiliation(s)
- Jenn A Leiferman
- Colorado School of Public Health, University of Colorado | Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA.
| | - Rachael Lacy
- Colorado School of Public Health, University of Colorado | Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Jessica Walls
- Colorado School of Public Health, University of Colorado | Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Charlotte V Farewell
- Colorado School of Public Health, University of Colorado | Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Mary K Dinger
- Colorado School of Public Health, University of Colorado | Anschutz Medical Campus, 13001 East 17th Place, Aurora, CO, 80045, USA
| | - Danielle Symons Downs
- Department of Kinesiology, College of Health and Human Development, The Pennsylvania State University, State College, PA, USA
- Department of Obstetrics and Gynecology, College of Medicine, The Pennsylvania State University, 266 Recreation Building University Park, State College, PA, 16802, USA
| | - Sarah S Farrabi
- Goldfarb School of Nursing at Barnes-Jewish College, 4483 Duncan Ave, St. Louis, MO, 63110, USA
- Center for Human Nutrition, Washington University School of Medicine, 660 S. Euclid, St. Louis, MO, 63110, USA
| | - Jennifer L Huberty
- College of Health Solutions, Arizona State University, 500 North 3rd Street, Phoenix, AZ, 85004, USA
| | - James F Paulson
- Department of Psychology, Old Dominion University, 5115 Terminal Blvd, Norfolk, VA, 23529, USA
| |
Collapse
|
11
|
Saidi L, Godbout PD, Morais-Savoie C, Registe PPW, Bélanger M. Association between physical activity education and prescription during prenatal care and maternal and fetal health outcomes: a quasi-experimental study. BMC Pregnancy Childbirth 2023; 23:496. [PMID: 37407926 PMCID: PMC10320878 DOI: 10.1186/s12884-023-05808-x] [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: 11/21/2021] [Accepted: 06/22/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Physical activity (PA) during pregnancy is associated with healthy gestational weight gain (GWG) and a reduced risk of developing gestational diabetes (GD), gestational hypertension (GHT) and fetal macrosomia. However, in Canada, less than 20% of pregnant women meet PA recommendations. This study assessed associations between an intervention including PA education by prenatal nurses and a PA prescription delivered by physicians and fetal and maternal outcomes. METHODS This is a quasi-experimental study. Two groups of women who received their prenatal care at the obstetrics clinic of a university hospital were created. In the first group, 394 pregnant women followed at the clinic received standard care. In the second group, 422 women followed at the clinic received standard care supplemented with education on the relevance of PA during pregnancy and a prescription for PA. Data for both study groups were obtained from the medical records of the mothers and their newborns. Logistic regressions were used to compare the odds of developing excessive GWG, GD, GHT, and fetal macrosomia between the two study groups. RESULTS The addition of PA education and PA prescription to prenatal care was associated with 29% lower odds of developing excessive GWG (adjusted odds ratios (OR) 0.71, 95% confidence intervals (CI) 0.51-0.99), 73% lower odds of developing GHT (0.27, 0.14-0.53), 44% lower odds of fetal macrosomia (> 4 kg) (0.56, 0.34-0.93), and 40% lower odds of being large for gestational age (0.60, 0.36-0.99). The intervention was not associated with a difference in odds of developing GD (0.48, 0.12-1.94). CONCLUSIONS The inclusion of education and prescription of PA as part of routine prenatal care was associated with improvements in maternal and fetal health outcomes, including significantly lower odds of GWG, GHT and macrosomia.
Collapse
Affiliation(s)
- Latifa Saidi
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, 2500, boul. de l ’Université, Sherbrooke, Québec J1K 2R1 Canada
| | - Pierre D. Godbout
- School of Nursing, Université de Moncton, Campus de Shippagan, 725, Rue du Collège, Bathurst, NB E2A 3Z2 Canada
| | - Camille Morais-Savoie
- Centre de Formation Médicale du Nouveau-Brunswick, Université de Sherbrooke, Pavillon J-Raymond-Frenette, 50 Rue de La Francophonie St, Moncton, NB E1A 7R1 Canada
| | - Pierre Philippe Wilson Registe
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, 2500, boul. de l ’Université, Sherbrooke, Québec J1K 2R1 Canada
| | - Mathieu Bélanger
- Department of Family and Emergency Medicine, Université de Sherbrooke, Centre de Formation Médicale du Nouveau-Brunswick, Vitalité Health Network, Pavillon J-Raymond-Frenette, 18, Avenue Antonine-Maillet, Moncton, NB E1A 3E9 Canada
| |
Collapse
|
12
|
Brinson AK, da Silva SG, Hesketh KR, Evenson KR. Impact of Physical Activity and Sedentary Behavior on Spontaneous Female and Male Fertility: A Systematic Review. J Phys Act Health 2023; 20:600-615. [PMID: 37146984 PMCID: PMC7614776 DOI: 10.1123/jpah.2022-0487] [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: 09/09/2022] [Revised: 02/10/2023] [Accepted: 02/28/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Before pregnancy is recognized, ovulation, fertilization, and implantation must all occur. Physical activity and sedentary behavior may impact pregnancy success by altering each or all of these processes. The aim of this review was to review the association between physical activity and sedentary behavior with spontaneous female and male fertility. METHOD PubMed/MEDLINE, Web of Science, CINAHL, SPORTDiscus, and Embase were searched from inception to August 9, 2021. Eligible studies included randomized controlled trials or observational studies, published in English, describing an association between physical activity or sedentary behavior (exposures) and spontaneous fertility (outcome) among women or men. RESULTS Thirty-four studies from 31 unique populations were included in this review (12 cross-sectional studies, 10 cohort studies, 6 case-control studies, 5 randomized controlled trials, and one case-cohort study). Of the 25 studies among women, the majority identified mixed results (n = 11) or no association (n = 9) between physical activity and female fertility. Seven studies reported on female fertility and sedentary behavior, and 2 found sedentary behavior was associated with decreased female fertility. Of the 11 studies among men, most of the studies (n = 6) found that physical activity was associated with increased male fertility. Two of the studies reported on male fertility and sedentary behavior, and neither identified an association. CONCLUSIONS The association between spontaneous fertility and physical activity in both men and women remains unclear, and the association with sedentary behavior remains largely unexplored.
Collapse
Affiliation(s)
| | - Shana G. da Silva
- Federal University of Fronteira Sul, Passo Fundo, RS, Brazil University of North Carolina—Chapel Hill, Chapel Hill, NC, USA
| | - Kathryn R. Hesketh
- University of North Carolina—Chapel Hill, Chapel Hill, NC, USA UCL Great Ormond Street Institute of Child Health, London, UK MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | |
Collapse
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
Murphy K, Berk J, Muhwava-Mbabala L, Booley S, Harbron J, Ware L, Norris S, Zarowsky C, Lambert EV, Levitt NS. Using the COM-B model and Behaviour Change Wheel to develop a theory and evidence-based intervention for women with gestational diabetes (IINDIAGO). BMC Public Health 2023; 23:894. [PMID: 37189143 DOI: 10.1186/s12889-023-15586-y] [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: 12/02/2021] [Accepted: 04/02/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND In South Africa, the prevalence of gestational diabetes (GDM) is growing, concomitant with the dramatically increasing prevalence of overweight/obesity among women. There is an urgent need to develop tailored interventions to support women with GDM to mitigate pregnancy risks and to prevent progression to type 2 diabetes post-partum. The IINDIAGO study aims to develop and evaluate an intervention for disadvantaged GDM women attending three large, public-sector hospitals for antenatal care in Cape Town and Soweto, SA. This paper offers a detailed description of the development of a theory-based behaviour change intervention, prior to its preliminary testing for feasibility and efficacy in the health system. METHODS The Behaviour Change Wheel (BCW) and the COM-B model of behaviour change were used to guide the development of the IINDIAGO intervention. This framework provides a systematic, step-by-step process, starting with a behavioural analysis of the problem and making a diagnosis of what needs to change, and then linking this to intervention functions and behaviour change techniques to bring about the desired result. Findings from primary formative research with women with GDM and healthcare providers were a key source of information for this process. RESULTS Key objectives of our planned intervention were 1) to address women's evident need for information and psychosocial support by positioning peer counsellors and a diabetes nurse in the GDM antenatal clinic, and 2) to offer accessible and convenient post-partum screening and counselling for sustained behaviour change among women with GDM by integrating follow-up into the routine immunisation programme at the Well Baby clinic. The peer counsellors and the diabetes nurse were trained in patient-centred, motivational counselling methods. CONCLUSIONS This paper offers a rich description and analysis of designing a complex intervention tailored to the challenging contexts of urban South Africa. The BCW was a valuable tool to use in designing our intervention and tailoring its content and format to our target population and local setting. It provided a robust and transparent theoretical foundation on which to develop our intervention, assisted us in making the hypothesised pathways for behaviour change explicit and enabled us to describe the intervention in standardised, precisely defined terms. Using such tools can contribute to improving rigour in the design of behavioural change interventions. TRIAL REGISTRATION First registered on 20/04/2018, Pan African Clinical Trials Registry (PACTR): PACTR201805003336174.
Collapse
Affiliation(s)
- Katherine Murphy
- Department of Medicine, Chronic Disease Initiative for Africa (CDIA), University of Cape Town, Cape Town, South Africa.
| | - Jamie Berk
- Department of Medicine, Chronic Disease Initiative for Africa (CDIA), University of Cape Town, Cape Town, South Africa
| | - Lorrein Muhwava-Mbabala
- Department of Medicine, Chronic Disease Initiative for Africa (CDIA), University of Cape Town, Cape Town, South Africa
| | - Sharmilah Booley
- Department of Human Biology, Division of Human Nutrition, University of Cape Town, Cape Town, South Africa
| | - Janetta Harbron
- Department of Human Biology, Division of Human Nutrition, University of Cape Town, Cape Town, South Africa
| | - Lisa Ware
- Department of Paediatrics, MRC/WITS Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Johannesburg, South Africa
| | - Shane Norris
- Department of Paediatrics, MRC/WITS Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Johannesburg, South Africa
- South African Medical Research Council (SAMRC), Cape Town, South Africa
| | - Christina Zarowsky
- Public Health Research Centre (CReSP - Centre de recherche en santé publique de l'Université de Montréal et du CIUSSS de Centre-Sud de Montréal), Montreal, Canada
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Canada
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Estelle V Lambert
- Department of Human Biology, Division of Physiological Sciences, Faculty of Health Sciences, Research Centre for Health Through Physical Activity, Lifestyle and Sport (HPALS), University of Cape Town, Cape Town, South Africa
| | - Naomi S Levitt
- Department of Medicine, Chronic Disease Initiative for Africa (CDIA), University of Cape Town, Cape Town, South Africa
| |
Collapse
|
15
|
Kumari A, Ranjan P, Vikram NK, Kaur D, Balsarkar G, Malhotra A, Puri M, Batra A, Madan J, Tyagi S, Guleria K, Dabral A, Sarkar S, Nigam A, Anwar W, Kamath S, Bhatla N, Kumari SS, Kumar R, Choranur A, Venkataraman S, Kaur T, Rathore AM, Kaloiya GS, Prakash A, Tiwaskar M, Verma A, Singh R, Sharma KA, Baitha U, Tewary K, Misra A, Guleria R. Evidence and consensus-based clinical practice guideline for the management of obesity and overweight in postpartum women: An AIIMS-DST initiative. J Family Med Prim Care 2023; 12:812-855. [PMID: 37448937 PMCID: PMC10336934 DOI: 10.4103/jfmpc.jfmpc_45_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/23/2022] [Accepted: 01/31/2022] [Indexed: 07/18/2023] Open
Affiliation(s)
- Archana Kumari
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Naval K. Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Divjyot Kaur
- Department of Home Science, University of Delhi, Delhi, India
| | - Geetha Balsarkar
- Department of Obstetrics and Gynaecology, Seth G. S. Medical College, Mumbai, Maharashtra, India
| | - Anita Malhotra
- Department of Home Science, University of Delhi, Delhi, India
| | - Manju Puri
- Director Professor and Head, Department of Obstetrics and Gynaecology, LHMC and SSK Hospital, New Delhi, India
| | - Achla Batra
- President, Association of Obstetricians and Gynaecologists of Delhi (AOGD), New Delhi, India
- Professor, Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Jagmeet Madan
- National President, Indian Dietetic Association, New Delhi, India
| | - Shakun Tyagi
- Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India
| | - Kiran Guleria
- Department of Obstetrics and Gynaecology, University College of Medical Sciences, New Delhi, India
| | - Anjali Dabral
- Professor and Head, Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Siddharth Sarkar
- Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India
| | - Aruna Nigam
- Department of Obstetrics and Gynaecology, Hamdard Institute of Medical Sciences & Research, New Delhi, India
| | - Wareesha Anwar
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sandhya Kamath
- Former Dean, LT Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
- Former Dean, Seth G. S. Medical College, and KEM Hospital, Mumbai, Maharashtra, India
| | - Neerja Bhatla
- Professor and Head, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - S. Shantha Kumari
- President, The Federation of Obstetric and Gynaecological Societies of India, India
| | - Raman Kumar
- President, Academy of Family Physicians of India, India
- President, World Organization of Family Doctors (WONCA), New Delhi, India
| | | | - Srikumar Venkataraman
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India
| | - Tanveer Kaur
- Department of Psychology, University of Delhi, Delhi, India
| | - Asmita Muthal Rathore
- Director Professor and Head, Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India
| | - Gauri Shankar Kaloiya
- Department of Clinical Psychology and NDDTC, All India Institute of Medical Sciences, New Delhi, India
| | - Anupam Prakash
- Department of Medicine, LHMC and SSK Hospital, New Delhi, India
| | | | - Archana Verma
- Vice President, The Federation of Obstetric and Gynaecological Societies of India, India
| | - Rakhi Singh
- The Federation of Obstetric and Gynaecological Societies of India, India
| | - K Aparna Sharma
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Upendra Baitha
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Kamlesh Tewary
- President, Association of the Physicians of India, India
| | - Anoop Misra
- Chairman, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, New Delhi, India
- Chairman, National Diabetes, Obesity and Cholesterol Foundation (N-DOC), New Delhi, India
- President, Diabetes Foundation (India) (DFI), New Delhi, India
| | - Randeep Guleria
- Director, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
16
|
Hayman M, Keppel M, Stanton R, Thwaite TL, Alfrey KL, Alley S, Harrison C, Keating SE, Schoeppe S, Cannon SS, Haakstad LAH, Gjestvang C, Williams SL. A mixed-methods exploration of attitudes towards pregnant Facebook fitness influencers. BMC Public Health 2023; 23:569. [PMID: 36973705 PMCID: PMC10041693 DOI: 10.1186/s12889-023-15457-6] [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: 10/25/2022] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Exercise during pregnancy is associated with various health benefits for both mother and child. Despite these benefits, most pregnant women do not meet physical activity recommendations. A known barrier to engaging in exercise during pregnancy is a lack of knowledge about appropriate and safe exercise. In our current era of social media, many pregnant women are turning to online information sources for guidance, including social media influencers. Little is known about attitudes towards pregnancy exercise information provided by influencers on social media platforms. This study aimed to explore attitudes towards exercise during pregnancy depicted by social media influencers on Facebook, and user engagement with posted content. METHODS A mixed-methods approach was used to analyse data from 10 Facebook video posts of social media influencers exercising during pregnancy. Quantitative descriptive analyses were used to report the number of views, shares, comments and emotive reactions. Qualitative analysis of user comments was achieved using an inductive thematic approach. RESULTS The 10 video posts analysed were viewed a total of 12,117,200 times, shared on 11,181 occasions, included 13,455 user comments and 128,804 emotive icon reactions, with the most frequently used icon being 'like' (81.48%). The thematic analysis identified three themes associated with attitudes including [1] exercise during pregnancy [2] influencers and [3] type of exercise. A fourth theme of community was also identified. Most user comments were associated with positive attitudes towards exercise during pregnancy and the influencer. However, attitudes towards the types of exercise the influencer performed were mixed (aerobic and body weight exercises were positive; resistance-based exercise with weights were negative). Finally, the online community perceived by users was mostly positive and recognised for offering social support and guidance. CONCLUSIONS User comments imply resistance-based exercise with weights as unsafe and unnecessary when pregnant, a perception that does not align with current best practice guidelines. Collectively, the findings from this study highlight the need for continued education regarding exercise during pregnancy and the potential for social media influencers to disseminate evidence-based material to pregnant women who are highly receptive to, and in need of reliable health information.
Collapse
Affiliation(s)
- Melanie Hayman
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia.
| | - Marian Keppel
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia
| | - Robert Stanton
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia
- Cluster for Resilience and Wellbeing, Appleton Institute, 44 Greenhill Road, Wayville, SA, 5034, Australia
| | - Tanya L Thwaite
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia
| | - Kristie-Lee Alfrey
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia
| | - Stephanie Alley
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia
| | - Cheryce Harrison
- School of Public Health and Preventive Medicine, Monash University, Wellington Road, Melbourne, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Stephanie Schoeppe
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia
| | - Summer S Cannon
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia
| | - Lene A H Haakstad
- Department of Sports Medicine, Norwegian School of Sports Sciences, Ullevål Stadion Melbourne, P.O Box 4014, Oslo, VIC, 3800 0806, Norway
| | - Christina Gjestvang
- Department of Sports Medicine, Norwegian School of Sports Sciences, Ullevål Stadion Melbourne, P.O Box 4014, Oslo, VIC, 3800 0806, Norway
| | - Susan L Williams
- Appleton Institute, School of Health Medical and Applied Sciences, Central Queensland University, Bruce Highway, North Rockhampton, Brisbane, QLD, 4702, Australia
| |
Collapse
|
17
|
Turner J, Clanchy K, Vincze L. Telehealth interventions for physical activity and exercise participation in postpartum women: A quantitative systematic review. Prev Med 2023; 167:107413. [PMID: 36603606 DOI: 10.1016/j.ypmed.2022.107413] [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: 08/25/2022] [Revised: 11/14/2022] [Accepted: 12/28/2022] [Indexed: 01/03/2023]
Abstract
Postpartum women are one of the least physically active vulnerable populations globally and telehealth has been proposed as a potential method of delivering effective exercise interventions for this population. However, clinical practice guidelines are based upon the recommendations for the general population and therefore, the most efficacious exercise dose and the delivery method for this population is unclear. This quantitative systematic review will examine the implementation and outcomes of telehealth exercise interventions in the postpartum population to synthesise the degree to which these outcomes have been assessed and evaluated. Five databases were searched from January 2001 to March 2022. Studies implementing synchronous telehealth exercise interventions for postpartum women were included. Interventions were examined against the Template for Intervention Description and Replication (TIDieR) checklist that assesses intervention reporting completeness and replicability. Of the 1036 records identified, 16 studies progressed to data extraction. Six interventions provided individualised exercise prescription, and only four were delivered by university-level exercise practitioners. Physical activity participation was well reported, however health-related outcomes (i.e., muscular strength and aerobic capacity) were very minimally assessed. Only one intervention utilised modern video conferencing as the primary telehealth communication method. With the minimal assessment of health-related outcomes, there is limited scope to assess the effectiveness of these interventions for postpartum women. Future research interventions need to be reported according to a validated trial reporting system and focus on relevant health related outcomes including postpartum depressive symptoms, quality of life, cardiovascular fitness, muscular strength and body composition.
Collapse
Affiliation(s)
- Jemma Turner
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
| | - Kelly Clanchy
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia.
| | - Lisa Vincze
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
| |
Collapse
|
18
|
Channon S, Coulman E, Cannings-John R, Henley J, Lau M, Lugg-Widger F, Strange H, Davies F, Sanders J, Scherf C, Couzens Z, Morantz L. Acceptability and feasibility of a planned preconception weight loss intervention in women with long-acting reversible contraception: the Plan-it mixed-methods study. Health Technol Assess 2023; 27:1-224. [PMID: 36688498 PMCID: PMC9885302 DOI: 10.3310/nkix8285] [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: 01/24/2023] Open
Abstract
BACKGROUND Women with overweight (a body mass index of ≥ 25 kg/m2) or obesity (a body mass index of ≥ 30 kg/m2) are at greater risk of experiencing complications during pregnancy and labour than women with a healthy weight. Women who remove their long-acting reversible contraception (i.e. coils or implants) are one of the few groups of people who contact services as part of their preparation for conception, creating an opportunity to offer a weight loss intervention. OBJECTIVES The objectives were to understand if routine NHS data captured the pathway from long-acting reversible contraception removal to pregnancy and included body mass index; to identify the suitable components of a preconception weight loss intervention; and to engage with key stakeholders to determine the acceptability and feasibility of asking women with overweight/obesity to delay the removal of their long-acting reversible contraception in order to take part in a preconception weight loss intervention. DESIGN This was a preparatory mixed-methods study, assessing the acceptability and feasibility of a potential intervention, using routine NHS data and purposefully collected qualitative data. PARTICIPANTS The NHS routine data included all women with a long-acting reversible contraception code. There were three groups of participants in the surveys and interviews: health-care practitioners who remove long-acting reversible contraception; weight management consultants; and women of reproductive age with experience of overweight/obesity and of using long-acting reversible contraception. SETTING UK-based health-care practitioners recruited at professional meetings; and weight management consultants and contraceptive users recruited via social media. DATA SOURCES Anonymised routine data from UK sexual health clinics and the Clinical Practice Research Datalink, including the Pregnancy Register; and online surveys and qualitative interviews with stakeholders. RESULTS The records of 2,632,871 women aged 16-48 years showed that 318,040 had at least one long-acting reversible contraception event, with 62% of records including a body mass index. Given the identified limitations of the routine NHS data sets, it would not be feasible to reliably identify women with overweight/obesity who request a long-acting reversible contraception removal with an intention to become pregnant. Online surveys were completed by 100 health-care practitioners, four weight management consultants and 243 contraceptive users. Ten health-care practitioners and 20 long-acting reversible contraception users completed qualitative interviews. A realist-informed approach generated a hypothesised programme theory. The combination of weight discussions and the delay of long-acting reversible contraception removal was unacceptable as an intervention to contraceptive users for ethical and practical reasons. However, a preconception health intervention incorporating weight loss could be acceptable, and one potential programme is outlined. LIMITATIONS There was very limited engagement with weight management consultants, and the sample of participating stakeholders may not be representative. CONCLUSIONS An intervention that asks women to delay long-acting reversible contraception removal to participate in a preconception weight loss intervention would be neither feasible nor acceptable. A preconception health programme, including weight management, would be welcomed but requires risk communication training of health-care practitioners. FUTURE WORK Work to improve routine data sets, increase awareness of the importance of preconception health and overcome health-care practitioner barriers to discussing weight as part of preconception care is a priority. TRIAL REGISTRATION This trial is registered as ISRCTN14733020. FUNDING This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 27, No. 1.
Collapse
Affiliation(s)
- Susan Channon
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Elinor Coulman
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | - Josie Henley
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Mandy Lau
- Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | | | - Freya Davies
- The Welsh Centre for Primary and Emergency Care Research (PRIME), Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Julia Sanders
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Caroline Scherf
- Cardiff and Vale University Health Board, Department of Sexual Health, Cardiff Royal Infirmary, Cardiff, UK
| | - Zoë Couzens
- Public Health Wales NHS Trust, Public Health Wales, Cardiff, UK
| | | |
Collapse
|
19
|
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.
Collapse
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
| |
Collapse
|
20
|
Cabrera-Domínguez G, de la Calle M, Herranz Carrillo G, Ruvira S, Rodríguez-Rodríguez P, Arribas SM, Ramiro-Cortijo D. Women during Lactation Reduce Their Physical Activity and Sleep Duration Compared to Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11199. [PMID: 36141479 PMCID: PMC9517522 DOI: 10.3390/ijerph191811199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 06/16/2023]
Abstract
Sleep, mental health and physical activity are fundamental for wellbeing, and some of these factors are interrelated. However, these aspects are not usually considered during pregnancy and lactation, which are particularly vulnerable periods. Therefore, our aims were to conduct a cross sectional study to assess the psychological capital, quality of life, sleep hygiene and physical activity in a cohort of women during pregnancy and lactation periods. Women were recruited from Spanish maternity and lactation non-profit associations and social networks through an online platform with the following inclusion criteria: pregnancy (in any period of gestation) or breastfeeding period (≤6 months postpartum). The cohort was categorized into ≤12 weeks of gestation (n = 32), >12 weeks of gestation (n = 119) and lactation (n = 60). The women self-reported the sociodemographic data, obstetric complications and full breastfeeding or mixed practices. In addition, women responded to the psychological capital instrument, the health survey form, the Pittsburg sleep quality index and the pregnancy physical activity questionnaire. Overall, the groups were similar in sociodemographic variables. Women in the lactation period perceived lower social support compared to the gestation period. No statistically differences were found between groups in the psychological capital nor in the general health survey form. However, the models adjusted by employment and civil and economic status and perceived social support, demonstrated that the sleep duration negatively associated with the lactation period (β = 1.13 ± 0.56; p-Value = 0.016), and the household tasks were associated with this period (β = 2147.3 ± 480.7; p-Value < 0.001). A decrease in physical daily activities were associated with both the end of gestation and the lactation periods. In addition, the decreasing total activity was associated with the lactation period (β = 1683.67 ± 688.05; p-Value = 0.016). In conclusion, during lactation, the poorer sleep and physical activity, together with a lower social support of the woman, may lead to deficient mental health adjustment. Our data suggest that women are at higher risk of vulnerability in lactation compared to the gestation period.
Collapse
Affiliation(s)
- Gema Cabrera-Domínguez
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
| | - María de la Calle
- Department of Obstetric and Gynecology, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain
| | - Gloria Herranz Carrillo
- Division of Neonatology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), C/Profesor Martin Lagos s/n, 28040 Madrid, Spain
| | - Santiago Ruvira
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
- Food, Oxidative Stress and Cardiovascular Health (FOSCH) Research Group, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain
- PhD Programme in Pharmacology and Physiology, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - Pilar Rodríguez-Rodríguez
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
- Food, Oxidative Stress and Cardiovascular Health (FOSCH) Research Group, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain
| | - Silvia M. Arribas
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
- Food, Oxidative Stress and Cardiovascular Health (FOSCH) Research Group, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain
| | - David Ramiro-Cortijo
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
- Food, Oxidative Stress and Cardiovascular Health (FOSCH) Research Group, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain
| |
Collapse
|
21
|
Bahri Khomami M, Teede HJ, Joham AE, Moran LJ, Piltonen TT, Boyle JA. Clinical management of pregnancy in women with polycystic ovary syndrome: An expert opinion. Clin Endocrinol (Oxf) 2022; 97:227-236. [PMID: 35383999 PMCID: PMC9544149 DOI: 10.1111/cen.14723] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/28/2022] [Accepted: 03/06/2022] [Indexed: 12/16/2022]
Abstract
Polycystic ovary syndrome (PCOS) is associated with a higher risk for pregnancy and birth complications according to the specific features associated with PCOS. The features include obesity before and during pregnancy, hyperandrogenism, insulin resistance, infertility, cardiometabolic risk factors, and poor mental health. PCOS is not often recognized as a risk factor for poor pregnancy and birth outcomes in pregnancy care guidelines, while its associated features are. Pregnancy-related risk profile should ideally be assessed for modifiable risk factors (e.g., lifestyle and weight management) at preconception in women with PCOS. Hyperglycaemia should be screened using a 75-g oral glucose tolerance test at preconception or within the first 20 weeks of pregnancy if it has not been performed at preconception and should be repeated at 24-28 weeks of pregnancy. In the absence of evidence of benefit for strategies specific to women with PCOS, the international evidence-based guidelines for the assessment and management of PCOS recommend screening, optimizing, and monitoring risk profile in women with PCOS (at preconception, during and postpregnancy) consistent with the recommendations for the general population. Recommended factors include blood glucose, weight, blood pressure, smoking, alcohol, diet, exercise, sleep and mental health, emotional, and sexual health among women with PCOS. The guidelines recommend Metformin in addition to lifestyle for assisting with weight management and improving cardiometabolic risk factors, particularly in those with overweight or obesity. Letrozole is considered the first-line pharmacological treatment for anovulatory infertility in PCOS. Individualized approach should be considered in the management of pregnancy in PCOS.
Collapse
Affiliation(s)
- Mahnaz Bahri Khomami
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health SciencesMonash UniversityClaytonLevel 1, 43‐51 Kanooka GroveAustralia
| | - Helena J Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health SciencesMonash UniversityClaytonLevel 1, 43‐51 Kanooka GroveAustralia
- Monash HealthMelbourneAustralia
| | - Anju E. Joham
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health SciencesMonash UniversityClaytonLevel 1, 43‐51 Kanooka GroveAustralia
- Monash HealthMelbourneAustralia
| | - Lisa J. Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health SciencesMonash UniversityClaytonLevel 1, 43‐51 Kanooka GroveAustralia
| | - Terhi T. Piltonen
- Department of Obstetrics and Gynecology, PEDEGO Research Unit, Medical Research Center, Oulu University HospitalUniversity of OuluOuluFinland
| | - Jacqueline A. Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health SciencesMonash UniversityClaytonLevel 1, 43‐51 Kanooka GroveAustralia
- Monash HealthMelbourneAustralia
| |
Collapse
|
22
|
Polanek E, Karai A, Molnár R, Németh G, Orvos H, Balogh P, Paulik E. Association between sociodemographic, obstetric, and lifestyle factors among Hungarian pregnant women—A cross‐sectional study. J Obstet Gynaecol Res 2022; 48:2541-2551. [DOI: 10.1111/jog.15364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 03/29/2022] [Accepted: 06/29/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Evelin Polanek
- Department of Public Health University of Szeged Szeged Hungary
| | - Adrienn Karai
- Department of Pediatrics University of Szeged Szeged Hungary
| | - Regina Molnár
- Department of Public Health University of Szeged Szeged Hungary
| | - Gábor Németh
- Department of Obstetrics and Gynecology University of Szeged Szeged Hungary
| | - Hajnalka Orvos
- Department of Obstetrics and Gynecology University of Szeged Szeged Hungary
| | - Péter Balogh
- Department of Sociology University of Szeged Szeged Hungary
| | - Edit Paulik
- Department of Public Health University of Szeged Szeged Hungary
| |
Collapse
|
23
|
Chen M, Lim S, Harrison CL. Limiting Postpartum Weight Retention in Culturally and Linguistically Diverse Women: Secondary Analysis of the HeLP-her Randomized Controlled Trial. Nutrients 2022; 14:2988. [PMID: 35889944 PMCID: PMC9316445 DOI: 10.3390/nu14142988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 02/04/2023] Open
Abstract
Postpartum weight retention (PPWR) contributes to maternal obesity development and is more pronounced in culturally and linguistically diverse (CALD) women. Our antenatal healthy lifestyle intervention (HeLP-her) demonstrated efficacy in reducing PPWR in non-Australian-born CALD women compared with Australian-born women. In this secondary analysis, we aimed to examine differences in the intervention effect on behavioral and psychosocial outcomes between Australian-born and non-Australian-born women and explore factors associated with the differential intervention effect on PPWR. Pregnant women at risk of gestational diabetes (Australian-born n = 86, non-Australian-born n = 142) were randomized to intervention (four lifestyle sessions) or control (standard antenatal care). PPWR was defined as the difference in measured weight between 6 weeks postpartum and baseline (12-15 weeks gestation). Behavioral (self-weighing, physical activity (pedometer), diet (fat-related dietary habits questionnaire), self-perceived behavior changes), and psychosocial (weight control confidence, exercise self-efficacy, eating self-efficacy) outcomes were examined by country of birth. Multivariable linear regression analysis was conducted to assess factors associated with PPWR. The intervention significantly increased self-weighing, eating self-efficacy, and self-perceived changes to diet and physical activity at 6 weeks postpartum in non-Australian-born women, compared with no significant changes observed among Australian-born women. Intervention allocation and decreased intake of snack foods were predictors of lower PPWR in non-Australian-born women. Results indicate that the HeLP-her intervention improved dietary behaviors, contributing to the reduction of PPWR in CALD women. Future translations could prioritize targeting diet while developing more effective strategies to increase exercise engagement during pregnancy in this population.
Collapse
Affiliation(s)
- Mingling Chen
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC 3168, Australia;
| | - Siew Lim
- Eastern Health Clinical School, Monash University, Box Hill, VIC 3128, Australia;
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, VIC 3168, Australia;
- Diabetes and Endocrine Unit, Monash Health, Clayton, VIC 3168, Australia
| |
Collapse
|
24
|
Davis JW, Hyer S, Xie R, Martinez VC, Wheeler JM, Misra DP, Giurgescu C. Physical activity changes among non-Hispanic Black pregnant women. Public Health Nurs 2022; 39:744-751. [PMID: 35037297 PMCID: PMC10476508 DOI: 10.1111/phn.13051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/17/2021] [Accepted: 01/02/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine aerobic physical activity (PA) among non-Hispanic Black pregnant women. DESIGN Longitudinal prospective cohort study. SAMPLE A subset of 161 non-Hispanic Black pregnant women from the Midwestern US participating in a larger study completed questionnaires about aerobic physical activity (PA) before pregnancy (reported at 24.46±2.13 weeks gestation), mid-pregnancy (24.46±2.13 weeks gestation), and late pregnancy (31.78±1.95 weeks gestation). MEASUREMENTS Aerobic PA was measured using the Rapid Assessment of Physical Activity (RAPA). RESULTS Most participants reported being active prior to pregnancy (n = 101, 63%), with 60 (37%) underactive/sedentary. Aerobic RAPA scores were highest pre-pregnancy (3.29±1.11, median = 4, interquartile range [IQR] = 1) compared with mid-pregnancy (3.05±1.26, median = 4, IQR = 2) and late pregnancy (3.05±1.24, median = 4, IQR = 2). Pre-pregnancy scores were significantly higher than mid-pregnancy scores (Wilcoxon test = 1472, p = .008) and late pregnancy scores (Wilcoxon test = 1854, p = .01). CONCLUSION Most Black pregnant participants reported high levels of aerobic PA both before pregnancy and during pregnancy. However, many were underactive or sedentary. Aerobic PA decreased during pregnancy compared with pre-pregnancy, without the drop in third trimester PA found in other populations. Providers should assess PA across pregnancy and promote adequate PA for maternal and infant health, particularly among Black women.
Collapse
Affiliation(s)
- Jean W. Davis
- University of Central Florida College of Nursing, Orlando, FL, USA
| | - Suzanne Hyer
- University of Central Florida College of Nursing, Orlando, FL, USA
| | - Rui Xie
- Assistant Professor University of Central Florida Department of Statistics and Data Science, Orlando, FL, USA
| | - Valerie C. Martinez
- Clinical Assistant Professor and Director of Family Nurse Practitioner and Adult Gerontology Primary Care Nurse Practitioner Programs, University of Central Florida College of Nursing, Orlando, FL, USA
| | - Jenna M. Wheeler
- University of Central Florida College of Nursing, Orlando, FL, USA
| | - Dawn P. Misra
- Professor and Department Chair of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
| | - Carmen Giurgescu
- Associate Dean of Research, and Chatlos Endowed Chair in Nursing, University of Central Florida College of Nursing, Orlando, FL, USA
| |
Collapse
|
25
|
Preconception period in women and men undergoing Assisted Reproduction: A gender approach for reproductive health. Eur J Obstet Gynecol Reprod Biol 2022; 275:1-8. [PMID: 35691220 DOI: 10.1016/j.ejogrb.2022.06.003] [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: 01/10/2022] [Revised: 05/09/2022] [Accepted: 06/05/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate lifestyle and risk factors playing a role in increasing the burden of cardiovascular diseases and to increase attention of clinicians who should envision a broader preconception approach in ART, not only in women but also in men. STUDY DESIGN In this cross-sectional study we investigated 90 Caucasian couples, referred to the Internal Medicine Clinic at the Assisted Reproductive Technology Centre, in order to better define in preconceptional period their cardiovascular risk profile, based on metabolic parameters and lifestyle behaviours. RESULTS We observed two-fold increase of overweight in men in comparison to women (p = 0.006). Values of waist ≥ 94 cm in men and ≥ 80 cm in women were present in 53.3% of men and 32.2% of women (p = 0.007). Similarly, values of WHR according to gender cut-off, were present in 64.4% of men and in 32.2% of women (p < 0.0001). In men we observed a significantly higher prevalence of hypertension (p = 0.02), significantly lower HDL-c (p = 0.001) and higher levels of total cholesterol (p = 0.01), LDL-c and triglycerides (p = 0.001). Sedentary behaviour was observed in about 60% of both genders. Alcohol consumption was reported by 42.2% of men and 26.7% of women (p = 0.04) and smokers were more prevalent among women (26.7%) than men (24.4%). We observed a lower adherence to Mediterranean Diet related to consumption of red meat and meat products (p = 0.02), as well as of legumes consumption (p = 0.01) in men, whereas sweet/pastries (p = 0.05) and fruits (p = 0.06) in women. Men and women with normal BMI, waist and WHR, showed a higher Mediterranean diet adherence in comparison to overweight/obese study population(p < 0.001). Finally, higher education level predicted the higher Mediterranean diet adherence in both gender (p = 0.01 for men, p = 0.03 for women). CONCLUSIONS This study paid attention on preconceptional health in couples planning ART. Women have a greater biological role in childbearing, whereas the role of men is underestimated. The need to conceive through ART offers a window of opportunity not only to evaluate cardiovascular profile and lifestyle factors in couples prior to conception, but also to manage comorbidities and promote health behaviours in order to improve fertility and health outcomes in both women and men at short and long-term.
Collapse
|
26
|
Xie F, You Y, Guan C, Gu Y, Yao F, Xu J. Association between physical activity and infertility: a comprehensive systematic review and meta-analysis. J Transl Med 2022; 20:237. [PMID: 35606876 PMCID: PMC9125843 DOI: 10.1186/s12967-022-03426-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/05/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Physical activity (PA) may protect against infertility by modulating the hypothalamic-pituitary–gonadal axis, thereby reducing gonadotropin levels, elevating immune function, and inhibiting inflammation and circulating sex hormones. However, whether PA reduces the risk of infertility remains largely unknown. We therefore conducted a systematic review and meta-analysis to determine the preventive effects of PA on infertility.
Methods
We searched PubMed, Cochrane Library, EMBASE, and CINAHL databases to retrieve published epidemiologic studies on the relationship between PA and infertility. Following the PRISMA guidelines, we selected English literature publishedprior to 11 April 2022, and assessed study quality using the Newcastle–Ottawa Scale. Our protocol, including the full methods employed for this review, is available on PROSPERO (ID = CRD42020143344).
Results
Six cohort studies and four case–control studies based on 708,965 subjects and 12,580 cases were eventually screened and retained. High levels of PA were shown to reduced risk of infertility relative to low levels (cumulative relative risk [RR] = 0.59, with a 95% confidence interval CI 0.49–0.71), and we reported results for cohort studies (RR = 0.63, 95% CI 0.50–0.79) and case–control studies (RR = 0.49, 95% CI 0.35–0.67). Our findings were comparable for men (RR = 0.65, 95% CI 0.41–1.04) and women (RR = 0.56, 95% CI 0.47–0.66). The meta-analysis of six risk estimates from five studies of low, moderate, and high PA levels showed that moderate PA may also reduce the risk of infertility compared with low PA (RR = 0.54, 95% CI 0.38–0.77). However, high PA also appeared to slightly augment the risk of infertility compared with moderate PA (RR = 1.31, 95% CI 1.08–1.59).
Conclusions
This present systematic review comprehensively reflected an inverse relationship between different levels of PA and infertility, and our meta-analysis showed that a moderate-to-high PA level significantly reduced the overall risk of infertility, and that this level of PA activity was a common protective factor. In addition, limited evidence suggested that compliance with international PA guidelines would greatly lower the risk of infertility (RR = 0.58, 95% CI 0.45–0.74; I2 = 0.0%). Future studies, however, need to be executed to further determine the frequency, optimal dosage, and duration required to effectively attenuate the risk of infertility.
Collapse
|
27
|
Ranjan P, Baboo AGK, Anwar W, Kumari A, Pradhan B, Maharana S, Venkataraman S. Physical Activity, Yoga, and Exercise Prescription for Postpartum and Midlife Weight Management: A Practical Review for Clinicians. J Obstet Gynaecol India 2022; 72:104-113. [PMID: 35492861 PMCID: PMC9008094 DOI: 10.1007/s13224-022-01627-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 01/17/2022] [Indexed: 10/18/2022] Open
Abstract
This narrative review is aimed to practically review and evaluate the existing evidence and illuminate the effectiveness of physical activity, yoga, and exercise for postpartum and midlife weight management. A comprehensive review was conducted using electronic databases such as PubMed and google scholar using search terms physical activity, exercise, yoga, postpartum, midlife, weight loss, weight reduction, and all the probable terms. This helped in generating evidence-based information and formulating practical physical activity prescriptions to be used by obstetricians, general clinicians, nutritionists, and other allied healthcare personnel. Overweight and obesity in postpartum and midlife women present long-term health risks and complications. Indulging in optimum physical activity comprising exercise and yoga will help in weight management, increasing muscular strength, and endurance thus improving overall health and well-being. Supplementary Information The online version contains supplementary material available at 10.1007/s13224-022-01627-w.
Collapse
|
28
|
St-Laurent A, Savard C, Plante AS, Gagnon M, Robitaille J, Lemieux S, May-Ruchat S, Morisset AS. Health-related preconception factors: adherence to guidelines and associations with weight status. J Acad Nutr Diet 2022; 122:1911-1921. [DOI: 10.1016/j.jand.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 01/28/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
|
29
|
Prospective associations between prepartum physical activity, birth experience, and maternal depressive symptoms in the postpartum period: Insights from the population-based DREAM cohort study. J Affect Disord 2022; 297:366-374. [PMID: 34715172 DOI: 10.1016/j.jad.2021.10.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 09/09/2021] [Accepted: 10/23/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND This study aims to examine whether physical activity (PA) before and during pregnancy and birth experience predict incident postpartum depressive (PPD) symptoms. Because PA may increase endurance and feelings of physical control, it may contribute to a positive birth experience and birth experience may mediate the association between PA before and during pregnancy and PPD symptoms. METHODS The study is part of the prospective-longitudinal cohort study "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Participants were n = 1,254 (expectant) mothers. PA was assessed during pregnancy, birth experience and PPD symptoms 8 weeks postpartum. Multiple regression analyses were performed, including potential confounders. RESULTS A negative birth experience was linked to PPD symptoms, when controlling for relevant confounders. There was no evidence for a link between PA before and during pregnancy and birth experience or between PA during pregnancy and PPD symptoms. PA at low and at vigorous intensity before pregnancy was associated with PPD symptoms, but not when controlling for confounders. Because PA was not associated with birth experience, no mediation analysis was performed. LIMITATIONS The current sample was relatively homogenous (i.e., mostly German native speakers, primiparous, highly educated). Birth experience was assessed retrospectively at 8 weeks following birth. CONCLUSIONS Our results highlight the importance of the birth experience in the development of PPD symptoms. Promoting a positive birth experience represents a promising approach to prevent PPD symptoms. Further research on the association between PA and PPD symptoms is warranted.
Collapse
|
30
|
Kaur D, Malhotra A, Ranjan P, Chopra S, Kumari A, Vikram NK. Weight management in postpartum women - An Indian perspective. Diabetes Metab Syndr 2021; 15:102291. [PMID: 34598009 DOI: 10.1016/j.dsx.2021.102291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/31/2021] [Accepted: 09/13/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS This narrative review is intended to present an evidence and opinion-based weight management module for Indian postpartum women to be used by clinicians. MATERIAL AND METHODS Electronic databases such as PubMed and Google Scholar were accessed to extract relevant studies to derive evidence-based information. The reference list of the extracted studies was also checked to obtain further relevant articles. The opinion-based information was achieved from the consensus among the gynaecologists, nutritionists and doctors from Medicine according to their practical experiences in real time. In this review, we have used the term "postpartum" to represent the time period of two years after delivery. RESULTS A postpartum weight management module consisting of information about diet, physical activity, sleep and breastfeeding was devised to be used in regular clinical practice, particularly in the Indian settings. CONCLUSION Postpartum women deal with various unique challenges as compared to other population groups. Individualised weight management strategies should be adopted to facilitate sustainable postpartum weight management.
Collapse
Affiliation(s)
- Divjyot Kaur
- Department of Home Science, University of Delhi, India
| | - Anita Malhotra
- Department of Home Science, Lakshmibai College, University of Delhi, India
| | - Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Sakshi Chopra
- Department of Home Science, University of Delhi, India
| | - Archana Kumari
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Naval K Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
31
|
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
| | | |
Collapse
|
32
|
Boedt T, Matthys C, Lie Fong S, De Neubourg D, Vereeck S, Seghers J, Van der Gucht K, Weyn B, Geerts D, Spiessens C, Dancet EAF. Systematic development of a mobile preconception lifestyle programme for couples undergoing IVF: the PreLiFe-programme. Hum Reprod 2021; 36:2493-2505. [PMID: 34379119 DOI: 10.1093/humrep/deab166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 06/04/2021] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION Can we develop a preconception lifestyle programme for couples undergoing IVF that is in line with their needs. SUMMARY ANSWER A mobile preconception lifestyle programme was systematically developed based on expert opinion, literature and needs of IVF-patients. WHAT IS KNOWN ALREADY A healthy lifestyle prior to conception is not only beneficial for the general health of couples, but evidence on its importance for their reproductive health and the health of their children is also emerging. So far, the vast majority of fertility clinics do not offer a lifestyle programme for couples undergoing IVF. Therefore, the present study aimed to develop a lifestyle programme for IVF-couples. STUDY DESIGN, SIZE, DURATION The development of the PreLiFe-programme was guided by the steps of the Medical Research Council (MRC) framework for developing complex interventions, a systematic approach for developing theory- and evidence-based health promotion interventions. PARTICIPANTS/MATERIALS, SETTINGS, METHODS First, the evidence base on lifestyle programmes for IVF-couples was reviewed. Second, several iterations between an expert panel, the literature, and quantitative and qualitative data from IVF-patients identified the content, the format, behaviour change techniques and theory of the programme. Third, the PreLiFe-programme was produced and the expected process and outcomes of a randomized controlled trial assessing it were modelled. Finally, user tests among experts and patients and pilot tests among patients were conducted. MAIN RESULTS AND ROLE OF CHANCE The finally developed PreLiFe-programme is a mobile application to be used autonomously by both partners of IVF-couples during the first year of IVF, in combination with motivational interviewing over the telephone every three months (i.e. blended care). The PreLiFe-programme provides advice and skills training on physical activity, diet and mindfulness based stress reduction and is in part tailored based on monitoring and tracking the lifestyle of patients. Based on the literature the expert panel considers it plausible that all three components contribute to IVF-success rates. The PreLiFe-programme is likely to be acceptable to patients as it meets the need of patients for lifestyle advice and treatment information. LIMITATIONS, REASON FOR CAUTION The pilot in IVF-couples had a 3-month duration. The feasibility of the PreLiFe-programme in other infertile populations and/or upon longer use is yet to be examined. Whether the PreLiFe-programme effectively improves lifestyle and IVF-success rates is currently being examined in a trial randomizing heterosexual couples starting IVF to the PreLiFe-programme or an attention-control group for 12 months. WIDER IMPLICATIONS OF THE FINDINGS If the PreLiFe-programme improves lifestyle and the chance of IVF-success, it will be a powerful tool and provide guidance for implementing lifestyle programmes in fertility clinics. STUDY FUNDING/COMPETING INTEREST(S) Funded by the Research Foundation Flanders (FWO-TBM (Applied Biomedical Research with a Primary Social finality); reference: T005417N). The authors have no conflict of interest to report. TRIAL REGISTRATION NUMBER NCT03790449.
Collapse
Affiliation(s)
- T Boedt
- Department of Chronic Diseases and Metabolism, Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium.,Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium
| | - C Matthys
- Department of Chronic Diseases and Metabolism, Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium.,Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - S Lie Fong
- Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - D De Neubourg
- Centre for Reproductive Medicine, Antwerp University Hospital, Edegem, Belgium
| | - S Vereeck
- Centre for Reproductive Medicine, Antwerp University Hospital, Edegem, Belgium
| | - J Seghers
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - K Van der Gucht
- Leuven Mindfulness Centre, KU Leuven, Leuven, Belgium.,Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - B Weyn
- Department of Electric Engineering, Leuven, Belgium
| | - D Geerts
- Meaningful Interactions Lab, KU Leuven, Leuven, Belgium
| | - C Spiessens
- Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - E A F Dancet
- Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| |
Collapse
|
33
|
O'Kelly AC, Scott N, DeFaria Yeh D. Delivering Coordinated Cardio-Obstetric Care from Preconception through Postpartum. Cardiol Clin 2021; 39:163-173. [PMID: 33222811 DOI: 10.1016/j.ccl.2020.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Coordinated preconception through postpartum cardio-obstetrics care is necessary to optimize both maternal and fetal health. Maternal mortality in the United States is increasing, largely driven by increasing cardiovascular (CV) disease burden during pregnancy and needs to be addressed emergently. Both for women with congenital and acquired heart disease, CV complications during pregnancy are associated with increased future risk of CV disease. Comprehensive cardio-obstetrics care is a powerful way of ensuring that women's CV risks before and during pregnancy are appropriately identified and treated and that they remain engaged in CV care long term to prevent future CV complications.
Collapse
Affiliation(s)
- Anna C O'Kelly
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Yawkey 5700, 55 Fruit Street, Boston, MA 02114, USA
| | - Nandita Scott
- Division of Cardiology, Cardiovascular Disease and Pregnancy Program, Massachusetts General Hospital and Harvard Medical School, Yawkey 5700, 55 Fruit Street, Boston, MA 02114, USA
| | - Doreen DeFaria Yeh
- Division of Cardiology, Cardiovascular Disease and Pregnancy Program, Massachusetts General Hospital and Harvard Medical School, Yawkey 5700, 55 Fruit Street, Boston, MA 02114, USA.
| |
Collapse
|
34
|
Bahri Khomami M, Walker R, Kilpatrick M, de Jersey S, Skouteris H, Moran LJ. The role of midwives and obstetrical nurses in the promotion of healthy lifestyle during pregnancy. Ther Adv Reprod Health 2021; 15:26334941211031866. [PMID: 34396131 PMCID: PMC8361518 DOI: 10.1177/26334941211031866] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 06/24/2021] [Indexed: 11/17/2022] Open
Abstract
Women with maternal obesity, an unhealthy lifestyle before and during pregnancy
and excess gestational weight gain have an increased risk of adverse pregnancy
and birth outcomes that can also increase the risk of long-term poor health for
them and their children. Pregnant women have frequent medical appointments and
are highly receptive to health advice. Healthcare professionals who interact
with women during pregnancy are in a privileged position to support women to
make lasting healthy lifestyle changes that can improve gestational weight gain
and pregnancy outcomes and halt the intergenerational nature of obesity.
Midwives and obstetrical nurses are key healthcare professionals responsible for
providing antenatal care in most countries. Therefore, it is crucial for them to
build and enhance their ability to promote healthy lifestyles in pregnant women.
Undergraduate midwifery curricula usually lack sufficient lifestyle content to
provide emerging midwives and obstetrical nurses with the knowledge, skills, and
confidence to effectively assess and support healthy lifestyle behaviours in
pregnant women. Consequently, registered midwives and obstetrical nurses may not
recognise their role in healthy lifestyle promotion specific to healthy eating
and physical activity in practice. In addition, practising midwives and
obstetrical nurses do not consistently have access to healthy lifestyle
promotion training in the workplace. Therefore, many midwives and obstetrical
nurses may not have the confidence and/or skills to support pregnant women to
improve their lifestyles. This narrative review summarises the role of midwives
and obstetrical nurses in the promotion of healthy lifestyles relating to
healthy eating and physical activity and optimising weight in pregnancy, the
barriers that they face to deliver optimal care and an overview of what we know
works when supporting midwives and obstetrical nurses in their role to support
women in achieving a healthy lifestyle.
Collapse
Affiliation(s)
- Mahnaz Bahri Khomami
- Monash Centre for Health Research and Implementation (MCHRI), Level 1, 43-51 Kanooka Grove, Clayton, VIC, 3168, Australia
| | - Ruth Walker
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Michelle Kilpatrick
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Susan de Jersey
- Perinatal Research Centre, Centre for Clinical Research and Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
35
|
Li X, Liu X, Zuo Y, Gao J, Liu Y, Zheng W. The risk factors of gestational diabetes mellitus in patients with polycystic ovary syndrome: What should we care. Medicine (Baltimore) 2021; 100:e26521. [PMID: 34397795 PMCID: PMC8341335 DOI: 10.1097/md.0000000000026521] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/15/2021] [Accepted: 06/03/2021] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT The influencing factors of gestational diabetes mellitus (GDM) in the polycystic ovary syndrome (PCOS) patients remain unclear, we aimed to investigate the risk factors of GDM in patients with PCOS, to provide reliable evidence for the prevention and treatment of GDM in PCOS patients.PCOS patients treated in our hospital from January 1, 2019 to October 31, 2020 were included. The personal and clinical treatment details of GDM and no GDM patients were analyzed. Logistic regressions were performed to analyze the factors influencing the occurrence of GDM.A total of 196 PCOS patients were included, the incidence of GDM in patients with PCOS was 23.98%. There were significant differences in the age, body mass index, insulin resistance index, fasting insulin, testosterone, androstenedione, and sex hormone-binding protein between GDM and no GDM patients with PCOS (all P < .05), and no significant differences in the family history of GDM, the history of adverse pregnancy, and multiple pregnancies were found (all P > .05). Age ≥30 years (odds ratio (OR) 2.418, 95% confidence interval (CI) 1.181-3.784), body mass index ≥24 kg/m2 (OR 1.973, 95%CI 1.266-3.121), insulin resistance index ≥22.69 (OR 2.491, 95%CI 1.193-4.043), fasting insulin ≥22.71 mIU/L (OR 2.508, 95%CI 1.166-5.057), testosterone ≥2.85 nmol/L (OR 1.821, 95%CI 1.104-2.762), androstenedione ≥6.63 nmol/L (OR 1.954, 95%CI 1.262-2.844), sex hormone-binding protein <64.22 nmol/L (OR 1.497, 95%CI 1.028-2.016) were the independent risk factors of GDM in patients with PCOS (all P < .05). The incidence of preeclampsia, premature delivery, premature rupture of membranes, polyhydramnios, and postpartum hemorrhage in the GDM group was significantly higher than that of the no-GDM group (all P < .05). There was no significant difference in the incidence of oligohydramnios between the 2 groups (P = .057).The incidence of GDM in PCOS patients is high, and the measures targeted at the risk factors are needed to reduce the occurrence of GDM in patients with PCOS.
Collapse
Affiliation(s)
- Xiaocui Li
- Department of Obstetrics and Gynecology, West China Second Hospital of Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education Chengdu, China
| | - Xinru Liu
- Department of Obstetrics and Gynecology, West China Second Hospital of Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education Chengdu, China
| | - Yan Zuo
- Department of Obstetrics and Gynecology, West China Second Hospital of Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education Chengdu, China
| | - Jiejun Gao
- Department of Obstetrics and Gynecology, West China Second Hospital of Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education Chengdu, China
| | - Yan Liu
- Department of Obstetrics and Gynecology, West China Second Hospital of Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education Chengdu, China
| | - Wei Zheng
- Department of Obstetrics and Gynecology, West China Second Hospital of Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education Chengdu, China
| |
Collapse
|
36
|
Mate A, Reyes-Goya C, Santana-Garrido Á, Vázquez CM. Lifestyle, Maternal Nutrition and Healthy Pregnancy. Curr Vasc Pharmacol 2021; 19:132-140. [PMID: 32234002 DOI: 10.2174/1570161118666200401112955] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 03/12/2020] [Accepted: 03/14/2020] [Indexed: 02/07/2023]
Abstract
Healthy lifestyle habits spanning from preconception to postpartum are considered as a major safeguard for achieving successful pregnancies and for the prevention of gestational diseases. Among preconception priorities established by the World Health Organization (WHO) are healthy diet and nutrition, weight management, physical activity, planned pregnancy and physical, mental and psychosocial health. Most studies covering the topic of healthy pregnancies focus on maternal diet because obesity increases the risks for adverse perinatal outcomes, including gestational diabetes mellitus, large for gestational age newborns, or preeclampsia. Thus, foods rich in vegetables, essential and polyunsaturated fats and fibre-rich carbohydrates should be promoted especially in overweight, obese or diabetic women. An adequate intake of micronutrients (e.g. iron, calcium, folate, vitamin D and carotenoids) is also crucial to support pregnancy and breastfeeding. Moderate physical activity throughout pregnancy improves muscle tone and function, besides decreasing the risk of preeclampsia, gestational diabesity (i.e. diabetes associated with obesity) and postpartum overweight. Intervention studies claim that an average of 30 min of exercise/day contributes to long-term benefits for maternal overall health and wellbeing. Other factors such as microbiome modulation, behavioural strategies (e.g. smoking cessation, anxiety/stress reduction and sleep quality), maternal genetics and age, social class and education might also influence the maternal quality of life. These factors contribute to ensure a healthy pregnancy, or at least to reduce the risk of adverse maternal and foetal outcomes during pregnancy and later in life.
Collapse
Affiliation(s)
- Alfonso Mate
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, E-41012 Sevilla, Spain
| | - Claudia Reyes-Goya
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, E-41012 Sevilla, Spain
| | - Álvaro Santana-Garrido
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, E-41012 Sevilla, Spain
| | - Carmen M Vázquez
- Departamento de Fisiología, Facultad de Farmacia, Universidad de Sevilla, E-41012 Sevilla, Spain
| |
Collapse
|
37
|
Gamble A, Baskin ML, Cranston KL, Herring SJ, Hinton E, Saulters MM, Moore JB, Welsch MA, Beech BM. Effects of eHealth interventions on physical activity and weight among pregnant and postpartum women and the sociodemographic characteristics of study populations: a systematic review protocol. JBI Evid Synth 2021; 18:2396-2403. [PMID: 32813415 PMCID: PMC8274360 DOI: 10.11124/jbisrir-d-19-00378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this review is to evaluate the impact of electronic health (eHealth) interventions on physical activity and weight changes among pregnant and/or postpartum populations and to describe the sociodemographic characteristics of the study populations. INTRODUCTION The American College of Obstetricians and Gynecologists recommends 20 minutes of daily physical activity during pregnancy and postpartum. Few pregnant women are physically active and among those who are, physical activity levels decline as pregnancy progresses and during postpartum. Behavioral eHealth interventions offer convenient and frequent accessibility at low cost and high reach. A search of the extant literature including PROSPERO, MEDLINE (PubMed), the Cochrane Database of Systematic Reviews and the JBI Database of Systematic Reviews and Implementation Reports revealed no published or in-progress reviews examining eHealth physical activity interventions among pregnant and/or postpartum populations. INCLUSION CRITERIA Studies of eHealth interventions including pregnant and/or within one-year postpartum populations will be included. METHODS This review will be conducted in accordance with JBI methodology for systematic reviews of effectiveness. The search strategy will aim to locate studies from the inception of each database. Citations will be collated, and duplicates removed. Titles and abstracts will be screened for eligibility against the inclusion criteria and relevant studies retrieved. Included studies will be appraised for methodological quality using JBI standardized critical appraisal instruments. Extracted data will include study methods, intervention design and outcomes (physical activity, weight, participant sociodemographic characteristics). The Grading of Recommendations, Assessment, Development and Evaluation approach for grading the certainty of evidence will be followed. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42020124611.
Collapse
Affiliation(s)
- Abigail Gamble
- John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.,Mississippi Center for Clinical and Translational Research, University of Mississippi Medical Center, Jackson, MS, USA.,Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS, USA.,Mississippi Centre for Evidence Based Practice: A JBI Centre of Excellence, Jackson, MS, USA
| | - Monica L Baskin
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Katherine L Cranston
- John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.,School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Sharon J Herring
- Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Elizabeth Hinton
- Mississippi Centre for Evidence Based Practice: A JBI Centre of Excellence, Jackson, MS, USA.,Rowland Medical Library, University of Mississippi Medical Center, Jackson, MS, USA
| | - Mary Margaret Saulters
- Mississippi Center for Clinical and Translational Research, University of Mississippi Medical Center, Jackson, MS, USA.,Center for Obesity Research, University of Mississippi Medical Center, MS, USA
| | - Justin B Moore
- Department of Family & Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Michael A Welsch
- John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.,Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS, USA
| | - Bettina M Beech
- John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.,Mississippi Center for Clinical and Translational Research, University of Mississippi Medical Center, Jackson, MS, USA.,Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS, USA.,Mississippi Centre for Evidence Based Practice: A JBI Centre of Excellence, Jackson, MS, USA
| |
Collapse
|
38
|
Bhattacharjee J, Mohammad S, Adamo KB. Does exercise during pregnancy impact organs or structures of the maternal-fetal interface? Tissue Cell 2021; 72:101543. [PMID: 33940567 DOI: 10.1016/j.tice.2021.101543] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/07/2021] [Accepted: 04/10/2021] [Indexed: 12/12/2022]
Abstract
Exercise during pregnancy has been shown to be associated with improved health outcomes both during and after pregnancy for mother and fetus across the lifespan. Increasing physical activity and reducing sedentary behaviour during pregnancy have been recommended by many researchers and clinicians-alike. It is thought that the placenta plays a central role in mediating any positive or negative pregnancy outcomes. The positive outcomes obtained through prenatal exercise are postulated to result from exercise-induced regulation of maternal physiology and placental development. Considerable research has been performed to understand the placenta's role in pregnancy-related diseases, such as preeclampsia, fetal growth restriction, and gestational diabetes mellitus. However, little research has examined the potential for healthy lifestyle and behavioural changes to improve placental growth, development, and function. While the placenta represents the critical maternal-fetal interface responsible for all gas, nutrient, and waste exchange between the mother and fetus, the impact of exercise during pregnancy on placental biology and function is not well known. This review will focus on prenatal exercise and its promising influence on the structures of the maternal-fetal interface, with particular emphasis on the placenta. Potential molecular mechanistic hypotheses are presented to aid future investigations of prenatal exercise and placental health.
Collapse
Affiliation(s)
- Jayonta Bhattacharjee
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Shuhiba Mohammad
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Kristi B Adamo
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.
| |
Collapse
|
39
|
Bijlholt M, Ameye L, Van Uytsel H, Devlieger R, Bogaerts A. The INTER-ACT E-Health Supported Lifestyle Intervention Improves Postpartum Food Intake and Eating Behavior, but Not Physical Activity and Sedentary Behavior-A Randomized Controlled Trial. Nutrients 2021; 13:nu13041287. [PMID: 33919758 PMCID: PMC8070698 DOI: 10.3390/nu13041287] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 12/20/2022] Open
Abstract
Unhealthy postpartum lifestyle is related to long-term adverse psychological, metabolic and cardiovascular health outcomes as well as to complications in the next pregnancy. Especially women with preceding excessive gestational weight gain are at risk. This paper aims to evaluate the effect of the postpartum phase of the INTER-ACT randomized controlled trial (RCT) on food intake, eating behavior, physical activity and sedentary time at the end of the intervention (six months postpartum) and at six-months follow-up (12 months postpartum). The study population comprised women with excessive gestational weight gain in the preceding pregnancy. The lifestyle intervention combined a smartphone application with four face-to-face coaching sessions between six weeks and six months postpartum. After the intervention, restrained eating score was 1 point higher (95% CI 0.5, 1.5; p < 0.001), uncontrolled eating score was 1 point lower (95% CI −1.9, −0.2; p = 0.02) and energy intake was 69 kcal lower (95% CI −123, −15; p = 0.01) in the intervention group compared to the control group. The differences were no longer statistically significant at follow-up. No significant effects on emotional eating, physical activity and sedentary behavior were found. In conclusion, the postpartum phase of the INTER-ACT RCT was effective in improving nutrition-related outcomes, however, these improvements could not be sustained at follow-up. ClinicalTrials.gov identifier: NCT02989142.
Collapse
Affiliation(s)
- Margriet Bijlholt
- Centre for Research and Innovation in Care (CRIC), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium;
- Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; (L.A.); (H.V.U.); (R.D.)
| | - Lieveke Ameye
- Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; (L.A.); (H.V.U.); (R.D.)
| | - Hanne Van Uytsel
- Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; (L.A.); (H.V.U.); (R.D.)
| | - Roland Devlieger
- Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; (L.A.); (H.V.U.); (R.D.)
- Department of Obstetrics and Gynecology, University Hospital Leuven, 3000 Leuven, Belgium
| | - Annick Bogaerts
- Centre for Research and Innovation in Care (CRIC), Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium;
- Research Unit Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; (L.A.); (H.V.U.); (R.D.)
- Faculty of Health, University of Plymouth, Devon PL4 8AA, UK
- Correspondence:
| |
Collapse
|
40
|
Hayman M, Alfrey KL, Cannon S, Alley S, Rebar AL, Williams S, Short CE, Altazan A, Comardelle N, Currie S, Denton C, Harrison CL, Lamerton T, Mena GP, Moran L, Mottola M, Nagpal TS, Vincze L, Schoeppe S. Quality, Features, and Presence of Behavior Change Techniques in Mobile Apps Designed to Improve Physical Activity in Pregnant Women: Systematic Search and Content Analysis. JMIR Mhealth Uhealth 2021; 9:e23649. [PMID: 33825693 PMCID: PMC8060865 DOI: 10.2196/23649] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/21/2020] [Accepted: 01/17/2021] [Indexed: 12/18/2022] Open
Abstract
Background Physical activity during pregnancy is associated with several health benefits for the mother and child. However, very few women participate in regular physical activity during pregnancy. eHealth platforms (internet and mobile apps) have become an important information source for pregnant women. Although the use of pregnancy-related apps has significantly increased among pregnant women, very little is known about their theoretical underpinnings, including their utilization of behavior change techniques (BCTs). This is despite research suggesting that inclusion of BCTs in eHealth interventions are important for promoting healthy behaviors, including physical activity. Objective The aim of this study was to conduct a systematic search and content analysis of app quality, features, and the presence of BCTs in apps designed to promote physical activity among pregnant women. Methods A systematic search in the Australian App Store and Google Play store using search terms relating to exercise and pregnancy was performed. App quality and features were assessed using the 19-item Mobile App Rating Scale (MARS), and a taxonomy of BCTs was used to determine the presence of BCTs (26 items). BCTs previously demonstrating efficacy in behavior changes during pregnancy were also identified from a literature review. Spearman correlations were used to investigate the relationships between app quality, app features, and number of BCTs identified. Results Nineteen exercise apps were deemed eligible for this review and they were accessed via Google Play (n=13) or App Store (n=6). The MARS overall quality scores indicated moderate app quality (mean 3.5 [SD 0.52]). Functionality was the highest scoring MARS domain (mean 4.2 [SD 0.5]), followed by aesthetics (mean 3.7 [SD 0.6]) and information quality (mean 3.16 [SD 0.42]). Subjective app quality (mean 2.54 [SD 0.64]) and likelihood for behavioral impact (mean 2.5 [SD 0.6]) were the lowest scoring MARS domains. All 19 apps were found to incorporate at least two BCTs (mean 4.74, SD 2.51; range 2-10). However, only 11 apps included BCTs that previously demonstrated efficacy for behavior change during pregnancy, the most common being provide opportunities for social comparison (n=8) and prompt self-monitoring of behavior (n=7). There was a significant positive correlation between the number of BCTs with engagement and aesthetics scores, but the number of BCTs was not significantly correlated with functionality, information quality, total MARS quality, or subjective quality. Conclusions Our findings showed that apps designed to promote physical activity among pregnant women were functional and aesthetically pleasing, with overall moderate quality. However, the incorporation of BCTs was low, with limited prevalence of BCTs previously demonstrating efficacy in behavior change during pregnancy. Future app development should identify and adopt factors that enhance and encourage user engagement, including the use of BCTs, especially those that have demonstrated efficacy for promoting physical activity behavior change among pregnant women.
Collapse
Affiliation(s)
- Melanie Hayman
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - Kristie-Lee Alfrey
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - Summer Cannon
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - Stephanie Alley
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - Amanda L Rebar
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - Susan Williams
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| | - Camille E Short
- School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Abby Altazan
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Natalie Comardelle
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Sinead Currie
- Division of Psychology, Stirling University, Scotland, United Kingdom
| | - Caitlin Denton
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Cheryce L Harrison
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Tayla Lamerton
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - Gabriela P Mena
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia
| | - Lisa Moran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Michelle Mottola
- Faculty of Health Sciences in Kinesiology, University of Western Ontario, London, ON, Canada
| | - Taniya S Nagpal
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Lisa Vincze
- School of Allied Health Sciences - Nutrition and Dietetics, Griffith University, Gold Coast, Australia
| | - Stephanie Schoeppe
- School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
| |
Collapse
|
41
|
Chronopoulou E, Raperport C, Serhal P, Saab W, Seshadri S. Preconception tests at advanced maternal age. Best Pract Res Clin Obstet Gynaecol 2020; 70:28-50. [PMID: 33358154 DOI: 10.1016/j.bpobgyn.2020.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 11/23/2020] [Indexed: 11/17/2022]
Abstract
Pregnancies at an advanced reproductive age are increasingly common. However, the safety of pregnancy remains a concern as maternal age is a recognized independent factor for various obstetric complications. Also, age is a risk factor for most systematic health problems and older women are more likely to enter into pregnancy with pre-existing conditions. At the moment there is no separate, structured guidance on preconception tests at advanced maternal age. However, the preconceptual period offers an ideal window to recognize and address underlying health issues, social issues and harmful lifestyle behaviours in order to optimize maternal health ultimately reducing infertility, perinatal morbidity and mortality. Preconception tests should be clinically relevant aiming to identify risk factors and address them to predict and prevent infertility and pregnancy complications. The importance of preconception care is magnified for women of advanced age for whom the risks are higher and the potential benefits greater.
Collapse
Affiliation(s)
- Elpiniki Chronopoulou
- Homerton Fertility Centre, Homerton University Hospital, Homerton Row, Clapton, London, E9 6SR, UK.
| | - Claudia Raperport
- Homerton Fertility Centre, Homerton University Hospital, Homerton Row, Clapton, London, E9 6SR, UK
| | - Paul Serhal
- The Centre for Reproductive and Genetic Health (CRGH), 230-232 Great Portland St, Fitzrovia, London, W1W 5QS, UK
| | - Wael Saab
- The Centre for Reproductive and Genetic Health (CRGH), 230-232 Great Portland St, Fitzrovia, London, W1W 5QS, UK
| | - Srividya Seshadri
- The Centre for Reproductive and Genetic Health (CRGH), 230-232 Great Portland St, Fitzrovia, London, W1W 5QS, UK
| |
Collapse
|
42
|
Physical Activity During Pregnancy and Preterm Birth: Findings From the 2015 Pelotas (Brazil) Birth Cohort Study. J Phys Act Health 2020; 17:1065-1074. [PMID: 32947261 DOI: 10.1123/jpah.2019-0604] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 06/08/2020] [Accepted: 07/16/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Physical activity (PA) during pregnancy is associated with several benefits in maternal and child outcomes, and its relationship with preterm birth is still conflicting. This study aims to examine the associations between PA during pregnancy and occurrence of preterm birth. METHODS PA was assessed by questionnaire (for each trimester) and accelerometry (second trimester) in women enrolled in a birth cohort study that started during pregnancy and included births that occurred between January 1 and December 31, 2015. Gestational age was based on the last menstrual period and ultrasonography. All deliveries before 37 weeks of gestation were considered preterm births. A Poisson regression model was used to measure associations controlling for potential confounders. RESULTS PA information was available for 4163 women and 13.8% of births were preterm. A total of 15.8% of women were engaged in PA during pregnancy. Multivariate analysis showed that only PA performed in the third trimester of pregnancy (prevalence ratio = 0.58; 95% confidence interval, 0.36-0.96) was associated with the outcome. CONCLUSIONS PA performed in the third trimester of pregnancy was associated with a protection to preterm birth. Pregnant women should be counseled to engage in PA to lower the risk of premature delivery.
Collapse
|
43
|
Effect of Evidence-Based Materials and Access to Local Resources on Physical Activity Levels, Beliefs, and Motivation During Pregnancy in a Rural Setting. J Phys Act Health 2020; 17:947-957. [PMID: 32858524 DOI: 10.1123/jpah.2019-0440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 06/14/2020] [Accepted: 07/16/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND The purpose of this study was to determine the impact of evidence-based educational materials and access to local resources on physical activity (PA) levels, beliefs, and motivation (including self-efficacy) regarding PA during pregnancy in a rural setting. METHODS Information on PA levels (step counts, Pregnancy Physical Activity Questionnaire) and beliefs and motivation regarding PA (main surveys: Exercise Beliefs Questionnaire, Protection Motivation Theory and Health Action Process Approach) were collected between 8 and 16 weeks gestation. Women from a rural community were randomly assigned to the PA group (PAG, n = 38) or control group (n = 32). The PAG participants received an evidence-based educational brochure and access (at no charge to them) to local fitness facilities. At approximately 34 to 37 weeks gestation, baseline assessments were repeated. RESULTS Sedentary time was significantly different between groups over time, with control participants increasing sedentary time and PAG participants decreasing sedentary time (P = .04). Sixteen women (42%) in the PAG utilized the resources provided (prenatal yoga being utilized most). Postintervention, there was a significant group × time interaction for Perceived Self-Efficacy scores; scores in the PAG remained consistent with baseline values, whereas scores in the control group decreased (P = .03). CONCLUSIONS The intervention reduced sedentary time and maintained self-efficacy scores during pregnancy.
Collapse
|
44
|
Mohammadkhani R, Khaledi N, Rajabi H, Salehi I, Komaki A. Influence of the maternal high-intensity-interval-training on the cardiac Sirt6 and lipid profile of the adult male offspring in rats. PLoS One 2020; 15:e0237148. [PMID: 32745152 PMCID: PMC7398538 DOI: 10.1371/journal.pone.0237148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 07/21/2020] [Indexed: 12/14/2022] Open
Abstract
The susceptibility to cardiovascular disease in offspring could be reduced prior to birth through maternal intervention, before and during pregnancy. We evaluated whether the initiation periods of maternal exercise in preconception and pregnancy periods induce beneficial effects in the adult male offspring. Thirty-two female rats were divided into control and exercise groups. The exercise groups involve exercise before pregnancy or the preconception periods, exercise during pregnancy, and exercise before and during pregnancy. The mothers in the exercise groups were run on the treadmill in different periods. Then the birth weight and weekly weight gain of male offspring were measured, and the blood and left ventricle tissue of samples were collected for analysis of the Sirtuin 6 (Sirt6) and insulin growth factor-2 (IGF-2) gene expression, serum levels of low-density lipoprotein (LDL), high-density lipoprotein (HDL), cholesterol (Cho), and triglycerides (TG). There was no significant difference in the birth weight of offspring groups (P = 0.246) while maternal HIIT only during pregnancy leads to reduce weekly weight gain of offspring. Our data showed that Sirt6 and IGF-2 gene expression was increased (P = 0.017) and decreased (P = 0.047) by maternal exercise prior to and during pregnancy, respectively. Also, the serum level of LDL (p = 0.002) and Cho (P = 0.007) were significantly decreased and maternal exercise leads to improves the running speed of the adult male offspring (p = 0.0176). This study suggests that maternal HIIT prior to and during pregnancy have positive intergenerational consequence in the health and physical readiness of offspring.
Collapse
Affiliation(s)
- Reihaneh Mohammadkhani
- Department of Exercise Physiology, Faculty of Physical Education & Sports Science, Kharazmi University, Tehran, Iran
| | - Neda Khaledi
- Department of Exercise Physiology, Faculty of Physical Education & Sports Science, Kharazmi University, Tehran, Iran
| | - Hamid Rajabi
- Department of Exercise Physiology, Faculty of Physical Education & Sports Science, Kharazmi University, Tehran, Iran
| | - Iraj Salehi
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Alireza Komaki
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
45
|
Kazemi A, Toghiyani Z, Nekoei-Zahraei N. Using social cognitive theory to explain physical activity in Iranian women preparing for pregnancy. Women Health 2020; 60:1024-1031. [PMID: 32631153 DOI: 10.1080/03630242.2020.1789259] [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: 10/23/2022]
Abstract
Despite the known useful effects of regular physical activity during the preconception period on pregnancy outcomes, sedentary lifestyle is a prevalent phenomenon in reproductive-aged women. Using social cognitive theory (SCT) as its theoretical framework, the aim of this study was to explain physical activity model in the women preparing for pregnancy in Isfahan, Iran. This cross-sectional study was conducted on 220 Iranian women undergoing preconception care. The SCT constructs were measured using a researcher-made questionnaire. The duration of physical activity with moderate/severe intensity was also measured using the long form of the International Physical Activity Questionnaire. The data were analyzed using Spearman correlation coefficient and multivariable linear regression. The theoretical model was tested using structural equation modeling. The results showed that observational learning (β =.65, p <.0001) was the most important determinant of the physical activity level. The default model provided an adequate to good fit to the data (CMIN/DF = 2.10, p =.097). The results of the present study emphasized the role of observational learning in forming physical activity behavior in pre-pregnancy period; therefore, the design of interventions for providing the opportunity of observational learning may improve the level of physical activity among the women preparing for pregnancy.
Collapse
Affiliation(s)
- Ashraf Kazemi
- Reproductive Health Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences , Isfahan, Iran
| | - Zahra Toghiyani
- Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences , Isfahan, Iran
| | | |
Collapse
|
46
|
Darvall JN, Wang A, Nazeem MN, Harrison CL, Clarke L, Mendoza C, Parker A, Harrap B, Teale G, Story D, Hessian E. A Pedometer-Guided Physical Activity Intervention for Obese Pregnant Women (the Fit MUM Study): Randomized Feasibility Study. JMIR Mhealth Uhealth 2020; 8:e15112. [PMID: 32348280 PMCID: PMC7284400 DOI: 10.2196/15112] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 11/23/2019] [Accepted: 02/12/2020] [Indexed: 12/16/2022] Open
Abstract
Background Obesity in pregnancy is a growing problem worldwide, with excessive gestational weight gain (GWG) occurring in the majority of pregnancies. This significantly increases risks to both mother and child. A major contributor to both prepregnancy obesity and excessive GWG is physical inactivity; however, past interventions targeting maternal weight gain and activity levels during the antenatal period have been ineffective in women who are already overweight. Pedometer-guided activity may offer a novel solution for increasing activity levels in this population. Objective This initial feasibility randomized controlled trial aimed to test a pedometer-based intervention to increase activity and reduce excessive GWG in pregnant women. Methods We supplied 30 pregnant women with obesity a Fitbit Zip pedometer and randomized them into 1 of 3 groups: control (pedometer only), app (pedometer synced to patients’ personal smartphone, with self-monitoring of activity), or app-coach (addition of a health coach–delivered behavioral change program). Feasibility outcomes included participant compliance with wearing pedometers (days with missing pedometer data), data syncing, and data integrity. Activity outcomes (step counts and active minutes) were analyzed using linear mixed models and generalized estimating equations. Results A total of 30 participants were recruited within a 10-week period, with a dropout rate of 10% (3/30; 2 withdrawals and 1 stillbirth); 27 participants thus completed the study. Mean BMI in all groups was ≥35 kg/m2. Mean (SD) percentage of missing data days were 23.4% (20.6%), 39.5% (32.4%), and 21.1% (16.0%) in control, app group, and app-coach group patients, respectively. Estimated mean baseline activity levels were 14.5 active min/day and 5455 steps/day, with no significant differences found in activity levels between groups, with mean daily step counts in all groups remaining in the sedentary (5000 steps/day) or low activity (5000-7499 steps/day) categories for the entire study duration. There was a mean decrease of 7.8 steps/day for each increase in gestation day over the study period (95% CI 2.91 to 12.69, P=.002). Conclusions Activity data syncing with a personal smartphone is feasible in a cohort of pregnant women with obesity. However, our results do not support a future definitive study in its present form. Recruitment and retention rates were adequate, as was activity data syncing to participants’ smartphones. A follow-up interventional trial seeking to reduce GWG and improve activity in this population must focus on improving compliance with activity data recording and behavioral interventions delivered. Trial Registration Australian and New Zealand Clinical Trials Registry ACTRN12617000038392; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370884
Collapse
Affiliation(s)
- Jai N Darvall
- Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Australia.,Centre for Integrated Critical Care, University of Melbourne, Melbourne, Australia
| | - Andrew Wang
- Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | | | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lauren Clarke
- Department of Physiotherapy, Western Health, Melbourne, Australia
| | | | - Anna Parker
- Centre for Integrated Critical Care, University of Melbourne, Melbourne, Australia
| | - Benjamin Harrap
- Melbourne Epicentre, University of Melbourne, Melbourne, Australia
| | - Glyn Teale
- Department of Women's and Children's Services, Western Health, Melbourne, Australia
| | - David Story
- Centre for Integrated Critical Care, University of Melbourne, Melbourne, Australia
| | - Elizabeth Hessian
- Department of Anaesthesia and Pain Management, Western Health, Melbourne, Australia
| |
Collapse
|
47
|
Most J, Altazan AD, St. Amant M, Beyl RA, Ravussin E, Redman LM. Increased Energy Intake After Pregnancy Determines Postpartum Weight Retention in Women With Obesity. J Clin Endocrinol Metab 2020; 105:5697304. [PMID: 31905403 PMCID: PMC7077954 DOI: 10.1210/clinem/dgz330] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 01/02/2020] [Indexed: 12/17/2022]
Abstract
CONTEXT This study was designed to understand causes and critical periods for postpartum weight retention by characterizing changes in body composition, energy intake, energy expenditure and physical activity in women with obesity during pregnancy and postpartum. DESIGN In this prospective, observational cohort study, body composition (plethysmography), energy expenditure (doubly labeled water, whole-body room calorimetry), physical activity (accelerometry), metabolic biomarkers, and eating behaviors were measured. Energy intake was calculated by the intake-balance method for pregnancy, and for 2 postpartum periods (0 to 6 months and 6 to 12 months). RESULTS During the 18-month observation period, weight loss occurred in 16 (43%) women (mean ± SEM, -4.9 ± 1.6 kg) and weight retention occurred in 21 (57%) women (+8.6 ± 1.4 kg). Comparing women with postpartum weight loss and weight retention, changes in body weight were not different during pregnancy (6.9 ± 1.0 vs 9.5 ± 0.9 kg, P = 0.06). After pregnancy, women with postpartum weight loss lost -3.6 ± 1.8 kg fat mass whereas women with weight retention gained 6.2 ± 1.7 kg fat mass (P < 0.001). Women with postpartum weight loss reduced energy intake during the postpartum period (compared with during pregnancy) by 300 kcal/d (1255 kJ/d), while women with weight retention increased energy intake by 250 kcal/d (1046 kJ/d, P < 0.005). There were no differences in the duration of breastfeeding, eating behavior, or metabolic biomarkers. CONCLUSIONS Postpartum weight gain was the result of increased energy intake after pregnancy rather than decreased energy expenditure. Dietary intake recommendations are needed for women with obesity during the postpartum period, and women should be educated on the risk of overeating after pregnancy.
Collapse
Affiliation(s)
- Jasper Most
- Reproductive Endocrinology and Women’s Health, Pennington Biomedical Research Center, Baton Rouge, LA
- Current Affiliation: Jasper Most is now with the Dept of Nutrition and Movement Sciences, Maastricht University Medical Center+, the Netherlands
| | - Abby D Altazan
- Reproductive Endocrinology and Women’s Health, Pennington Biomedical Research Center, Baton Rouge, LA
| | | | - Robbie A Beyl
- Clinical Sciences, Pennington Biomedical Research Center, Baton Rouge, LA
| | - Eric Ravussin
- Clinical Sciences, Pennington Biomedical Research Center, Baton Rouge, LA
| | - Leanne M Redman
- Reproductive Endocrinology and Women’s Health, Pennington Biomedical Research Center, Baton Rouge, LA
- Correspondence and Reprint Requests: Leanne M. Redman, PhD, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808. E-mail:
| |
Collapse
|
48
|
Hill B, Skouteris H, Boyle JA, Bailey C, Walker R, Thangaratinam S, Sundseth H, Stephenson J, Steegers E, Redman LM, Montanaro C, Lim S, Jorgensen L, Jack B, Borges ALV, Bergmeier HJ, Baxter JAB, Harrison CL, Teede HJ. Health in Preconception, Pregnancy and Postpartum Global Alliance: International Network Pregnancy Priorities for the Prevention of Maternal Obesity and Related Pregnancy and Long-Term Complications. J Clin Med 2020; 9:E822. [PMID: 32197374 PMCID: PMC7141234 DOI: 10.3390/jcm9030822] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/12/2020] [Accepted: 03/14/2020] [Indexed: 12/19/2022] Open
Abstract
In this article, we describe the process of establishing agreed international pregnancy research priorities to address the global issues of unhealthy lifestyles and rising maternal obesity. We focus specifically on the prevention of maternal obesity to improve related clinical pregnancy and long-term complications. A team of multidisciplinary, international experts in preconception and pregnancy health, including consumers, were invited to form the Health in Preconception, Pregnancy and Postpartum (HiPPP) Global Alliance. As an initial activity, a priority setting process was completed to generate pregnancy research priorities in this field. Research, practice and policy gaps were identified and enhanced through expert and consumer consultation, followed by a modified Delphi process and Nominal Group Technique, including an international workshop. Research priorities identified included optimising: (1) healthy diet and nutrition; (2) gestational weight management; (3) screening for and managing pregnancy complications and pre-existing conditions; (4) physical activity; (5) mental health; and (6) postpartum (including intrapartum) care. Given extensive past research in many of these areas, research priorities here recognised the need to advance pregnancy research towards pragmatic implementation research. This work has set the agenda for large-scale, collaborative, multidisciplinary, implementation research to address the major public health and clinical issue of maternal obesity prevention.
Collapse
Affiliation(s)
- Briony Hill
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
| | - Helen Skouteris
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
- Warwick Business School, Warwick University; Coventry CV47AL, UK
| | - Jacqueline A. Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
| | - Cate Bailey
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
| | - Ruth Walker
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
| | - Shakila Thangaratinam
- Barts Research Centre for Women’s Health (BARC), Women’s Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, 58 Turner Street, London E1 2AB, UK; (S.T.); (L.J.)
| | - Hildrun Sundseth
- European Institute of Women’s Health, 33 Pearse Street, Dublin 2, Ireland;
| | - Judith Stephenson
- Institute for Women’s Health, University College London, EGA Institute for Women’s Health, 74 Huntley St, London WC1E 6AU, UK;
| | - Eric Steegers
- Department of Obstetrics and Gynaecology, Erasmus Medical Centre–Sophia Children’s Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands;
| | - Leanne M. Redman
- Reproductive Endocrinology and Women’s Health Laboratory, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, USA;
| | - Cynthia Montanaro
- Wellington-Dufferin-Guelph Public Health, 160 Chancellors Way, Guelph, ON N1G 0E1, Canada;
| | - Siew Lim
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
| | - Laura Jorgensen
- Barts Research Centre for Women’s Health (BARC), Women’s Health Research Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, 58 Turner Street, London E1 2AB, UK; (S.T.); (L.J.)
| | - Brian Jack
- Department of Family Medicine, Boston University School of Medicine, 771 Albany St, Boston, MA 02118, USA;
| | - Ana Luiza Vilela Borges
- Public Health Nursing Department, University of Sao Paulo, 419 Cerqueira Cesar, Sao Paulo 05403000, Brazil;
| | - Heidi J. Bergmeier
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
| | - Jo-Anna B. Baxter
- Centre for Global Child Health, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 686 Bay Street, Toronto, ON MG5 0A4, Canada;
- Department of Nutritional Sciences, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
| | - Helena J. Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Level 1, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia; (B.H.); (H.S.); (J.A.B.); (C.B.); (R.W.); (S.L.); (H.J.B.); (C.L.H.)
- Monash Partners Advanced Health Research Translation Centre, Locked Bag 29, Clayton, VIC 3168, Australia
- Monash Health, 246 Clayton Road, Clayton, VIC 3168, Australia
| |
Collapse
|
49
|
Bauer I, Hartkopf J, Kullmann S, Schleger F, Hallschmid M, Pauluschke-Fröhlich J, Fritsche A, Preissl H. Spotlight on the fetus: how physical activity during pregnancy influences fetal health: a narrative review. BMJ Open Sport Exerc Med 2020; 6:e000658. [PMID: 32206341 PMCID: PMC7078670 DOI: 10.1136/bmjsem-2019-000658] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2020] [Indexed: 12/16/2022] Open
Abstract
Before and during pregnancy, women often aim to improve their lifestyle so as to provide a healthier environment for their developing child. It remains unresolved, however, as to whether physical activity (PA) during pregnancy poses a possible risk or whether it might even have beneficial effects on the developing child. There is increasing evidence that PA during pregnancy is indeed beneficial to maternal physiological and psychological health and that it is generally not detrimental to the fetal cardiovascular system and neuronal function in the developing child. This also led to international recommendations for PAs during pregnancy. In the current review, we aimed to comprehensively assess the evidence of beneficial and harmful effects of maternal PA, including high-performance sports, on fetal development. The different mental and body-based relaxation techniques presented here are frequently performed during pregnancy. We found a considerable number of studies addressing these issues. In general, neither low key, moderate maternal PA nor relaxation techniques were observed to have a harmful effect on the developing child. However, we identified some forms of PA which could have at least a transient unfavourable effect. Notably, the literature currently available does not provide enough evidence to enable us to make a general conclusive statement on this subject. This is due to the lack of longitudinal studies on the metabolic and cognitive effects of regular PA during pregnancy and the wide diversity of methods used. In particular, the kind of PA investigated in each study differed from study to study.
Collapse
Affiliation(s)
- Ilena Bauer
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen/fMEG Center, Tübingen, Germany
- German Center for Diabetes Research (DZD e.V.), University of Tübingen, Tübingen, Germany
| | - Julia Hartkopf
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen/fMEG Center, Tübingen, Germany
- German Center for Diabetes Research (DZD e.V.), University of Tübingen, Tübingen, Germany
| | - Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen/fMEG Center, Tübingen, Germany
- German Center for Diabetes Research (DZD e.V.), University of Tübingen, Tübingen, Germany
- Department of Internal Medicine IV, Division of Endocrinology, Diabetology, and Nephrology, University Hospital Tübingen, Tübingen, Germany
| | - Franziska Schleger
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen/fMEG Center, Tübingen, Germany
- German Center for Diabetes Research (DZD e.V.), University of Tübingen, Tübingen, Germany
| | - Manfred Hallschmid
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen/fMEG Center, Tübingen, Germany
- German Center for Diabetes Research (DZD e.V.), University of Tübingen, Tübingen, Germany
- Institute of Medical Psychology and Behavioral Neurobiology, Eberhard Karls University Tübingen, Tübingen, Germany
| | | | - Andreas Fritsche
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen/fMEG Center, Tübingen, Germany
- German Center for Diabetes Research (DZD e.V.), University of Tübingen, Tübingen, Germany
- Department of Internal Medicine IV, Division of Endocrinology, Diabetology, and Nephrology, University Hospital Tübingen, Tübingen, Germany
| | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen/fMEG Center, Tübingen, Germany
- German Center for Diabetes Research (DZD e.V.), University of Tübingen, Tübingen, Germany
- Department of Internal Medicine IV, Division of Endocrinology, Diabetology, and Nephrology, University Hospital Tübingen, Tübingen, Germany
- Department of Pharmacy and Biochemistry, Institute of Pharmaceutical Sciences; Interfaculty Centre for Pharmacogenomics and Pharma Research, Eberhard Karls University Tübingen, Tübingen, Germany
| |
Collapse
|
50
|
Vannuccini S, Fondelli F, Clemenza S, Galanti G, Petraglia F. Dysmenorrhea and Heavy Menstrual Bleeding in Elite Female Athletes: Quality of Life and Perceived Stress. Reprod Sci 2020; 27:888-894. [DOI: 10.1007/s43032-019-00092-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 06/12/2019] [Indexed: 11/30/2022]
|