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Xiang Z, Sun K, Han R, Chen L, Wang Z, Gao L. Predictors of physical inactivity among pregnant women. Nurs Health Sci 2024; 26:e13086. [PMID: 38356050 DOI: 10.1111/nhs.13086] [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: 01/31/2023] [Revised: 12/18/2023] [Accepted: 12/29/2023] [Indexed: 02/16/2024]
Abstract
It is recommended that pregnant women be physically active to promote maternal and child health. This study aimed to explore the prevalence of physical inactivity and its modifiable predictors in the three trimesters in Chinese pregnant women. Four hundred forty-four pregnant women completed the Pregnant Physical Activity Questionnaire in the first, second, and third trimesters. The prevalence of physical inactivity reached its highest (66.2%) in the first trimester and lowest (19.4%) in the second trimester. Pregnant women with inadequate physical activity knowledge and low self-efficacy were at higher risk for physical inactivity. Monitoring physical inactivity could be incorporated into antenatal care and start from the first trimester. Prenatal care professionals should take action to increase pregnant women's physical activity self-efficacy and knowledge to enhance their physical activity.
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Affiliation(s)
- Zhixuan Xiang
- School of Nursing, Xiangtan Medicine and Health Vocational College, Xiangtan, China
| | - Ke Sun
- Gynecology & Obstetrics Department, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Rongrong Han
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Lu Chen
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Zhong Wang
- Nursing Department, Dongguan Hospital of Integrated Traditional Chinese and Western Medicine, Dongguan, China
| | - Lingling Gao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Weng YM, Green J, Yu JJ, Zhang HY, Cui H. The relationship between incidence of cesarean section and physical activity during pregnancy among pregnant women of diverse age groups: Dose-response meta-analysis. Int J Gynaecol Obstet 2024; 164:504-515. [PMID: 37326328 DOI: 10.1002/ijgo.14915] [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: 11/12/2022] [Revised: 05/14/2023] [Accepted: 05/17/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND There is a lack of evidence related to physical activity and risk of cesarean section (CS) by age and/or weight in pregnant women. OBJECTIVES To evaluate the effect of physical activity on the incidence of CS and explore the relationship of age and body mass index (BMI) with incidence of CS. SEARCH STRATEGY A systematic search was conducted in CNKI, WANGFANG, Web of Science, and PubMed from inception to 31 August 2021. SELECTION CRITERIA Experimental studies were included if the participants were pregnant, if intervention included physical activity and controls received routine prenatal care only, and if primary outcome was CS. DATA COLLECTION AND ANALYSIS Meta-analysis included a heterogeneity test, data combination, subgroup analysis, forest plot, sensitivity analysis, and dose-response regression analysis. MAIN RESULTS Sixty-two studies were included. Physical activity during pregnancy decreased the incidence of CS (relative risk [RR] 0.81, 95% confidence interval [CI] 0.74-0.88, P < 0.001). The incidence of CS was lower among the overweight/obese group (RR 0.78, 95% CI 0.65-0.93) compared with the normal weight group (RR 0.82, 95% CI 0.74-0.90). The incidence of CS was lowest among the young age group (RR 0.61, 95% CI 0.46-0.80) compared with the middle age group (RR 0.74, 95% CI 0.64-0.85) and the older age group (RR 0.90, 95% CI 0.82-1.00). The critical value, when age becomes a risk factor for CS, was 31.7 years in the intervention group and 28.5 years in the control group. CONCLUSIONS Physical activity during pregnancy can reduce the incidence of CS, especially among obese people, and prolong the gestational age span.
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Affiliation(s)
- Yeming M Weng
- China Wushu School, Beijing Sport University, Beijing, China
| | - Jeni Green
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA
| | - Jingjing J Yu
- Key Laboratory of Exercise and Physical Fitness, Beijing Sport University, Beijing, China
| | - Hanyue Y Zhang
- School of Physical Education, Northeast Normal University, Changchun, China
| | - Hua Cui
- Sport Information Research and Teaching Center, Beijing Sport University, Beijing, China
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González-Cazorla E, Brenes-Romero AP, Sánchez-Gómez MJ, Estévez-Ruiz E, Díaz-Enjuto A, Cantón-Cisneros A, Lubián-López D, Mozas-Moreno J, González-Mesa ES. Physical Activity in Work and Leisure Time during Pregnancy, and Its Influence on Maternal Health and Perinatal Outcomes. J Clin Med 2024; 13:723. [PMID: 38337416 PMCID: PMC10856528 DOI: 10.3390/jcm13030723] [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: 11/18/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Physical inactivity during pregnancy has been shown to be linked to an increased risk of complications. However, during pregnancy, doubts arise about what type, intensity and frequency of physical activity are most recommended. OBJECTIVE Our main objective was to know the level of physical activity (PA) and sedentary lifestyle in a representative sample of pregnant women in Málaga, one of the most populated cities in Spain. Also, we aimed to find out the effects of PA on obstetric and perinatal outcomes and on the mental health of pregnant women, differentiated according to PA intensity and domain. METHODS Five hundred and forty full-term pregnant women who had their obstetric checks in the maternity ward of the Regional University Hospital of Málaga were recruited through consecutive sampling. Participants answered a questionnaire that included the WHO Global Physical Activity Questionnaire (GPAQ), the Edinburgh Depression Scale (EDS), the Generalized Anxiety Disorder Scale (GAD-7) and some other sociodemographic and health-related questions. Subsequently, information about perinatal outcomes was obtained after birth. RESULTS Only 50.8% of women followed the WHO recommendations on activity. We found a high proportion of obese pregnant women and a direct effect of a sedentary lifestyle on the rate of cesarean sections and vulvovaginal tears in spontaneous births, as well as on the mental health of future mothers. Women's age, the number of children, BMI at the beginning of pregnancy and leisure time physical activity (LTPA) explained anxiety scores, and age, LTPA, BMI at the end of pregnancy and intense work-related physical activity (WTPA) predicted depression scores. CONCLUSIONS LTPA improves obstetric outcomes, helping to reduce the rate of cesarean sections and vulvovaginal tears, as well as reducing prenatal anxiety and depression.
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Affiliation(s)
| | - Ana Pilar Brenes-Romero
- Department of Obstetrics and Gynecology, Regional University Hospital of Málaga, 29001 Málaga, Spain
| | - María José Sánchez-Gómez
- Department of Obstetrics and Gynecology, Regional University Hospital of Málaga, 29001 Málaga, Spain
| | - Elena Estévez-Ruiz
- Department of Obstetrics and Gynecology, Regional University Hospital of Málaga, 29001 Málaga, Spain
| | - Antonio Díaz-Enjuto
- Department of Obstetrics and Gynecology, Regional University Hospital of Málaga, 29001 Málaga, Spain
| | - Ana Cantón-Cisneros
- Department of Obstetrics and Gynecology, Regional University Hospital of Málaga, 29001 Málaga, Spain
| | - Daniel Lubián-López
- Department of Obstetrics and Gynecology, Viamed Bahía de Cádiz Hospital, 11130 Cádiz, Spain
| | - Juan Mozas-Moreno
- Department of Obstetrics and Gynecology, University of Granada, 18016 Granada, Spain
- Obstetrics and Gynecology Service, Virgen de las Nieves University Hospital, 18014 Granada, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), 28029 Madrid, Spain
- Biohealth Research Institute (Instituto de Investigación Biosanitaria Ibs. GRANADA), 18014 Granada, Spain
| | - Ernesto S González-Mesa
- Department of Obstetrics and Gynecology, Regional University Hospital of Málaga, 29001 Málaga, Spain
- Surgical Specialties, Biochemistry and Immunology Department, Málaga University, 29071 Málaga, Spain
- Research Group in Maternal-Fetal Medicine, Epigenetics, Women’s Diseases and Reproductive Health, Biomedical Research Institute of Malaga (IBIMA-Plataforma Bionand), 29071 Málaga, Spain
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Gonçalves H, Soares ALG, Domingues MR, Bertoldi AD, Santos MGD, Silveira MFD, Coll CDVN. Why are pregnant women physically inactive? A qualitative study on the beliefs and perceptions about physical activity during pregnancy. CAD SAUDE PUBLICA 2024; 40:e00097323. [PMID: 38198382 PMCID: PMC10775962 DOI: 10.1590/0102-311xen097323] [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: 05/26/2023] [Revised: 08/25/2023] [Accepted: 09/29/2023] [Indexed: 01/12/2024] Open
Abstract
This study aimed to describe the beliefs and perceptions of pregnant women and healthcare providers about physical activity during pregnancy. Using a qualitative approach, 30 pregnant women and the 14 healthcare providers caring for them were interviewed in the second trimester of pregnancy. We included women who maintained, decreased, or stopped physical activity since becoming pregnant. They were divided into low (≤ 8 years) and high schooling (> 8 years). Semi-structured, in-depth interviews were conducted and guided by three key questions: (1) When does physical activity during pregnancy start to be considered a wrong behavior?; (2) What are the main barriers (biological or others) to physical activity?; and (3) Do the actions of healthcare providers and people close to pregnant women reinforce barriers? Interviews were audio recorded, transcribed, and analyzed based on recurring themes. All women changed their physical activity behavior (decreased or stopped) when they discovered their pregnancy. Fear of miscarriage, contractions, bleeding, and of causing malformations in the baby were the most reported reasons for decreasing or stopping physical activity. Participants also lacked access to consistent information and healthcare providers' support on the benefits of physical activity. Despite the current international recommendations to regular physical activity during pregnancy, uncertainty regarding its benefits remains. Interventions to promote physical activity during this period should include the training of healthcare providers so they can advise and discard ideas contrary to mother-child health benefits.
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Xiang Z, Han R, Chen L, Gao L. Predictors of physical activity among Chinese pregnant women during the first trimester: A cross-sectional study. J Sports Sci 2023; 41:1883-1891. [PMID: 38234226 DOI: 10.1080/02640414.2024.2306448] [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: 08/27/2022] [Accepted: 01/10/2024] [Indexed: 01/19/2024]
Abstract
Physical activity during pregnancy has numerous health benefits for the woman and the foetus. The current study investigated physical activity engagement and its predictors among pregnant Chinese women during the first trimester. A total of 687 pregnant women completed the Pregnancy Physical Activity Questionnaire. Bivariate and multivariate logistic regression were used to analyse the data. The current physical activity guidelines were not met by 64.3% of respondents. Women with higher levels of physical activity self-efficacy (aOR = 0.96; 95% CI: 0.92-0.99) and social support (aOR = 0.95; 95% CI: 0.94-0.97) had lower odds of not meeting the current physical activity guidelines. Women who were aged < 35 years (aOR = 1.85; 95% CI: 1.02-3.34), had lower education (aOR = 1.63; 95% CI: 1.04-2.55), were primiparous (aOR = 11.03; 95% CI: 6.98-17.44), were unsure of their delivery mode (aOR = 2.32; 95% CI: 1.95-5.64), and those who had higher levels of pregnancy-associated discomfort (aOR = 1.10; 95% CI: 1.03-1.19) had higher odds of not meeting the current physical activity guidelines. The current study suggests that healthcare professionals should assess physical activity engagement during routine antenatal care and increase efforts to strengthen pregnant women's self-efficacy and social support to promote physical activity engagement during the first trimester.
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Affiliation(s)
- Zhixuan Xiang
- School of Nursing, Xiangtan Medicine & Health Vocational College, Xiangtan, China
| | - Rongrong Han
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Lu Chen
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Lingling Gao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Bernardo D, Carvalho C, Leirós-Rodríguez R, Mota J, Santos PC. Comparison of the Portuguese Version of the Pregnancy Physical Activity Questionnaire (PPAQ) with Accelerometry for Classifying Physical Activity among Pregnant Women with Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:929. [PMID: 36673683 PMCID: PMC9859283 DOI: 10.3390/ijerph20020929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
In recent years, the number of pregnant women with obesity has increased exponentially; thus, it is important to evaluate and characterize the physical activity levels of this specific group. The aim of this study is to evaluate the reliability and validity of the Portuguese version of the Physical Activity and Pregnancy Questionnaire and Pregnancy Questionnaire in pregnant women with obesity and to classify physical activity using the Physical Activity and Pregnancy Questionnaire and accelerometry. An analytical observational study was carried out between May and August of 2019 at the University Hospital Center of São João, with a sample of 31 pregnant women with obesity (30.9 ± 4.6 years 36.5 ± 4.6 kg/m2 of BMI and 21.5 ± 9 gestational weeks). The physical activity of participants was evaluated using an accelerometer and Physical Activity and Pregnancy Questionnaire at two time points (the first visit at the moment of consultation and the second seven days after, with accelerometer retest), the interclass correlation coefficient was used to test reliability between the Physical Activity and Pregnancy Questionnaire filled out at visit1 and the Physical Activity and Pregnancy Questionnaire filled out at visit2, and Pearson's correlation was used to determine validity between the Physical Activity and Pregnancy Questionnaire and accelerometry. The interclass correlation coefficient values for total activity were 0.95, 0.97 for moderate and 0.58 for vigorous intensities. It ranged from 0.74 for sports/exercise to 0.96 for domestic activities. The Pearson's correlations showed that the Physical Activity and Pregnancy Questionnaire is moderately valid for moderate intensity (r = 0.435). A total of 67.7% of the pregnant women complied with international physical activity recommendations.
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Affiliation(s)
- Diana Bernardo
- KinesioLab Research Unit in Human Movement, Department of Physiotherapy, Piaget Institute, School of Health, 4405-678 Vila Nova de Gaia, Portugal
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), 4200-450 Porto, Portugal
| | - Carlos Carvalho
- Sword Health Technologies, Department of Physiotherapy, 4100-467 Porto, Portugal
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Nursing and Physical Therapy Department, University of Leon, 24004 León, Spain
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), 4200-450 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto (FADEUP), 4200-450 Porto, Portugal
| | - Paula Clara Santos
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto (FADEUP), 4200-450 Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto (FADEUP), 4200-450 Porto, Portugal
- Department of Physiotherapy, School of Health, Polytechnic of Porto (ESS), 4200-072 Porto, Portugal
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
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SANDBORG JOHANNA, MIGUELES JAIROH, SÖDERSTRÖM EMMIE, BLOMBERG MARIE, HENRIKSSON PONTUS, LÖF MARIE. Physical Activity, Body Composition, and Cardiometabolic Health during Pregnancy: A Compositional Data Approach. Med Sci Sports Exerc 2022; 54:2054-2063. [PMID: 36069838 PMCID: PMC9671591 DOI: 10.1249/mss.0000000000002996] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE The aim of this study was to examine the cross-sectional and longitudinal associations of 24-h movement behaviors (sleep, sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA)) with body composition and cardiometabolic health in i) early and ii) late pregnancy (gestational weeks 14 and 37). METHODS This observational study utilized cross-sectional ( n = 273) and longitudinal data ( n = 242) from the HealthyMoms trial. Time spent in movement behaviors over seven consecutive 24-h periods (ActiGraph wGT3x-BT accelerometer), body composition (Bod Pod), and cardiometabolic health indicators (glucose levels, homeostatic model for insulin resistance (HOMA-IR), systolic and diastolic blood pressure, metabolic syndrome (MetS) score) were measured in early and late pregnancy. RESULTS In early pregnancy, reallocating time to MVPA from LPA, SB, and sleep was associated with lower MetS score (adjusted γ = -0.343, P = 0.002). Correspondingly, reallocating time to LPA from SB and sleep in early pregnancy was associated with lower body weight (adjusted γ = -5.959, P = 0.047) and HOMA-IR (adjusted γ = -0.557, P = 0.031) at the same time point. Furthermore, reallocating time to LPA from SB and sleep in early pregnancy was associated with lower fat mass index (adjusted γ = -0.668, P = 0.028), glucose levels (adjusted γ = -0.315, P = 0.006), HOMA-IR (adjusted γ = -0.779, P = 0.004), and MetS score (adjusted γ = -0.470, P = 0.027) in late pregnancy. The changes in behaviors throughout pregnancy were not associated with body weight, body composition, and MetS score in late pregnancy. CONCLUSIONS Our results demonstrated that increasing LPA or MVPA while reducing SB and sleep was associated with lower weight and more favorable cardiometabolic health in early pregnancy. In contrast, LPA in early pregnancy seems to be a stimulus of enough intensity to improve body composition and cardiometabolic health indicators in late pregnancy.
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Affiliation(s)
- JOHANNA SANDBORG
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, SWEDEN
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SWEDEN
| | - JAIRO H. MIGUELES
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, SWEDEN
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Research Institute of Sport and Health, University of Granada, Granada, SPAIN
| | - EMMIE SÖDERSTRÖM
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, SWEDEN
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SWEDEN
| | - MARIE BLOMBERG
- Department of Obstetrics and Gynecology and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, SWEDEN
| | - PONTUS HENRIKSSON
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SWEDEN
| | - MARIE LÖF
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Stockholm, SWEDEN
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, SWEDEN
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Dolatabadi Z, Amiri-Farahani L, Ahmadi K, Pezaro S. Barriers to physical activity in pregnant women living in Iran and its predictors: a cross sectional study. BMC Pregnancy Childbirth 2022; 22:815. [PMID: 36333661 PMCID: PMC9636628 DOI: 10.1186/s12884-022-05124-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND AND AIMS Despite the benefits of physical activity (PA) on maternal and fetal health, the level of PA is low among pregnant women globally. The aim of this study was to determine the barriers to PA and its predictors in Iranian pregnant women specifically. METHODS This cross-sectional study included 300 pregnant women referred to the Ilam health centers of Iran. The sampling strategy used stratified random proportional allocation sampling from both comprehensive health centers and health bases. Data were collected from September to December 2018 in relation to individual characteristics. Data collection tools used included the Pregnancy Physical Activity Questionnaire and the Barriers to Physical Activity during Pregnancy Scale. To analyze the data, descriptive statistics and statistical tests of analysis including variance, independent t-test and multiple linear regression were used. RESULTS The mean and SD of the total score of PA barriers was 88.55 and 19.28, respectively. The highest and lowest mean scores of the subscale of PA barriers were related to interpersonal and environmental barriers, respectively. Among the intrapersonal barriers related to pregnancy; fear of pregnancy complications, drowsiness, and nausea and vomiting, heaviness or swelling barriers scored higher than other barriers. Lack of regular schedule, insufficient time, and lack of motivation received the highest score in terms of intrapersonal barriers non-related to pregnancy. In the interpersonal subscale; lack of knowledge about how to be physically active during pregnancy, forbiddance of PA by friends and family, as well as lack of advice from physicians and midwives scored higher than other barriers. Lack of adequate facilities and air pollution were identified as barriers to PA in the environmental subscale. PA barriers were significantly associated with pre-pregnancy or early pregnancy body mass index (B = - 14.643), level of education (B = 17.215), and habitual exercise pre-pregnancy (B = - 7.15). CONCLUSION Interpersonal barriers were reported to be the most common barriers to PA during pregnancy. Perinatal care providers should encourage, educate and reassure pregnant women, their spouses and their families about the benefits, type and frequency of safe PA in pregnancy. PA interventions focused on women with lower levels of education and income in particular are required.
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Affiliation(s)
- Zari Dolatabadi
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Amiri-Farahani
- Nursing and Midwifery Care Research Center, Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, 1996713883 Iran
| | - Katayon Ahmadi
- Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Sally Pezaro
- The University of Notre Dame, Fremantle, Australia
- The Centre for Healthcare Research, Coventry University, Coventry, UK
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Nagpal TS, Sánchez-Polán M, da Silva DF, Souza SCS, Pelaez M, Perales M, Cordero Y, Vargas-Terrones M, Adamo KB, Barakat R. Population characteristics associated with adherence to prenatal group-based exercise programs. J Sports Sci 2022; 40:2275-2281. [PMID: 36526440 DOI: 10.1080/02640414.2022.2158011] [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: 12/23/2022]
Abstract
Community-based supervised group exercise may be an effective option to increase activity levels throughout pregnancy. Previous studies that have explored predictors of low adherence to exercise during pregnancy have not examined group-based settings. We analysed an international cohort of 347 pregnant women who participated in group-based prenatal exercise interventions (from <20 weeks to 34-36 weeks pregnant). Probable adherence predictors informed by previous literature that were assessed included: pre-pregnancy physical activity level and body mass index (BMI) classification, age, number of previous pregnancies, and education level. Adherence was measured by attendance. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated to explore the relationship between the selected predictors and high adherence (≥70%). Post-secondary education level versus only secondary (aOR 5.28; CI 1.67; 16.72) or primary level (aOR 13.82; CI 4.30; 44.45) presented greater likelihood to have high adherence to the exercise intervention than low adherence. Future research and public health initiatives should consider implementing strategies to overcome education-related barriers to improve accessibility to prenatal exercise.
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Affiliation(s)
- Taniya S Nagpal
- Faculty of Kinesiology, Sport and Recreation, The University of Alberta, Edmonton, Alberta, Canada
| | - Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Danilo F da Silva
- Sports Studies Department, Faculty of Arts and Science, Bishop's University, Sherbrooke, Quebec, Canada
| | - Sara C S Souza
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Mireia Pelaez
- Faculty of Health Sciences, Universidad Europea del Atlántico, Spain
| | - María Perales
- Faculty of Sport Science, Camilo José Cela University, Villanueva de la Cañada, Spain.,Research Institute of Hospital 12 Octubre ('i+12'), Madrid, Spain
| | - Yaiza Cordero
- Faculty of Education, Complutense University of Madrid (UCM), Spain
| | - Marina Vargas-Terrones
- AFIPE Research Group, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Kristi B Adamo
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Ruben Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, Madrid, Spain
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The Profiling of Diet and Physical Activity in Reproductive Age Women and Their Association with Body Mass Index. Nutrients 2022; 14:nu14132607. [PMID: 35807789 PMCID: PMC9268133 DOI: 10.3390/nu14132607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 12/25/2022] Open
Abstract
Pre-pregnancy, pregnancy and postpartum are critical life stages associated with higher weight gain and obesity risk. Among these women, the sociodemographic groups at highest risk for suboptimal lifestyle behaviours and core lifestyle components associated with excess adiposity are unclear. This study sought to identify subgroups of women meeting diet/physical activity (PA) recommendations in relation to sociodemographics and assess diet/PA components associated with body mass index (BMI) across these life stages. Cross-sectional data (Australian National Nutrition and Physical Activity Survey 2011–2012) were analysed for pre-pregnancy, pregnant and postpartum women. The majority (63–95%) of women did not meet dietary or PA recommendations at all life stages. Core and discretionary food intake differed by sociodemographic factors. In pre-pregnant women, BMI was inversely associated with higher whole grain intake (β = −1.58, 95% CI −2.96, −0.21; p = 0.025) and energy from alcohol (β = −0.08, −0.14, −0.005; p = 0.035). In postpartum women, BMI was inversely associated with increased fibre (β = −0.06, 95% CI −0.11, −0.004; p = 0.034) and PA (β = −0.002, 95% CI −0.004, −0.001; p = 0.013). This highlights the need for targeting whole grains, fibre and PA to prevent obesity across life stages, addressing those most socioeconomically disadvantaged.
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Okafor UB, Goon DT. Uncovering Barriers to Prenatal Physical Activity and Exercise Among South African Pregnant Women: A Cross-Sectional, Mixed-Method Analysis. Front Public Health 2022; 10:697386. [PMID: 35433615 PMCID: PMC9010665 DOI: 10.3389/fpubh.2022.697386] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe barriers to prenatal physical activity and exercise have been widely reported in the literature, highlighting context-specific challenges. However, generally, research on prenatal physical activity and exercise among pregnant women in South Africa is rare; and particularly concerning the barriers to their prenatal physical activity practice. This study assessed the barriers to physical activity participation among pregnant women in the Eastern Cape, South Africa.MethodsThis was a sequential explanatory mixed method, predominantly quantitative study involving 1,082 pregnant women. A structured self-administered questionnaire on perceived barriers to physical participation was applied to collect quantitative data; while a subset of 15 pregnant women participated in individual in-depth semi-structured interviews to augment quantitative data. Quantitative and qualitative data were analyzed using descriptive statistics and thematic analysis, respectively.ResultsThe results of the quantitative analysis presented major barriers: lack of advice on prenatal physical activity and inadequate or conflicting information about prenatal physical activity; tiredness; work commitments; discomfort; lack of time; low energy; non-accessibility to physical activity; lack of financial resources, and safety concerns for the mother and the baby. Qualitatively, the barriers identified relate to four main themes: individual, lack of information, lack of resources, and environmental barriers.ConclusionThe major barriers cited by the women were tiredness, lack of time, discomfort, and low energy. They also include lack of support, advice and information about prenatal physical activity. The multiple constraining factors responsible for low or non-prenatal physical activity of pregnant women in this setting highlight the need to tailor interventions to address their individual uniquely perceived barriers.
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Affiliation(s)
- Uchenna Benedine Okafor
- Department of Nursing Science, University of Fort Hare, Alice, South Africa
- *Correspondence: Uchenna Benedine Okafor
| | - Daniel Ter Goon
- Department of Public Health, University of Fort Hare, Alice, South Africa
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Al Hassan R, Ali RR, Alsheikh MSK. The Effect of Physical Activity during Pregnancy on Childbirth. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Active pregnant women have fewer physical problems and gain weight during pregnancy, and this often leads to fewer complications as exercise also increases self-confidence and reduces the risk of mood swings after childbirth (postpartum) and depression, and “it is not only the women who benefits from being active.” Studies have shown that exercise during pregnancy has a “training effect” on the baby, and this is reflected in increased heart rate variability and a decrease in the fetus’s resting heart rate. Aim of this study is known Effect of Physical Activity during Pregnancy on Childbirth. 155 patients were collected from Bint Al-Huda Maternity & Children Hospital, Thi-Qar, Iraq, and the samples were divided into two groups (90 women who practiced exercise and 65 for control). All demographic information about patients was obtained through the distribution of questionnaires, and several techniques were used to analyze the results, including the statistical analysis program in evaluating physical activity on childbirth and analyzing the effects generated during pregnancy and the duration of the stage of labor and Positive results were found in the assessment of physical activity on pregnant women, and the results were in another way related to age and body mass index.
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Ahmadi K, Amiri-Farahani L, Haghani S, Hasanpoor-Azghady SB, Pezaro S. Exploring the intensity, barriers and correlates of physical activity In Iranian pregnant women: a cross-sectional study. BMJ Open Sport Exerc Med 2021; 7:e001020. [PMID: 34691760 PMCID: PMC8496388 DOI: 10.1136/bmjsem-2020-001020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 12/25/2022] Open
Abstract
Objectives To determine the intensity, barriers and correlates of physical activity (PA) in Iranian pregnant women. Methods This cross-sectional study was carried out with 300 eligible pregnant women referred to the Ilam health centres and bases using stratified random sampling with proportional allocation. Data collection tools included a demographic and obstetrical history questionnaire, the Pregnancy Physical Activity Questionnaire and the Exercise Benefits/Barriers Scale. The association between demographic and obstetrical characteristics and PA intensity and barriers were studied using multiple linear regression models. Results The mean and SD of the total score of PA intensity were 47.15 and 26.25 metabolic equivalent of task (MET)-hour/week, respectively. The highest and the lowest barriers were related to the time expenditure (42.77±18.04) and family discouragement (50.72±24.99) constructs, respectively. The PA intensity was significantly associated with prepregnancy or early pregnancy body mass index (B=25.6), ethnicity (B=16.94), level of education (B=−8.77), number of children (B=5.95), gestational age (B=0.81), participation in childbirth preparation classes (B=−11.27), habitual exercise before pregnancy (B=6.09), income (B=−9.22). The PA barriers were significantly associated with ethnicity (B=−4.96), income (B=2.23) and habitual exercise before pregnancy (B =−1.35). Conclusion PA intensity may be enhanced by encouraging individuals to be more physically active before pregnancy. Additionally, strategies to enhance support from friends and family to engage in PA throughout pregnancy and PA interventions focused on women with lower levels of income and education are required.
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Affiliation(s)
- Katayon Ahmadi
- Department of Reproductive Health and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Amiri-Farahani
- Department of Reproductive Health and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Shima Haghani
- Department of Biostatistics, Iran University of Medical Sciences, Tehran, Iran
| | | | - Sally Pezaro
- School of Nursing, Midwifery and Health, Centre for Arts Memory and Communities, Coventry University, Coventry, UK
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Amiri-Farahani L, Ahmadi K, Hasanpoor-Azghady SB, Pezaro S. Development and psychometric testing of the 'barriers to physical activity during pregnancy scale' (BPAPS). BMC Public Health 2021; 21:1483. [PMID: 34325684 PMCID: PMC8323252 DOI: 10.1186/s12889-021-11511-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 07/20/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Pregnancy can affect the amount of physical activity that women engage in, so ensuring adequate physical activity in pregnant women can be a challenge. Therefore, there is a need to explore and identify barriers to physical activity in this population. Consequently, this study was conducted in order to develop and validate a scale to assess barriers to physical activity in pregnant populations. METHODS The study was conducted in two phases. During phase 1, a comprehensive review of the most relevant literature from electronic databases on barriers to physical activity was carried out and appropriate scale items were extracted using a deductive approach. During phase 2, the psychometric properties of the extracted scale items were determined using face, content and construct validity, internal consistency and stability. Qualitative and quantitative face validity was assessed via face-to-face interviews with 30 and 10 pregnant women, respectively. To confirm the qualitative and quantitative content validity, 10 experts in the field of research and instrument design were invited to complete the resulting scale. To assess construct validity, the scale items were further tested among 320 pregnant women attending perinatal clinics at health centers in Ilam, Iran, where data were collected via continuous sampling. The internal consistency and stability of the study were measured by Cronbach's alpha and intra-class correlation coefficient (ICC), respectively. RESULTS Following a review of the relevant literature, 48 items for the BPAPS were extracted. Subsequent to the assessment of face and content validity, the number of items was reduced to 38. Through a subsequent exploratory factor analysis, the number of items dropped further to 29. These items were then structured under four major factors. Finally, the internal consistency and stability of the scale was confirmed by a Cronbach alpha coefficient of 0.824 and a test-retest reliability score of 0.87. CONCLUSION Findings show that the 29-item scale to assess barriers to physical activity in pregnant populations is a valid and appropriate instrument.
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Affiliation(s)
- Leila Amiri-Farahani
- Department of Reproductive Health and Midwifery, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Postal code, Tehran, 1996713883 Iran
| | - Katayon Ahmadi
- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Syedeh Batool Hasanpoor-Azghady
- Department of Reproductive Health and Midwifery, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Postal code, Tehran, 1996713883 Iran
| | - Sally Pezaro
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
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15
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Andersson-Hall U, de Maré H, Askeli F, Börjesson M, Holmäng A. Physical activity during pregnancy and association with changes in fat mass and adipokines in women of normal-weight or with obesity. Sci Rep 2021; 11:12549. [PMID: 34131242 PMCID: PMC8206069 DOI: 10.1038/s41598-021-91980-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/03/2021] [Indexed: 11/20/2022] Open
Abstract
Adipose tissue and adipokine concentrations change markedly during pregnancy, but the effects of physical activity on these changes are rarely studied. We aimed to assess physical activity levels in pregnant women of normal-weight (NW) or with obesity (OB), and to determine the relation with changes in fat mass and adipokines. In each trimester, pregnant women (136 NW, 51 OB) were interviewed about their physical activity and had their body composition, leptin, soluble leptin receptor (sOB-R) and adiponectin determined. NW reported higher activity and more aerobic exercise than OB during early pregnancy. Both groups maintained training frequency but reduced overall activity as pregnancy progressed. NW women reporting aerobic and/or resistance exercise and OB women reporting aerobic exercise had greater sOB-R increases (independent of BMI or gestational weight gain). In NW, exercise also associated with lower fat mass and leptin increases. Higher activity levels associated with lower gestational weight gain in both groups. The relationship between physical activity and adiponectin differed between NW and OB. Maternal exercise may partly mediate its beneficial effects through regulation of leptin bioavailability, by enhancing pregnancy-induced increases in sOB-R. This could be of particular importance in OB with pre-gestational hyperleptinemia and leptin resistance.
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Affiliation(s)
- Ulrika Andersson-Hall
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 432, 405 30, Gothenburg, Sweden.
| | - Hanna de Maré
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 432, 405 30, Gothenburg, Sweden
| | - Freja Askeli
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 432, 405 30, Gothenburg, Sweden
| | - Mats Börjesson
- Department of Food and Nutrition, and Sport Science, Centre for Health and Performance, University of Gothenburg, Gothenburg, Sweden
- Department of Acute and Molecular Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of MGA, Sahlgrenska University Hospital, Region of Västra Götaland, Gothenburg, Sweden
| | - Agneta Holmäng
- Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 432, 405 30, Gothenburg, Sweden
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16
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Malta MB, Gomes CDB, Barros AJD, Baraldi LG, Takito MY, Benício MHD, Carvalhaes MADBL. Effectiveness of an intervention focusing on diet and walking during pregnancy in the primary health care service. CAD SAUDE PUBLICA 2021; 37:e00010320. [PMID: 34037070 DOI: 10.1590/0102-311x00010320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 08/17/2020] [Indexed: 11/22/2022] Open
Abstract
Interventions during prenatal care can mitigate negative outcomes of a sedentary lifestyle and unhealthy diet during pregnancy. We aimed to evaluate the effectiveness of an intervention that promoted healthy diet and leisure-time walking during antenatal care in a pragmatic, controlled, non-randomized intervention study. Physicians and nurses from all health care units of the Family Health Strategy model of health assistance participated in educational training to promote leisure-time walking and healthy diet during antenatal care visits. Pregnant women who received health care from these professionals constituted the intervention group (n = 181). The control group (n = 172) included pregnant women who received routine antenatal care, in health care units of the traditional model of health assistance. Data were collected in each trimester of pregnancy. Diet was investigated using a food frequency questionnaire adapted from Risk and Protective Factors Surveillance System for Chronic Non-Comunicable Diseases Through Telephone Interview (Vigitel). Leisure-time walking in a typical week was assessed using questions from the Physical Activity in Pregnancy Questionnaire. There were positive effects on leisure-time walking during the second trimester and the third trimester of pregnancy and on the women who achieved 150 minutes per week of walking during the third trimester. The intervention reduced the risk of pregnant women consuming soft drinks and/or commercially prepared cookies in the third trimester. This lifestyle intervention was partially effective, tripling the proportion of pregnant women who achieved the recommended walking time and reducing by half the proportion of women who had a high weekly consumption of soft drinks and industrially processed cookies.
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Affiliation(s)
- Maíra Barreto Malta
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brasil.,Programa de Pós-graduação em Saúde Coletiva, Universidade Católica de Santos, Santos, Brasil
| | - Caroline de Barros Gomes
- Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, Brasil
| | - Aluísio J D Barros
- Programa de Pós-graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, Brasil
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Steckle V, Shynlova O, Lye S, Bocking A. Low-intensity physical activity may protect pregnant women against spontaneous preterm labour: a prospective case-control study. Appl Physiol Nutr Metab 2021; 46:337-345. [DOI: 10.1139/apnm-2019-0911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The innate immune system plays a significant role in onset of parturition. Maternal antenatal physical activity can influence immune function and timing of labour. We examined physical activity patterns and concentration of 19 cytokines at 16 and 27 weeks gestational age (GA), in peripheral plasma of 28 asymptomatic women who later had spontaneous preterm labour (SPTL, <37 weeks GA) and 52 women who later delivered at term (TL; ≥37 weeks GA). This nested case-control study used data from the Ontario Birth Study cohort. Exercise was assessed using the International Physical Activity Questionnaire, and cytokines were analyzed using Luminex assays. There was no significant difference in exercise patterns between SPTL and TL subjects. Plasma concentration of interleukin (IL)-10 was significantly higher in SPTL women at 16 and 27 weeks, while tumour necrosis factor alpha (TNF-α), IL-8, and monocyte chemoattractant protein (MCP)-1 concentrations were increased at 27 weeks GA (p < 0.05). Concentration of IL-10 was negatively correlated with the amount of reported walking (ρ = −0.264, p = 0.03). Women should be encouraged to partake in low-intensity exercise throughout pregnancy, as it may confer a protective effect against SPTL through IL-10–mediated pathways. Additionally, plasma cytokine analysis at 27 weeks GA may be useful for predicting SPTL in asymptomatic women. Novelty: In women that delivered preterm, plasma levels of anti-inflammatory cytokine IL-10 were significantly elevated at 16 and 27 weeks of gestation. Plasma levels of IL-10 were negatively correlated with the amount of reported walking. Concentration of IL-8, MCP-1 and TNF-α were increased in plasma of asymptomatic women that subsequently deliver preterm.
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Affiliation(s)
- Valerie Steckle
- Lunenfeld Tanenbaum Research Institute, Sinai Health System, Toronto, ON M5T 3H7, Canada
- Department of Physiology, University of Toronto, Toronto, ON M5S 3G5, Canada
| | - Oksana Shynlova
- Lunenfeld Tanenbaum Research Institute, Sinai Health System, Toronto, ON M5T 3H7, Canada
- Department of Physiology, University of Toronto, Toronto, ON M5S 3G5, Canada
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, ON M5G 1Z5, Canada
| | - Stephen Lye
- Lunenfeld Tanenbaum Research Institute, Sinai Health System, Toronto, ON M5T 3H7, Canada
- Department of Physiology, University of Toronto, Toronto, ON M5S 3G5, Canada
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, ON M5G 1Z5, Canada
| | - Alan Bocking
- Lunenfeld Tanenbaum Research Institute, Sinai Health System, Toronto, ON M5T 3H7, Canada
- Department of Physiology, University of Toronto, Toronto, ON M5S 3G5, Canada
- Department of Obstetrics and Gynecology, Mount Sinai Hospital, Toronto, ON M5G 1Z5, Canada
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Carlsen OC, Gudmundsdóttir HK, Bains KES, Bertelsen R, Carlsen KC, Carlsen KH, Endre KM, Granum B, Haugen G, Hedlin G, Jonassen CM, Kreyberg I, Landrø L, Mägi CAO, Nordlund B, Nordhagen LS, Pehrson K, Saunders CM, Sjøborg K, Skjerven HO, Staff AC, Svanes C, Söderhäll C, Vettukattil R, Værnesbranden M, Wiik J, Rehbinder EM. Physical activity in pregnancy: a Norwegian-Swedish mother-child birth cohort study. AJOG GLOBAL REPORTS 2021; 1:100002. [PMID: 36378878 PMCID: PMC9563683 DOI: 10.1016/j.xagr.2020.100002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Physical activity during pregnancy is important for maternal and offspring health. Optimal conditions during pregnancy may help reduce the burden of noncommunicable diseases. National and international guidelines recommend at least 150 minutes of physical activity of at least moderate intensity per week. To optimize physical activity in pregnant women, it is important to identify factors associated with higher levels of physical activity. OBJECTIVE This study aimed to explore types and levels of physical activity in midpregnancy in Norway and Sweden and to identify factors associated with higher levels of physical activity. MATERIALS AND METHODS From the population-based mother-child cohort Preventing Atopic Dermatitis and Allergies in Children study recruiting 2697 women in Norway and Sweden from 2014 to 2016, we included 2349 women who answered an electronic questionnaire at enrollment in midpregnancy. Women were asked about regular physical activity in the last 2 weeks of pregnancy and afterward for types and levels of physical activity in pregnancy and before pregnancy and socioeconomic status, lifestyle, and maternal health. Logistic regression analyses were used to identify factors associated with higher levels of physical activity in pregnancy, defined as >30 minutes per session of ≥2 times per week of moderate- or high-intensity brisk walking, strength training, jogging, and bicycling. RESULTS No regular physical activity during the last 2 weeks before answering the questionnaire at midpregnancy was reported by 689 women (29%). In this study, 1787 women (76%) reported weekly strolling during pregnancy. Regular physical activity at least twice weekly in the first half of pregnancy was reported as brisk walking by 839 women (36%), bicycling by 361 women (15%), strength training by 322 women (14%), and other activities by <10% of women. Among the 1430 women with regular moderate- or high-intensity physical activity, the estimated median duration per week was 120 minutes. Higher physical activity levels were achieved in 553 women (23.5%) by brisk walking, 287 women (12.2%) by strength training, 263 women (11.2%) by bicycling, and 114 women (4.9%) by jogging. Higher physical activity levels were positively associated with regular physical activity before pregnancy, dog ownership, and atopic dermatitis and negatively associated with higher body mass index, study location in Østfold, previous pregnancy or pregnancies, non-Nordic origin, suburban living, and sick leave. CONCLUSION At midpregnancy, 29% of women were inactive, and less than 50% of women had at least 2 hours of moderate-intensity physical activity weekly. Awareness of physical activity in pregnancy should be discussed at pregnancy follow-up visits, particularly among women with higher body mass index, sick leave, previous pregnancy or pregnancies, and non-Nordic origin.
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Al-Ziyadi S, Almashyakhi S, AlEssa H, Turkistani O, Al-Harthi R. Barriers to physical activity during pregnancy among Saudi population on the Western region. SAUDI JOURNAL FOR HEALTH SCIENCES 2021. [DOI: 10.4103/sjhs.sjhs_66_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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20
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Baena-García L, Acosta-Manzano P, Ocón-Hernández O, Borges-Cosic M, Romero-Gallardo L, Marín-Jiménez N, Aparicio VA. Objectively measured sedentary time and physical activity levels in Spanish pregnant women. Factors affecting the compliance with physical activity guidelines. Women Health 2020; 61:27-37. [PMID: 33143596 DOI: 10.1080/03630242.2020.1828231] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The aims of this cross-sectional study were to describe objectively measured sedentary time (ST) and physical activity (PA) levels in Spanish pregnant women, to analyze the degree of compliance with PA guidelines during the early second trimester of pregnancy and to explore sociodemographic and clinical factors associated with meeting these PA guidelines. One hundred and thirty-four Caucasian pregnant women were recruited between October 2015 and October 2017 to participate in this study. Triaxial accelerometers were used to analyze ST andPA levels for seven consecutive valid days. Womenspent512 ± 92.1 minutes daily in sedentary behaviors, and 85 ± 108.2 minutes in moderate-to-vigorous physical activity (MVPA) in bouts of at least 10 minutes. They walked on average 7436 ± 2410steps per day. Only 22% of the study sample complied with the PA guidelines. Having an University degree was related with threefold higher odds of compliance with the PA guidelines (95% confidence interval: 0.096-0.913, p < .05). Binary logistic regressions showed that being primiparous was associated with fivefold higher odds of compliance with the PA guidelines (95% confidence interval 1.658-18.039, respectively, p < .01). Maternal age, BMI, marital status, working status, and previous miscarriages were not associated with compliance with PA guidelines. Pregnant women spent more than a third of the day in sedentary behaviors and the compliance with PA guidelines was less than desirable. Finally, not having an university degree or having children could be factors related to lower odds of compliance with these guidelines, and therefore require special attention from healthcare professionals.
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Affiliation(s)
- Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada , Granada, Spain
| | - Pedro Acosta-Manzano
- Sport and Health Research Centre, University of Granada , Spain.,Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada, Spain
| | - Olga Ocón-Hernández
- UGC of Gynaecology and Obstetrics, San Cecilio-Campus University Hospital , Granada, Spain
| | - Milkana Borges-Cosic
- Sport and Health Research Centre, University of Granada , Spain.,Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada, Spain
| | - Lidia Romero-Gallardo
- Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada, Spain
| | - Nuria Marín-Jiménez
- Sport and Health Research Centre, University of Granada , Spain.,Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada, Spain
| | - V A Aparicio
- UGC of Gynaecology and Obstetrics, San Cecilio-Campus University Hospital , Granada, Spain.,Department of Physiology, Institute of Nutrition and Food Technology and Biomedical Research Centre, University of Granada , Granada, Spain
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21
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Román-Gálvez MR, Amezcua-Prieto C, Salcedo-Bellido I, Olmedo-Requena R, Martínez-Galiano JM, Khan KS, Bueno-Cavanillas A. Physical activity before and during pregnancy: A cohort study. Int J Gynaecol Obstet 2020; 152:374-381. [PMID: 32978781 DOI: 10.1002/ijgo.13387] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/17/2020] [Accepted: 09/18/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To estimate physical activity (PA) in healthy women before and during pregnancy and to evaluate the features associated with moderate PA (MPA). METHODS A prospective cohort study was conducted on women selected 14 weeks of pregnancy during 2013-2015 in primary public health service centers in southern Spain. Type, duration, and frequency of PA (IPAQ questionnaire in first, second, and third trimesters [T1, T2, T3]) were measured. Variables associated with MPA were evaluated using multiple logistic regressions controlling for age, pre-pregnancy obesity, level of education, number of living children, pre-pregnancy PA, and adherence to Mediterranean diet (AMD). RESULTS Out of 463 women, MPA was estimated in 64% pre-pregnancy, and 54%, 61%, and 59% in T1, T2, and T3, respectively. MPA was associated with greater AMD in T2 (adjusted odds ratio [aOR] 1.17, 95% confidence interval [CI] 1.04-1.33) and T3 (aOR 1.16, 95% CI 1.02-1.31), previous PA (aOR 13.5, 95% CI 8.12-22.5 in T1; aOR 2.61, 95% CI 1.72-3.96 in T2; aOR 2.59, 95% CI 1.65-4.05 in T3), and pre-pregnancy obesity (aOR 2.97, 95% CI 1.28-6.89 in T1; aOR 2.69, 95% CI 1.23-3.60 in T3). CONCLUSION PA decreased at the beginning of pregnancy, but compliance remained over 50%. MPA was associated with diet, pre-pregnancy PA, and obesity.
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Affiliation(s)
- María Rosario Román-Gálvez
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Unidad de Gestión Clínica Churriana de la Vega, Andalusian Health Service, Granada, Spain
| | - Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Inmaculada Salcedo-Bellido
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Rocío Olmedo-Requena
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Juan Miguel Martínez-Galiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Nursing, University of Jaén, Jaén, Spain
| | - Khalid S Khan
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Women's Health Research Unit, Barts and the London, School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
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22
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Analysis of the Impact of the Confinement Resulting from COVID-19 on the Lifestyle and Psychological Wellbeing of Spanish Pregnant Women: An Internet-Based Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165933. [PMID: 32824191 PMCID: PMC7460363 DOI: 10.3390/ijerph17165933] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 12/14/2022]
Abstract
(1) Background: This study aimed to analyze the impact of the confinement due to the COVID-19 pandemics on the eating, exercise, and quality-of-life habits of pregnant women. (2) Methods: This was an internet-based cross-sectional survey which collected information about adherence to the Mediterranean diet, physical exercise, health-related quality of life (HRQoL), and perceived obstacles (in terms of exercise, preparation for delivery, and medical appointments) of pregnant women before and after the confinement. The survey was conducted in 18–31 May 2020. (3) Results: A total of 90 pregnant women participated in this study. There was a significant decrease in the levels of physical activity (p < 0.01) as well as in HRQoL (p < 0.005). The number of hours spent sitting increased by 50% (p < 0.001), 52.2% were unable to attend delivery preparation sessions because these had been cancelled. However, there were no significant differences in the eating pattern of these women (p = 0.672). Conclusions: These results suggest the need to implement specific online programs to promote exercise and reduce stress, thus improving the HRQoL in this population, should similar confinements need to occur again for any reason in the future.
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Zhu G, Qian X, Qi L, Xia C, Ming Y, Zeng Z, Liu Y, Yang Y, Zhang M, Zhang H. The intention to undertake physical activity in pregnant women using the theory of planned behaviour. J Adv Nurs 2020; 76:1647-1657. [PMID: 32153052 DOI: 10.1111/jan.14347] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/06/2020] [Accepted: 03/03/2020] [Indexed: 02/06/2023]
Abstract
AIM To identify the intention of Chinese pregnant women to undertake physical activity (PA) using the theory of planned behaviour. DESIGN A cross-sectional survey. METHODS From April - October 2017, a cross-sectional questionnaire was completed by 746 pregnant women from the Health Birth Cohort in Wuhan, China. The theory of planned behaviour variables as well as sociodemographic characteristics was recorded, and the Pregnancy PA Questionnaire was together used to assess their PA during pregnancy. RESULTS Only 11.3% of the women met the international guideline. The intention to undertake PA was found it to be positive in 63.9% of pregnant women. Structural equation modelling analysis revealed that behavioural attitudes, subjective norms, and perceived behavioural control (PBC) influenced PA by directly influencing the behaviour intention. Both behavioural attitude and subjective norms influenced PA by indirectly affecting the behaviour. Overall, the model described 60% variance of the behavioural intention to undertake PA during pregnancy. CONCLUSION PBC was confirmed to be a prominent factor in determining behavioural intention to undertake PA during pregnancy. Pregnant women should be helped and appropriately guided by health providers to overcome barriers to PA. EFFECT This study investigates the effect of perceived behavioural control (PBC) on the intention to undertake physical activity (PA). The findings suggest that nurses' and midwives' attention should be focused on how to promote the improvement of perceived behavioural control ability of pregnant women to improve pregnant women's PA intention. The attitude of pregnant women on taking up PA and their ability to control behaviours can be improved with support from family or healthcare providers.
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Affiliation(s)
- Gangjiao Zhu
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Xiangzi Qian
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Ling Qi
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Chang Xia
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Yu Ming
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Zhi Zeng
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Yuanxia Liu
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Yan Yang
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Mengtian Zhang
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Hongling Zhang
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
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Hailemariam TT, Gebregiorgis YS, Gebremeskel BF, Haile TG, Spitznagle TM. Physical activity and associated factors among pregnant women in Ethiopia: facility-based cross-sectional study. BMC Pregnancy Childbirth 2020; 20:92. [PMID: 32041582 PMCID: PMC7011444 DOI: 10.1186/s12884-020-2777-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 01/29/2020] [Indexed: 11/12/2022] Open
Abstract
Background Regular physical activity (PA) has health benefits, including reducing the risk of complications during pregnancy. In Ethiopia, little is known about PA status and its determinants among pregnant women. The purpose of this study was to assess PA status and associated factors among pregnant women attending antenatal care at public and private health facilities in Mekelle, Ethiopia. Methods A facility-based cross-sectional study was conducted. Data was collected from 299 pregnant women using a structured questionnaire. Study participants were selected using a simple random sampling technique. A binary logistic regression was modeled to investigate the statistical significance of independent variables with PA status during pregnancy. Factors associated with PA status were estimated using adjusted odds ratios with 95% confidence intervals and statistical significance was declared at p-value < 0.05. Results 79.3% of the study participants were classified as sedentary. The age group of 26–35 years (AOR: 2.69, 95% CI: 1.07–6.78), attending non-formal education (AOR: 13.50, 95% CI: 2.65–68.91), and women who did not work outside the home (AOR: 5.23, 95% CI: 1.34–20.38) were significantly associated with a higher risk of sedentary activity status. Pregnant women who were married (AOR: 0.26, 95% CI: 0.09–0.73), had two children (AOR: 0.13, 95% CI: 0.03–0.59), traveled an hour or more to health facilities (AOR: 0.31, 95% CI: 0.11–0.89) were protected from being sedentary. Conclusion Sedentary PA status was highly prevalent during pregnancy. Pregnant women in the age group of 26–35 years, with a non-formal education, and women who did not work outside the home had a greater risk of reporting being sedentary. Those who were married, had two children, and traveled an hour or more to health facilities were less likely to be sedentary. Stakeholders (Tigrai regional health bureau, Mekelle University, local NGOs working with pregnant women and societies at large) should give higher emphasis on designing appropriate strategies including educational interventions to overcome barriers to PA during pregnancy.
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Affiliation(s)
- Teklehaimanot Tekle Hailemariam
- Department of Physiotherapy, School of Medicine, College of health sciences, and Ayder comprehensive specialized hospital, Mekelle University, P.O. Box - 1871, Tigrai, Mekelle, Ethiopia.
| | - Yosef Sibhatu Gebregiorgis
- Department of Epidemiology, School of Public health, College of health sciences, Mekelle University, P.O. Box - 1871, Tigrai, Mekelle, Ethiopia
| | - Berihu Fisseha Gebremeskel
- Department of Physiotherapy, School of Medicine, College of health sciences, and Ayder comprehensive specialized hospital, Mekelle University, P.O. Box - 1871, Tigrai, Mekelle, Ethiopia
| | - Tsiwaye Gebreyesus Haile
- Department of Physiotherapy, School of Medicine, College of health sciences, and Ayder comprehensive specialized hospital, Mekelle University, P.O. Box - 1871, Tigrai, Mekelle, Ethiopia
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Rhudy MB, Dreisbach SB, Moran MD, Ruggiero MJ, Veerabhadrappa P. Cut points of the Actigraph GT9X for moderate and vigorous intensity physical activity at four different wear locations. J Sports Sci 2019; 38:503-510. [PMID: 31865845 DOI: 10.1080/02640414.2019.1707956] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Accelerometer cut points are an important consideration for distinguishing the intensity of activity into categories such as moderate and vigorous. It is well-established in the literature that these cut points depend on a variety of factors, including age group, device, and wear location. The Actigraph GT9X is a newer model accelerometer that is used for physical activity research, but existing cut points for this device are limited since it is a newer device. Furthermore, there is not existing data on cut points for the GT9X at the ankle or foot locations, which offers some potential benefit for activities that do not involve arm and/or core motion. A total of N = 44 adults completed a four-stage treadmill protocol while wearing Actigraph GT9X sensors at four different locations: foot, ankle, wrist, and hip. Metabolic Equivalent of Task (MET) levels assessed by indirect calorimetry along with Receiver Operating Characteristic (ROC) curves were used to establish cut points for moderate and vigorous intensity for each wear location of the GT9X. Area under the ROC curves indicated high discrimination accuracy for each case.
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Affiliation(s)
- Matthew B Rhudy
- Engineering, Division of Engineering, Business, and Computing, The Pennsylvania State University, Reading, PA, USA
| | - Scott B Dreisbach
- Kinesiology, Division of Science, The Pennsylvania State University, Reading, PA, USA
| | - Matthew D Moran
- Kinesiology, Division of Science, The Pennsylvania State University, Reading, PA, USA
| | - Marissa J Ruggiero
- Kinesiology, Division of Science, The Pennsylvania State University, Reading, PA, USA
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Patient Attitudes toward Gestational Weight Gain and Exercise during Pregnancy. J Pregnancy 2019; 2019:4176303. [PMID: 31637057 PMCID: PMC6766150 DOI: 10.1155/2019/4176303] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/30/2019] [Indexed: 02/08/2023] Open
Abstract
Body mass index (BMI) and gestational weight gain (GWG) are important factors for neonatal and maternal health. Exercise helps women moderate their BMI and GWG, and provides health benefits to mother and child. This survey study assessed patients' perceptions of counseling they received during pregnancy, their sources of information about GWG, and their attitudes toward exercise during pregnancy. We distributed an anonymous survey to 200 pregnant women over the age of 18 at a tertiary care center in Danville, Pennsylvania. Survey questions included demographics, discussions with medical providers regarding GWG and exercise, and their exercise habits before and during pregnancy. 182 women (91%) responded. Most reported their provider discussed weight and diet (78.8%), expected GWG (81.6%), and exercise during pregnancy (79.8%); however, 28% of obese women and 25% of women who did not plan to exercise during pregnancy reported not receiving exercise counseling. Approximately 20% of women did not plan to exercise during pregnancy. Women decreased the number of days per week they exercised (40.6% with 3 or more days prepregnancy versus 30.7% during pregnancy, P = 0.002). Some patients who did not exercise prior to pregnancy (12%) expressed interest in a personal training session. Among women in the eight month or later, 42.4% were above GWG recommendations. Our study found barriers to adequate activity during pregnancy; 20% of pregnant women not receiving/remembering counseling regarding exercise. Interest in personal training from patients that did not exercise suggests they would benefit from increased efforts to encourage physical activity. Exercise and GWG counseling based in medical science as well as patient psychological needs will help efforts to reduce GWG and improve pregnancy outcomes.
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Most J, Dervis S, Haman F, Adamo KB, Redman LM. Energy Intake Requirements in Pregnancy. Nutrients 2019; 11:nu11081812. [PMID: 31390778 PMCID: PMC6723706 DOI: 10.3390/nu11081812] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/02/2019] [Accepted: 04/08/2019] [Indexed: 12/21/2022] Open
Abstract
Energy intake requirements in pregnancy match the demands of resting metabolism, physical activity, and tissue growth. Energy balance in pregnancy is, therefore, defined as energy intake equal to energy expenditure plus energy storage. A detailed understanding of these components and their changes throughout gestation can inform energy intake recommendations for minimizing the risk of poor pregnancy outcomes. Energy expenditure is the sum of resting and physical activity-related expenditure. Resting metabolic rate increases during pregnancy as a result of increased body mass, pregnancy-associated physiological changes, i.e., cardiac output, and the growing fetus. Physical activity is extremely variable between women and may change over the course of pregnancy. The requirement for energy storage depends on maternal pregravid body size. For optimal pregnancy outcomes, women with low body weight require more fat mass accumulation than women with obesity, who do not require to accumulate fat mass at all. Given the high energy density of fat mass, these differences affect energy intake requirements for a healthy pregnancy greatly. In contrast, the energy stored in fetal and placental tissues is comparable between all women and have small impact on energy requirements. Different prediction equations have been developed to quantify energy intake requirements and we provide a brief review of the strengths and weaknesses and discuss their application for healthy management of weight gain in pregnant women.
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Affiliation(s)
- Jasper Most
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Sheila Dervis
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Francois Haman
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Kristi B Adamo
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Leanne M Redman
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA.
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Ekelin M, Langeland Iversen M, Grønbæk Backhausen M, Hegaard HK. Not now but later - a qualitative study of non-exercising pregnant women's views and experiences of exercise. BMC Pregnancy Childbirth 2018; 18:399. [PMID: 30305060 PMCID: PMC6180661 DOI: 10.1186/s12884-018-2035-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 09/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence has shown that there are several physical and mental advantages of exercise during pregnancy. Despite this, the recommendations for exercise during pregnancy are poorly fulfilled. The aim of this study was to illuminate non-exercising pregnant women's views and experiences concerning exercise before and during pregnancy. METHOD The study had a qualitative design with an inductive approach and was analysed by content analysis. A total of 16 individual and face-to-face interviews were conducted with healthy pregnant women, mainly in the third trimester and living in Sweden. The participating women had not been exercising 3 months before pregnancy or during pregnancy. RESULTS The main category "Insurmountable now, but possible in the future" was based on the four categories: "Lost and lack of routines", "Feelings of inadequacy", "Having a different focus" and "Need for support". The women experienced that their lack of routines was a major barrier that prevented them from exercising. Other factors that contributed were, for example, pregnancy-related problems, long working days and prioritizing family life. The women described it as difficult to combine exercise with their focus on the pregnancy and they missed continuous support from the antenatal care provider. The women expressed a need for suggestions concerning exercise during pregnancy and follow-up on previous counselling, especially when pregnancy-related issues arose. Information about easily accessible alternatives or simple home exercises was requested. They felt immobile and were not satisfied with their inactivity and tried to partly compensate with everyday activities. The women identified the postpartum period as an important possibility for becoming more active, for their own sake, but also because they wanted to become role models for their children. CONCLUSION Continuous support during pregnancy is needed concerning exercise. Pregnancy is mostly a barrier that prevents exercise for this group of women but, at the same time, may be a motivator and a possibility for better health. As the result showed that these women were highly motivated to a life-style change post-pregnancy, it may be crucial to support previously non-exercising women postpartum.
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Affiliation(s)
- Maria Ekelin
- Department of Health Sciences, Lund University, PO Box 157, S-22100, Lund, Sweden.
| | - Mette Langeland Iversen
- The Research Unit Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Mette Grønbæk Backhausen
- Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,The Research Unit Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Department of Gynecology and Obstetrics, Zealand University Hospital, Sygehusvej 10, 4000, Roskilde, Denmark
| | - Hanne Kristine Hegaard
- Department of Health Sciences, Lund University, PO Box 157, S-22100, Lund, Sweden.,Department of Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,The Research Unit Women's and Children's Health, The Juliane Marie Centre, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,The Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, Copenhagen, Denmark
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Sytsma TT, Zimmerman KP, Manning JB, Jenkins SM, Nelson NC, Clark MM, Boldt K, Borowski KS. Perceived Barriers to Exercise in the First Trimester of Pregnancy. J Perinat Educ 2018; 27:198-206. [PMID: 31073266 PMCID: PMC6491162 DOI: 10.1891/1058-1243.27.4.198] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Regular physical activity has been shown to improve pregnancy outcomes. We sought to identify barriers to exercise during the first trimester of pregnancy. Five hundred forty-nine pregnant women in their first trimester rated barriers to exercise on a scale of 1 (not a barrier) to 5 (a huge barrier) and recorded physical activity (minutes/week). Women were placed into one of three classifications, nonexercisers (zero exercise), infrequent exercisers (<150 minutes/week), or exercisers (≥150 minutes/week). The greatest barriers (mean) were nausea/fatigue (3.0) and lack of time (2.6). Exercisers reported significantly lower barrier levels. Nausea/fatigue was a greater barrier for nonexercisers compared to exercisers (3.6 vs 2.8, p < .001). Focusing education and interventions on these barriers may help pregnant women achieve healthy exercise levels.
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How does a lifestyle intervention during pregnancy influence perceived barriers to leisure-time physical activity? The Norwegian fit for delivery study, a randomized controlled trial. BMC Pregnancy Childbirth 2018; 18:127. [PMID: 29724165 PMCID: PMC5934849 DOI: 10.1186/s12884-018-1771-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 04/24/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To develop effective health promotional and preventive prenatal programs, it is important to understand perceived barriers to leisure-time physical activity during pregnancy, including exercise and sport participation. The aims of the present study was 1) to assess the effect of prenatal lifestyle intervention on the perceived barrier to leisure-time physical activity during pregnancy and the first year after delivery and 2) identify the most important perceived barriers to leisure-time physical activity at multiple time points during and after pregnancy. METHODS This secondary analysis was part of the Norwegian Fit for Delivery study, a combined lifestyle intervention evaluated in a blinded, randomized controlled trial. Healthy, nulliparous women with singleton pregnancy of ≤20 gestational weeks, age ≥ 18 years and body mass index ≥19 kg/m2 were recruited via healthcare clinics in southern Norway, including urban and rural settings. Participants were randomized to either twice-weekly supervised exercise sessions and nutritional counselling (n = 303) or standard prenatal care (n = 303). The principal analysis was based on the participants who completed the standardized questionnaire assessing their perceived barriers to leisure-time physical activity at inclusion (gestational week 16, n = 589) and following intervention (gestational week 36, n = 509), as well as six months (n = 470) and 12 months (n = 424) postpartum. RESULTS Following intervention (gestation week 35.4 ± 1.0), a significant between-group difference in perceived barriers to leisure-time physical activity was found with respect to time constraints: "... I do not have the time" (intervention: 22 vs. control: 38, p = 0.030), mother-child safety concerns: "... afraid to harm the baby" (intervention: 8 vs. control: 25, p = 0.002) and self-efficacy: "... I do not believe/think that I can do it" (intervention: 3 vs. control: 10, p = 0.050). No positive effect was seen at postpartum follow-up. Intrapersonal factors (lack of time, energy and interest) were the most frequently perceived barriers, and consistent over time among all participants. CONCLUSION The intervention had effect on intrapersonal perceived barriers in pregnancy, but not in the postpartum period. Perceived barriers to leisure-time physical activity were similar from early pregnancy to 12 months postpartum. TRIAL REGISTRATION ClinicalTrials.gov: NCT01001689 , registered July 2, 2009.
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Huberty JL, Buman MP, Leiferman JA, Bushar J, Hekler EB, Adams MA. Dose and timing of text messages for increasing physical activity among pregnant women: a randomized controlled trial. Transl Behav Med 2017; 7:212-223. [PMID: 27800565 PMCID: PMC5526801 DOI: 10.1007/s13142-016-0445-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Text4baby (T4b), a free nation-wide mobile health information service, delivers health-related text messages (SMS) to pregnant women. The objective of this study was to determine the effectiveness of physical activity (PA) specific SMS to improve PA in pregnant women (vs standard T4b) and the most effective dose/timing of PA-specific SMS to improve PA. Pregnant women (N = 80) were randomized to one of four groups that differed in frequency and time of SMS. The Fitbit™ Flex measured PA. Data were analyzed using mixed model analyses. There were no increases in PA regardless of frequency or time. Those that received six PA SMS/week had greater decreases in activity and greater increases in sedentary time. SMS may not be a "potent" enough strategy to improve PA. Future studies should explore a modified focus on behavior change (e.g., decrease sedentary activity, increase light activity) and incorporate SMS as part of a multi-level approach with other evidence-based strategies.
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Affiliation(s)
- Jennifer L Huberty
- Exercise Science and Health Promotion, Arizona State University, 500 North 3rd Street, Phoenix, AZ, 85004, USA.
| | - Matthew P Buman
- Exercise Science and Health Promotion, Arizona State University, 500 North 3rd Street, Phoenix, AZ, 85004, USA
| | - Jenn A Leiferman
- Department of Community and Behavioral Health Colorado School of Public Health, University of Colorado Denver, Aurora, CO, USA
| | | | - Eric B Hekler
- Nutrition and Health Promotion, Arizona State University, Phoenix, AZ, USA
| | - Marc A Adams
- Exercise Science and Health Promotion, Arizona State University, 500 North 3rd Street, Phoenix, AZ, 85004, USA
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Thompson EL, Vamos CA, Daley EM. Physical activity during pregnancy and the role of theory in promoting positive behavior change: A systematic review. JOURNAL OF SPORT AND HEALTH SCIENCE 2017; 6:198-206. [PMID: 30356571 PMCID: PMC6189011 DOI: 10.1016/j.jshs.2015.08.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 06/16/2015] [Accepted: 07/10/2015] [Indexed: 05/28/2023]
Abstract
BACKGROUND Physical activity (PA) during pregnancy provides physical and psychological benefits for mother and child. U.S. guidelines recommend ≥30 min of moderate exercise for healthy pregnant women most days of the week; however, most women do not meet these recommendations. Theory assists in identifying salient determinants of health behavior to guide health promotion interventions; however, the application of theory to examine PA among pregnant women has not been examined cohesively among multiple levels of influence (e.g., intrapersonal, interpersonal, neighborhood/environmental, and organizational/political). Subsequently, this systematic review aims to identify and evaluate the use of health behavior theory in studies that examine PA during pregnancy. METHODS Articles published before July 2014 were obtained from PubMed and Web of Science. Inclusion criteria applied were: (1) empirically-based; (2) peer-reviewed; (3) measured factors related to PA; (4) comprised a pregnant sample; and (5) applied theory. Fourteen studies were included. Each study's application of theory and theoretical constructs were evaluated. RESULTS Various theories were utilized to explain and predict PA during pregnancy; yet, the majority of these studies only focused on intrapersonal level determinants. Five theoretical frameworks were applied across the studies-all but one at the intrapersonal level. Few determinants identified were from the interpersonal, neighborhood/environmental, or organizational/political levels. CONCLUSION This systematic review synthesized the literature on theoretical constructs related to PA during pregnancy. Interpersonal, community, and societal levels remain understudied. Future research should employ theory-driven multi-level determinants of PA to reflect the interacting factors influencing PA during this critical period in the life course.
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Schmidt T, Heilmann T, Savelsberg L, Maass N, Weisser B, Eckmann-Scholz C. Physical Exercise During Pregnancy - How Active Are Pregnant Women in Germany and How Well Informed? Geburtshilfe Frauenheilkd 2017; 77:508-515. [PMID: 28579622 DOI: 10.1055/s-0043-107785] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 03/27/2017] [Accepted: 03/28/2017] [Indexed: 10/19/2022] Open
Abstract
INTRODUCTION There is sufficient evidence showing the positive effects of physical exercise on various aspects of pregnancy. This study evaluates knowledge and status of physical exercise among pregnant women. METHODS The standardised paper-pencil questionnaire "Pregnancy Physical Activity Questionnaire" (PPAQ) as well as general demographic questions were used to assess the exercise behaviour of study participants. 83 questionnaires completed by women presenting to the Kiel University Hospital for antenatal assessment were included in the analysis. RESULTS At the time of questionnaire completion 10 women were in the first trimester of pregnancy, 64 in the second, and 9 in the third. Just less than 90% of participants felt they had been informed "sufficiently" on the topic physical exercise during pregnancy, over 50% felt they were "well" or "very well" informed. Just less than half of participants received their information from a doctor (either their gynaecologist or general practitioner) and none of these felt "insufficiently" informed. Almost 80% of participants reported still doing no sport or less exercise than before falling pregnant. The maximum proportional energy expenditure for recreational activity - just under 20% - was in the third trimester. Women who felt they had been well counselled tended to have higher activity levels. CONCLUSION Study participants demonstrated a clear decline in physical exercise during pregnancy despite clear evidence of the benefits of regular exercise for pregnant women, and despite participants feeling they were well informed. Detailed information on the recommendations for physical exertion in pregnancy should form an integral part of antenatal counselling.
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Affiliation(s)
- Thorsten Schmidt
- Supportivangebote Sport- und Bewegungstherapie Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel
| | - Thorsten Heilmann
- Universitätsklinikum Schleswig-Holstein Campus Kiel, Klinik für Gynäkologie und Geburtshilfe, Kiel
| | - Luisa Savelsberg
- Institut für Sportwissenschaft, Christian-Albrechts-Universität Kiel, Kiel
| | - Nicolai Maass
- Universitätsklinikum Schleswig-Holstein Campus Kiel, Klinik für Gynäkologie und Geburtshilfe, Kiel
| | - Burkhard Weisser
- Institut für Sportwissenschaft, Christian-Albrechts-Universität Kiel, Kiel
| | - Christel Eckmann-Scholz
- Universitätsklinikum Schleswig-Holstein Campus Kiel, Klinik für Gynäkologie und Geburtshilfe, Kiel
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Verdière S, Guinhouya BC, Salerno D, Deruelle P. [Should physical activity be contraindicated during pregnancy in relation to its potentially related risks?]. ACTA ACUST UNITED AC 2017; 45:104-111. [PMID: 28368790 DOI: 10.1016/j.gofs.2016.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 12/19/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This paper aimed at providing a critical analysis of data on the risks associated with physical activity of women during their pregnancy. METHODS Cochrane Library, Google Scholar, PubMed (Medline) and Web of Sciences were searched using a combination of MeSH terms associated to "Physical activity", "Pregnancy" and "Adverse events" or "Risks". Only review papers published from inception of these databases to November 2016 were used in the present analysis. RESULTS The electronic search yield a total of 104 citations. After a critical analysis of abstracts and/or full-texts, only a systematic review and cohort study on injuries related to physical activity during pregnancy appeared relevant for the current study. Data reveals a very small proportion (<1 %) of adverse events in direct link with the physical activity behavior of pregnant women. Furthermore, there would be less than one serious adverse event per 5000hours of physical activity. The only serious adverse event attributable to physical activity during pregnancy was uterine contractions. The threat of preterm labor and miscarriage risk cannot be primarily attributed to the participation of pregnant women in a physical activity, even vigorous. Moreover, no adverse effects of maternal physical activity on neonatal outcomes were found. CONCLUSION Physical activity-related risks during pregnancy appear to be infrequent and of minor severity. Though further studies are required to better understand the risk/benefit balance of physical activity during pregnancy, current data do not support the contraindication of this behavior in pregnant women.
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Affiliation(s)
- S Verdière
- Pôle mère enfant gynécologie, centre hospitalier de Seclin, 59113 Seclin, France
| | - B C Guinhouya
- Université de Lille, EA 2694, santé publique : épidémiologie et qualité des soins & UFR ingénierie et management de la santé, 59000 Lille, France.
| | - D Salerno
- Université de Lille, laboratoire MERCUR - LSRC & UFR ingénierie et management de la santé, 59000 Lille, France
| | - P Deruelle
- Pôle femme mère nouveau-né, clinique d'obstétrique, maternité Jeanne-de-Flandre, CHRU de Lille, Lille, France; Université de Lille, EA 4489, environnement périnatal et croissance & faculté de médecine, 59000 Lille, France
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Santos CMD, Santos WMD, Gallarreta FMP, Pigatto C, Portela LOC, Morais END. Effect of maternal exercises on biophysical fetal and maternal parameters: a transversal study. EINSTEIN-SAO PAULO 2017; 14:455-460. [PMID: 28076590 PMCID: PMC5221369 DOI: 10.1590/s1679-45082016ao3758] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 10/31/2016] [Indexed: 01/16/2023] Open
Abstract
Objective To evaluate the acute effects of maternal and fetal hemodynamic responses in pregnant women submitted to fetal Doppler and an aerobic physical exercise test according to the degree of effort during the activity and the impact on the well-being. Methods Transversal study with low risk pregnant women, obtained by convenience sample with gestational age between 26 to 34 weeks. The participants carry out a progressive exercise test. Results After the exercise session, reduced resistance (p=0.02) and pulsatility indices (p=0.01) were identified in the umbilical artery; however, other Doppler parameters analyzed, in addition to cardiotocography and fetal biophysical profile did not achieve significant change. Maternal parameters obtained linear growth with activity, but it was not possible to establish a standard with the Borg scale, and oxygen saturation remained stable. Conclusion A short submaximal exercise had little effect on placental blood flow after exercise in pregnancies without complications, corroborating that healthy fetus maintains homeostasis even in situations that alter maternal hemodynamics.
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Affiliation(s)
| | | | | | - Camila Pigatto
- Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
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Relationship between dairy product intake during pregnancy and neonatal and maternal outcomes among Portuguese women. Obes Res Clin Pract 2016; 11:276-286. [PMID: 27473300 DOI: 10.1016/j.orcp.2016.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 06/28/2016] [Accepted: 07/04/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND The role played by dairy product intake during pregnancy on neonatal outcomes has raised interest in the last few years. However, studies on this association remain scarce. Thus, the aim of this study was to determine the association between dairy product consumption during pregnancy and neonatal and maternal outcomes. METHODS A prospective study was conducted with 98 pregnant women, aged 18-40, from the city of Porto, Portugal. Socio-demographic and lifestyle characteristics were assessed through a questionnaire. Dairy product consumption was assessed with a three-day food diary completed during the first and second trimesters. Postpartum medical records were examined for neonatal and maternal outcomes. Multivariate linear regression analyses were performed to assess the association between dairy intake and neonatal and maternal outcomes, adjusting for dietary variables and maternal characteristics. RESULTS Compared to the first trimester pregnant women had higher energy intake and lower calcium, iodine and yogurt intake in the second trimester (P<0.05). Total dairy and yogurt intake in the first trimester were positively associated with head circumference and placental weight (respectively β=0.002, P=0.014, β=0.333, P=0.012). Change in total dairy intake between the second and first trimester was negatively associated with maternal weight gain during pregnancy (β=-0.007, P=0.020). CONCLUSION The findings of this study suggest that dairy product intake during pregnancy may have an effect on neonatal head circumference, placental weight, and gestational weight gain.
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Richardsen KR, Falk RS, Jenum AK, Mørkrid K, Martinsen EW, Ommundsen Y, Berntsen S. Predicting who fails to meet the physical activity guideline in pregnancy: a prospective study of objectively recorded physical activity in a population-based multi-ethnic cohort. BMC Pregnancy Childbirth 2016; 16:186. [PMID: 27460363 PMCID: PMC4962490 DOI: 10.1186/s12884-016-0985-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 07/22/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND A low physical activity (PA) level in pregnancy is associated with several adverse health outcomes. Early identification of pregnant women at risk of physical inactivity could inform strategies to promote PA, but no studies so far have presented attempts to develop prognostic models for low PA in pregnancy. Based on moderate-to-vigorous intensity PA (MVPA) objectively recorded in mid/late pregnancy, our objectives were to describe MVPA levels and compliance with the PA guideline (≥150 MVPA minutes/week), and to develop a prognostic model for non-compliance with the PA guideline. METHODS From a multi-ethnic population-based cohort, we analysed data from 555 women with MVPA recorded in gestational week (GW) 28 with the monitor SenseWear™ Pro3 Armband. Predictor variables were collected in early pregnancy (GW 15). We organized the predictors within the domains health, culture, socioeconomic position, pregnancy, lifestyle, psychosocial factors, perceived preventive effect of PA and physical neighbourhood. The development of the prognostic model followed several steps, including univariate and multiple logistic regression analyses. RESULTS Overall, 25 % complied with the PA guideline, but the proportion was lower in South Asians (14 %) and Middle Easterners (16 %) compared with Westerners (35 %). Among South Asians and Middle Easterners, 35 and 28 %, respectively, did not accumulate any MVPA minutes/week compared with 18 % among Westerners. The predictors retained in the prognostic model for PA guideline non-compliance were ethnic minority background, multiparity, high body fat percentage, and perception of few physically active friends. The prognostic model provided fair discrimination between women who did vs. did not comply with the PA guideline. CONCLUSION Overall, the proportion who complied with the PA guideline in GW 28 was low, and women with ethnic minority background, multiparity, high body fat percentage and few physically active friends had increased probability of non-compliance. The prognostic model showed fair performance in discriminating between women who did comply and those who did not comply with the PA guideline.
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Affiliation(s)
- Kåre Rønn Richardsen
- Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Oslo, Norway. .,Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway. .,Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
| | - Ragnhild Sørum Falk
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Anne Karen Jenum
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kjersti Mørkrid
- Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Egil Wilhelm Martinsen
- Clinic Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Yngvar Ommundsen
- Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway.,Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Sveinung Berntsen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Currie S, Gray C, Shepherd A, McInnes RJ. Antenatal physical activity: a qualitative study exploring women's experiences and the acceptability of antenatal walking groups. BMC Pregnancy Childbirth 2016; 16:182. [PMID: 27448657 PMCID: PMC4957850 DOI: 10.1186/s12884-016-0973-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 07/12/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Regular physical activity (PA) can be beneficial to pregnant women, however, many women do not adhere to current PA guidelines during the antenatal period. Patient and public involvement is essential when designing antenatal PA interventions in order to uncover the reasons for non-adherence and non-engagement with the behaviour, as well as determining what type of intervention would be acceptable. The aim of this research was to explore women's experiences of PA during a recent pregnancy, understand the barriers and determinants of antenatal PA and explore the acceptability of antenatal walking groups for further development. METHODS Seven focus groups were undertaken with women who had given birth within the past five years. Focus groups were transcribed and analysed using a grounded theory approach. Relevant and related behaviour change techniques (BCTs), which could be applied to future interventions, were identified using the BCT taxonomy. RESULTS Women's opinions and experiences of PA during pregnancy were categorised into biological/physical (including tiredness and morning sickness), psychological (fear of harm to baby and self-confidence) and social/environmental issues (including access to facilities). Although antenatal walking groups did not appear popular, women identified some factors which could encourage attendance (e.g. childcare provision) and some which could discourage attendance (e.g. walking being boring). It was clear that the personality of the walk leader would be extremely important in encouraging women to join a walking group and keep attending. Behaviour change technique categories identified as potential intervention components included social support and comparison of outcomes (e.g. considering pros and cons of behaviour). CONCLUSIONS Women's experiences and views provided a range of considerations for future intervention development, including provision of childcare, involvement of a fun and engaging leader and a range of activities rather than just walking. These experiences and views relate closely to the Health Action Process Model which, along with BCTs, could be used to develop future interventions. The findings of this study emphasise the importance of involving the target population in intervention development and present the theoretical foundation for building an antenatal PA intervention to encourage women to be physically active throughout their pregnancies.
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Affiliation(s)
- Sinéad Currie
- />Psychology, School of Natural Sciences, University of Stirling, Stirling, FK9 4LA UK
| | - Cindy Gray
- />Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, 27 Bute Gardens, Glasgow, G12 8RS UK
| | - Ashley Shepherd
- />School of Health Sciences, University of Stirling, Stirling, FK9 4LA UK
| | - Rhona J. McInnes
- />School of Health Sciences, University of Stirling, Stirling, FK9 4LA UK
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Coll CVN, Domingues MR, Gonçalves H, Bertoldi AD. Perceived barriers to leisure-time physical activity during pregnancy: A literature review of quantitative and qualitative evidence. J Sci Med Sport 2016; 20:17-25. [PMID: 27372276 DOI: 10.1016/j.jsams.2016.06.007] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 05/24/2016] [Accepted: 06/16/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Identify perceived barriers to leisure-time physical activity during pregnancy to inform future interventions aimed at improving physical activity levels in pregnancy. DESIGN PubMed/Medline and Web of Science databases were systematically searched using a reference period between 1986 and January/2016. METHODS A comprehensive search strategy was developed combining the following keywords: (barriers OR constraints OR perceptions OR attitudes) AND (physical activity OR exercise OR motor activity) AND (pregnancy OR pregnant women OR antenatal OR prenatal). Thematic synthesis was conducted to analyze the data. A socioecological model was used to categorize the reported barriers. RESULTS Twelve quantitative studies and 14 qualitative studies were included. Barriers belonging to the intrapersonal level of the socioecological model were the most reported in the studies and were categorized in five themes as follows: (1) Pregnancy-related symptoms and limitations; (2) Time constraints; (3) Perceptions of already being active, (4) Lack of motivation and (5) Mother-child safety concerns. At the interpersonal level, barriers were coded into two descriptive themes: (1) Lack of advice and information and (2) Lack of social support. Two other themes were used to summarize Environmental, Organizational and Policy barriers: (1) Adverse weather and (2) Lack of resources. CONCLUSIONS A range of relevant barriers to leisure-time physical-activity engagement during pregnancy were identified in this literature review. Pregnancy-related symptoms and limitations barriers were the most reported in studies, regardless of study design. Mother-child safety concerns, lack of advice/information and lack of social support were also important emphasized pregnancy-related barriers to be targeted in future interventions.
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Affiliation(s)
- Carolina V N Coll
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil.
| | - Marlos R Domingues
- Postgraduate Program in Physical Education, Federal University of Pelotas, Brazil
| | - Helen Gonçalves
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil
| | - Andréa D Bertoldi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil
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Ussher M, Lewis S, Aveyard P, Manyonda I, West R, Lewis B, Marcus B, Riaz M, Taylor AH, Barton P, Daley A, Essex H, Esliger D, Coleman T. The London Exercise And Pregnant smokers (LEAP) trial: a randomised controlled trial of physical activity for smoking cessation in pregnancy with an economic evaluation. Health Technol Assess 2016; 19:vii-xxiv, 1-135. [PMID: 26491878 DOI: 10.3310/hta19840] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Smoking during pregnancy is the main preventable cause of poor birth outcomes. Improved methods are needed to help women to stop smoking during pregnancy. Pregnancy provides a compelling rationale for physical activity (PA) interventions as cessation medication is contraindicated or ineffective, and an effective PA intervention could be highly cost-effective. OBJECTIVE To examine the effectiveness and cost-effectiveness of a PA intervention plus standard behavioural support for smoking cessation relative to behavioural support alone for achieving smoking cessation at the end of pregnancy. DESIGN Multicentre, two-group, pragmatic randomised controlled trial and economic evaluation with follow-up at the end of pregnancy and 6 months postnatally. Randomisation was stratified by centre and a computer-generated sequence was used to allocate participants using a 1 : 1 ratio. SETTING 13 hospitals offering antenatal care in the UK. PARTICIPANTS Women between 10 and 24 weeks' gestation smoking five or more cigarettes a day before pregnancy and one or more during pregnancy. INTERVENTIONS Participants were randomised to behavioural support for smoking cessation (control) or behavioural support plus a PA intervention consisting of supervised treadmill exercise plus PA consultations. Neither participants nor researchers were blinded to treatment allocation. MAIN OUTCOME MEASURES The primary outcome was self-reported, continuous smoking abstinence between a quit date and end of pregnancy, validated by expired carbon monoxide and/or salivary cotinine. Secondary outcomes were maternal weight, depression, birth outcomes, withdrawal symptoms and urges to smoke. The economic evaluation investigated the costs of the PA intervention compared with the control intervention. RESULTS In total, 789 women were randomised (n = 394 PA, n = 395 control). Four were excluded post randomisation (two had been enrolled twice in sequential pregnancies and two were ineligible and randomised erroneously). The intention-to-treat analysis comprised 785 participants (n = 392 PA, n = 393 control). There was no significant difference in the rate of abstinence at the end of pregnancy between the PA group (7.7%) and the control group (6.4%) [odds ratio for PA group abstinence 1.21, 95% confidence interval (CI) 0.70 to 2.10]. For the PA group compared with the control group, there was a 33% (95% CI 14% to 56%), 28% (95% CI 7% to 52%) and 36% (95% CI 12% to 65%) significantly greater increase in self-reported minutes of moderate- and vigorous-intensity PA from baseline to 1 week, 4 weeks and 6 weeks respectively. Accelerometer data showed that there was no significant difference in PA levels between the groups. There were no significant differences between the groups for change in maternal weight, depression, withdrawal symptoms or urges to smoke. Adverse events and birth outcomes were similar between the groups except for there being significantly more caesarean births in the control group than in the PA group (28.7% vs. 21.3%; p < 0.023). The PA intervention was less costly than the control intervention by £35 per participant. This was mainly attributable to increased health-care usage in the control group. However, there was considerable statistical uncertainty around this estimate. CONCLUSIONS During pregnancy, offering an intervention combining supervised exercise and PA counselling does not add to the effectiveness of behavioural support for smoking cessation. Only 10% of participants had PA levels accessed by accelerometer and it is, therefore, unclear whether or not the lack of an effect on the primary outcome is the result of insufficient increases in PA. Research is needed to identify the smoking populations most suitable for PA interventions and methods for increasing PA adherence. TRIAL REGISTRATION Current Controlled Trials ISRCTN48600346. FUNDING This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 19, No. 84. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Michael Ussher
- Population Health Research Institute, St George's, University of London, London, UK
| | - Sarah Lewis
- Division of Epidemiology and Public Health and UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Isaac Manyonda
- Department of Obstetrics and Gynaecology, St George's, University of London, and St George's Healthcare NHS Trust, London, UK
| | - Robert West
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, UK
| | - Beth Lewis
- School of Kinesiology, University of Minnesota, Minneapolis, MN, USA
| | - Bess Marcus
- Department of Family and Preventive Medicine, University of California, San Diego, San Diego, CA, USA
| | - Muhammad Riaz
- Population Health Research Institute, St George's, University of London, London, UK
| | - Adrian H Taylor
- Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - Pelham Barton
- Health Economics Unit, School of Health and Population Sciences, University of Birmingham, Birmingham, UK
| | - Amanda Daley
- Primary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, UK
| | - Holly Essex
- Department of Health Sciences, University of York, York, UK
| | - Dale Esliger
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Tim Coleman
- Division of Primary Care and UK Centre for Tobacco and Alcohol Studies, University of Nottingham, Nottingham, UK
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Potential benefits of physical activity during pregnancy for the reduction of gestational diabetes prevalence and oxidative stress. Early Hum Dev 2016; 94:57-62. [PMID: 26833143 DOI: 10.1016/j.earlhumdev.2016.01.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 01/07/2016] [Indexed: 01/28/2023]
Abstract
Changes in quality of nutrition, habits, and physical activity in modern societies increase susceptibility to obesity, which can deleteriously affect pregnancy outcome. In particular, a sedentary lifestyle causes dysfunction in blood flow, which impacts the cardiovascular function of pregnant women. The main molecular mechanism responsible for this effect is the synthesis and bioavailability of nitric oxide, a phenomenon regulated by the antioxidant capacity of endothelial cells. These alterations affect the vascular health of the mother and vascular performance of the placenta, the key organ responsible for the healthy development of the fetus. In addition to the increases in systemic vascular resistance in the mother, placental oxidative stress also affects the feto-placental blood flow. These changes can be integrated into the proteomics and metabolomics of newborns.
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Santos PC, Abreu S, Moreira C, Santos R, Ferreira M, Alves O, Moreira P, Mota J. Physical Activity Patterns During Pregnancy in a Sample of Portuguese Women: A Longitudinal Prospective Study. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016; 18:e22455. [PMID: 27247788 PMCID: PMC4884625 DOI: 10.5812/ircmj.22455] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 03/30/2015] [Accepted: 04/16/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND Physical activity (PA) patterns during pregnancy have not been explored in depth and most previous studies lack assessment of variables such as type, frequency, duration and intensity of activity. OBJECTIVES This study had two goals: 1) to analyze PA patterns during pregnancy according to weekly time spent on different types of activity; and 2) to determine women's perception about health care providers regarding PA advisement during pregnancy. PATIENTS AND METHODS A longitudinal prospective study was carried out with a 118-pregnant women cohort. Participants were evaluated during all trimesters. Self-reported questionnaires were used to collect personal and obstetric data. Type, duration and frequency of PA were evaluated using the pregnancy physical activity questionnaire (PPAQ) and intensity levels were calculated. Repeated measure analysis of variance was performed to determine differences between trimesters, and Wilcoxon signed-rank test was performed when appropriate. RESULTS A decrease in values of self-reported PA (MET.h.wk(-1)) was found from the first to the second and the first to the third trimester of pregnancy, respectively; total (270.91 vs 220.54 vs 210.35; P < 0.01), light (109.45 vs 95.11vs 92.40; P < 0.01) and moderate intensity (81.99 vs 50.69 vs 62.94; P = 0.002). Time spent on most activities remained fairly stable throughout pregnancy. Women spent most of their weekly time during the entire pregnancy on household and caregiving activities, occupational activities and leisure, except sport activities. Swimming was the most reported organized PA, reaching its highest proportion (12.7%) in the second trimester. Prenatal exercise classes were reported by 39.8% of women during the 3rd trimester. Pregnant women reported that PA was recommended by health professionals: 53.9% in the 1st trimester, 70.4% in the 2nd trimester and 56.8% in the 3rd trimester. CONCLUSIONS Self-reported PA decreased, especially from the first to the second trimester, in total, light and moderate intensity. Women spent most of their weekly time on domestic, occupational and leisure activities, except sport activities. There are some health care providers that do not recommend physical activity during pregnancy.
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Affiliation(s)
- Paula Clara Santos
- Department of Physiotherapy, School of Health Technology of Porto, Polytechnic Institute of Porto, Porto, Portugal
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Sandra Abreu
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Carla Moreira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Rute Santos
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
- Early Start Research Centre, School of Education, Faculty of Social Sciences, University of Wollongong, Wollongong, Australia
| | - Margarida Ferreira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
| | - Odete Alves
- Ponte da Barca Health Unit, Alto Minho Local Health Unit, Porto, Portugal
| | - Pedro Moreira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
- Faculty of Science, Nutrition and Food Science, University of Porto, Porto, Portugal
| | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
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Currie S, Sinclair M, Liddle DS, Nevill A, Murphy MH. Application of objective physical activity measurement in an antenatal physical activity consultation intervention: a randomised controlled trial. BMC Public Health 2015; 15:1259. [PMID: 26686681 PMCID: PMC4684930 DOI: 10.1186/s12889-015-2548-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 11/30/2015] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Physical Activity (PA) during pregnancy has many health benefits, however, inactivity in this population is common and PA often declines with increasing gestation. PA consultations have been useful in promoting PA in the general population, however their use for addressing PA in pregnancy is unknown. This study aimed to examine if a theory-based intervention using PA consultations would reduce the magnitude of decline in objectively measured PA between the first and third trimesters of pregnancy. METHODS A RCT was carried out in an urban maternity unit in Northern Ireland between September 2012 and June 2013. 109 low-risk, primigravida pregnant women were randomised to a control (n = 54) or intervention group (n = 55). Intervention participants received three face-to-face individual PA consultations. Daily PA was measured in each trimester using seven day accelerometry. The study was approved by a NHS trust (12/NI/0036). PA data in counts per minute (CPM) were categorised into intensity using Freedson cut points and mean minutes of PA were compared between groups using repeated measures ANOVA with a sub-analysis stratifying participants per PA level in trimester one. RESULTS Intention to treat analysis was performed on data from 97 participants. Time in moderate, vigorous and moderate-vigorous intensity PA (MVPA) significantly declined between trimesters one and three in both groups (P < 0.001). There were no statistically significant differences in PA between groups in any trimester. Women in the intervention group who were less active in trimester one did not demonstrate a significant decline in MVPA throughout pregnancy (in contrast with the decline identified in the more active participants). CONCLUSIONS The findings indicate that PA consultations were not effective in reducing the decline of MVPA in throughout pregnancy, however, women who were less active in trimester one and received PA consultations had a lesser decrease in MVPA. It is possible that pregnant women, specifically those who are more active at the start of pregnancy, have differing needs for PA behaviour change and maintenance, requiring more intense interventions than less active women. TRIAL REGISTRATION Current Controlled Trials Register ISRCTN61829137.
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Affiliation(s)
- Sinead Currie
- Psychology, School of Natural Sciences, University of Stirling, Stirling, Scotland.
| | - Marlene Sinclair
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, Northern Ireland.
| | - Dianne S Liddle
- Institute of Nursing and Health Research, Ulster University, Newtownabbey, Northern Ireland.
| | - Alan Nevill
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, England.
| | - Marie H Murphy
- Centre for Physical Activity and Health Research, Ulster University, Newtownabbey, Northern Ireland.
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Broberg L, Ersbøll AS, Backhausen MG, Damm P, Tabor A, Hegaard HK. Compliance with national recommendations for exercise during early pregnancy in a Danish cohort. BMC Pregnancy Childbirth 2015; 15:317. [PMID: 26614105 PMCID: PMC4661949 DOI: 10.1186/s12884-015-0756-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 11/20/2015] [Indexed: 11/28/2022] Open
Abstract
Background Exercise during pregnancy is associated with health benefits for both the mother and the fetus, and is therefore recommended in several national guidelines. Only few studies investigate whether these guideline recommendations are met. The aims of this study were 1. To assess the prevalence of pregnant women meeting the Danish recommendations for exercise during early pregnancy, 2. To identify pre-pregnancy factors associated with a lower probability for meeting the recommendations, and 3. To describe which types of exercise pregnant women prefer before and during pregnancy. Methods We conducted a cross-sectional study based on a questionnaire during the first trimester among 7,915 women participating in the prospective Copenhagen Pregnancy Cohort. Associations were estimated by multivariate regression analyses. Results In early pregnancy, 38 % of the study population met the recommendation for exercise from the Danish Health and Medicines Authority (≥3.5 hours a week). Multiparity, previous miscarriage use of assisted reproductive technology, no engagement in exercise before pregnancy, smoking, pregnancy following assisted reproductive technology, overweight, not understanding Danish language and a low educational level were all factors associated a lower probability for meeting the recommendations. The preferred types of exercise before and during pregnancy were bicycling, brisk walking, running and strength training. The proportion of women engaged in any type of exercise decreased in early pregnancy with the exception of swimming and aquatic exercise. Conclusions In this cohort, more than one-third met the Danish recommendation for exercise during early pregnancy. Exercise in pregnancy is still an issue to address because the most vulnerable groups of pregnant women do not exercise. This is a cause of concern because it may reflect social inequalities in health and highlights the need for a structural and systematic approach to preconception care and early antenatal counselling.
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Affiliation(s)
- Lotte Broberg
- Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. .,The Research Unit Women's and Children's Health, the Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
| | - Anne S Ersbøll
- Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. .,The Research Unit Women's and Children's Health, the Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
| | - Mette G Backhausen
- Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. .,The Research Unit Women's and Children's Health, the Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. .,Department of Gynaecology and Obstetrics, Roskilde University Hospital, Roskilde, Denmark.
| | - Peter Damm
- Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. .,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Ann Tabor
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,Centre for Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
| | - Hanne K Hegaard
- Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. .,The Research Unit Women's and Children's Health, the Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. .,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,Department of Health Sciences, Child, Family, and Reproductive Health, Faculty of Medicine, Lund University, Lund, Sweden.
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Hayman M, Short C, Reaburn P. An investigation into the exercise behaviours of regionally based Australian pregnant women. J Sci Med Sport 2015; 19:664-8. [PMID: 26481261 DOI: 10.1016/j.jsams.2015.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2015] [Revised: 06/24/2015] [Accepted: 09/17/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Regular exercise during pregnancy is a recommended prenatal care strategy with short and long-term health benefits to mother and child. Unfortunately, most pregnant women are insufficiently active to obtain health benefits and there is evidence that activity levels decrease overall during pregnancy. Physical activity among regionally based women is lower than that of urban-based women within Australia. However, little is currently known about exercise behaviours of regionally based Australian pregnant women. To successfully promote exercise among regionally based pregnant women, a greater understanding of exercise behaviours must first be explored. This study investigated exercise behaviours in a sample of regionally based Australian pregnant women. DESIGN Regionally based Australian pregnant women (n=142) completed a modified version of the Godin Leisure-Time Exercise Questionnaire examining exercise behaviours before and during pregnancy. METHODS Women self-reported their exercise behaviours, including exercise frequency, intensity, time and type, before and during pregnancy. RESULTS Chi-square analysis revealed significantly less (χ(2)=31.66, p<0.05) women participated in exercise during pregnancy (61%) compared to before pregnancy (87%). During pregnancy, respondents exercised at a significantly lower frequency (χ(2)=111.63, p<0.05), intensity (χ(2)=67.41, p<0.05), shorter time/duration (χ(2)=114.33, p<0.05), and significantly less (χ(2)=8.55, p<0.05) women (8%) are meeting 'exercise during pregnancy' guidelines compared to women before pregnancy (49%) meeting physical activity guidelines. CONCLUSIONS Exercise during pregnancy decreases to levels significantly lower than what is currently recommended. Public health initiatives that promote exercise among Australian pregnant women should aim to increase frequency, intensity, time and type of exercise to be undertaken during pregnancy.
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Affiliation(s)
- Melanie Hayman
- School of Medical and Applied Sciences, Central Queensland University, Australia.
| | - Camille Short
- Freemasons Foundation Centre for Men's Health, Faculty of Health Sciences, The University of Adelaide, Australia
| | - Peter Reaburn
- School of Medical and Applied Sciences, Central Queensland University, Australia
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Huberty J, Leiferman JA, Gold KJ, Rowedder L, Cacciatore J, McClain DB. Physical activity and depressive symptoms after stillbirth: informing future interventions. BMC Pregnancy Childbirth 2014; 14:391. [PMID: 25432802 PMCID: PMC4254184 DOI: 10.1186/s12884-014-0391-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Accepted: 11/06/2014] [Indexed: 12/17/2022] Open
Abstract
Background In the United States, approximately one in 110 pregnancies end in stillbirth affecting more than 26,000 women annually. Women experiencing stillbirth have a threefold greater risk of developing depressive symptoms compared to women experiencing live birth. Depression contributes negatively to health outcomes for both mothers and babies subsequent to stillbirth. Physical activity may improve depression in these women, however, little is known about acceptable physical activity interventions for women after stillbirth. This is the purpose of this descriptive exploratory study. Methods Eligible women were between ages 19 and 45, and experienced stillbirth within one year of the study. An online survey was used to ask questions related to 1) pregnancy and family information (i.e., time since stillbirth, weight gain during pregnancy, number of other children) 2) physical activity participation, 3) depressive symptomatology, and 4) demographics. Results One hundred seventy-five women participated in the study (M age = 31.26 ± 5.52). Women reported participating in regular physical activity (at least 150 minutes of moderate activity weekly) before (60%) and during (47%) their pregnancy, as well as after their stillbirth (61%). Only 37% were currently meeting physical activity recommendations. Approximately 88% reported depression (i.e., score of >10 on depression scale). When asked how women cope with depression, anxiety, or grief, 38% said physical activity. Of those that reported using physical activity to cope after stillbirth, they did so to help with depression (58%), weight loss (55%), and better overall physical health (52%). To cope with stillbirth, women used walking (67%), followed by jogging (35%), and yoga (23%). Women who participated in physical activity after stillbirth reported significantly lower depressive symptoms (M = 15.10, SD = 5.32) compared to women who did not participate in physical activity (M = 18.06, SD = 5.57; t = -3.45, p = .001). Conclusions Physical activity may serve as a unique opportunity to help women cope with the multiple mental sequelae after stillbirth. This study provides data to inform healthcare providers about the potential role of physical activity in bereavement and recovery for women who have experienced stillbirth. Additional research is necessary in this vulnerable population.
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Affiliation(s)
- Jennifer Huberty
- Exercise and Wellness, Arizona State University, Phoenix, AZ, USA.
| | - Jenn A Leiferman
- Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, USA.
| | - Katherine J Gold
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA. .,Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA.
| | - Lacey Rowedder
- Exercise and Wellness, Arizona State University, Phoenix, AZ, USA.
| | | | - Darya Bonds McClain
- College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.
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