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Jing G, Wei Q, Zou J, Zhang Y, Shi H, Gao X. Longitudinal association between maternal cardiovascular health in pregnancy and child birth outcomes. Sci Rep 2024; 14:15355. [PMID: 38961151 PMCID: PMC11222450 DOI: 10.1038/s41598-024-66029-6] [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: 02/10/2024] [Accepted: 06/26/2024] [Indexed: 07/05/2024] Open
Abstract
The American Heart Association has updated its definition of cardiovascular health (CVH) with a new framework known as Life's Essential 8 (LE8). Although gestational CVH assessment has been recommended, its significance based on LE8 for birth outcomes is unknown. We thus evaluated the status of gestational CVH based on LE8 in 3036 pregnant women of the Shanghai Maternal-Child Pairs Cohort and the population of China Maternal Nutrition and Health Sciences Survey, and also examined the association between gestational CVH and child birth outcomes. We found that only a small proportion (12.84%) had high CVH, while 1.98% had low CVH in this cohort study. In adjusted models, a 10-point increase in the gestational CVH score, indicating a more favorable score, was associated with lower neonatal size such as birth weight (β: - 37.05 [95% confidence interval: - 52.93, - 21.16]), birth length (- 0.12[- 0.22, - 0.01]), weight-for-height z-score (- 0.07[- 0.12, - 0.03]), body mass index z-score (- 0.09 [- 0.13, - 0.04]), length-for-age Z-score (- 0.03 [- 0.06, - 0.01]), and weight-for-age z-score (- 0.08 [- 0.12, - 0.05]). Also, a 10-point increase in the gestational CVH score was associated with the lower risk of large for gestational age (LGA) (0.82 [0.73, 0.92]) and macrosomia infant (0.75 [0.64, 0.88]). CVH categories showed similar results. That is, better maternal CVH status in pregnancy was associated with lower neonatal size and lower risks for LGA and macrosomia in newborns.
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Affiliation(s)
- Guangzhuang Jing
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Dong'an Road, 130, Shanghai, 200032, China
| | - Qian Wei
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Dong'an Road, 130, Shanghai, 200032, China
| | - Jiaojiao Zou
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Dong'an Road, 130, Shanghai, 200032, China
| | - Yunhui Zhang
- Department of Environment Health, School of Public Health, Fudan University, Dong'an Road, 130, Shanghai, 200032, China
| | - Huijing Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Dong'an Road, 130, Shanghai, 200032, China.
| | - Xiang Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Dong'an Road, 130, Shanghai, 200032, China
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Altaş ZM, Lüleci NE, Hıdıroğlu S. Evaluation of Physical Activity Level and Related Factors in Pregnancy During the COVID-19 Period. Int J Public Health 2023; 68:1605800. [PMID: 37215648 PMCID: PMC10196054 DOI: 10.3389/ijph.2023.1605800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 04/26/2023] [Indexed: 05/24/2023] Open
Abstract
Objectives: It was aimed to determine the level of physical activity and related factors in pregnant women. Methods: The study is a mixed methods study. The participants are women applied to the pregnancy outpatient clinic of a hospital. The level of physical activity was assessed with the Pregnancy Physical Activity Questionnaire. Sociodemographic questions and seven questions of the International Physical Activity Environment Module were asked. Besides, in-depth interviews were conducted with 14 women. Results: The study was conducted with 304 women. The median age was 29.0 (18.0-40.0) years. The mean total activity and sedentary activity scores were 195.8 ± 107.9 and 37.22 ± 31.08 MET-hours/week, respectively. Pregnant women were mostly involved in light-intensity and housework/caregiving activities. Most of the participants mentioned that they were less active than pre-pregnancy period. The most common reasons for being less active were weakness, fatigue, lack of time and complaints such as low back pain and nausea. Conclusion: More than half of the pregnant women mentioned that they were less active during pregnancy. Thus, interventions should be planned to increase physical activity level of pregnant women.
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Sparks JR, Flanagan EW, Kebbe M, Redman LM. Understanding Barriers and Facilitators to Physical Activity Engagement to Inform a Precision Prescription Approach during Pregnancy. Am J Lifestyle Med 2023; 17:108-122. [PMID: 36636400 PMCID: PMC9830245 DOI: 10.1177/15598276221108669] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Physical activity during pregnancy is an important health behavior. However, many pregnant individuals are provided with little-to-no guidance to adequately engage in physical activity. The purpose of this quantitative and quasi-qualitative study of currently or previously pregnant women was to examine physical activity behaviors in pregnancy and understand barriers and facilitators to achieving physical activity recommendations. Overall, 431 women (18+ years), White/Caucasian (84.5%), married (84.9%), and currently pregnant (66.6%), completed an online survey study. Most women (69.4%) reported engaging in cardio-based physical activity and willing to engage in physical activity to meet guidelines between 2 and 5 days per week (77.4 -88.8%). The most frequently reported barriers were feeling too tired (72.8%) or uncomfortable (71.8%) and childcare needs (57.8%). Being able to choose time of day (96.0%), accessing home workouts (92.9%), and having a personalized prescription (95.6%) were the most reported facilitators. Open comment feedback resulted in additional barriers, such as ensuring proper energy intake, while motivation and support from other pregnant individuals were fundamental facilitators. Individualized physical activity prescription is lacking in routine prenatal care. To support pregnant individuals to achieve physical activity recommendations, developing a prescription with suitable modalities, at-home options, and consideration for physical activity timing are required.
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Affiliation(s)
- Joshua R. Sparks
- Reproductive Endocrinology and Women’s Health Laboratory, Pennington Biomedical Research
Center, Louisiana State University, Baton Rouge, Louisiana, USA
| | | | | | - Leanne M. Redman
- Reproductive Endocrinology and Women’s Health Laboratory, Pennington Biomedical Research
Center, Louisiana State University, Baton Rouge, Louisiana, USA
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Prochnow T, Arlinghaus KR, Johnston CA. The Importance of Social Networks for Support and Health Beliefs throughout Pregnancy. Am J Lifestyle Med 2023; 17:46-49. [PMID: 36636401 PMCID: PMC9830239 DOI: 10.1177/15598276221129821] [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: 01/07/2023] Open
Abstract
Pregnancy is a unique time when health care providers have more regular contact with women. Using this time to more fully understand the social influences at play can provide physicians an opportunity to leverage networks to improve health and wellbeing while stemming the exposure to health misinformation. Advocating for supportive social networks or exercise groups/programs can provide additional support and behavioral reinforcement which is needed for sustained behavior change. In this manner, fostering these networks is likely more beneficial to supporting healthy exercise behavior during pregnancy than education alone.
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Affiliation(s)
- Tyler Prochnow
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Katherine R Arlinghaus
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Craig A Johnston
- Department of Health and Human Performance, University of Houston, Houston, TX, USA
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Sparks JR, Ghildayal N, Hivert MF, Redman LM. Lifestyle interventions in pregnancy targeting GDM prevention: looking ahead to precision medicine. Diabetologia 2022; 65:1814-1824. [PMID: 35150287 PMCID: PMC10994387 DOI: 10.1007/s00125-022-05658-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/05/2021] [Indexed: 12/12/2022]
Abstract
Gestational diabetes mellitus (GDM) is the most prevalent pregnancy-related endocrinopathy, affecting up to 25% of pregnancies worldwide. Pregnant individuals who develop GDM have an increased risk of complications during pregnancy and birth, as well as future development of type 2 diabetes mellitus and CVD. This increased risk is subsequently passed along to the offspring, perpetuating a cycle of metabolic dysfunction across generations. GDM prevention strategies have had mixed results for many years, but more recent systematic reviews and meta-analyses have suggested potential new avenues of prevention. The objective of this review is to summarise the literature examining the efficacy of lifestyle interventions for the prevention of GDM and to uncover if specific individual-level characteristics influence this outcome. Based on the present literature, we determined that future trials should be designed to understand if initiation of lifestyle intervention in the preconception period is more effective to reduce GDM. Furthermore, trials initiated during pregnancy should be developed through the lens of precision prevention. That is, trials should tailor intervention approaches based on individual-level risk defined by the presence of modifiable and non-modifiable risk factors. Finally, future interventions might also benefit from just-in-time adaptive intervention designs, which allow for interventions to be modified in real-time based on objective assessments of an individual's response.
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Affiliation(s)
- Joshua R Sparks
- Reproductive Endocrinology and Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Nidhi Ghildayal
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Harvard University, Boston, MA, USA
| | - Marie-France Hivert
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Harvard University, Boston, MA, USA.
| | - Leanne M Redman
- Reproductive Endocrinology and Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA.
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Wieloch N, Klostermann A, Kimmich N, Spörri J, Scherr J. Sport and exercise recommendations for pregnant athletes: a systematic scoping review. BMJ Open Sport Exerc Med 2022; 8:e001395. [DOI: 10.1136/bmjsem-2022-001395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2022] [Indexed: 11/27/2022] Open
Abstract
ObjectivesTo analyse the available evidence and identify gaps in current knowledge regarding physical activity volume and intensity and their effects on pregnancy outcomes in female athletes.DesignScoping review.Data sourcesA structured literature search of three electronic databases (Embase, PubMed and Web of Science) was conducted on 25 February 2022, and a rerun search was conducted on 8 September 2022.Eligibility criteriaStudies were eligible if they contained information on the relevant population (ie, elite or competitive amateur female athletes), intervention/exposure (ie, minimum of 10 hours of sport per week) and fetal and maternal outcomes. Eligible comparators included female recreational athletes and pregnant non-exercisers.Risk of biasThe risk of bias was evaluated with the National Institutes of Health (National Heart, Lung and Blood Institute) quality assessment tool.ResultsThe results revealed a discrepancy between the number of original research papers and the number of reviews and recommendations derived from them. The identified studies focused primarily on pregnant recreational athletes. Sixteen clinical studies met the inclusion criteria. No adverse effects on maternal or fetal outcomes were reported. Only during performance tests involving acute intensive exercise with the mother exercising at more than 90% of her maximal heart rate did some fetuses experience decelerations in heart rate.Summary/conclusionA lack of high-quality studies and direct evidence on pregnant elite and competitive amateur female athletes is evident. Further prospective observational cohort studies are needed using new monitoring methods (eg, non-invasive, wireless monitoring systems) aiming to gain a broader understanding of the stress tolerance of pregnant athletes and fetuses during exercise. Following that, interventional studies with stress tests in laboratory settings should be conducted. Therefore, technology plays a decisive role in gaining new knowledge and providing evidence-based recommendations on this topic.PROSPERO registration numberCRD42022309541.
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Choong SYX, Tan XYJ, Cheng LJ, Lau Y. Effectiveness of Exercise in Improving Sleep Outcomes among Perinatal Women: A Systematic Review and Meta-analysis of randomised Controlled Trials. Behav Sleep Med 2022; 20:410-428. [PMID: 34081551 DOI: 10.1080/15402002.2021.1931221] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Sleep problems are prevalent among perinatal women, contributing to the poor overall well-being of mother and child. Exercise is an inexpensive and sustainable intervention to improve sleep outcomes and can be personalized accordingly to individuals. This systematic review and meta-analysis aim to consolidate available evidence to evaluate the effectiveness of exercise on improving sleep outcomes among perinatal women. METHODS Eight databases (CINAHL, Cochrane, EMBASE, PsycINFO, PubMed, Scopus, Web of Science and ProQuest) were used to perform a systematic search for studies in the English language from the inception of each database to 7 December 2019. The quality of studies was assessed using the risk of bias and GRADE. Review Manager was used for meta-analyses. Heterogeneity was determined by Cochran's Q (chi-square) and I2 values. The overall effect was evaluated using effect size and Z-statistics. RESULTS A total of 2,139 records were identified. Ten randomized controlled trials were included, with seven in the meta-analysis, involving 998 pregnant and postpartum women across eight countries. With medium to very large effect sizes, the results favored exercise interventions on sleep quality, sleep efficiency, sleep duration, sleep latency, insomnia, diurnal tiredness and daytime dysfunction. CONCLUSION Exercise interventions produced significant effects on improving sleep among perinatal women. This can increase advocacy for exercise among perinatal women to improve sleep and general health. Future randomized controlled trial designs should adhere to the Consolidated Standards of Reporting Trials and Template to ensure reliability when conducting and reporting such studies.
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Affiliation(s)
- Shanise Yi Xin Choong
- Department of Nursing, Khoo Teck Puat Hospital, Yishun Health Campus, National Healthcare Group, Singapore, Singapore
| | - Xing Yee Jolyn Tan
- Department of Nursing, Khoo Teck Puat Hospital, Yishun Health Campus, National Healthcare Group, Singapore, Singapore
| | - Ling Jie Cheng
- Health Systems and Behavioural Sciences Domain, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Stevanović-Silva J, Beleza J, Coxito P, Costa RC, Ascensão A, Magalhães J. Fit mothers for a healthy future: Breaking the intergenerational cycle of non-alcoholic fatty liver disease with maternal exercise. Eur J Clin Invest 2022; 52:e13596. [PMID: 34120338 DOI: 10.1111/eci.13596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/01/2021] [Accepted: 05/06/2021] [Indexed: 12/20/2022]
Abstract
UNLABELLED SPECIAL ISSUE: 'FOIEGRAS-Bioenergetic Remodelling in the Pathophysiology and Treatment of Non-Alcoholic Fatty Liver Disease'. BACKGROUND Non-alcoholic fatty liver disease (NAFLD) emerges as significant health burden worldwide. Lifestyle changes, unhealthy dietary habits and physical inactivity, can trigger NAFLD development. Persisting on these habits during pregnancy affects in utero environment and prompts a specific metabolic response in foetus resulting in offspring metabolic maladjustments potentially critical for developing NAFLD later in life. The increasing prevalence of NAFLD, particularly in children, has shifted the research focus towards preventive and therapeutic strategies. Yet, designing effective approaches that can break the NAFLD intergenerational cycle becomes even more complicated. Regular physical exercise (PE) is a powerful non-pharmacological strategy known to counteract deleterious metabolic outcomes. In this narrative review, we aimed to briefly describe NAFLD pathogenesis focusing on maternal nutritional challenge and foetal programming, and to provide potential mechanisms behind the putative intergenerational effect of PE against metabolic diseases, including liver diseases. METHODS Following detailed electronic database search, recent existing evidence about NAFLD development, intergenerational programming and gestational exercise effects was critically analysed and discussed. RESULTS PE during pregnancy could have a great potential to counteract intergenerational transmission of metabolic burden. The interplay between different PE roles-metabolic, endocrine and epigenetic-could offer a more stable in utero environment to the foetus, thus rescuing offspring vulnerability to metabolic disturbances. CONCLUSIONS The better understanding of maternal PE beneficial consequences on offspring metabolism could reinforce the importance of PE during pregnancy as an indispensable strategy in improving offspring health.
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Affiliation(s)
- Jelena Stevanović-Silva
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, Porto, Portugal
| | - Jorge Beleza
- Department of Cell Biology, Physiology & Immunology, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Pedro Coxito
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, Porto, Portugal
| | - Rui Carlos Costa
- Department of Communication and Art, Research Institute for Design, Media and Culture (ID+), Aveiro University, Aveiro, Portugal
| | - António Ascensão
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, Porto, Portugal
| | - José Magalhães
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, Porto, Portugal
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Nelson RK, Hafner SM, Cook AC, Sterner NJ, Butler EL, Jakiemiec BE, Saltarelli WA. Exercise During Pregnancy: What Do OB/GYNs Believe and Practice? A Descriptive Analysis. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:274-280. [PMID: 35262066 PMCID: PMC8896212 DOI: 10.1089/whr.2021.0132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
Introduction: Although regular exercise is recommended during non-complicated pregnancies to promote maternal and fetal/infant health, estimates suggest that only 15% of expectant mothers achieve current exercise recommendations. Although lack of motivation and fear related to potential fetal injury are often cited as reasons for not engaging in regular physical activity/exercise during pregnancy, less is understood about individual attitudes and practice habits of obstetrician and gynecologists (OB/GYNs) regarding exercise recommendations that may influence patient engagement in exercise during pregnancy. Purpose: To describe the attitudes, knowledge, and clinical practice of OB/GYNs regarding exercise during pregnancy. Methods: Surveys were sent via U.S. mail to 950 practicing OB/GYNs identified via publicly available databases. The survey included 11 questions regarding demographic information, exercise physiology knowledge, as well as their attitudes and clinical practice recommendations regarding exercise during pregnancy. Results: One hundred thirty-nine completed surveys were returned (14.6% response rate). Ninety-four percent of physicians surveyed agreed that there are benefits of exercise during pregnancy and/or the benefits of exercise during pregnancy outweigh the risks. Ninety-eight percent of physicians surveyed reported that they (or their medical staff) routinely advise their patients to exercise during pregnancy and 46% reported discussing exercise guidelines related to time, intensity, and type of exercise. Only 13% of physicians surveyed reported taking a semester-long exercise physiology course, yet 27% of physicians surveyed reported developing personalized exercise prescriptions for all (6%) or some (21%) of their patients. Conclusions: Low exercise engagement among expectant mothers does not appear to be due to a lack of guidance or negative views of OB/GYNs regarding exercise during pregnancy.
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Affiliation(s)
- Rachael K. Nelson
- Division of Exercise and Health Sciences, School of Health Sciences, Central Michigan University, Herbert H. and Grace A. Dow College of Health Professions, Mount Pleasant, Michigan, USA
| | - Selina M. Hafner
- Division of Exercise and Health Sciences, School of Health Sciences, Central Michigan University, Herbert H. and Grace A. Dow College of Health Professions, Mount Pleasant, Michigan, USA
| | - Alyssa C. Cook
- Division of Exercise and Health Sciences, School of Health Sciences, Central Michigan University, Herbert H. and Grace A. Dow College of Health Professions, Mount Pleasant, Michigan, USA
| | - Natalie J. Sterner
- Division of Exercise and Health Sciences, School of Health Sciences, Central Michigan University, Herbert H. and Grace A. Dow College of Health Professions, Mount Pleasant, Michigan, USA
| | - Erin L. Butler
- Division of Exercise and Health Sciences, School of Health Sciences, Central Michigan University, Herbert H. and Grace A. Dow College of Health Professions, Mount Pleasant, Michigan, USA
| | - Brooke E. Jakiemiec
- Division of Exercise and Health Sciences, School of Health Sciences, Central Michigan University, Herbert H. and Grace A. Dow College of Health Professions, Mount Pleasant, Michigan, USA
| | - William A. Saltarelli
- Division of Exercise and Health Sciences, School of Health Sciences, Central Michigan University, Herbert H. and Grace A. Dow College of Health Professions, Mount Pleasant, Michigan, USA
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Sun JJ, Chien LY. Decreased Physical Activity during Pregnancy Is Associated with Excessive Gestational Weight Gain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312597. [PMID: 34886322 PMCID: PMC8656838 DOI: 10.3390/ijerph182312597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/19/2021] [Accepted: 11/27/2021] [Indexed: 12/16/2022]
Abstract
The majority of pregnant women in Taiwan are not considered physically active. During pregnancy, many women decrease their physical activity levels when compared to pre-pregnancy. The purpose of this study was to examine the association between decreased physical activity from pre-pregnancy to pregnancy and excessive gestational weight gain (GWG). This study applied a prospective panel design. Recruitment was conducted at six medical facilities in Taiwan and lasted from August 2016 to April 2017. Physical activity levels were determined both before and during pregnancy using the International Physical Activity Questionnaire—Short Form, with data subsequently being transformed into METs-min/week. Excessive GWG was determined based on the body mass index (BMI) specific GWG range. We recruited 747 pregnant women in their second trimester and followed them through to one-month postpartum. About 40% of participants (41.2%) exhibited excessive GWG. Physical activity decreased from an average of 2261 (SD = 3999) to 1252 (SD = 2258) METs-min/week from pre-pregnancy to pregnancy (p < 0.0001). Controlling for age and pre-pregnancy BMI, a logistic regression model revealed that a decline in physical activity of > 4000 METs-min/week from pre-pregnancy to pregnancy was associated with an increased risk for excessive GWG (OR = 2.83, 95% CI: 1.27–4.43). A substantial decrease in physical activity from pre-pregnancy to pregnancy was a risk factor for excessive GWG. Although most women decreased their physical activity during pregnancy, only those pregnant women who were physically active pre-pregnancy could show the kind of large decrease that resulted in excessive GWG. Health professionals should continue to develop strategies for counteracting the problematic trend of decreasing PA during pregnancy among low-risk pregnant women.
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Affiliation(s)
- Jia-Jing Sun
- School of Nursing, College of Medicine, National Taiwan University, Taipei 112304, Taiwan;
- Department of Nursing, Heping Fuyou Branch of Taipei City Hospital, Taipei 112304, Taiwan
| | - Li-Yin Chien
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Yang-Ming Campus, Taipei 112304, Taiwan
- Correspondence: ; Tel.: +886-2-28267142; Fax: +886-2-28238614
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Abstract
For apparently healthy pregnant women, regular physical activity is recommended. The American College of Obstetricians and Gynecologists (ACOG) created recommendations for physical activity and exercise during pregnancy in 1985. At that time, pregnant women were advised to not exceed a heart rate of 140 beats per minute with physical activity. The heart rate recommendation was subsequently removed with the recommendations published in 1994, 2002, and 2015. In 2020, the ACOG updated its recommendations on physical activity for pregnant and postpartum women. The recommendation included exercising at a "fairly light to somewhat hard" perceived intensity and at less than 60-80% of age-predicted maximum heart rate, usually not exceeding a heart rate of 140 beats per minute. Women often seek advice from healthcare providers on physical activity during pregnancy, yet providers report concern about giving appropriate physical activity guidance. This paper summarizes the key scientific literature on monitoring absolute and relative exercise intensity in relation to the current ACOG recommendations, providing background on intensity-related concepts used in the recommendation. This paper also provides practical guidance to assist healthcare providers in relaying this information to pregnant women.
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Affiliation(s)
- Kelly R. Evenson
- Kelly R. Evenson, Department of
Epidemiology, University of NC, Gillings School of Global Public Health, 123 W
Franklin Street, Building C, Suite 410, Chapel Hill, NC, USA; e-mail:
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Gutke A, Sundfeldt K, De Baets L. Lifestyle and Chronic Pain in the Pelvis: State of the Art and Future Directions. J Clin Med 2021; 10:jcm10225397. [PMID: 34830680 PMCID: PMC8622577 DOI: 10.3390/jcm10225397] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/07/2021] [Accepted: 11/16/2021] [Indexed: 12/13/2022] Open
Abstract
During their lifespan, many women are exposed to pain in the pelvis in relation to menstruation and pregnancy. Such pelvic pain is often considered normal and inherently linked to being a woman, which in turn leads to insufficiently offered treatment for treatable aspects related to their pain experience. Nonetheless, severe dysmenorrhea (pain during menstruation) as seen in endometriosis and pregnancy-related pelvic girdle pain, have a high impact on daily activities, school attendance and work ability. In the context of any type of chronic pain, accumulating evidence shows that an unhealthy lifestyle is associated with pain development and pain severity. Furthermore, unhealthy lifestyle habits are a suggested perpetuating factor of chronic pain. This is of specific relevance during lifespan, since a low physical activity level, poor sleep, or periods of (di)stress are all common in challenging periods of women’s lives (e.g., during menstruation, during pregnancy, in the postpartum period). This state-of-the-art paper aims to review the role of lifestyle factors on pain in the pelvis, and the added value of a lifestyle intervention on pain in women with pelvic pain. Based on the current evidence, the benefits of physical activity and exercise for women with pain in the pelvis are supported to some extent. The available evidence on lifestyle factors such as sleep, (di)stress, diet, and tobacco/alcohol use is, however, inconclusive. Very few studies are available, and the studies which are available are of general low quality. Since the role of lifestyle on the development and maintenance of pain in the pelvis, and the value of lifestyle interventions for women with pain in the pelvis are currently poorly studied, a research agenda is presented. There are a number of rationales to study the effect of promoting a healthy lifestyle (early) in a woman’s life with regard to the prevention and management of pain in the pelvis. Indeed, lifestyle interventions might have, amongst others, anti-inflammatory, stress-reducing and/or sleep-improving effects, which might positively affect the experience of pain. Research to disentangle the relationship between lifestyle factors, such as physical activity level, sleep, diet, smoking, and psychological distress, and the experience of pain in the pelvis is, therefore, needed. Studies which address the development of management strategies for adapting lifestyles that are specifically tailored to women with pain in the pelvis, and as such take hormonal status, life events and context, into account, are required. Towards clinicians, we suggest making use of the window of opportunity to prevent a potential transition from localized or periodic pain in the pelvis (e.g., dysmenorrhea or pain during pregnancy and after delivery) towards persistent chronic pain, by promoting a healthy lifestyle and applying appropriate pain management.
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Affiliation(s)
- Annelie Gutke
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 40350 Gothenburg, Sweden
- Correspondence:
| | - Karin Sundfeldt
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 40350 Gothenburg, Sweden;
- Department of Gynecology, Sahlgrenska University Hospital, 41346 Gothenburg, Sweden
| | - Liesbet De Baets
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1050 Brussel, Belgium;
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Jimah T, Borg H, Kehoe P, Pimentel P, Turner A, Labbaf S, Asgari Mehrabadi M, Rahmani AM, Dutt N, Guo Y. A Technology-Based Pregnancy Health and Wellness Intervention (Two Happy Hearts): Case Study. JMIR Form Res 2021; 5:e30991. [PMID: 34787576 PMCID: PMC8663690 DOI: 10.2196/30991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 09/11/2021] [Accepted: 09/18/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The physical and emotional well-being of women is critical for healthy pregnancy and birth outcomes. The Two Happy Hearts intervention is a personalized mind-body program coached by community health workers that includes monitoring and reflecting on personal health, as well as practicing stress management strategies such as mindful breathing and movement. OBJECTIVE The aims of this study are to (1) test the daily use of a wearable device to objectively measure physical and emotional well-being along with subjective assessments during pregnancy, and (2) explore the user's engagement with the Two Happy Hearts intervention prototype, as well as understand their experiences with various intervention components. METHODS A case study with a mixed design was used. We recruited a 29-year-old woman at 33 weeks of gestation with a singleton pregnancy. She had no medical complications or physical restrictions, and she was enrolled in the Medi-Cal public health insurance plan. The participant engaged in the Two Happy Hearts intervention prototype from her third trimester until delivery. The Oura smart ring was used to continuously monitor objective physical and emotional states, such as resting heart rate, resting heart rate variability, sleep, and physical activity. In addition, the participant self-reported her physical and emotional health using the Two Happy Hearts mobile app-based 24-hour recall surveys (sleep quality and level of physical activity) and ecological momentary assessment (positive and negative emotions), as well as the Perceived Stress Scale, Center for Epidemiologic Studies Depression Scale, and State-Trait Anxiety Inventory. Engagement with the Two Happy Hearts intervention was recorded via both the smart ring and phone app, and user experiences were collected via Research Electronic Data Capture satisfaction surveys. Objective data from the Oura ring and subjective data on physical and emotional health were described. Regression plots and Pearson correlations between the objective and subjective data were presented, and content analysis was performed for the qualitative data. RESULTS Decreased resting heart rate was significantly correlated with increased heart rate variability (r=-0.92, P<.001). We found significant associations between self-reported responses and Oura ring measures: (1) positive emotions and heart rate variability (r=0.54, P<.001), (2) sleep quality and sleep score (r=0.52, P<.001), and (3) physical activity and step count (r=0.77, P<.001). In addition, deep sleep appeared to increase as light and rapid eye movement sleep decreased. The psychological measures of stress, depression, and anxiety appeared to decrease from baseline to post intervention. Furthermore, the participant had a high completion rate of the components of the Two Happy Hearts intervention prototype and shared several positive experiences, such as an increased self-efficacy and a normal delivery. CONCLUSIONS The Two Happy Hearts intervention prototype shows promise for potential use by underserved pregnant women.
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Affiliation(s)
- Tamara Jimah
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Holly Borg
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Priscilla Kehoe
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Pamela Pimentel
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Arlene Turner
- First 5 Orange County Children & Families Commission, Santa Ana, CA, United States
| | - Sina Labbaf
- Department of Computer Science, University of California, Irvine, Irvine, CA, United States
| | - Milad Asgari Mehrabadi
- Department of Electrical Engineering and Computer Science, University of California, Irvine, Irvine, CA, United States
| | - Amir M Rahmani
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
- Department of Computer Science, University of California, Irvine, Irvine, CA, United States
- Institute for Future Health, University of California, Irvine, Irvine, CA, United States
| | - Nikil Dutt
- Department of Computer Science, University of California, Irvine, Irvine, CA, United States
- Department of Electrical Engineering and Computer Science, University of California, Irvine, Irvine, CA, United States
| | - Yuqing Guo
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
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Benabid A, Deslauriers L, Sinclair I, St-Pierre M, Vaillancourt C, Gagnon S, Dancause KN. Relationships between Objectively Measured Sedentary Behavior during Pregnancy and Infant Birthweight. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910000. [PMID: 34639301 PMCID: PMC8508190 DOI: 10.3390/ijerph181910000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/10/2021] [Accepted: 09/17/2021] [Indexed: 11/16/2022]
Abstract
Background: Although numerous studies have assessed physical activity during pregnancy and relationships with infant outcomes, such as birthweight, few have evaluated sedentary behavior. Our objective was to evaluate sedentary behavior across pregnancy and relationships with infant birthweight in a sociodemographically diverse sample. Methods: We measured device-assessed sedentary behavior and physical activity over three days at 16–18, 24–26, and 32–34 weeks gestation and infant birthweight from medical records among 71 participants. We used linear regression to assess relationships between sedentary behavior at each evaluation period with birthweight-for-gestational age Z-scores (BW-for-GA). Results: There were no linear relationships between sedentary behavior and BW-for-GA at any evaluation period. We observed a modest curvilinear relationship between sedentary behavior at 16–18 weeks and BW-for-GA (R2 = 0.073, p = 0.021). Low and high levels of sedentary behavior predicted lower BW-for-GA. Multivariate models suggested that this relationship was independent of physical activity levels. Conclusions: Considering the high levels of sedentary behavior during pregnancy observed in many studies, even modest associations with birthweight merit further consideration. Relationships might not be evident later in pregnancy or if only linear relationships are considered. More detailed studies could help guide recommendations on sedentary behavior during pregnancy and the development of more comprehensive interventions.
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Affiliation(s)
- Abdelmoumene Benabid
- Département des Sciences de L’activité Physique, Université du Québec à Montréal (UQAM), Montreal, QC H2X 1Y4, Canada; (A.B.); (L.D.); (I.S.); (M.S.-P.)
| | - Lara Deslauriers
- Département des Sciences de L’activité Physique, Université du Québec à Montréal (UQAM), Montreal, QC H2X 1Y4, Canada; (A.B.); (L.D.); (I.S.); (M.S.-P.)
| | - Isabelle Sinclair
- Département des Sciences de L’activité Physique, Université du Québec à Montréal (UQAM), Montreal, QC H2X 1Y4, Canada; (A.B.); (L.D.); (I.S.); (M.S.-P.)
| | - Myriane St-Pierre
- Département des Sciences de L’activité Physique, Université du Québec à Montréal (UQAM), Montreal, QC H2X 1Y4, Canada; (A.B.); (L.D.); (I.S.); (M.S.-P.)
| | - Cathy Vaillancourt
- INRS-Centre Armand Frappier Santé Biotechnologie, Laval, QC H7V 1B7, Canada;
- Réseau Intersectoriel de Recherche en Santé, Université du Québec (RISUQ), Québec, QC G1K 9H7, Canada
| | - Sonia Gagnon
- Département D’obstétrique-Gynécologie, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, QC H4J 1C5, Canada;
| | - Kelsey N. Dancause
- Département des Sciences de L’activité Physique, Université du Québec à Montréal (UQAM), Montreal, QC H2X 1Y4, Canada; (A.B.); (L.D.); (I.S.); (M.S.-P.)
- Réseau Intersectoriel de Recherche en Santé, Université du Québec (RISUQ), Québec, QC G1K 9H7, Canada
- Correspondence: or ; Tel.: +(514)-987-3000 (ext. 5263)
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15
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Rudin LR, Dunn L, Lyons K, Livingston J, Waring ME, Pescatello LS. Professional Exercise Recommendations for Healthy Women Who Are Pregnant: A Systematic Review. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2021; 2:400-412. [PMID: 34671761 PMCID: PMC8524738 DOI: 10.1089/whr.2021.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
Background: Exercise in pregnancy favorably affects maternal and fetal outcomes, yet only 50% of women receive exercise guidance during prenatal care and 15% are told to stop exercising. Reasons for clinician reluctance to recommend exercise include safety concerns and ambiguity of recommendations. To better inform clinicians, this systematic review assembled a consensus exercise prescription (ExRx) for healthy pregnant women framed by the Frequency, Intensity, Time, and Type (FITT) principle. Methods: In April 2021, PubMed, Scopus, SPORTDiscus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Cochrane databases were searched. Reports were eligible if: (1) targeted healthy pregnant women, (2) framed the ExRx by the FITT, and (3) published by a professional society from 2000 to 2021 in English. The Appraisal of Guidelines for Research and Evaluation II tool assessed risk of bias. Results: Twelve reports of poor to good quality were included. Nine societies conducted systematic reviews, but only three provided a detailed, transparent description of the review conducted. Although the FITT varied, the most common was most days of the week, moderate intensity, 30 minutes/session to accumulate 150 minutes/week, and aerobic, resistance, and flexibility exercise with three societies advising neuromotor exercise. All professional societies specified activities to avoid and eight societies included contraindications to exercise. Conclusions: This systematic review produced a consensus ExRx for healthy pregnant women to better inform clinicians about advising their patients to exercise during pregnancy. Future research is needed to determine the upper limits of exercise while pregnant and provide better informed guidance relating to safety concerns for women who are pregnant.
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Affiliation(s)
- Lauren R. Rudin
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - Leslie Dunn
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - Kaitlyn Lyons
- Central Connecticut State University, New Britain, Connecticut, USA
| | - Jill Livingston
- Wesleyan Library, Wesleyan University, Middletown, Connecticut, USA
| | - Molly E. Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut, USA
| | - Linda S. Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut, USA
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16
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Shrestha A, Prowak M, Berlandi-Short VM, Garay J, Ramalingam L. Maternal Obesity: A Focus on Maternal Interventions to Improve Health of Offspring. Front Cardiovasc Med 2021; 8:696812. [PMID: 34368253 PMCID: PMC8333710 DOI: 10.3389/fcvm.2021.696812] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 06/07/2021] [Indexed: 12/13/2022] Open
Abstract
Maternal obesity has many implications for offspring health that persist throughout their lifespan that include obesity and cardiovascular complications. Several different factors contribute to obesity and they encompass interplay between genetics and environment. In the prenatal period, untreated obesity establishes a foundation for a myriad of symptoms and negative delivery experiences, including gestational hypertensive disorders, gestational diabetes, macrosomia, and labor complications. However, data across human and animal studies show promise that nutritional interventions and physical activity may rescue much of the adverse effects of obesity on offspring metabolic health. Further, these maternal interventions improve the health of the offspring by reducing weight gain, cardiovascular disorders, and improving glucose tolerance. Mechanisms from animal studies have also been proposed to elucidate the signaling pathways that regulate inflammation, lipid metabolism, and oxidative capacity of the tissue, ultimately providing potential specific courses of treatment. This review aims to pinpoint the risks of maternal obesity and provide plausible intervention strategies. We delve into recent research involving both animal and human studies with maternal interventions. With the increasing concerning of obesity rates witnessed in the United States, it is imperative to acknowledge the long-term effects posed on future generations and specifically modify maternal nutrition and care to mitigate these adverse outcomes.
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Affiliation(s)
- Akriti Shrestha
- Department of Nutrition and Food Studies, Syracuse University, Syracuse, NY, United States
| | - Madison Prowak
- Department of Nutrition and Food Studies, Syracuse University, Syracuse, NY, United States
| | | | - Jessica Garay
- Department of Nutrition and Food Studies, Syracuse University, Syracuse, NY, United States
| | - Latha Ramalingam
- Department of Nutrition and Food Studies, Syracuse University, Syracuse, NY, United States
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17
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Stickford ASL, Taylor EK, Rodriguez DV, Stroup S, Nunnery DL. Exercise Behaviors and Beliefs Among Pregnant Women in Rural Communities. Am J Lifestyle Med 2021; 17:32-40. [PMID: 36636390 PMCID: PMC9830243 DOI: 10.1177/15598276211026591] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Exercise during pregnancy is safe and beneficial; however, most pregnant women do not meet evidence-based exercise recommendations. Further, data on pregnant women's physical activity are largely limited to women living in urban environments. PURPOSE The purpose of this study is to examine beliefs and behaviors regarding exercise during pregnancy in pregnant and postpartum women living in rural communities. METHODS Surveys were distributed in healthcare settings and via social media to pregnant and postpartum (< 3 months) women living in rural communities. RESULTS Seventy-five women (28.1 ± 5.4 year) participated. Nearly all believed light (96%) and moderate (89%) intensity exercise are safe to perform during pregnancy, while fewer agreed vigorous intensity (52%) or resistance (40%) exercise is safe. Most (88%) believed women can continue their exercise regimen, and 73% believed that previously inactive women can begin training while pregnant. Only one-third of women met recommendations for cardiorespiratory exercise. The majority (66%) never engaged in vigorous exercise, and most (73%) did not participate in resistance exercise. CONCLUSION Pregnant women in rural communities participate in light intensity exercise, but are largely not meeting guidelines for aerobic or resistance training. Knowledge related to safe exercises, particularly resistance training, during pregnancy is limited. Targeted education and programmatic planning are needed in this population regarding exercise guidelines.
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Affiliation(s)
- Abigail S. L. Stickford
- Abigail S. L. Stickford, PhD, Department of Health
& Exercise Science, Appalachian State University, 1179 State Farm Rd, Suite 432,
Boone, NC 28608, USA; e-mail:
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18
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Laying the Foundation for Pregnancy Physical Activity Profiling: A Framework for Providing Tailored Physical Activity Advice and Guidance to Pregnant Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115996. [PMID: 34204932 PMCID: PMC8199782 DOI: 10.3390/ijerph18115996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/11/2021] [Accepted: 05/24/2021] [Indexed: 11/17/2022]
Abstract
The aim of this study was to examine the predictive utility of the theory of planned behaviour (TPB) in explaining pregnant women’s physical activity (PA) intentions and behaviour and to scrutinise the role of past behaviour within this context. Pregnant women (n = 89) completed the pregnancy physical activity questionnaire (PPAQ) and newly developed TPB questionnaire on two separate occasions during their pregnancy. Analyses were carried out in relation to three scenarios. Firstly, when considering the original TPB, intention emerged as the strongest determinant of pregnant women’s PA behaviour. Secondly, controlling for past behaviour attenuated the influence of intention and perceived behavioural control on behaviour, with neither of the original variables providing a unique influence. Finally, the addition of past behaviour added significantly to the prediction of intention with the model as a whole, explaining 85% of the variance in pregnant women’s PA intention, and with past behaviour uniquely contributing 44.8% of the variance. Pregnancy physical activity profiling based on intention and behaviour status is subsequently introduced as a novel and practical framework. This provides healthcare professionals with the opportunity and structure to provide tailored advice and guidance to pregnant women, thereby facilitating engagement with PA throughout motherhood.
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Tinius RA, Polston M, Bradshaw H, Ashley P, Greene A, Parker AN. An Assessment of Mobile Applications Designed to Address Physical Activity During Pregnancy and Postpartum. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2021; 14:382-399. [PMID: 34055180 PMCID: PMC8136604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Only 15% of women meet physical activity guidelines during and after pregnancy despite the well-established positive impacts on both the mother and the neonate. There is a clear lack of guidance on this topic, and mobile health interventions are a promising direction for future interventions to facilitate a necessary increase in physical activity during pregnancy and postpartum. The purpose of the study was to objectively assess the quality and perceived impact of existing free mobile apps that are designed to cover physical activity during and after pregnancy. The Mobile Application Rating Scale (MARS) was used by two independent reviewers to determine overall quality of mobile apps freely available in the U.S. iTunes store. The initial search for pregnancy and postpartum physical activity apps yielded 732 results. After careful screening, 567 apps were excluded, leaving 165 that went under further screening procedures. Upon further screening, 54 apps were downloaded and scored using the MARS system. Of the 54 apps included in the analyses, 20 apps contained physical activity information for pregnant women (37.0%), 11 apps contained information for postpartum women (20.4%), and 23 apps contained information pertaining to both pregnant and postpartum women (42.6%). Of note, 33 (61.1%) of the apps required hidden costs in the form of in-app purchases. The mean overall MARS score was 3.06 ± 0.94 out of 5 (1-inadequate and 5-excellent). Overall, the quality of existing apps appears low, and none of the existing apps had specific goal setting based on current recommendations for pregnant women. Due to low quality and perceived impact, existing mobile apps are insufficient to enable women to achieve recommended levels of physical activity during pregnancy and postpartum.
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Affiliation(s)
- Rachel A Tinius
- Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY, USA
| | - Mackenzie Polston
- Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY, USA
| | - Hannah Bradshaw
- Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY, USA
| | - Paula Ashley
- Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY, USA
| | - Ashley Greene
- Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY, USA
| | - Angel N Parker
- Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY, USA
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20
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Fiutem JJ, Watanabe M. Introduction for the special issue on "exercise during pregnancy". Birth Defects Res 2020; 113:209-213. [PMID: 33258283 DOI: 10.1002/bdr2.1850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 11/20/2020] [Indexed: 11/06/2022]
Affiliation(s)
- Justin J Fiutem
- Department of Pediatrics, Rainbow Babies and Children's Hospital, The Congenital Heart Collaborative, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Michiko Watanabe
- Department of Pediatrics, Rainbow Babies and Children's Hospital, The Congenital Heart Collaborative, University Hospitals Cleveland Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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21
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Coughlin JW, Martin LM, Henderson J, Dalcin AT, Fountain J, Wang N, Appel LJ, Clark JM, Bennett W. Feasibility and acceptability of a remotely-delivered behavioural health coaching intervention to limit gestational weight gain. Obes Sci Pract 2020; 6:484-493. [PMID: 33082990 PMCID: PMC7556432 DOI: 10.1002/osp4.438] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 05/27/2020] [Accepted: 05/30/2020] [Indexed: 11/07/2022] Open
Abstract
INTRODUCTION Gestational weight gain (GWG) and postpartum weight retention (PPWR) are significant, potentially modifiable, contributors to women's future weight and health trajectories. There is a need for feasible and patient-centered (i.e., convenient, remotely-delivered, technology-enhanced, and accessible through the prenatal care setting) behavioural interventions that limit GWG and PPWR. This study tests the feasibility and acceptability of a remotely-delivered behavioural health coaching intervention to limit gestational weight gain and postpartum weight retention. METHODS Pregnant women (11-16 weeks gestation) were recruited from two prenatal clinics and randomized to the active intervention or health education comparison group. Completion of the program was monitored and perceived helpfulness was rated (0-100). RESULTS Twenty-six women were randomized (n = 13 per arm; mean age = 31.6 years, SD = 3.6; mean BMI = 26.7 kg/m2, SD = 7.4). Participants completed a median of 18 coaching calls and 16/19 learning activities during pregnancy, and a median of 6 calls and 5/6 learning activities postpartum. They logged weights at least once/week for a median of 36/38 expected weeks and tracked daily calories and exercise for a median of 154/266 days and 72/266 days, respectively. Median (Q1, Q3) helpfulness ratings of the program during pregnancy were 80 (64, 91) and 62 (50, 81) postpartum; helpfulness ratings of coaching calls were 85 (58, 98). At 37 weeks gestation, 77% of participants achieved IOM weight gain recommendations compared to 54% in the comparison group. CONCLUSIONS This study provides evidence for the feasibility and acceptability of a remotely-delivered behavioural weight control intervention in pregnancy and postpartum.
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Affiliation(s)
- J. W. Coughlin
- Department of Psychiatry and Behavioral SciencesJohns Hopkins University School of MedicineBaltimoreMDUSA
- Welch Center for Prevention, Epidemiology and Clinical ResearchJohns Hopkins UniversityBaltimoreMDUSA
| | - L. M. Martin
- Division of General Internal Medicine, Department of MedicineJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - J. Henderson
- Department of Obstetrics and GynecologyJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - A. T. Dalcin
- Welch Center for Prevention, Epidemiology and Clinical ResearchJohns Hopkins UniversityBaltimoreMDUSA
- Division of General Internal Medicine, Department of MedicineJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - J. Fountain
- Division of General Internal Medicine, Department of MedicineJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - N.‐Y. Wang
- Welch Center for Prevention, Epidemiology and Clinical ResearchJohns Hopkins UniversityBaltimoreMDUSA
- Division of General Internal Medicine, Department of MedicineJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - L. J. Appel
- Welch Center for Prevention, Epidemiology and Clinical ResearchJohns Hopkins UniversityBaltimoreMDUSA
- Division of General Internal Medicine, Department of MedicineJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - J. M. Clark
- Welch Center for Prevention, Epidemiology and Clinical ResearchJohns Hopkins UniversityBaltimoreMDUSA
- Division of General Internal Medicine, Department of MedicineJohns Hopkins University School of MedicineBaltimoreMDUSA
| | - W. Bennett
- Welch Center for Prevention, Epidemiology and Clinical ResearchJohns Hopkins UniversityBaltimoreMDUSA
- Division of General Internal Medicine, Department of MedicineJohns Hopkins University School of MedicineBaltimoreMDUSA
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22
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Fiutem JJ. Letter to the editor for this special issue on "Exercise during pregnancy". Birth Defects Res 2020; 113:216-217. [PMID: 32939991 DOI: 10.1002/bdr2.1800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 08/25/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Justin J Fiutem
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA.,The Congenital Heart Collaborative at Rainbow Babies and Children's Hospital, Cleveland, Ohio, USA
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Arigo D, Mogle JA, Brown MM, Roberts SR, Pasko K, Butryn ML, Downs DS. Differences between accelerometer cut point methods among midlife women with cardiovascular risk markers. Menopause 2020; 27:559-567. [PMID: 32049926 PMCID: PMC7903971 DOI: 10.1097/gme.0000000000001498] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Midlife women experience elevated risk for cardiovascular disease and often receive advice to increase physical activity to mitigate this risk. Use of accelerometers to measure ambulatory physical activity requires selection of appropriate thresholds for estimating moderate-to-vigorous physical activity (MVPA), and choice of cut points may lead to meaningfully different conclusions about midlife women's physical activity (PA) engagement. This is particularly important given the recent elimination of 10-minute bout requirements for MVPA. This two-phase study examined differences between four cut point methods among midlife women with cardiovascular disease (CVD) risk. We used findings from Study 1 (exploratory) to generate hypotheses for Study 2 (confirmatory). METHODS Across studies, participants (N = 65) were midlife women with an additional CVD risk factor (eg, hypertension). Participants wore waistband accelerometers for seven days. Daily totals were calculated for minutes in light and MVPA using four common quantification methods (Freedson, Matthews, Swartz, and Troiano). RESULTS Multilevel models showed meaningful differences between methods (P < 0.0001). For total (non-bouted) minutes of MVPA, Freedson and Troiano methods showed that participants barely met MVPA recommendations (30 min per day), whereas Matthews and Swartz methods showed that participants greatly exceeded this goal. As differences between methods were smaller using MVPA bouts of 10 minutes or more (though remained significant), the observed variation was due in part to small bursts of MVPA dispersed throughout the day. CONCLUSIONS Findings demonstrate the need for careful consideration of PA quantification among midlife women with CVD risk, and for further investigation to determine the most appropriate quantification method. : Video Summary:http://links.lww.com/MENO/A545.
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Affiliation(s)
- Danielle Arigo
- Department of Psychology, Rowan University, Glassboro, NJ
| | | | - Megan M. Brown
- Department of Psychology, Rowan University, Glassboro, NJ
| | | | - Kristen Pasko
- Department of Psychology, Rowan University, Glassboro, NJ
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Walasik I, Kwiatkowska K, Kosińska Kaczyńska K, Szymusik I. Physical Activity Patterns among 9000 Pregnant Women in Poland: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051771. [PMID: 32182850 PMCID: PMC7084336 DOI: 10.3390/ijerph17051771] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/02/2020] [Accepted: 03/04/2020] [Indexed: 12/11/2022]
Abstract
The aim was to analyze the knowledge and experience of women regarding physical activity during their latest pregnancy. An anonymous questionnaire was completed electronically, in 2018, by 9345 women who gave birth at least once, with 52% of the women having performed exercises during pregnancy. Physically non-active respondents suffered from gestational hypertension (9.2% vs. 6.7%; p < 0.01) and gave birth prematurely (9% vs. 7%; p < 0.01) to newborns with a low birth weight significantly more often (6% vs. 3.6%; p < 0.001). Physically active women delivered vaginally more often (61% vs. 55%; p < 0.001) and were more likely to have a spontaneous onset of the delivery as compared with non-active women (73.8% vs. 70.7% p = 0.001). The women who were informed by gynaecologist about the beneficial influence of physical activity during pregnancy exercised significantly more often (67% vs. 44% p < 0.001). In addition, 13% of the women felt discrimination due to their physical activity during a pregnancy, 22% of respondents' physical activity was not accepted by their environment, and 39.1% of the women were told by others to stop physical exercise because it was bad for the baby's health. Physical activity during pregnancy is associated with improved fitness, decreased pregnancy ailments occurrence, and therefore influences the course of pregnancy and delivery in a positive way.
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Affiliation(s)
- Izabela Walasik
- Students Scientific Association at the 1st Department of Obstetrics and Gynecology, First Faculty of Medicine, Medical University of Warsaw, Plac Starynkiewicza 1/3, 02-015 Warsaw, Poland; (I.W.); (K.K.)
| | - Katarzyna Kwiatkowska
- Students Scientific Association at the 1st Department of Obstetrics and Gynecology, First Faculty of Medicine, Medical University of Warsaw, Plac Starynkiewicza 1/3, 02-015 Warsaw, Poland; (I.W.); (K.K.)
| | - Katarzyna Kosińska Kaczyńska
- 2nd Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Marymoncka st. 99/103, 01-813 Warsaw, Poland
- 1st Department of Obstetrics and Gynecology, First Faculty of Medicine, Medical University of Warsaw, Plac Starynkiewicza 1/3, 02-015 Warsaw, Poland;
- Correspondence: ; Tel.: +48-22-56-90-274
| | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology, First Faculty of Medicine, Medical University of Warsaw, Plac Starynkiewicza 1/3, 02-015 Warsaw, Poland;
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Kaur S, Teoh AN, Shukri NHM, Shafie SR, Bustami NA, Takahashi M, Lim PJ, Shibata S. Circadian rhythm and its association with birth and infant outcomes: research protocol of a prospective cohort study. BMC Pregnancy Childbirth 2020; 20:96. [PMID: 32046676 PMCID: PMC7014629 DOI: 10.1186/s12884-020-2797-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 02/07/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Circadian rhythm plays an important role as our internal body's clock that synchronizes behavior and physiology according to the external 24-h light-dark cycle. Past studies have associated disrupted circadian rhythm with higher risk of miscarriages, preterm birth and low birth weights. This paper described the protocol of a prospective cohort study which aims to determine the circadian rhythm in pregnant women, identify its association with maternal factors during pregnancy, gestational weight gain, birth and infant outcomes. METHODS Ten government maternal and child health clinics in Kuala Lumpur, Malaysia will be randomly selected. Sample size of 438 first-trimester pregnant women will be followed-up until the birth of their infant. Salivary melatonin and cortisol concentration among subsample will be determined using enzyme-linked immunosorbent assay. Data on sleep quality, psychological distress and morningness/eveningness chronotype of pregnant women will be collected using validated questionnaires. Pedometer will be used to measure 5-day physical activity data. Total gestational weight gain will be determined at the end of pregnancy. Utilization of 3-day food record is to capture meal timing and nutrient intake. All measurements will be done in 2nd and 3rd trimester. Birth outcomes will be collected through clinic records and Centers for Disease Control and Prevention (CDC) Neonatal questionnaire. Infants will be followed-up at 6 and 12 months old to obtain anthropometric measurements. DISCUSSION There is a growing recognition of the role of maternal circadian rhythm, which entrains fetal circadian rhythms that may subsequently have long-term health consequences. The present study will identify the effect of circadian rhythm on pregnancy outcomes and infant growth in the first year of life.
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Affiliation(s)
- Satvinder Kaur
- Faculty of Applied Sciences, UCSI University, No. 1, Jalan Menara Gading, UCSI Heights 56000 Cheras, Kuala Lumpur, Malaysia
| | - Ai Ni Teoh
- Faculty of Applied Sciences, UCSI University, No. 1, Jalan Menara Gading, UCSI Heights 56000 Cheras, Kuala Lumpur, Malaysia
| | - Nurul Husna Mohd Shukri
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri kembangan, Malaysia
| | - Siti Raihanah Shafie
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Seri kembangan, Malaysia
| | - Normina Ahmad Bustami
- School of Healthy Aging, Medical Aesthetics and Regenerative Medicine, Faculty of Medicine and Health Sciences, UCSI University, Kuala Lumpur, Malaysia
| | | | - Pei Jean Lim
- Waseda Bioscience Research Institute, Waseda, Singapore
| | - Shigenobu Shibata
- Department of Electrical Engineering and Biosciences, School of Advanced Engineering and Sciences, Waseda University, Tokyo, Japan
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Denize KM, Akbari P, da Silva DF, Haman F, Adamo KB. Greater energy demand of exercise during pregnancy does not impact mechanical efficiency. Appl Physiol Nutr Metab 2019; 45:493-499. [PMID: 31614094 DOI: 10.1139/apnm-2019-0450] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Pregnant women are recommended to engage in 150 min of moderate-intensity physical activity per week to reduce pregnancy complications. Many women struggle to remain physically active throughout pregnancy, and there is no consensus about whether women adopt a less efficient movement pattern as they progress through pregnancy and experience gestational weight gain. This study assessed the change in energy expenditure and mechanical efficiency in pregnant women (PREG; n = 10) when performing a walking treadmill task in early, mid, and late pregnancy and also compared with an age- and body mass index-matched, nonpregnant (CON; n = 10) group. On average, the PREG group gained within the Institute of Medicine's gestational weight gain guidelines (11.6 ± 3.6 kg) and were all inactive (measured using accelerometry), except for 1 participant, by the third trimester, as per the 2019 Canadian physical activity guidelines for pregnant women. Energy expended to complete the walking task increased throughout pregnancy and was higher than the controls (111.5 ± 24.6 kcal) in mid and late pregnancy (139.0 ± 22.2 kcal, p = 0.02, and 147.3 ± 24.6 kcal, p = 0.005, respectively), but not early pregnancy (129.9 ± 18.9 kcal, p = 0.08). Walking mechanical efficiency was similar within pregnant women at each time point and compared to nonpregnant controls. Our findings add to the growing body of evidence demonstrating that pregnant women can safely perform physical activity by showing that walking mechanical efficiency is unchanged at low to moderate intensities. Novelty Energy demand during exercise increases proportionally to weight gain across pregnancy trimesters. However, mechanical efficiency remains unchanged during low- to moderate-intensity walking.
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Affiliation(s)
- Kathryn M Denize
- Department of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON K1N 6N5, Canada.,Department of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Pegah Akbari
- Department of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON K1N 6N5, Canada.,Department of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Danilo Fernandes da Silva
- Department of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON K1N 6N5, Canada.,Department of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Francois Haman
- Department of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON K1N 6N5, Canada.,Department of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Kristi B Adamo
- Department of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, ON K1N 6N5, Canada
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27
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Liang Z, Wang L, Liu H, Chen Y, Zhou T, Heianza Y, Leng J, Li W, Yang X, Shen Y, Gao R, Hu G, Qi L. Genetic susceptibility, lifestyle intervention and glycemic changes among women with prior gestational diabetes. Clin Nutr 2019; 39:2144-2150. [PMID: 31542245 DOI: 10.1016/j.clnu.2019.08.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 08/18/2019] [Accepted: 08/30/2019] [Indexed: 01/01/2023]
Abstract
AIMS Women with prior gestational diabetes mellitus (GDM) or high genetic susceptibility are prone to development of type 2 diabetes. We examined whether a lifestyle intervention modified the genetic effect on changes in glycemic markers among women with prior GDM. RESEARCH DESIGN AND METHODS This study included 560 women with prior GDM from a randomized controlled trial, the Tianjin Gestational Diabetes Mellitus Prevention Program, who were assigned into an intervention arm (improved physical activity and healthy dietary intakes) or a control arm. We assessed associations of GDM related genetic variants in/near the CDKAL1 (rs7754840) and MTNR1B (rs10830962) genes with changes in fasting levels of glucose and insulin, β-cell function (HOMA-B) and insulin resistance (HOMA-IR) at 1 year and 2 years after the baseline. RESULTS We found significant interactions between CDKAL1 variant rs7754840 and lifestyle intervention on changes in fasting insulin and HOMA-IR at 1 year (P for interactions = 0.008 and 0.006, respectively). The GDM-increasing C allele was associated with a 0.07-unit greater increase in fasting insulin (P = 0.048) and HOMA-IR (P = 0.045) in the control group, while opposite-directional associations were observed in the intervention group; women with the C allele seemed to decrease more in these glycemic markers than the non-C-carriers (both P ≤ 0.06). The interactions between the CDKAL1 genetic variant and lifestyle intervention on changes in fasting insulin (P = 0.035) and HOMA-IR (P = 0.024) remained significant over the 2-year period, even though the effects of lifestyle intervention were attenuated at 2-year. The MTNR1B variant rs10830962 did not show interaction with lifestyle intervention on changes in the glycemic markers. CONCLUSIONS Healthy lifestyle intervention may be beneficial for women with the GDM predisposing CDKAL1 genetic variant in improvement of insulin resistance. TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT01554358. URL OF REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT01554358.
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MESH Headings
- Adult
- Biomarkers/blood
- Blood Glucose/metabolism
- China
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/diagnosis
- Diabetes Mellitus, Type 2/genetics
- Diabetes Mellitus, Type 2/prevention & control
- Diabetes, Gestational/blood
- Diabetes, Gestational/diagnosis
- Diabetes, Gestational/genetics
- Diabetes, Gestational/therapy
- Diet, Healthy
- Exercise
- Female
- Gene-Environment Interaction
- Genetic Predisposition to Disease
- Healthy Lifestyle
- Humans
- Insulin/blood
- Insulin Resistance
- Insulin-Secreting Cells/metabolism
- Middle Aged
- Pregnancy
- Protective Factors
- Receptor, Melatonin, MT2/genetics
- Risk Assessment
- Risk Factors
- Risk Reduction Behavior
- Time Factors
- Treatment Outcome
- Young Adult
- tRNA Methyltransferases/genetics
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Affiliation(s)
- Zhaoxia Liang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Department of Obstetrical, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Leishen Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Huikun Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Yuhang Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Department of Public Health Laboratory Sciences, West China School of Public Health, Sichuan University, Chengdu, Sichuan Province, China
| | - Tao Zhou
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Junhong Leng
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Weiqin Li
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Xilin Yang
- Department of Epidemiology, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yun Shen
- Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai, China
| | - Ru Gao
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
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28
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Physical Activity and Health-Related Quality of Life in Pregnant Women. WOMEN’S HEALTH BULLETIN 2019. [DOI: 10.5812/whb.90477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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29
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Bahri Khomami M, Moran LJ, Kenny L, Grieger JA, Myers J, Poston L, McCowan L, Walker J, Dekker G, Norman R, Roberts CT. Lifestyle and pregnancy complications in polycystic ovary syndrome: The SCOPE cohort study. Clin Endocrinol (Oxf) 2019; 90:814-821. [PMID: 30801750 DOI: 10.1111/cen.13954] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 02/18/2019] [Accepted: 02/19/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To investigate the risk of pregnancy complications in women with and without polycystic ovary syndrome after consideration of lifestyle factors. DESIGN Prospective cohort. PATIENTS AND MEASUREMENTS Participants (n = 5628) were apparently healthy nulliparous women with singleton pregnancies from the Screening for Pregnancy Endpoints study in New Zealand, Australia, United Kingdom and Ireland. Multivariable regression models were performed assessing the association of self-reported polycystic ovary syndrome status with pregnancy complications with consideration of lifestyle factors at the 15th week of gestation. RESULTS Women with polycystic ovary syndrome (n = 354) were older, had a higher socio-economic index and body mass index and were less likely to consume alcohol and smoke but more likely to do vigorous exercise and take multivitamins. In univariable analysis, polycystic ovary syndrome was associated with increased risk of gestational diabetes (OR: 2.2, 95% CI: 1.2, 4.0). In multivariable models, polycystic ovary syndrome was only significantly associated with decreased risk of large for gestational age (OR: 0.62, 95% CI: 0.40, 0.98) with a population attributable risk of 0.22%. None of the other outcomes were attributable to polycystic ovary syndrome status. CONCLUSIONS Polycystic ovary syndrome is associated with a lower risk of large for gestational age infants. In this low-risk population, the risk of pregnancy complications was not increased in women with polycystic ovary syndrome who were following a healthy lifestyle. Further studies are warranted assessing the contribution of lifestyle factors to the risk of pregnancy complications in higher risk groups of women with and without polycystic ovary syndrome.
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Affiliation(s)
- Mahnaz Bahri Khomami
- Monash Center for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Lisa J Moran
- Monash Center for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
| | - Louise Kenny
- Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Jessica A Grieger
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, North Terrace, University of Adelaide, Adelaide, South Australia, Australia
| | - Jenny Myers
- The Maternal and Fetal Health Research Center, University of Manchester, Manchester, UK
| | - Lucilla Poston
- Department of Women and Children's Health, King's College, London, UK
| | - Lesley McCowan
- Department of Obstetrics and Gynecology, University of Auckland, Auckland, New Zealand
| | - James Walker
- Department of Obstetrics and Gynecology, University of Leeds, Leeds, UK
| | - Gustaaf Dekker
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, North Terrace, University of Adelaide, Adelaide, South Australia, Australia
- Women and Children's Division, Lyell McEwin Hospital, University of Adelaide, Adelaide, South Australia, Australia
| | - Robert Norman
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
- Fertility SA, Adelaide, South Australia, Australia
| | - Claire T Roberts
- Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, North Terrace, University of Adelaide, Adelaide, South Australia, Australia
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30
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Chan CWH, Au Yeung E, Law BMH. Effectiveness of Physical Activity Interventions on Pregnancy-Related Outcomes among Pregnant Women: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101840. [PMID: 31126153 PMCID: PMC6571580 DOI: 10.3390/ijerph16101840] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 05/08/2019] [Accepted: 05/21/2019] [Indexed: 12/16/2022]
Abstract
Regular physical activity has been demonstrated to contribute to physical and psychological health. Nevertheless, pregnant women generally exhibit low levels of physical activity. Implementation of interventions that enhance the self-efficacy of pregnant women on increasing physical activity is required. This paper provides an in-depth review of studies reporting the effect of various physical activity interventions dedicated for pregnant women on pregnancy-related issues, including gestational weight gain, pain and depression, physical activity level, and quality of life among these individuals. Five databases were used in searching the literature. Findings of the included studies were presented narratively, and appraisal of their methodological quality was conducted using the quality assessment tool developed by Effective Public Health Practice Project. Review findings demonstrated that physical activity interventions are effective in enhancing physical activity levels of pregnant women. Further, they are potentially useful in alleviating pregnancy-related pain and psychological symptoms, reducing gestational weight gain, and increasing self-efficacy in enhancing physical activity levels among these individuals. Nevertheless, inconsistencies in findings between studies hamper the drawing of firm conclusions on these latter outcomes. Overall, studies demonstrated a positive effect of physical activity interventions on the well-being and physical and psychological health of pregnant women.
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Affiliation(s)
- Carmen W H Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Elce Au Yeung
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Bernard M H Law
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
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31
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Tinius RA, López JD, Cade WT, Stein RI, Haire-Joshu D, Cahill AG. Patient and obstetric provider communication regarding weight gain management among socioeconomically disadvantaged African American women who are overweight/obese. Women Health 2019; 60:156-167. [PMID: 31096872 DOI: 10.1080/03630242.2019.1616044] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
To examine the communication between obstetric providers and their socioeconomically disadvantaged, African American patients who are overweight and obese during pregnancy, and whether this communication relates to outcomes. Pregnant patients and their obstetric providers were surveyed between October 2012 and March 2016 at Washington University School of Medicine in St. Louis, MO. Percent agreement between patients' and obstetric providers' survey responses was analyzed and measured (κ coefficient). Descriptive and multilevel logistic regression analyses aimed at identifying the relation of perceived communication between providers and patients to gestational weight gain, diet, and exercise during pregnancy. A total of 99 pregnant women and 18 obstetric providers participated in the study. Significant lack of agreement was observed between patients and obstetric providers regarding communication about weight gain recommendations, risk factors associated with excessive weight gain, what constitutes adequate exercise per week, exercise recommendations, dietary recommendations, and risk factors associated with a poor diet. Our findings suggest patients were not receiving intended messages from their obstetric providers. Thus, more effective patient-obstetric provider communication is needed regarding gestational weight gain, exercise and dietary recommendations among overweight/obese, socioeconomically disadvantaged, African American women.
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Affiliation(s)
- Rachel A Tinius
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, KY, USA.,Program in Physical Therapy, Washington University in St Louis, St. Louis, MO, USA
| | - Julia D López
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA
| | - W Todd Cade
- Program in Physical Therapy, Washington University in St Louis, St. Louis, MO, USA
| | - Richard I Stein
- Department of Internal Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Debra Haire-Joshu
- George Warren Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Alison G Cahill
- Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, USA
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32
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Guérin E, Ferraro ZM, Adamo KB, Prud'homme D. The Need to Objectively Measure Physical Activity During Pregnancy: Considerations for Clinical Research and Public Health Impact. Matern Child Health J 2019; 22:637-641. [PMID: 29411253 DOI: 10.1007/s10995-018-2475-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Engaging in recommended levels of physical activity during pregnancy can provide a host of physical and mental health benefits for the expecting mother and her child. However, methodological issues related to physical activity measurement have plagued many studies examining the effects of physical activity during this important life stage. Burgeoning support exists for the more widespread use of objective methods, and accelerometers specifically, for an accurate appraisal of maternal physical activity. In this commentary, we highlight discrepancies between activity estimates obtained via self-report and objective measures and describe the implications of erroneous measurement when making clinical recommendations and in conducting future physical activity and pregnancy research. Most importantly, we aim to foster academic discussion and propose a call to action requiring a paradigm shift where we acknowledge the shortcomings of self-report and move toward an empirically driven approach for physical activity measurement. Results from more high-quality research studies will help support public health messaging and facilitate trust among health care providers, clinical researchers, and expecting mothers regarding the health benefits of physical activity recommendations.
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Affiliation(s)
- Eva Guérin
- Institut du Savoir Montfort (ISM), 202-745A Montréal Rd., Ottawa, ON, K1K 0T1, Canada
| | - Zachary M Ferraro
- Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, K1H 8M5, Canada.,Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H8L1, Canada
| | - Kristi B Adamo
- Healthy Active Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON, K1H8L1, Canada.,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Denis Prud'homme
- Institut du Savoir Montfort (ISM), 202-745A Montréal Rd., Ottawa, ON, K1K 0T1, Canada. .,School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, K1N 6N5, Canada.
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33
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Sattler MC, Jaunig J, Watson ED, van Poppel MNM, Mokkink LB, Terwee CB, Dietz P. Physical Activity Questionnaires for Pregnancy: A Systematic Review of Measurement Properties. Sports Med 2019; 48:2317-2346. [PMID: 30094797 PMCID: PMC6132497 DOI: 10.1007/s40279-018-0961-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background In order to assess physical activity (PA) during pregnancy, it is important to choose the instrument with the best measurement properties. Objectives To systematically summarize, appraise, and compare the measurement properties of all self-administered questionnaires assessing PA in pregnancy. Methods We searched PubMed, Embase, and SPORTDiscus with the following inclusion criteria: (i) the study reported at least one measurement property (reliability, criterion validity, construct validity, responsiveness) of a self-administered questionnaire; (ii) the questionnaire intended to measure PA; (iii) the questionnaire was evaluated in healthy pregnant women; and (iv) the study was published in English. We evaluated results, quality of individual studies, and quality of evidence using a standardized checklist (Quality Assessment of Physical Activity Questionnaires [QAPAQ]) and the GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) approach. Results Seventeen articles, reporting 18 studies of 11 different PA questionnaires (17 versions), were included. Most questionnaire versions showed insufficient measurement properties. Only the French and Turkish versions of the Pregnancy Physical Activity Questionnaire (PPAQ) showed both sufficient reliability and construct validity. However, all versions of the PPAQ pooled together showed insufficient construct validity. The quality of individual studies was usually high for reliability but varied considerably for construct validity. Overall, the quality of evidence was very low to moderate. Conclusions We recommend the PPAQ to assess PA in pregnancy, although the pooled results revealed insufficient construct validity. The lack of appropriate standards in data collection and processing criteria for objective devices in measuring PA during pregnancy attenuates the quality of evidence. Therefore, research on the validity of comparison instruments in pregnancy followed by consensus on validation reference criteria and standards of PA measurement is needed. Electronic supplementary material The online version of this article (10.1007/s40279-018-0961-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Johannes Jaunig
- Institute of Sport Science, University of Graz, Graz, Austria
| | - Estelle D Watson
- Centre for Exercise Science and Sports Medicine, Faculty of Health Sciences, School of Therapeutic Sciences, University of Witwatersrand, Private Bag 3, Johannesburg, 2050, South Africa.,MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of Witwatersrand, Private Bag 3, Johannesburg, 2050, South Africa
| | - Mireille N M van Poppel
- Institute of Sport Science, University of Graz, Graz, Austria.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Lidwine B Mokkink
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Pavel Dietz
- Institute of Sport Science, University of Graz, Graz, Austria.,Institute of Occupational, Social and Environmental Medicine, University Medical Centre, University of Mainz, Mainz, Germany
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34
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Thomson JL, Goodman MH, Landry AS. Assessment of neighborhood street characteristics related to physical activity in the Lower Mississippi Delta. Health Promot Perspect 2019; 9:24-30. [PMID: 30788264 PMCID: PMC6377699 DOI: 10.15171/hpp.2019.03] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 11/18/2018] [Indexed: 12/17/2022] Open
Abstract
Background: Physical activity levels were low for pregnant and postpartum participants in a diet and physical activity intervention. To explore micro level characteristics of participants'neighborhoods related to physical activity, an ancillary study was conducted. Methods: This cross-sectional study encompassed the neighborhood street segments of women participating in a diet and physical activity intervention that was conducted in the Lower Mississippi Delta. A neighborhood was defined as all street segments within one-fourth walking mile of a participant's home address. Street segments were measured using the Rural Active Living Assessment's Street Segment Assessment tool. In the field and on foot, raters measured street segments using neighborhood maps with segments identified. Results: Mean street segment length was 0.22 miles (SD = 0.14). All segments had flat terrain with residential (98%), open spaces (74%), and public/civic (34%) as the most prevalent land uses. Almost three-fourths of segments did not have any sidewalks (69%), sidewalk buffers or defined shoulders (73%), crosswalks or pedestrian signage (69%), or posted speed limits (74%).However, 88% had stop signs and almost all (96%) had street lighting and were paved multi lane roads (95%) with low traffic volume (90%). Most residential structures present were single family detached homes (95%) and the most common public/civic and commercial structures were churches (24%) and convenience stores (9%), respectively. Almost all of the street segments were rated as walk able (99%) and aesthetically pleasing (94%). Conclusion: Neighborhood street segments surrounding Delta Healthy Sprouts participants'homes were walk able and aesthetically pleasing. However, safety features such as sidewalks,pedestrian signage, and posted speed limit signs were lacking. To address these inadequate pedestrian safety features, infrastructure changes are needed for small rural towns.
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Affiliation(s)
- Jessica L. Thomson
- US Department of Agriculture, Agricultural Research Service, Stoneville, MS, USA
| | - Melissa H. Goodman
- US Department of Agriculture, Agricultural Research Service, Stoneville, MS, USA
| | - Alicia S. Landry
- Department of Family and Consumer Sciences, University of Central Arkansas, Conway, AR, USA
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Krzepota J, Sadowska D, Biernat E. Relationships between Physical Activity and Quality of Life in Pregnant Women in the Second and Third Trimester. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122745. [PMID: 30563083 PMCID: PMC6313753 DOI: 10.3390/ijerph15122745] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/01/2018] [Accepted: 12/03/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND The problem of an inadequate level of physical activity (PA) is important in the context of its relationship with the quality of life (QoL) of pregnant women. The aim of this study was to analyze the relationships between PA and QoL among pregnant women. METHODS The study analyzed 346 questionnaires filled in by pregnant women (157 in the second trimester and 189 in the third). The tool used for assessment of PA was the Pregnancy Physical Activity Questionnaire-Polish version (PPAQ-PL). The quality of life (QoL) was assessed by the World Health Organization Quality of Life Questionnaire-short form (WHOQoL-Bref). The results obtained from the PPAQ-PL and WHOQoL-Bref questionnaires for women in the second and third trimesters of pregnancy and intergroup differences were analyzed. RESULTS There was a significant correlation in the group of women in the second trimester of pregnancy between quality of life in the physical health domain and the intensity and type of physical activity. The women who rated their quality of life higher in this domain declared higher energy expenditures (EE) associated with vigorous activity (R = 0.159, p ≤ 0.05), as well as with occupational activity (R = 0.166; p ≤ 0.05) and sport/exercise activity (R = 0.187; p ≤ 0.05). In women in the third trimester, higher EE related to sport/exercise activity coincided with higher assessments of the overall quality of life (R = 0.149, p ≤ 0.05) and general health (R = 0.170, p ≤ 0.05). In the case of the psychological domain (R = 0.161, p ≤ 0.05) and social relationship domain (R = 0.188; p ≤ 0.05) of QoL, positive correlations occurred with EE related to vigorous activity. In contrast, high assessment of physical health domain coincided with higher EE related to occupational activity (R = 0.174; p ≤ 0.05). CONCLUSIONS Our study makes an important contribution to knowledge concerning the correlations between PA and QoL in pregnancy. The results suggest the need for improvement in prenatal care and promotion of PA programs for pregnant women.
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Affiliation(s)
- Justyna Krzepota
- Department of Physical Culture and Health Promotion, University of Szczecin, al. Piastów 40b, blok 6, 71-065 Szczecin, Poland.
| | - Dorota Sadowska
- Department of Physiology, Institute of Sport-National Research Institute, ul. Trylogii 2/16, 01-982 Warsaw, Poland.
| | - Elżbieta Biernat
- Department of Tourism, Collegium of World Economy, Warsaw School of Economics, al. Niepodległości 162, 02-554 Warsaw, Poland.
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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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Oviedo-Caro MA, Bueno-Antequera J, Munguía-Izquierdo D. Explanatory factors and levels of health-related quality of life among healthy pregnant women at midpregnancy: A cross-sectional study of The PregnActive Project. J Adv Nurs 2018; 74:2766-2776. [PMID: 29989189 DOI: 10.1111/jan.13787] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Revised: 05/11/2018] [Accepted: 05/21/2018] [Indexed: 01/08/2023]
Abstract
AIMS To identify potential explanatory factors and establish health-related quality of life (HRQoL) levels of healthy pregnant women at midpregnancy. BACKGROUND The HRQoL levels perceived by pregnant women are lower than those perceived by women of similar age and decline during the course of pregnancy. DESIGN An exploratory cross-sectional design was used. METHODS One hundred thirty-four healthy women from antenatal clinics completed questionnaires were administered a cardiorespiratory fitness (CRF) test and wore a multisensor body monitor for 7 days at midpregnancy. Data were collected from September 2015-December 2016. RESULTS Cardiorespiratory fitness, musculoskeletal symptoms, and age were identified as explanatory factors of the physical component summary of HRQoL. Explanatory factors of the mental component summary included musculoskeletal and psychological symptoms and light activity. Significant differences in HRQoL levels were identified among groups of pregnant women stratified by age, occupational status, pregnancy symptoms, and CRF. CONCLUSIONS Modifiable factors of HRQoL, such as CRF and active lifestyle may be important areas to target in interventions aimed at promoting HRQoL in healthy women at midpregnancy. The identification of the groups of pregnant women with lower levels of HRQoL may help midwives and health professional to focus their advice and conduct interventions on these groups of pregnant women. These modifiable factors should be considered in future longitudinal studies to determine causal effects, will likely help improve multidisciplinary treatments.
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Affiliation(s)
- Miguel Angel Oviedo-Caro
- Department of Sports and Computer Science, Section of Physical Education and Sports, University Pablo de Olavide, Seville, Spain
| | - Javier Bueno-Antequera
- Department of Sports and Computer Science, Section of Physical Education and Sports, University Pablo de Olavide, Seville, Spain
| | - Diego Munguía-Izquierdo
- Department of Sports and Computer Science, Section of Physical Education and Sports, University Pablo de Olavide, Seville, Spain
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Porter H, West DS, Cleves MA, Saylors ME, Andres A, Krukowski RA. Association Between Household Food Environment and Excessive Gestational Weight Gain. J Womens Health (Larchmt) 2018; 27:1064-1070. [DOI: 10.1089/jwh.2017.6552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Delia S. West
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Mario A. Cleves
- Pediatrics Biostatistics, Arkansas Children's Nutrition Center, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
| | - Marie E. Saylors
- Pediatrics Biostatistics, Arkansas Children's Nutrition Center, University of Arkansas for Medical Sciences, College of Medicine, Little Rock, Arkansas
| | - Aline Andres
- Arkansas Children's Nutrition Center, Little Rock, Arkansas
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Rebecca A. Krukowski
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
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Othman SME, Steen MP, Jayasekara R, Fleet JA. A Healthy Eating Education Program for Midwives to Investigate and Explore Their Knowledge, Understanding, and Confidence to Support Pregnant Women to Eat Healthily: Protocol for a Mixed-Methods Study. JMIR Res Protoc 2018; 7:e143. [PMID: 29802092 PMCID: PMC5993976 DOI: 10.2196/resprot.9861] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 03/28/2018] [Accepted: 04/24/2018] [Indexed: 12/13/2022] Open
Abstract
Background Nutrition and healthy eating behaviors during pregnancy are vitally important for the health of a mother and her developing baby. However, some midwives have reported a lack of evidence-based nutrition knowledge for providing information about healthy eating to women during pregnancy. Objective In this study, the aim is to design and evaluate a healthy eating education program to enhance midwives’ knowledge, understanding, and confidence to support pregnant women in South Australia to make healthy eating choices. Methods This mixed-methods study consists of two phases. The first phase, Phase 1, consists of an education program for midwives, “Healthy Eating in Pregnancy,” to be delivered through a workshop or webinar. Each midwife will attend one workshop or webinar, which will be approximately two hours in length. This program will be evaluated through pre-, immediate-, and post-educational questionnaires utilizing a website specifically designed for this study. The participants will be midwives who are members of the Australian College of Midwives and the Australian Nursing and Midwives Federation, and users of social media (eg, Facebook and Twitter) residing and employed in South Australia. Phase 2 will consist of semistructured interviews with a purposive sample of midwives. These interviews will be undertaken to gain an in-depth understanding of midwives’ views and how confident they feel educating pregnant women after receiving the healthy eating education. Interviews will be face-to-face or conducted by telephone with midwives who have participated in the healthy eating educational program. Results A systematic review has previously been undertaken to inform this study protocol. This paper describes and discusses the protocol for this mixed-methods study, which will be completed in April 2019. Conclusions The results from the systematic review suggest that there is clear justification to undertake this mixed-methods study to investigate and explore midwives’ knowledge, understanding and confidence to support healthy eating in pregnant women. The results and conclusions from the systematic review provided some guidance for the design and development of this study protocol. This mixed-methods study will address a gap in the literature. The results from quantitative and qualitative data sources in this proposed study will help to draw conclusions to address the research topic. Registered Report Identifier RR1-10.2196/9861
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Affiliation(s)
- Shwikar Mahmoud Etman Othman
- Obstetrics and Gynaecology Nursing Department, Faculty of Nursing, South Valley University, Qena, Egypt.,School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, Adelaide, Australia
| | - Mary P Steen
- School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, Adelaide, Australia
| | - Rasika Jayasekara
- School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, Adelaide, Australia
| | - Julie-Anne Fleet
- School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, Adelaide, Australia
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Kuhrt K, Harmon M, Hezelgrave NL, Seed PT, Shennan AH. Is recreational running associated with earlier delivery and lower birth weight in women who continue to run during pregnancy? An international retrospective cohort study of running habits of 1293 female runners during pregnancy. BMJ Open Sport Exerc Med 2018; 4:e000296. [PMID: 29644086 PMCID: PMC5891750 DOI: 10.1136/bmjsem-2017-000296] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2018] [Indexed: 12/11/2022] Open
Abstract
Background Increasingly, women of reproductive age participate in recreational running, but its impact on pregnancy outcome is unknown. We investigated whether running affects gestational age at delivery and birth weight as indicators of cervical integrity and placental function, respectively. Methods 1293 female participants were recruited from parkrun, which organises weekly runs involving 1.25 million runners across 450 parks worldwide. Those under 16 or unable to provide outcome data were excluded. Women were categorised according to whether they continued to run during pregnancy or not. Those who continued were further stratified dependent on average weekly kilometres, and which trimester they ran until. Retrospectively collected primary outcomes were gestational age at delivery and birthweight centile. Other outcomes included assisted vaginal delivery rate and prematurity at clinically important gestations. Results There was no significant difference in gestational age at delivery: 279.0 vs 279.6 days (mean difference 0.6 days, CI −1.3 to 2.4 days; P=0.55) or birthweight centile: 46.9%vs 44.9% (mean difference 2.0%, CI −1.3% to −5.3%; P=0.22) in women who stopped running and those who continued, respectively. Assisted vaginal delivery rate was increased in women who ran: 195/714 (27%) vs 128/579 (22%) (OR 1.32; CI 1.02 to 1.71; P=0.03). Conclusion Continuing to run during pregnancy does not appear to affect gestational age or birthweight centile, regardless of mean weekly distance or stage of pregnancy. Assisted vaginal delivery rates were higher in women who ran, possibly due to increased pelvic floor muscle tone. Randomised prospective analysis is necessary to further explore these findings.
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Affiliation(s)
- Katy Kuhrt
- Division of Women's Health, King's College London, St Thomas' Hospital, London, UK
| | - Mark Harmon
- Division of Women's Health, King's College London, St Thomas' Hospital, London, UK
| | - Natasha L Hezelgrave
- Division of Women's Health, King's College London, St Thomas' Hospital, London, UK
| | - Paul T Seed
- Division of Women's Health, King's College London, St Thomas' Hospital, London, UK
| | - Andrew H Shennan
- Division of Women's Health, King's College London, St Thomas' Hospital, London, UK
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Sadeghi B, Sirati-Nir M, Hajimini Z, Ebadi A, Ali-Asgari M. Comparing the Effects of Progressive Muscle Relaxation and Physical Activity on Pregnant Women's General Health. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2018; 23:298-304. [PMID: 30034491 PMCID: PMC6034525 DOI: 10.4103/ijnmr.ijnmr_54_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Pregnancy is important because maternal health and well-being directly affects another person's life. This study aimed to compare the effects of progressive muscle relaxation (PMR) and physical activity (PA) on the general health of pregnant women. Materials and Methods: This randomized clinical trial was conducted among 96 primiparous women enrolled in a prenatal clinic in Tehran (Iran) between May 3, 2013 and August 7, 2013. The participants were selected through convenience sampling over 3 weeks and randomly assigned to the PMR, PA, and control groups, comprising 32 participants each. Six participants did not complete the follow-up measurement (N = 90). The PMR group underwent three sessions of 1.5–2 h in theoretical and practical training, and in the PMR group, training was given in groups of three to four persons. Both groups performed exercises at home for 8 weeks and recorded them in daily report sheets. The general health of all three groups was assessed before and after intervention by using the General Health Questionnaire-28. Results: Differences in the mean (SD) general health scores obtained before and after intervention in the PMR, PA, and control groups were 15.63 (5.73), 19.11 (7.79), and 8.27 (2.14), respectively. One-way analysis of variance test showed a significant difference between the three groups (F = 28.10; p < 0.001). Conclusions: As the study results confirm the positive effects of PMR and PA on the subscales of the general health of pregnant women, the two techniques are recommended to promote the general health of pregnant women.
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Affiliation(s)
- Bita Sadeghi
- Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Masoud Sirati-Nir
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Zahra Hajimini
- Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Matin Ali-Asgari
- Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
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da Silva SG, Hallal PC, Domingues MR, Bertoldi AD, Silveira MFD, Bassani D, da Silva ICM, da Silva BGC, Coll CDVN, Evenson K. A randomized controlled trial of exercise during pregnancy on maternal and neonatal outcomes: results from the PAMELA study. Int J Behav Nutr Phys Act 2017; 14:175. [PMID: 29273044 PMCID: PMC5741924 DOI: 10.1186/s12966-017-0632-6] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 12/07/2017] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Women are encouraged to be physically active during pregnancy. Despite available evidence supporting antenatal physical activity to bring health benefits for both the mother and child, the most effective way to prevent some maternal and fetal outcomes is still unclear. The purpose of this study was to evaluate the efficacy of an exercise intervention to prevent negative maternal and newborn health outcomes. METHODS A randomized controlled trial (RCT) nested into the 2015 Pelotas (Brazil) Birth Cohort Study was carried-out with 639 healthy pregnant women, 213 in the intervention group (IG) and 426 in the control (CG) group. An exercise-based intervention was conducted three times/week for 16 weeks from 16-20 to 32-36 weeks' gestation. The main outcomes were preterm birth and pre-eclampsia. Gestational age was calculated based on several parameters, including routine ultrassounds and/or last menstrual period and categorized as < 37 weeks and ≥ 37 weeks for evaluation of preterm birth. Pre-eclampsia was self-reported. Secondary outcomes were gestational weight gain, gestational diabetes, birth weight, infant length, and head circumference. Analyses were performed by intention-to-treat (ITT) and per protocol (70% of the 48 planned exercise sessions). Odds ratio were derived using unconditional logistic regression. RESULTS The IG and CG did not differ at baseline regarding their mean age (27.2 years ± 5.3 vs. 27.1 years ± 5.7) and mean pre-pregnancy body mass index (25.1 ± 3.9 vs. 25.2 ± 4.1 kg/m2). The mean adherence to the exercise intervention was 27 ± 17.2 sessions (out of a potential 48) with 40.4% attending > = 70% of the recommended exercise sessions. A total of 594 participants (IG:198; CG: 396) were included in the ITT and 479 (IG: 83; CG: 396) were included in the per protocol analyses. There were no significant differences in the incidence of preterm birth and pre-eclampsia between groups in the ITT and per protocol analysis. There were also no differences between the two groups in mean gestational weight gain, gestational diabetes, birth weight, infant length, and head circumference. CONCLUSIONS While the RCT did not support the benefits of exercise performed during pregnancy on preeclampsia and preterm birth, the exercise program also did not present adverse impacts on newborn health. Our findings may contribute to promote intervention strategies that motivate health providers to encourage pregnant women to be more physically active. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT02148965 , registered on 22 May 2014.
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Affiliation(s)
- Shana Ginar da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul Brazil
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina – Chapel Hill, Chapel Hill, NC USA
| | - Pedro Curi Hallal
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul Brazil
| | | | - Andréa Dâmaso Bertoldi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul Brazil
| | - Mariângela Freitas da Silveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul Brazil
| | - Diego Bassani
- Department of Paediatrics, Faculty of Medicine, Centre for Global Child Health, University of Toronto; King’s College Circle, The Hospital for Sick Children, Toronto, Canada
| | - Inácio Crochemore Mohnsam da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul Brazil
| | - Bruna Gonçalves Cordeiro da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul Brazil
| | - Carolina de Vargas Nunes Coll
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160-3° piso, CEP: 96020-220, Bairro Centro, Pelotas, Rio Grande do Sul Brazil
| | - Kelly Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina – Chapel Hill, Chapel Hill, NC USA
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Sattler MC, Jelsma JGM, Bogaerts A, Simmons D, Desoye G, Corcoy R, Adelantado JM, Kautzky-Willer A, Harreiter J, van Assche FA, Devlieger R, Jans G, Galjaard S, Hill D, Damm P, Mathiesen ER, Wender-Ozegowska E, Zawiejska A, Blumska K, Lapolla A, Dalfrà MG, Bertolotto A, Dunne F, Jensen DM, Andersen LLT, Snoek FJ, van Poppel MNM. Correlates of poor mental health in early pregnancy in obese European women. BMC Pregnancy Childbirth 2017; 17:404. [PMID: 29202779 PMCID: PMC5715612 DOI: 10.1186/s12884-017-1595-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 11/24/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Depression during pregnancy is associated with higher maternal morbidity and mortality, and subsequent possible adverse effects on the cognitive, emotional and behavioral development of the child. The aim of the study was to identify maternal characteristics associated with poor mental health, in a group of overweight/obese pregnant women in nine European countries, and thus, to contribute to better recognition and intervention for maternal depression. METHODS In this cross-sectional observational study, baseline data from early pregnancy (< 20 weeks) of the DALI (Vitamin D and Lifestyle Intervention for gestational diabetes mellitus prevention) study were analyzed. Maternal mental health was assessed with the World Health Organization Well-Being Index (WHO-5). Women were classified as having a low (WHO-5 ≤ 50) or high wellbeing. RESULTS A total of 735 pregnant women were included. The prevalence of having a low wellbeing was 27.2%, 95% CI [24.0, 30.4]. Multivariate analysis showed independent associations between low wellbeing and European ethnicity, OR = .44, 95% CI [.25, .77], shift work, OR = 1.81, 95% CI [1.11, 2.93], insufficient sleep, OR = 3.30, 95% CI [1.96, 5.55], self-efficacy, OR = .95, 95% CI [.92, .98], social support, OR = .94, 95% CI [.90, .99], and pregnancy-related worries (socioeconomic: OR = 1.08, 95% CI [1.02, 1.15]; health: OR = 1.06, 95% CI [1.01, 1.11]; relationship: OR = 1.17, 95% CI [1.05, 1.31]). CONCLUSIONS Mental health problems are common in European overweight/obese pregnant women. The identified correlates might help in early recognition and subsequent treatment of poor mental health problems during pregnancy. This is important to reduce the unfavorable effects of poor mental health on pregnancy outcomes. TRIAL REGISTRATION ISRCTN70595832 , 02.12.2011.
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Affiliation(s)
- Matteo C. Sattler
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria
| | - Judith G. M. Jelsma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, the Netherlands
| | - Annick Bogaerts
- Department of Development and Regeneration KULeuven, University of Leuven, Leuven, Belgium and Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Belgium and Faculty of Health and Social Work, research unit Healthy Living, UC Leuven-Limburg, Leuven, Belgium
| | - David Simmons
- Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, England and Macarthur Clinical School, Western Sydney University, Sydney, Australia
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medizinische Universität Graz, Graz, Austria
| | - Rosa Corcoy
- Institut de Recerca de L’Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Zaragaza, Spain
| | - Juan M. Adelantado
- Institut de Recerca de L’Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Alexandra Kautzky-Willer
- Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Jürgen Harreiter
- Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Frans A. van Assche
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals, Leuven, Belgium
| | - Roland Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals, Leuven, Belgium
| | - Goele Jans
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals, Leuven, Belgium
| | - Sander Galjaard
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals, Leuven, Belgium
- Department of Obstetrics and Gynaecology Division of Obstetrics and Prenatal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - David Hill
- Recherche en Santé Lawson SA, Bronschhofen, Switzerland
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth R. Mathiesen
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Agnieszka Zawiejska
- Division of Reproduction, Poznan University of Medical Sciences, Poznan, Poland
| | - Kinga Blumska
- Division of Reproduction, Poznan University of Medical Sciences, Poznan, Poland
| | | | | | | | | | | | | | - Frank J. Snoek
- Department of Medical Psychology, VU University Medical Centre, Amsterdam, the Netherlands
- Department of Medical Psychology, Academic Medical Centre, Amsterdam, the Netherlands
| | - Mireille N. M. van Poppel
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, the Netherlands
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Franklin A, Mishtal J, Johnson T, Simms-Cendan J. Rowers' Self-Reported Behaviors, Attitudes, and Safety Concerns Related to Exercise, Training, and Competition During Pregnancy. Cureus 2017; 9:e1534. [PMID: 28983443 PMCID: PMC5624563 DOI: 10.7759/cureus.1534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 07/13/2017] [Indexed: 11/05/2022] Open
Abstract
Background The American College of Obstetrics and Gynecology notes that pregnant athletes require more supervision due to their involvement in strenuous training schedules throughout pregnancy. Currently, rowing is not mentioned in the guidelines despite its increasing popularity, high cardiovascular demands, and risk for abdominal trauma. Methods This study aimed to elicit information from competitive female rowers regarding exercise, training, and competition during pregnancy. We administered a survey consisting of 122 items to female Masters rowers in the United States, aged 21 to 49 years, from June to December 2013. Results A total of 224 recreational and elite rowers met the inclusion criteria. Pregnant rowers self-reported high levels of exercise engagement: 85.2% (n/N = 98/115) exercised during any past pregnancy; exercise adherence decreased throughout pregnancy with 51.3%, 42.4%, and 15.7% meeting and/or exceeding national guidelines during the first, second, and third trimesters, respectively. Rowers were significantly (p < 0.001) more likely to state that an activity at a specified intensity and trimester was unsafe if they were younger, had less rowing experience, or were nulliparous. Decreased perceived rowing safety was associated with on-water training, higher intensity exercise, competition, and increasing gestational age. Primary safety concerns were the risk of oar-induced abdominal trauma and physiological effects due to high intensities required by the sport. Novel barriers to exercise in pregnancy included guilt towards the team and a mental barrier due to decreased performance. Healthcare providers are the number one information source for rowers regarding exercise during pregnancy. Conclusion Pregnant rowers are a relevant obstetrics population and have barriers and sport-specific safety concerns not previously identified in the literature. Rowers consider exercising in pregnancy to be important and struggle to meet exercise guidelines like the general population, indicating the need for healthcare providers to provide prenatal and antenatal education and interventions to support exercise during pregnancy even amongst athletes.
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Affiliation(s)
| | - Joanna Mishtal
- Department of Anthropology, University of Central Florida
| | - Teresa Johnson
- Office of Assessment and Evaluation, Johns Hopkins University School of Medicine
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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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Hayman M, Reaburn P, Browne M, Vandelanotte C, Alley S, Short CE. Feasibility, acceptability and efficacy of a web-based computer-tailored physical activity intervention for pregnant women - the Fit4Two randomised controlled trial. BMC Pregnancy Childbirth 2017; 17:96. [PMID: 28335767 PMCID: PMC5364580 DOI: 10.1186/s12884-017-1277-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 03/14/2017] [Indexed: 11/12/2022] Open
Abstract
Background Physical activity (PA) during pregnancy is associated with a variety of health benefits including a reduced risk of pregnancy related conditions such as pre-eclampsia and pregnancy-induced hypertension and leads to greater control over gestational weight gain. Despite these associated health benefits, very few pregnant women are sufficiently active. In an attempt to increase health outcomes, it is important to explore innovative ways to increase PA among pregnant women. Therefore, the aim of this study was to assess the feasibility, acceptability and efficacy of a four week web-based computer-tailored PA intervention among pregnant women. Methods Seventy-seven participants were randomised into either: (1) an intervention group that received tailored PA advice and access to a resource library of articles relating to PA during pregnancy; or (2) a standard information group that only received access to the resources library. Objective moderate-to-vigorous physical activity (MVPA) was assessed at baseline and immediately post-intervention. Recruitment, attrition, intervention adherence, and website engagement were assessed. Questions on usability and satisfaction were administered post-intervention. Results Feasibility was demonstrated through acceptable recruitment (8.5 participants recruited and randomised/month), and attrition (25%). Acceptability among intervention group participants was positive with high intervention adherence (96% of 4 modules completed). High website engagement (participants logged in 1.6 times/week although only required to log in once per week), usability (75/100), and satisfaction outcomes were reported in both groups. However, participants in the intervention group viewed significantly more pages on the website (p < 0.05), reported that the website felt more personally relevant (p < 0.05), and significantly increased their MVPA from baseline to post-intervention (mean difference = 35.87 min), compared to the control group (mean difference = 9.83 min) (p < 0.05), suggesting efficacy. Conclusions The delivery of a computer-tailored web-based intervention designed to increase PA in pregnant women is feasible, well accepted and associated with increases in short-term MVPA. Findings suggest the use of computer-tailored information leads to greater website engagement, satisfaction and greater PA levels among pregnant women compared to a generic information only website. Trial registration The trial was ‘retrospectively registered’ with the Australian New Zealand Clinical Trials Registry (ACTRN12614001105639) on 17th October, 2014.
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Affiliation(s)
- Melanie Hayman
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, 4702, Australia
| | - Peter Reaburn
- School of Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, 4702, Australia
| | - Matthew Browne
- School of Human, Health and Social Sciences, Central Queensland University, Bundaberg, QLD, 4670, Australia
| | - Corneel Vandelanotte
- School of Human, Health and Social Sciences, Central Queensland University, Rockhampton, QLD, 4702, Australia.
| | - Stephanie Alley
- School of Human, Health and Social Sciences, Central Queensland University, Rockhampton, QLD, 4702, Australia
| | - Camille E Short
- NHMRC ECR Fellow. Freemasons Foundation Centre for Men's Health. Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, 5000, Australia
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Sanda B, Vistad I, Haakstad LAH, Berntsen S, Sagedal LR, Lohne-Seiler H, Torstveit MK. Reliability and concurrent validity of the International Physical Activity Questionnaire short form among pregnant women. BMC Sports Sci Med Rehabil 2017; 9:7. [PMID: 28316789 PMCID: PMC5351171 DOI: 10.1186/s13102-017-0070-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Accepted: 02/17/2017] [Indexed: 11/23/2022]
Abstract
ABSTRACT Sanda B, Vistad I, Haakstad LAH, Berntsen S, Sagedal LR, Lohne-Seiler H, Torstveit MK. Reliability and concurrent validity of the International Physical Activity Questionnaire short form among pregnant women. BACKGROUND The International Physical Activity Questionnaire short-form (IPAQ-SF) is frequently used to assess physical activity (PA) level in the general adult population including pregnant women. However, the reliability and validity of the questionnaire in pregnancy is unknown. Therefore, the aims of the present study were to investigate test-retest reliability and concurrent validity of IPAQ-SF among pregnant women, and whether PA is reported differently among those who fulfill (active) vs. do not fulfill (inactive) recommendations of ≥150 min of weekly moderate intensity PA in pregnancy. METHOD Test-retest reliability was examined by answering IPAQ-SF twice, two weeks apart (n = 88). To assess validity, IPAQ-SF was compared to the physical activity monitor SenseWear Armband® (SWA) (n = 64). The participants wore SWA for 8 consecutive days before answering IPAQ-SF. PA level was reported as time spent in moderate-, vigorous- and moderate-to-vigorous intensity PA (MPA, VPA and MVPA) corresponding to the cut-off points 3-6, >6 and >3 Metabolic Equivalents (METs), respectively. RESULTS Test-retest intraclass-correlation of MPA, VPA and MVPA ranged from 0.81-0.84 (95% Confidence Intervals: 0.69,0.90). Comparing time spent performing PA at various intensities; the mean differences and limits of agreement (±1.96 Standard Deviation) from Bland-Altman plots were-84 ± 402 min/week for MPA,-85 ± 452 min/week for MVPA and 26 ± 78 min/week for VPA, illustrating that the total group under-reported MPA by 72% and MVPA by 52%, while VPA was over-reported by 1400%. For the inactive group corresponding numbers were 44 ± 327 min/week for MPA, 52 ± 355 min/week for MVPA and 16 ± 33 min/week for VPA, illustrating that the inactive group over-reported MPA by 13% and MVPA by 49%, while VPA was not detected by SWA, but participants reported 16 min of VPA/week. In contrast, corresponding numbers for the active group were-197 ± 326 min/week for MPA,-205 ± 396 min/week for MVPA and 35 ± 85 min/week for VPA, illustrating that the active group under-reported MPA by 81% and MVPA by 60%, while they over-reported VPA by 975%. CONCLUSION IPAQ-SF had good test-retest reliability, but low to fair concurrent validity for MPA, VPA and MVPA compared to an objective criterion measure among pregnant women. Further, women fulfilling PA guidelines in pregnancy under-reported, while inactive women over-reported PA level.
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Affiliation(s)
- Birgitte Sanda
- Faculty of Health and Sport Sciences, University of Agder, P.O. Box 422, 4604 Kristiansand, Norway
- Department of Obstetrics and Gynaecology, Southern Norway Hospital Trust, Kristiansand, Norway
| | - Ingvild Vistad
- Department of Obstetrics and Gynaecology, Southern Norway Hospital Trust, Kristiansand, Norway
| | | | - Sveinung Berntsen
- Faculty of Health and Sport Sciences, University of Agder, P.O. Box 422, 4604 Kristiansand, Norway
| | - Linda Reme Sagedal
- Department of Obstetrics and Gynaecology, Southern Norway Hospital Trust, Kristiansand, Norway
| | - Hilde Lohne-Seiler
- Faculty of Health and Sport Sciences, University of Agder, P.O. Box 422, 4604 Kristiansand, Norway
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Coll CDVN, Domingues MR, Hallal PC, da Silva ICM, Bassani DG, Matijasevich A, Barros A, Santos IS, Bertoldi AD. Changes in leisure-time physical activity among Brazilian pregnant women: comparison between two birth cohort studies (2004 - 2015). BMC Public Health 2017; 17:119. [PMID: 28122524 PMCID: PMC5267459 DOI: 10.1186/s12889-017-4036-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 01/13/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Low levels of leisure-time physical activity (LTPA) during pregnancy have been shown in studies conducted worldwide. Surveillance is extremely important to monitor the progress of physical activity patterns over time and set goals for effective interventions to decrease inactivity among pregnant women. The aim of this study was to evaluate time changes in LTPA among Brazilian pregnant women in an 11-year period (2004-2015) by comparing data from two birth cohort studies. METHODS Two population-based birth cohort studies were carried out in the city of Pelotas, southern Brazil, in 2004 and 2015. A total of 4244 and 4271 mothers were interviewed after delivery. Weekly frequency and duration of each session of LTPA in a typical week were reported for the pre-pregnancy period and for each trimester of pregnancy. Trends in both recommended LTPA (≥150 min/week) and any LTPA (regardless of weekly amount) were analysed overtime. Changes were also calculated separately for subgroups of maternal age, schooling, family income, parity, pre-pregnancy body mass index and pre-pregnancy LTPA. RESULTS The proportion of women engaged in recommended levels of LTPA pre-pregnancy increased from 11.2% (95%CI 10.0-12.2) in 2004 to 15.8% (95%CI 14.6-16.9) in 2015. During pregnancy, no changes were observed over the period for the first (10.6 to 10.9%) and second (8.7 to 7.9%) trimesters, whereas there was a decrease from 3.4% (95%CI 2.9-4.0) to 2.4% (95%CI 1.9-2.8) in the last trimester. Major decreases in LTPA in the last trimester were observed among women who were younger, with intermediate to high income, high schooling, primiparous, pre-pregnancy obese and, engaged in LTPA before pregnancy. Changes in any LTPA practice followed the same patterns described for recommended LTPA. CONCLUSIONS Despite the increase in the proportion of women engaged in LTPA before pregnancy between 2004 and 2005, LTPA levels remained stable during the first and second trimesters of pregnancy and declined during the third gestational trimester over the period. Interventions to encourage the maintenance of LTPA practice throughout pregnancy are urgently needed.
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Affiliation(s)
| | | | - Pedro Curi Hallal
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Inácio Crochemore Mohnsam da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Diego Garcia Bassani
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Alicia Matijasevich
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Aluísio Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Iná S. Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Devlin CA, Huberty J, Downs DS. Influences of prior miscarriage and weight status on perinatal psychological well-being, exercise motivation and behavior. Midwifery 2016; 43:29-36. [PMID: 27838526 PMCID: PMC5314732 DOI: 10.1016/j.midw.2016.10.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 09/28/2016] [Accepted: 10/26/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES women who have experienced miscarriage may be at increased risk for elevated depressive and anxiety symptoms in subsequent pregnancies. Exercise may be a useful strategy for coping with these symptoms. Little is known about how miscarriage influences prenatal exercise behavior. The study purpose was to examine the influences of miscarriage history and prepregnancy weight status on pregnant women's psychological health, exercise motivation, and behavior using the Theory of Planned Behavior. PARTICIPANTS/SETTING Pregnant women (N=203; 41 with prior miscarriage; 72 overweight/obese; BMI > 25.0) in the northeast United States. DESIGN Women prospectively reported their depressive/anxiety symptoms and exercise motivation/behavior in the 1st, 2nd, and 3rd trimesters via mailed surveys. Group differences in depressive/anxiety symptoms, exercise behavior, and its motivational determinants were examined using Chi Square analyses and Univariate and Multivariate Analyses of Covariance. MEASUREMENTS AND FINDINGS Women with a history of miscarriage had higher 1st and 2nd trimester depressive/anxiety symptoms and lower 1st trimester attitudes about exercise and 1st and 2nd trimester perceived behavior control than women without a history of miscarriage. Overweight/obese women had higher 1st and 2nd trimester pregnancy depressive/anxiety symptoms, engaged in less prepregnancy exercise, and had lower levels of exercise intention, attitude, and perceived behavior control throughout pregnancy than normal weight women. KEY CONCLUSIONS Women with a history of miscarriage and overweight/obese women have poorer psychological health and lower motivation to exercise during pregnancy than women without a history of miscarriage and normal weight women. IMPLICATIONS FOR PRACTITIONERS Interventions and healthcare provider communications aimed at promoting perinatal exercise behavior and psychological health should take into account pre-pregnancy weight status and pregnancy history to identify strategies to help women, particularly overweight/obese women with a history of miscarriage, to overcome exercise barriers.
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Affiliation(s)
- Courtenay A Devlin
- Exercise Psychology Laboratory, Department of Kinesiology, Penn State University, University Park, PA, USA.
| | - Jennifer Huberty
- Department of Exercise Science & Health, School of Nutrition Health and Promotion, Arizona State University, Phoenix, AZ, USA
| | - Danielle Symons Downs
- Exercise Psychology Laboratory, Department of Kinesiology, Penn State University, University Park, PA, USA; Department of OBGYN, Hershey Medical Center, Hershey, PA, USA
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Richardsen KR, Mdala I, Berntsen S, Ommundsen Y, Martinsen EW, Sletner L, Jenum AK. Objectively recorded physical activity in pregnancy and postpartum in a multi-ethnic cohort: association with access to recreational areas in the neighbourhood. Int J Behav Nutr Phys Act 2016; 13:78. [PMID: 27386943 PMCID: PMC4936091 DOI: 10.1186/s12966-016-0401-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 06/15/2016] [Indexed: 11/18/2022] Open
Abstract
Background Physical activity may reduce the risk of adverse pregnancy outcomes; however, compared to non-pregnant women, a lower proportion of pregnant women meet the physical activity guidelines. Our objectives were to explore overall changes and ethnic differences in objectively recorded moderate-to-vigorous intensity physical activity (MVPA) during pregnancy and postpartum and to investigate the associations with objective and perceived access to recreational areas. Methods We analysed 1,467 person-observations from 709 women in a multi-ethnic population-based cohort, with MVPA data recorded with the SenseWear™ Pro3 Armband in early pregnancy (mean gestational week (GW) 15), mid-pregnancy (mean GW 28) and postpartum (mean postpartum week 14). MVPA was limited to bouts ≥10 min. Women were nested within 56 neighbourhoods defined by postal code area. We derived neighbourhood-level objective access to recreational areas (good vs limited) by geographic information systems. We collected information about perceived access (high vs low perception) to recreational areas in early pregnancy. We treated ethnicity, objective and perceived access as explanatory variables in separate models based on linear mixed effects regression analyses. Results Overall, MVPA dropped between early and mid-pregnancy, followed by an increase postpartum. Western women performed more MVPA than women in other ethnic groups across time points, but the differences increased postpartum. Women residing in neighbourhoods with good objective access to recreational areas accumulated on average nine additional MVPA minutes/day (p < 0.01) compared with women in neighbourhoods with limited access. Women with perceptions of high access to recreational areas accumulated on average five additional MVPA minutes/day (p < 0.01) compared with women with perceptions of low access. After mutual adjustments, perceived and objective access to recreational areas remained significantly associated with MVPA. The association between MVPA and access to recreational areas did not differ by time point, ethnic group or socio-economic position. Conclusions In all ethnic groups, we observed a decline in MVPA between early and mid-pregnancy. However, at both time points during pregnancy, and especially three months postpartum, Western women were more physically active than ethnic minority women. In all ethnic groups, and at all three time points, both objective and perceived access to recreational areas were positively associated with MVPA levels. Electronic supplementary material The online version of this article (doi:10.1186/s12966-016-0401-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kåre Rønn Richardsen
- Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Oslo, Norway. .,Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, PB 4 St Olavs Plass, N-0130, Oslo, Norway. .,Faculty of Medicine, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
| | - Ibrahimu Mdala
- Faculty of Medicine, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Sveinung Berntsen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Yngvar Ommundsen
- Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
| | - Egil Wilhelm Martinsen
- Clinic Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Line Sletner
- Department of Pediatric and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Anne Karen Jenum
- Faculty of Medicine, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
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