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Zhang L, Piao J, Zhang W, Liu N, Zhang X, Shen Y, Jin Y, Wang F, Feng S. Physical activity changes and influencing factors among Chinese pregnant women: a longitudinal study. J Matern Fetal Neonatal Med 2024; 37:2306190. [PMID: 38262926 DOI: 10.1080/14767058.2024.2306190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024]
Abstract
OBJECTIVE Participating in physical activity during pregnancy has benefited a lot from maternal and child health. However, there are few longitudinal studies describing activity patterns and related factors during pregnancy. The aim of this study is to investigate longitudinal physical activity changes and the influencing factors of Chinese pregnant women. METHODS From January to August 2020, 240 pregnant women were recruited in Hangzhou, China. Physical activity during pregnancy was assessed in the first, second, and third trimesters of pregnancy by using the Pregnancy Physical Activity Questionnaire. RESULTS The daily energy consumption during first, second, and third trimesters was 20.55, 20.76, 17.19 METs-h/d. The results of repeated-measure analysis of variance and pairwise comparison showed that the total daily energy consumption of physical activity in the third trimester was significantly lower than that in the first and second trimesters, with statistical significance (p < 0.001). The generalized estimation equation showed that education level, pre-pregnancy BMI, gravidity, unnaturally conceived and pre-pregnancy exercise habits were the influencing factors of physical activity during pregnancy (p < 0.05). CONCLUSION Physical activity levels of pregnant women during different trimester were not optimistic. In order to improve physical activity during pregnancy and promote the health status of both mother and the developing baby, more attention should be paid on pregnant women with low education level, high BMI before pregnancy, primipara, unnaturally conceived and no good exercise habits before pregnancy.
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Affiliation(s)
- Le Zhang
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jinlan Piao
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wei Zhang
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ningning Liu
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xuesong Zhang
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yu Shen
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ying Jin
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Fangfang Wang
- Department of Obstetric, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Suwen Feng
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Sun H, Chen M, Liao J, He L, Wan B, Yin J, Zhang X. The maternal lifestyle in pregnancy: Implications for foetal skeletal muscle development. J Cachexia Sarcopenia Muscle 2024. [PMID: 39155495 DOI: 10.1002/jcsm.13556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/20/2024] [Accepted: 07/15/2024] [Indexed: 08/20/2024] Open
Abstract
The world is facing a global nutrition crisis, as evidenced by the rising incidence of metabolic disorders such as obesity, insulin resistance and chronic inflammation. Skeletal muscle is the largest tissue in humans and plays an important role in movement and host metabolism. Muscle fibre formation occurs mainly during the embryonic stage. Therefore, maternal lifestyle, especially nutrition and exercise during pregnancy, has a critical influence on foetal skeletal muscle development and the subsequent metabolic health of the offspring. In this review, the influence of maternal obesity, malnutrition and micronutrient intake on foetal skeletal muscle development is systematically summarized. We also aim to describe how maternal exercise shapes foetal muscle development and metabolic health in the offspring. The role of maternal gut microbiota and its metabolites on foetal muscle development is further discussed, although this field is still in its 'infancy'. This review will provide new insights to reduce the global crisis of metabolic disorders and highlight current gaps to promote further research.
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Affiliation(s)
- Haijun Sun
- State Key Laboratory of Animal Nutrition and Feeding, College of Animal Science and Technology, China Agricultural University, Beijing, China
| | - Meixia Chen
- Institute of Animal Husbandry and Veterinary Medicine, Beijing Academy of Agriculture and Forestry Sciences, Beijing, China
| | - Jialong Liao
- State Key Laboratory of Animal Nutrition and Feeding, College of Animal Science and Technology, China Agricultural University, Beijing, China
| | - Linjuan He
- State Key Laboratory of Animal Nutrition and Feeding, College of Animal Science and Technology, China Agricultural University, Beijing, China
| | - Boyang Wan
- State Key Laboratory of Animal Nutrition and Feeding, College of Animal Science and Technology, China Agricultural University, Beijing, China
| | - Jingdong Yin
- State Key Laboratory of Animal Nutrition and Feeding, College of Animal Science and Technology, China Agricultural University, Beijing, China
- Frontiers Science Center for Molecular Design Breeding (MOE), Beijing, China
| | - Xin Zhang
- State Key Laboratory of Animal Nutrition and Feeding, College of Animal Science and Technology, China Agricultural University, Beijing, China
- Frontiers Science Center for Molecular Design Breeding (MOE), Beijing, China
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Selman R, Early KS. A Pre and Postnatal Physical Therapy Protocol for Recreational Athletes: A Case Series. Int J Sports Phys Ther 2024; 19:1012-1019. [PMID: 39100934 PMCID: PMC11297362 DOI: 10.26603/001c.121421] [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: 01/09/2024] [Accepted: 06/21/2024] [Indexed: 08/06/2024] Open
Abstract
Background and Purpose Recent changes to medical recommendations for exercise in pregnancy and postpartum have expanded to include recreational athletes. While women are transitioning into motherhood at the height of their athletic careers, there is limited guidance on musculoskeletal training from pregnancy through safe return to activity. The lack of education and support in this population may lead to increased prevalence of symptoms and delay of treatment, ultimately hindering athletic performance. The purpose of this case series is to assess pelvic floor symptoms through implementing a new pre- and postnatal exercise training paradigm in a group of women aiming to return to recreational athletics. Study Design Case series. Methods Six recreationally athletic women between 25-35 years of age were referred to physical therapy during pregnancy to participate in this protocol. The women completed a standardized pregnancy and postpartum rehabilitation plan focused on core and pelvic floor control in addition to specific strength and mobility training. Results Pain, urinary dysfunction, and pelvic floor muscle strength were assessed at six weeks postpartum and at discharge. Meaningful improvement was noted in pain, urinary dysfunction, and muscle strength by the time of discharge. Conclusion The decrease in symptoms and improvements in measures of musculoskeletal health suggests that a physical therapist guided rehabilitation protocol may be useful as part of the standard of care to reduce prevalence of pain and dysfunction, particularly in the recreational athlete population. Improving understanding of exercise training in this population may minimize musculoskeletal symptoms and encourage additional research to improve the standard of care for this group of patients. Level of Evidence Level 4.
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Affiliation(s)
| | - Kate S. Early
- Kinesiology and Health SciencesColumbus State University
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Lesser I, Wurz A, Bean C, Hatfield G. Exploring the Feasibility, Acceptability, and Potential Benefits of the Mom Movement Intervention (MOMmi). Nurs Womens Health 2024; 28:264-276. [PMID: 38782044 DOI: 10.1016/j.nwh.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/18/2024] [Accepted: 04/09/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE To explore the feasibility, acceptability, and potential benefits associated with a mind-body intervention and varied delivery styles among women during the postpartum period. DESIGN Mixed-methods feasibility study. SETTING Fraser Valley, British Columbia, Canada. PARTICIPANTS Forty-three women (93% White), with an average age of 32.1 (SD = 2.9) years, who had given birth within the last 6 months. METHODS Participants were randomized to three physical activity groups. Validated questionnaires were administered before and after the 12-week intervention. Attendance and feasibility metrics and qualitative semistructured interviews were conducted to assess the intervention. RESULTS The intervention and trial were partially feasible, and retention to the intervention was high; however, adherence as assessed by attendance was lower than expected. There was high acceptability among those in the group-based, in-person intervention. There was moderate acceptability among those in the individual, home-based asynchronous program. CONCLUSION Findings highlight the necessity of better understanding what is desired by this population or simply providing more options to participants so that we can tailor physical activity to their needs and provide the necessary support.
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Wan CS, Teede H, Nankervis A, Aroni R. Ethnic differences in physical activity participation when managing gestational diabetes mellitus: a mixed-methods study comparing ethnic Chinese migrants and Australian women. ETHNICITY & HEALTH 2024; 29:665-684. [PMID: 38805266 DOI: 10.1080/13557858.2024.2359379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/20/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Physical activity is a key component in gestational diabetes mellitus management to optimise glycaemic control and reduce adverse pregnancy outcomes. However, inadequate physical activity during pregnancy is common. Underpinned by a woman-centred pregnancy care model, appropriate strategies targeting patients' cultural needs may facilitate physical activity participation. Ethnic Chinese migrants have a four-fold higher risk of gestational diabetes mellitus than the Australian Caucasian host population. To identify potentially effective disease management strategies to improve physical activity participation, understanding and comparing ethnic Chinese migrants' and Caucasian women's views will provide insights into developing an end-user-informed intervention. AIMS This study aimed to compare perceptions and practices around physical activity participation during pregnancy between 44 ethnic Chinese migrants and 39 Australian-born Caucasian women with gestational diabetes mellitus. METHODS This mixed-methods study used in-depth, semi-structured audio-recorded interviews, validated pregnancy physical activity questionnaires and pedometers. Qualitative data were thematically analysed and compared between ethnicities. SPSS (SPSS Inc) was used in quantitative data analysis. Data triangulation was made to identify patterns in participant characteristics, physical activity beliefs and participation. RESULTS Despite both ethnic groups doing less physical activity than recommended, Chinese participants were less physically active than Caucasian participants. Chinese participants expressed greater safety concerns about physical activity and opted for a more sedentary lifestyle. Data triangulation indicated that non-Australian-born Chinese participants whose husbands were Asian were overcautious about miscarriage risk related to physical activity, which promoted a sedentary lifestyle. Chinese participants suggested individualised, specific physical activity advice on safe physical activity during pregnancy would mitigate their concerns. Caucasian participants reported that digital step measurement technologies motivated their participation in physical activity. CONCLUSION Different strategies are suggested by Chinese and Caucasian participants to improve physical activity participation to manage gestational diabetes mellitus among ethnic Chinese and Caucasian populations, which will be evaluated in future interventions.
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Affiliation(s)
- Ching Shan Wan
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Endocrinology and Diabetes, Monash Health, Clayton, Australia
| | - Alison Nankervis
- Departments of Diabetes and Endocrinology, The Royal Melbourne and Royal Women's Hospitals, Parkville, Australia
- Department of Medicine, The University of Melbourne, Parkville, Australia
| | - Rosalie Aroni
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- ANU Medical School, College of Health and Medicine, Australian National University, Canberra, Australia
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Stephansson O, Sandström A. Can short- and long-term maternal and infant risks linked to hypertension and diabetes during pregnancy be reduced by therapy? J Intern Med 2024. [PMID: 39045893 DOI: 10.1111/joim.13823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Hypertensive disorders of pregnancy (HDP), especially preeclampsia, and diabetes during pregnancy pose significant risks for both maternal and infant health, extending to long-term outcomes such as early-onset cardiovascular disease and metabolic disorders. Current strategies for managing HDP focus on screening, prevention, surveillance, and timely intervention. No disease-modifying therapies exist so far for established preeclampsia; delivery remains the definitive resolution. Preventive measures-including early pregnancy screening, exercise, and low-dose aspirin-show promise. Antihypertensive treatments reduce severe hypertension risks, whereas magnesium sulfate remains the standard for preventing eclampsia. Planned delivery from gestational week 37 can balance maternal benefits and neonatal risks in women with established preeclampsia. Delivery between 34 and 37 weeks gestation in women with preeclampsia has to balance risks for mother and infant. Lifestyle interventions-particularly diet and physical activity-are pivotal in managing gestational diabetes mellitus and type 2 diabetes. The oral antidiabetic metformin has shown benefits in glycaemic control and reducing maternal weight gain, although its long-term effects on offspring remain uncertain. The safety of other peroral antidiabetics in pregnancy is less studied. Advancements in glucose monitoring and insulin administration present encouraging prospects for enhancing outcomes in women with diabetes types 1 and 2. Both HDP and diabetes during pregnancy necessitate vigilant management through a combination of lifestyle modifications, pharmacological interventions, and timely obstetric care. Although certain treatments such as low-dose aspirin and metformin show efficacy in risk reduction, further research is ongoing to ensure safety for both mothers and their offspring to reduce short- and long-term adverse effects.
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Affiliation(s)
- Olof Stephansson
- Department of Medicine, Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
- Department of Women's Health, Division of Obstetrics, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Sandström
- Department of Medicine, Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden
- Department of Women's Health, Division of Obstetrics, Karolinska University Hospital, Stockholm, Sweden
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Lin J, Horswell R, Chu S, Dumas SA, Hu G. Trends in the Incidence of Gestational Diabetes Mellitus Among the Medicaid Population Before and During the COVID-19 Pandemic. J Womens Health (Larchmt) 2024. [PMID: 39029471 DOI: 10.1089/jwh.2023.0746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2024] Open
Abstract
Importance: Although there are many regional and national studies on the trends in the incidence of gestational diabetes mellitus (GDM), the trends in the incidence of GDM among the Medicaid population are lacking, especially before and during coronavirus disease of 2019 (COVID-19). Objective: To investigate the trends in the incidence of GDM before and during COVID-19 pandemic (2016-2021) among the Louisiana Medicaid population. Design, Setting, and Participants: This study included 111,936, Louisiana Medicaid pregnant women of age 18-50 between January 1, 2016, to December 31, 2021. Main Outcomes and Measures: Pregnancies, GDM, and pre-pregnancy diabetes cases were identified by using the Tenth Revisions of the International Classification of Disease code. The annual incidence of GDM and annual prevalence of pre-pregnancy diabetes were calculated for each age and race subgroup. Results: The age-standardized incidence of GDM increased from 10.2% in 2016 to 14.8 in 2020 and decreased to 14.0% in 2021. The age-standardized prevalence of pre-pregnancy diabetes increased from 2.8% in 2016 to 3.4% in 2018 and decreased to 2.3% in 2021. The age-standardized rate of GDM was the highest among Asian women (23.0%), then White women (15.5%), and African American women (13.9%) (p for difference <0.001). The COVID-19 pandemic saw an increase in the incidence of GDM, with a rise in prominent GDM risk factors, such as obesity and sedentary behaviors, suggesting an association. Conclusion and Relevance: The incidence of GDM significantly increased during the COVID-19 pandemic. Potential reasons might include increased sedentary behavior and increased prevalence of obesity. GDM is a major public health issue, and the prevention of GDM is particularly essential for the Louisiana Medicaid population owing to the high prevalence of GDM-related risk factors in this population.
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Affiliation(s)
- Jessica Lin
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Ronald Horswell
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - San Chu
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - S Amanda Dumas
- Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Gang Hu
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
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Claiborne A, Wisseman B, Kern K, Steen D, Jevtovic F, Mcdonald S, Strom C, Newton E, Isler C, Devente J, Mouro S, Collier D, Kuehn D, Kelley GA, May LE. Exercise during pregnancy Dose: Influence on preterm birth outcomes. Eur J Obstet Gynecol Reprod Biol 2024; 300:190-195. [PMID: 39025039 DOI: 10.1016/j.ejogrb.2024.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/03/2024] [Accepted: 07/08/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Preterm delivery typically increases health risk for neonates and is associated with longer infant hospital stay and financial burden. Prenatal exercise dose (frequency, intensity, type, time, volume) have been shown to influence birth outcomes. Increased prenatal exercise dose could therefore provide a critical reduction in health risk and financial burden in preterm neonates. OBJECTIVE It was our aim to explore the effects of prenatal exercise dose from a supervised exercise intervention in pregnant women on the occurrence of preterm (<37 weeks gestation) births, and the impact on health outcomes in preterm neonates. STUDY DESIGN This study is a retrospective, secondary analysis of pooled data from three blinded, prospective, randomized controlled trials. Prenatal exercise dose were assessed in supervised aerobic, resistance, and combination sessions throughout pregnancy. In addition to gestational age, birth weight, resting heart rate, neonatal morphometrics (body circumferences, ponderal index), and health status (Apgar-1 and -5) metrics were obtained for 21 women at birth. One-way analysis of variance tests were used to assess the differences between dose grouped as tertiles, while Pearson correlations determined the association between dose and birth outcomes. RESULTS Women exercised for an average of 19.6 wks (range: 6 - 21 wks) during pregnancy. Exercise during pregnancy tended to result in later preterm deliveries (p = 0.08). Greater prenatal exercise volume and duration were associated with reduced infant hospital stay post-delivery (p = 0.02). Weekly exercise volume was associated with increased Apgar scores (p = 0.01). CONCLUSION Increased prenatal exercise volume and duration is associated with improved birth outcomes in preterm neonates.
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Affiliation(s)
- Alex Claiborne
- Department of Kinesiology, East Carolina University (ECU), Greenville, NC, USA; Human Performance Laboratory, ECU, Greenville, NC, USA; East Carolina Diabetes & Obesity Institute, ECU, Greenville, NC, USA
| | - Breanna Wisseman
- Department of Kinesiology, East Carolina University (ECU), Greenville, NC, USA; Human Performance Laboratory, ECU, Greenville, NC, USA; East Carolina Diabetes & Obesity Institute, ECU, Greenville, NC, USA
| | - Kara Kern
- Department of Kinesiology, East Carolina University (ECU), Greenville, NC, USA; Human Performance Laboratory, ECU, Greenville, NC, USA; East Carolina Diabetes & Obesity Institute, ECU, Greenville, NC, USA
| | - Dylan Steen
- Department of Kinesiology, East Carolina University (ECU), Greenville, NC, USA; Human Performance Laboratory, ECU, Greenville, NC, USA; East Carolina Diabetes & Obesity Institute, ECU, Greenville, NC, USA
| | - Filip Jevtovic
- Department of Kinesiology, East Carolina University (ECU), Greenville, NC, USA; Human Performance Laboratory, ECU, Greenville, NC, USA; East Carolina Diabetes & Obesity Institute, ECU, Greenville, NC, USA
| | - Samantha Mcdonald
- School of Kinesiology and Recreation, Illinois State University, Normal, IL, USA
| | - Cody Strom
- Department of Kinesiology and Sport, University of Southern Indiana, Evansville, IN, USA
| | - Edward Newton
- Department of Obstetrics & Gynecology, East Carolina University, USA
| | - Christy Isler
- Department of Obstetrics & Gynecology, East Carolina University, USA
| | - James Devente
- Department of Obstetrics & Gynecology, East Carolina University, USA
| | - Steven Mouro
- Department of Obstetrics & Gynecology, East Carolina University, USA
| | - David Collier
- Department of Pediatrics, East Carolina University, USA
| | - Devon Kuehn
- Department of Pediatrics, East Carolina University, USA
| | - George A Kelley
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, WV, USA; School of Public and Population Health, Boise State University, Boise, ID, USA
| | - Linda E May
- Department of Kinesiology, East Carolina University (ECU), Greenville, NC, USA; Human Performance Laboratory, ECU, Greenville, NC, USA; East Carolina Diabetes & Obesity Institute, ECU, Greenville, NC, USA; Department of Obstetrics & Gynecology, East Carolina University, USA.
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Bulguroglu M, Bulguroglu HI. The effects of online pilates on the mood and fear of birth of pregnant women: a randomized controlled study. Sci Rep 2024; 14:16143. [PMID: 38997441 PMCID: PMC11245483 DOI: 10.1038/s41598-024-67290-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 07/09/2024] [Indexed: 07/14/2024] Open
Abstract
The Pilates exercise method is applied online to various population groups. This study aimed to determine the effect of online Pilates exercises on depression, anxiety, and fear of childbirth in pregnant women. Our randomized controlled study divided participants into the online pilates group (OPG) and the control group (CG). Pilates exercises were applied to the OPG according to the American College of Obstetricians and Gynecologists guidelines, while the CG was given a home program. Assessments were made before and after the training. All measurements improved after Online Pilates (p < 0.05), while there was no change in the control group (p > 0.05). While initial measurement values were similar in both groups (p > 0.05), a statistical difference was observed in favor of OPG with a moderate effect percentage in all results after training (p < 0.05). These results revealed that eight weeks of online Pilates training could effectively reduce depression, anxiety, and fear of childbirth.Trial registration:Clinical trial registry: NCT05305716.
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Affiliation(s)
- Merve Bulguroglu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara Medipol University, Ankara, Turkey
| | - Halil I Bulguroglu
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ankara Medipol University, Ankara, Turkey.
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Bønnelycke J, Larsen M, Jespersen AP. Pregnancy As Window of Opportunity? A Danish RCT on Physical Activity During Pregnancy. Med Anthropol 2024; 43:441-454. [PMID: 39046335 DOI: 10.1080/01459740.2024.2376007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
Pregnancy is seen as a window of opportunity for health interventions, with the potential to produce long-term health changes for mother and child. The RCT FitMum investigates the effects of different regimes of physical activity during pregnancy. We suggest that rather than hitting a window of opportunity, the trial works in choreography with different timescapes through the processes of management of time. These timescapes are characterized by linear progression and futurity, alongside composite, complex time. We reconceptualize the intervention as a navigation of flows and passages in collective efforts, providing a situated and sustainable approach to interventions.
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Affiliation(s)
- Julie Bønnelycke
- Department of Applied Business Research University College Lillebælt & University of Copenhagen, Odense, Denmark
| | - Maria Larsen
- Zealand University Hospital & University of Copenhagen, Koge, Denmark
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Wagoner K, Dempsey A, Dunn F, Hemphill A. Normal Pregnancy Care and Physiology and Select Pregnancy Complications: A Flipped Classroom Case for the OB/GYN Clerkship. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2024; 20:11413. [PMID: 38957532 PMCID: PMC11219084 DOI: 10.15766/mep_2374-8265.11413] [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: 09/06/2023] [Accepted: 03/04/2024] [Indexed: 07/04/2024]
Abstract
Introduction This module teaches core knowledge and skills for undergraduate medical education in reproductive health, providing instruction in the management of normal and abnormal pregnancy and labor utilizing interactive small-group flipped classroom methods and case-based instruction. Methods Advance preparation materials were provided before the education session. The 2-hour session was facilitated by clinical educators using a faculty guide. Using voluntary surveys, we collected data to measure satisfaction among obstetrics and gynecology clerkship students and facilitators following each education session. Results Capturing six clerkships spanning 9 months, 116 students participated, and 64 students completed the satisfaction survey, with 97% agreeing that the session was helpful in applying knowledge and principles to common clinical scenarios. Most students (96%) self-reported that they achieved the session's learning objectives utilizing prework and interactive small-group teaching. Nine clinical instructors completed the survey; all agreed the provided materials allowed them to facilitate active learning, and the majority (89%) agreed they spent less time preparing to teach this curriculum compared to traditional didactics. Discussion This interactive flipped classroom session meets clerkship learning objectives related to the management of pregnancy and labor using standardized materials. The curriculum reduced preparation time for clinical educators as well.
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Affiliation(s)
- Krista Wagoner
- Assistant Professor, Department of Obstetrics and Gynecology, Medical University of South Carolina College of Medicine
| | - Angela Dempsey
- Professor, Department of Obstetrics and Gynecology, Medical University of South Carolina College of Medicine
| | - Faith Dunn
- Second-Year Resident, Department of Obstetrics and Gynecology, Medical University of South Carolina College of Medicine
| | - Ashleigh Hemphill
- Obstetrician Gynecologist, Department of Obstetrics and Gynecology, Naval Hospital Okinawa, Uniformed Services University of the Health Sciences
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Téoule J, Woll C, Ray J, Sütterlin M, Filsinger B. The effectiveness of integrated online health-coaching on physical activity and excessive gestational weight gain: a prospective randomized-controlled trial. Arch Gynecol Obstet 2024; 310:307-314. [PMID: 38217763 PMCID: PMC11168974 DOI: 10.1007/s00404-023-07296-y] [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: 07/19/2023] [Accepted: 11/08/2023] [Indexed: 01/15/2024]
Abstract
PURPOSE Low levels of physical activity during pregnancy go along with increased risks for numerous health complications. We investigated whether an integrated lifestyle intervention leads to higher levels of physical activity and reduces the rate of excessive gestational weight gain (EGWG). METHODS We conducted a randomized-controlled trial on 97 pregnant women, randomly assigned to receive an additional telehealth lifestyle intervention (experimental group, EG; n = 49) or conventional antenatal care (control group, CG; n = 48). The core lifestyle intervention comprised regular video calls, providing integrated personal support and motivation to physical activity. The primary outcome was change in physical activity measured in steps per day. An additional exploratory outcome was the proportion of participants with EGWG. RESULTS The mean step count during the third trimester was 6483 steps/day (EG) and 5957 steps/day (CG), respectively (p = 0.078). Repeated-measures ANOVA revealed a significant interaction effect (p = 0.045) reflecting an overall increase of 497 steps per day in the EG vs. a decrease of 300 steps per day in the CG. The proportion of participants who met the IOM recommendation for total weight gain during pregnancy was significantly higher in the EG (p = 0.048) and the ratio of women that gained excessively was higher in the CG (p = 0.026). CONCLUSIONS We assume that the personalized online intervention supports women in increasing or at least maintaining their level of physical activity during the course of pregnancy. Additionally, it reduces the rate of excessive weight gain.
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Affiliation(s)
- Julia Téoule
- Department of Gynecology and Obstetrics, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.
| | - Christian Woll
- Department of Psychology, Clinical Psychology of Childhood and Adolescence and Counselling Psychology, Ludwig-Maximilians-University, Munich, Germany
- Institute of Clinical Psychology and Psychotherapy, Clinical Psychology of Children and Adolescents, Technical University Dresden, Dresden, Germany
| | - Jana Ray
- Department of Gynecology and Obstetrics, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- Institute of Clinical Psychology and Psychotherapy, Clinical Psychology of Children and Adolescents, Technical University Dresden, Dresden, Germany
- Department of Psychology, School of Social Sciences, University of Mannheim, Mannheim, Germany
| | - Marc Sütterlin
- Department of Gynecology and Obstetrics, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Barbara Filsinger
- Department of Gynecology and Obstetrics, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
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Evenson KR, Brown WJ, Brinson AK, Budzynski-Seymour E, Hayman M. A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:472-483. [PMID: 38158180 PMCID: PMC11184298 DOI: 10.1016/j.jshs.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The period following pregnancy is a critical time window when future habits with respect to physical activity (PA) and sedentary behavior (SB) are established; therefore, it warrants guidance. The purpose of this scoping review was to summarize public health-oriented country-specific postpartum PA and SB guidelines worldwide. METHODS To identify guidelines published since 2010, we performed a (a) systematic search of 4 databases (CINAHL, Global Health, PubMed, and SPORTDiscus), (b) structured repeatable web-based search separately for 194 countries, and (c) separate web-based search. Only the most recent guideline was included for each country. RESULTS We identified 22 countries with public health-oriented postpartum guidelines for PA and 11 countries with SB guidelines. The continents with guidelines included Europe (n = 12), Asia (n = 5), Oceania (n = 2), Africa (n = 1), North America (n = 1), and South America (n = 1). The most common benefits recorded for PA included weight control/management (n = 10), reducing the risk of postpartum depression or depressive symptoms (n = 9), and improving mood/well-being (n = 8). Postpartum guidelines specified exercises to engage in, including pelvic floor exercises (n = 17); muscle strengthening, weight training, or resistance exercises (n = 13); aerobics/general aerobic activity (n = 13); walking (n = 11); cycling (n = 9); and swimming (n = 9). Eleven guidelines remarked on the interaction between PA and breastfeeding; several guidelines stated that PA did not impact breast milk quantity (n = 7), breast milk quality (n = 6), or infant growth (n = 3). For SB, suggestions included limiting long-term sitting and interrupting sitting with PA. CONCLUSION Country-specific postpartum guidelines for PA and SB can help promote healthy behaviors using a culturally appropriate context while providing specific guidance to public health practitioners.
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Affiliation(s)
- Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8050, USA.
| | - Wendy J Brown
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Alison K Brinson
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3115, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8120, USA
| | | | - Melanie Hayman
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
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Thomopoulos C, Hitij JB, De Backer T, Gkaliagkousi E, Kreutz R, Lopez-Sublet M, Marketou M, Mihailidou AS, Olszanecka A, Pechère-Bertschi A, Pérez MP, Persu A, Piani F, Socrates T, Stolarz-Skrzypek K, Cífková R. Management of hypertensive disorders in pregnancy: a Position Statement of the European Society of Hypertension Working Group 'Hypertension in Women'. J Hypertens 2024; 42:1109-1132. [PMID: 38690949 DOI: 10.1097/hjh.0000000000003739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
Hypertensive disorders in pregnancy (HDP), remain the leading cause of adverse maternal, fetal, and neonatal outcomes. Epidemiological factors, comorbidities, assisted reproduction techniques, placental disorders, and genetic predisposition determine the burden of the disease. The pathophysiological substrate and the clinical presentation of HDP are multifarious. The latter and the lack of well designed clinical trials in the field explain the absence of consensus on disease management among relevant international societies. Thus, the usual clinical management of HDP is largely empirical. The current position statement of the Working Group 'Hypertension in Women' of the European Society of Hypertension (ESH) aims to employ the current evidence for the management of HDP, discuss the recommendations made in the 2023 ESH guidelines for the management of hypertension, and shed light on controversial issues in the field to stimulate future research.
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Affiliation(s)
- Costas Thomopoulos
- Department of Cardiology, General Hospital of Athens 'Laiko', Athens, Greece
| | - Jana Brguljan Hitij
- Department of Hypertension, University Medical Centre Ljubljana, Medical University Ljubljana, Slovenia
| | - Tine De Backer
- Cardiovascular Center & Clinical Pharmacology, University Hospital Gent, Belgium
| | - Eugenia Gkaliagkousi
- 3rd Department of Internal Medicine, Papageorgiou Hospital Faculty of Medicine, Aristotle University of Thessaloniki, Greece
| | - Reinhold Kreutz
- Charite-Universitätsmedizin Berlin, Institute of Clinical Pharmacology and Toxicology, Berlin, Germany
| | - Marilucy Lopez-Sublet
- AP-HP, Hopital Avicenne, Centre d'Excellence Europeen en Hypertension Arterielle, Service de Medecine Interne, INSERM UMR 942 MASCOT, Paris 13-Universite Paris Nord, Bobigny, FCRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists)
| | - Maria Marketou
- School of Medicine, University of Crete, Heraklion, Greece
| | - Anastasia S Mihailidou
- Department of Cardiology and Kolling Institute, Royal North Shore Hospital, St Leonards
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Agnieszka Olszanecka
- 1st Department of Cardiology, Interventional Electrocardiology, and Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | | | - Mariana Paula Pérez
- Department of Hypertension. Hospital de Agudos J. M. Ramos Mejía, Buenos Aires, Argentina
| | - Alexandre Persu
- Division of Cardiology, Cliniques Universitaires Saint-Luc and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Federica Piani
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Thenral Socrates
- Medical Outpatient and Hypertension Clinic, ESH Hypertension Centre of Excellence University Hospital Basel, Basel, Switzerland
| | - Katarzyna Stolarz-Skrzypek
- 1st Department of Cardiology, Interventional Electrocardiology, and Hypertension, Jagiellonian University Medical College, Krakow, Poland
| | - Renata Cífková
- Center for Cardiovascular Prevention, Charles University in Prague, First Faculty of Medicine and Thomayer University Hospital
- Department of Medicine II, Charles University in Prague, First Faculty of Medicine, Prague, Czech Republic
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Moholdt T, Sujan MAJ, Ashby ER, Beetham K. Interval training and cardiometabolic health in reproductive-aged females. Appl Physiol Nutr Metab 2024; 49:993-1001. [PMID: 38478956 DOI: 10.1139/apnm-2023-0498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2024]
Abstract
Physical activity and exercise training are especially important for reproductive-aged females as exercise-induced health benefits can also affect their infants. However, levels of physical inactivity remain high among females in this age group, before, during, and after pregnancy. There is a great need for practical and feasible exercise modes to increase adherence to exercise in this population, and interval training may be a time-efficient training modality. Interval training is a form of exercise involving intermittent bouts of intense effort interspersed with recovery periods of rest or lower-intensity exercise. A substantial amount of research indicates that interval training induces superior cardiometabolic health benefits compared with iso-energetic moderate-intensity continuous exercise. This review provides a comprehensive overview of research on interval training interventions in reproductive-aged females across various life stages, focusing on the cardiometabolic health benefits. We discuss the potential role of interval training in premenopausal females with overweight/obesity, polycystic ovary syndrome, and subfertility, as well as the potential influence of oral contraceptives on cardiometabolic adaptations to interval training. Furthermore, this review also highlights recent findings supporting the beneficial role of high-intensity interval training for cardiometabolic health outcomes during pregnancy. In summary, the existing evidence suggests that interval training can improve several cardiometabolic and reproductive outcomes in females spanning different life stages. However, more research is needed to further strengthen the evidence-base for physical activity recommendations for females in their reproductive years of life.
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Affiliation(s)
- T Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Women's Health, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - M A J Sujan
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Women's Health, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - E R Ashby
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - K Beetham
- School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
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Lv C, Lu Q, Zhang C, Yan S, Chen H, Pan XF, Fu C, Wang R, Song X. Relationship between first trimester physical activity and premature rupture of membranes: a birth cohort study in Chinese women. BMC Public Health 2024; 24:1736. [PMID: 38944666 PMCID: PMC11214697 DOI: 10.1186/s12889-024-18791-5] [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: 02/21/2023] [Accepted: 05/08/2024] [Indexed: 07/01/2024] Open
Abstract
OBJECTIVE This study aimed to examine prospective associations of different intensity levels and types of physical activity (PA) in early pregnancy with premature rupture of membranes (PROM) among Chinese pregnant women. METHODS A total of 6284 pregnant women were included from the Tongji-Shuangliu Birth Cohort. Household/caregiving, occupational, sports/exercise and transportation activities during early pregnancy were investigated by the pregnancy physical activity questionnaire (PPAQ), and the diagnosis of PROM was ascertained during the whole pregnancy. Multivariate logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence interval (CI) for the associations between PA and PROM. RESULTS Among the 6284 pregnant women, 1246 were identified to have PROM (19.8%). Women undertaking the highest level (3 third tertile) of PA during pregnancy appeared to have a lower risk of PROM [OR = 0.68, 95%CI 0.58-0.80) when compared to those at the lowest tertile of PA. Similarly, women with increased levels of light intensity activity, moderate-vigorous intensive, household/caregiving activity and meeting exercise guidelines during pregnancy were associated with reduced risks of PROM (OR = 0.69, 95% CI 0.59-0.81, OR = 0.70, 95% CI 0.60-0.82, OR = 0.62, 95% CI 0.53-0.73 and OR = 0.82, 95% CI 0.70-0.97, respectively). CONCLUSIONS High levels of PA of different intensities and PA of household/caregiving activities and meeting exercise guidelines during the first trimester were associated with a lower incidence of PROM. TRIAL REGISTRATION The data of human participants in this study were conducted in accordance with the Helsinki Declaration. This study has been approved by the Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China ([2017] No. S225). All participants provided written informed consent prior to enrollment. A statement to confirm that all methods were carried out in accordance with relevant guidelines and regulations.
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Affiliation(s)
- Chuanzhu Lv
- Emergency Medicine Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China
- Research Unit of Island Emergency Medicine, Hainan Medical University, Chinese Academy of Medical Sciences, (No. 2019RU013), Haikou, 570100, Hainan, China
| | - Qian Lu
- School of Public Health, Hainan Medical University, Haikou, 570100, Hainan, China
| | - Caihong Zhang
- International school of Nursing, Hainan Medical University, Haikou, 570100, China
| | - Shijiao Yan
- School of Public Health, Hainan Medical University, Haikou, 570100, Hainan, China
| | - Huanjun Chen
- School of Public Health, Hainan Medical University, Haikou, 570100, Hainan, China
| | - Xiong-Fei Pan
- Section of Epidemiology and Population Health, Department of Gynecology and Obstetrics, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & National Medical Products Administration Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
- Shuangliu Institute of Women's and Children's Health, Shuangliu Maternal and Child Health Hospital, Chengdu, 610200, Sichuan, China
- Center for Epidemiology and Population Health, Integrated Traditional Chinese and Western Medicine Institute & Chengdu Integrated Traditional Chinese and Western Medicine Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, 610041, Sichuan, China
| | - Chao Fu
- Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570100, Hainan, China.
| | - Rixing Wang
- Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570100, Hainan, China.
| | - Xingyue Song
- Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, 570100, Hainan, China.
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Daglas V, Kostopoulos N, Mrvoljak-Theodoropoulou I, Mitrotasios M, Dagla M, Lykeridou A, Antoniou E. Healthcare Professionals' Attitudes and Practices According to Their Recommendations on Exercise during the First Trimester of Pregnancy: A Greek Cross-Sectional Study. Sports (Basel) 2024; 12:173. [PMID: 39058064 PMCID: PMC11281032 DOI: 10.3390/sports12070173] [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: 04/29/2024] [Revised: 06/16/2024] [Accepted: 06/18/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND The aim of this study is to investigate healthcare professionals' attitudes and practices when it comes to their recommendations on exercise during the first trimester of pregnancy and to highlight the factors that influence or predict these attitudes. METHODS This cross-sectional study was conducted between January 2022 and March 2023, on a sample of 237 Greek healthcare professionals (midwives and obstetricians) employed in healthcare settings in Attica/Greece. In the statistical analysis, eight independent models of multivariate analyses of variance were conducted. RESULTS Only half of the participants (54.89%) report that they recommend exercise to pregnant women in the first trimester of pregnancy. The majority do not routinely recommend a specific frequency and duration of exercise. Participants who believe that exercise during pregnancy is of little benefit to pregnant women were less likely to recommend the following, in the first trimester of pregnancy: (a) exercise in general (p = 0.002), (b) resistance/muscle strengthening exercises (p = 0.039), (c) relaxation exercises (p = 0.002), and (d) a specific exercise duration (p = 0.011). Those who report being very familiar with the international guidelines are (a) more likely to recommend exercise in general (p = 0.013), as well as aerobic exercises (p = 0.023); (b) less likely to not recommend a specific frequency (p = 0.027); and (c) more likely to recommend a duration of 30-45 min of exercise in the first trimester (p = 0.017). CONCLUSIONS I this study, a significant proportion of health professionals' attitudes appear to diverge from the recommendations set forth by international scientific bodies regarding exercise during pregnancy. Furthermore, health professionals' beliefs regarding the benefits of exercise during pregnancy, along with their familiarity with international guidelines, appear to influence their usual practices in recommending exercise during the first trimester of pregnancy to pregnant women.
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Affiliation(s)
- Vasileios Daglas
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (M.D.); (A.L.); (E.A.)
| | - Nikolaos Kostopoulos
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece; (N.K.); (M.M.)
| | | | - Michalis Mitrotasios
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece; (N.K.); (M.M.)
| | - Maria Dagla
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (M.D.); (A.L.); (E.A.)
| | - Aikaterini Lykeridou
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (M.D.); (A.L.); (E.A.)
| | - Evangelia Antoniou
- Department of Midwifery, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (M.D.); (A.L.); (E.A.)
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18
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Duchette C, Perera M, Arnett S, White E, Belcher E, Tinius R. Benefits of Resistance Training During Pregnancy for Maternal and Fetal Health: A Brief Overview. Int J Womens Health 2024; 16:1137-1147. [PMID: 38912201 PMCID: PMC11193983 DOI: 10.2147/ijwh.s462591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/11/2024] [Indexed: 06/25/2024] Open
Abstract
Research demonstrates resistance training is not only safe but also beneficial for pregnant women. However, exercise recommendations for pregnant women still minimize the importance of resistance exercise and provide minimal guidance. With a large increase in strength-focused sports among women, it is critical to re-evaluate the risk/benefit ratio of these exercises and ensure the latest recommendations reflect the latest clinical research. The purpose of this review is to highlight the safety and benefits of resistance training for both maternal and fetal health, particularly focusing on recent work. Relevant research involving resistance training during pregnancy was accessed and analyzed via a quasi-systematic search. Results demonstrate that appropriate prenatal resistance training can help alleviate some of the common symptoms of pregnancy, such as fatigue, back pain, and poor mental health. Resistance exercise can assist with glucose control in gestational diabetes mellitus, as well as decrease the risk of infant macrosomia and childhood metabolic dysfunction associated with uncontrolled gestational diabetes. Resistance training can also increase the likelihood of a vaginal delivery, which is beneficial for both mother and baby. Concerning fetal health, resistance training increases uterine blood flow, decreases the risk of neonatal macrosomia, and improves cognitive function and metabolic health in childhood. As with all forms of exercise, pregnant women should avoid resistance exercises that involve the supine position for extended bouts of time, trauma (or risk of trauma) to the abdomen, ballistic movements, movements that rely heavily on balance, and conditions that prohibit appropriate temperature control. With these considerations in mind, resistance training's benefits far surpass the lack of risk to the fetus. Resistance training is a safe and effective way to improve and maintain physical fitness during pregnancy and represents no risk to fetal health and development. Thus, healthcare providers should recommend resistance training for pregnant women.
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Affiliation(s)
| | - Madhawa Perera
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Scott Arnett
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Erin White
- Health, Exercise, and Rehabilitative Sciences, Winona State University, Winona, Minnesota, USA
| | - Elizabeth Belcher
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Rachel Tinius
- School of Kinesiology, Recreation, and Sport, Western Kentucky University, Bowling Green, Kentucky, USA
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Zhang W, Zhang L, Xu P, Guo P, Mao M, Zhao R, Feng S. Physical activity levels and influencing factors among pregnant women in China: A systematic review and meta-analysis. Int J Nurs Stud 2024; 158:104841. [PMID: 38917748 DOI: 10.1016/j.ijnurstu.2024.104841] [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: 08/09/2023] [Revised: 05/21/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Physical activity during pregnancy has been recommended as an effective measure to prevent various pregnancy complications. However, global physical activity participation during pregnancy is not optimal, and the factors influencing physical activity participation during pregnancy need to be further investigated. In China, where there are no localized guidelines for physical activity during pregnancy, the prevalence of meeting recommended physical activity levels among Chinese pregnant women is still unclear. OBJECTIVES This study aimed to comprehensively review the prevalence of meeting recommended physical activity levels among pregnant women in China and to further explore the factors influencing physical activity participation during pregnancy. DESIGN This was a systematic review and meta-analysis. METHODS A systematic review was conducted in both English and Chinese databases from inception until August 1, 2023. Two reviewers independently screened literature, assessed study eligibility and extracted data. The Agency for Healthcare Research and Quality was used to evaluate methodological quality of included studies. The pooled prevalence was calculated using a random-effects model. Subgroup analyses were conducted to explore sources of heterogeneity. RESULTS A total of 12 cross-sectional studies, including 11,323 Chinese pregnant women with a mean age ranging from 27.0 to 33.0 years, met the inclusion criteria. The prevalence of meeting recommended physical activity levels among pregnant women in China was 21.0 % (95 % confidence interval (CI):12.5 %-29.5 %). A higher prevalence of meeting recommended physical activity levels was observed among pregnant women who were in their second trimester, who were living in the southern region, who were assessed by validated questionnaires, and who used 150 min physical activity per week as a criterion for meeting recommendation. CONCLUSIONS The findings suggested a low prevalence of meeting recommended physical activity levels among Chinese pregnant women, which was affected by a variety of factors. It is recommended that further research be conducted in the future to explore physical activity intervention strategies for women of childbearing age before and during pregnancy based on the factors affecting physical activity to improve physical activity compliance, maternal and child health and population quality. REGISTRATION NUMBER CRD42022372722 (PROSPERO).
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Affiliation(s)
- Wei Zhang
- Women's Hospital School of Medicine Zhejiang University, No.1 Xue Shi Road, Hangzhou 310006, Zhejiang Province, China; Zhejiang University School of Medicine, No.866 Yu Hang Tang Road, Hangzhou 310058, Zhejiang Province, China.
| | - Le Zhang
- Women's Hospital School of Medicine Zhejiang University, No.1 Xue Shi Road, Hangzhou 310006, Zhejiang Province, China.
| | - Ping Xu
- Women's Hospital School of Medicine Zhejiang University, No.1 Xue Shi Road, Hangzhou 310006, Zhejiang Province, China; Zhejiang University School of Medicine, No.866 Yu Hang Tang Road, Hangzhou 310058, Zhejiang Province, China.
| | - Pingping Guo
- Women's Hospital School of Medicine Zhejiang University, No.1 Xue Shi Road, Hangzhou 310006, Zhejiang Province, China; Zhejiang University School of Medicine, No.866 Yu Hang Tang Road, Hangzhou 310058, Zhejiang Province, China.
| | - Minna Mao
- Women's Hospital School of Medicine Zhejiang University, No.1 Xue Shi Road, Hangzhou 310006, Zhejiang Province, China; Zhejiang University School of Medicine, No.866 Yu Hang Tang Road, Hangzhou 310058, Zhejiang Province, China.
| | - Rujia Zhao
- Women's Hospital School of Medicine Zhejiang University, No.1 Xue Shi Road, Hangzhou 310006, Zhejiang Province, China; Zhejiang University School of Medicine, No.866 Yu Hang Tang Road, Hangzhou 310058, Zhejiang Province, China.
| | - Suwen Feng
- Women's Hospital School of Medicine Zhejiang University, No.1 Xue Shi Road, Hangzhou 310006, Zhejiang Province, China.
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Manca A, Meloni M, Ventura L, Consoli G, Fenu S, Mura G, Deriu F, Cugusi L. Dose-Response Effects on LBP, Sleep, and Depression of Online Pre-Partum and Post-Partum Pilates-Based Programs. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024:1-10. [PMID: 38837186 DOI: 10.1080/02701367.2024.2340047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 03/31/2024] [Indexed: 06/06/2024]
Abstract
Purpose: Pilates-based programs can help pregnant women deal with the physical and psychological burden derived by major changes in their body. This study was designed to primarily test, in pregnant women, the dose-response and health effects of both pre-partum and post-partum, online Pilates-based program on weight control, low back pain (LBP) severity, sleep disturbances, mood and depression levels. Methods: A total of 136 pregnant women were screened for eligibility (low-risk pregnancy; aged 18-45 years; single pregnancy; 20-28-week gestational age, normal BMI). Participants completed an online Pilates-based program during pregnancy and after delivery, through an online platform guided by a Pilates, Yoga and Lagree certified instructor. Main outcomes (weight control, LBP disability, sleep quality, mood, and mental health) were assessed at baseline and at the completion of pre- and post-partum programs. Results: Regarding pre-partum, significant gains in weight were observed only in low- and intermediate-amount exercisers. Only high-amount exercisers did not display significant increase in LBP-related disability (+42.7%; p = .21) unlike low (+12.2%; p < .0001) and intermediate exercisers (+9.6%; p < .0001). Sleep disturbances increased significantly in low- (+24.3%; p = .005) but not in intermediate- (+4.6%; p = .50) and high-amount exercisers (-0.1%; p = .91). Regardless of the amount of exercise, depression scores improved in all groups. Following post-partum intervention (n = 40), only intermediate-amount exercisers showed significant reductions in sleep disturbances (-24.1%; p = .003) and depression (15.9%; p = .04). Conclusions: Approximately 270 min/week of an online Pilates-based program were needed to prevent LBP worsening, and sleep deterioration in pregnant women. A different pattern was outlined for those women resuming the Pilates-based intervention at post-partum, with 150 min/week emerging as the "dose" of exercise capable of inducing the largest improvements in LBP, sleep, and mood disturbances.
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Affiliation(s)
| | | | | | | | | | | | - F Deriu
- University of Sassari
- AOU Sassari, Unit of Endocrinology, Nutritional and Metabolic Disorders
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Dennis CL, Singla DR, Brown HK, Savel K, Clark CT, Grigoriadis S, Vigod SN. Postpartum Depression: A Clinical Review of Impact and Current Treatment Solutions. Drugs 2024; 84:645-659. [PMID: 38811474 DOI: 10.1007/s40265-024-02038-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2024] [Indexed: 05/31/2024]
Abstract
Depression during the first year postpartum (postpartum depression) impacts millions of women and their families worldwide. In this narrative review, we provide a summary of postpartum depression, examining the etiology and consequences, pharmacological and psychological treatments, and potential mechanisms of change and current barriers to care. Psychological treatments are effective and preferred by many perinatal patients over medications, but they often remain inaccessible. Key potential mechanisms underlying their effectiveness include treatment variables (e.g., dosage and therapeutic alliance) and patient behaviors (e.g., activation and avoidance and emotional regulation). Among pharmacological treatments, the selective serotonin reuptake inhibitor (SSRI) sertraline is generally the first-line antidepressant medication recommended to women in the postpartum period due to its minimal passage into breastmilk and the corresponding decades of safety data. Importantly, most antidepressant drugs are considered compatible with breastfeeding. Neurosteroids are emerging as an effective treatment for postpartum depression, although currently this treatment is not widely available. Barriers to widespread access to treatment include those that are systematic (e.g., lack of specialist providers), provider-driven (e.g., lack of flexibility in treatment delivery), and patient-driven (e.g., stigma and lack of time for treatment engagement). We propose virtual care, task-sharing to non-specialist treatment providers, and collaborative care models as potential solutions to enhance the reach and scalability of effective treatments to address the growing burden of postpartum depression worldwide and its negative impact on families and society.
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Affiliation(s)
- Cindy-Lee Dennis
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada.
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Rm 280, Toronto, ON, M6J 1H4, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
| | - Daisy R Singla
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
| | - Hilary K Brown
- Department of Health and Society, University of Toronto, Toronto, Canada
- Women's College Hospital, Toronto, Canada
- Women's College Research Institute, Toronto, Canada
| | - Katarina Savel
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
| | - Crystal T Clark
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Women's College Hospital, Toronto, Canada
- Women's College Research Institute, Toronto, Canada
| | - Sophie Grigoriadis
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Simone N Vigod
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Women's College Hospital, Toronto, Canada
- Women's College Research Institute, Toronto, Canada
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22
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Ngene NC, Moodley J. Preventing maternal morbidity and mortality from preeclampsia and eclampsia particularly in low- and middle-income countries. Best Pract Res Clin Obstet Gynaecol 2024; 94:102473. [PMID: 38513504 DOI: 10.1016/j.bpobgyn.2024.102473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/15/2023] [Accepted: 02/05/2024] [Indexed: 03/23/2024]
Abstract
Preeclampsia (PE) is a complex heterogeneous disorder with overlapping clinical phenotypes that complicate diagnosis and management. Although several pathophysiological mechanisms have been proposed, placental dysfunction due to inadequate remodelling of uterine spiral arteries leading to mal-perfusion and syncytiotrophoblast stress is recognized as the unifying characteristic of early-onset PE. Placental overgrowth and or premature senescence are probably the causes of late-onset PE. The frequency of PE has increased over the last few decades due to population-wide increases in risk factors viz. obesity, diabetes, multifetal pregnancies and pregnancies at an advanced maternal age. Whilst multimodal tools with components comprising risk factors, biomarkers and sonography are used for predicting PE, aspirin is most effective in preventing early-onset PE. The incidence and clinical consequences of PE and eclampsia are influenced by socioeconomic and cultural factors, therefore management strategies should involve multi-sector partnerships to mitigate the adverse outcomes.
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Affiliation(s)
- Nnabuike Chibuoke Ngene
- Department of Obstetrics and Gynaecology, Rahima Moosa Mother and Child Hospital, Johannesburg, Gauteng, South Africa; Department of Obstetrics and Gynaecology, School of Clinical Medicine, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, Gauteng, South Africa.
| | - Jagidesa Moodley
- Women's Health and HIV Research Group, Department of Obstetrics and Gynecology, School of Clinical Medicine, Faculty of Health Sciences, University of Kwa Zulu-Natal, Durban, South Africa.
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23
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Alves FCR, Moreira A, Moutinho O. Maternal and long-term offspring outcomes of obesity during pregnancy. Arch Gynecol Obstet 2024; 309:2315-2321. [PMID: 38502190 DOI: 10.1007/s00404-023-07349-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 03/21/2024]
Abstract
PURPOSE Obesity`s prevalence is rising in women of reproductive age worldwide and has become the most common medical condition at this age group. Besides, its occurrence is also rising during pregnancy. This condition not only increases the risk of noncommunicable diseases on the mother, such as cardiovascular disease and diabetes, but also transfers this risk to the offspring. METHODS This is a narrative review based on scientific and review articles on the matter. RESULTS Obesity is associated with an increased risk of gestational diabetes mellitus, gestational hypertension and preeclampsia, venous thromboembolism, infection, and mental health problems. Furthermore, it has an impact on the progress of labor and induction matters. Regarding offspring outcomes, it is related to higher incidence of congenital anomalies, perinatal mortality, and the occurrence of large for gestational age newborns. Still, it has implications on cardiometabolic risk and neurodevelopment in offspring. CONCLUSION It is, therefore, imperative to encourage the adoption of healthy lifestyles, especially in the peri-conception and interpregnancy periods. Likewise, there must be support in the multidisciplinary monitoring of these pregnant women to minimize associated complication rates.
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Affiliation(s)
- Fernanda Cristina Ribeiro Alves
- Obstetrics and Gynecology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Avenida da Noruega, Lordelo, Vila Real, Portugal.
| | - Ana Moreira
- Obstetrics and Gynecology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Avenida da Noruega, Lordelo, Vila Real, Portugal
| | - Osvaldo Moutinho
- Obstetrics and Gynecology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Avenida da Noruega, Lordelo, Vila Real, Portugal
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Rodrigues-Denize N, Zolnikov BTR, Furio F. A systematic review on the physical, mental, and occupational effects of exercise on pregnant women. DIALOGUES IN HEALTH 2024; 4:100181. [PMID: 38813580 PMCID: PMC11133494 DOI: 10.1016/j.dialog.2024.100181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/18/2024] [Accepted: 05/08/2024] [Indexed: 05/31/2024]
Abstract
Complications in pregnancy have been proven to be less frequent with exercise. The American College of Obstetrics and Gynecology suggests pregnant women should exercise an average of 20 to 30 min a day; however, only 13% of pregnant women exercise throughout their pregnancy. This amount could be improved if women are aware that exercise: 1. Can help avoid pregnancy complications or death and 2. Comes in various forms with different health outcomes associated with it. For this reason, this systematic literature review was conducted to review different types of exercise for pregnant women. Peer-reviewed articles were selected to discuss the benefits of the most researched exercises for pregnant women, which included yoga, resistance training, aquatic exercises, dance, and aerobic exercise such as running, walking, and cycling. Data from the review revealed that different types of exercises led to various benefits at different stages of pregnancy. Aquatic activities and yoga helped pregnant women toward the end of their pregnancies, whereas resistance training, dance, and aerobic exercises provided the most benefits during the first trimester. Other studies found that any form of exercise for 30 min a day or every other day for 60 min provided extensive beneficial results. Ultimately, this information could be used to create individualized exercise plans for pregnant women to adhere to throughout their pregnancy.
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Affiliation(s)
| | - By Tara Rava Zolnikov
- National University, Department of Community Health, San Diego, CA, USA
- California Southern University, School of Behavioral Sciences, Costa Mesa, CA, USA
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Agarwala A, Dixon DL, Gianos E, Kirkpatrick CF, Michos ED, Satish P, Birtcher KK, Braun LT, Pillai P, Watson K, Wild R, Mehta LS. Dyslipidemia management in women of reproductive potential: An expert clinical consensus from the national lipid association. J Clin Lipidol 2024:S1933-2874(24)00188-0. [PMID: 38824114 DOI: 10.1016/j.jacl.2024.05.005] [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: 04/30/2024] [Accepted: 05/20/2024] [Indexed: 06/03/2024]
Abstract
Cardiovascular disease (CVD) is the leading cause of death among women and its incidence has been increasing recently, particularly among younger women. Across major professional society guidelines, dyslipidemia management remains a central tenet for atherosclerotic CVD prevention for both women and men. Despite this, women, particularly young women, who are candidates for statin therapy are less likely to be treated and less likely to achieve their recommended therapeutic objectives for low-density lipoprotein cholesterol (LDL-C) levels. Elevated LDL-C and triglycerides are the two most common dyslipidemias that should be addressed during pregnancy due to the increased risk for adverse pregnancy outcomes, such as preeclampsia, gestational diabetes mellitus, and pre-term delivery, as well as pancreatitis in the presence of severe hypertriglyceridemia. In this National Lipid Association Expert Clinical Consensus, we review the roles of nutrition, physical activity, and pharmacotherapy as strategies to address elevated levels of LDL-C and/or triglycerides among women of reproductive age. We include a special focus on points to consider during the shared decision-making discussion regarding pharmacotherapy for dyslipidemia during preconception planning, pregnancy, and lactation.
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Affiliation(s)
- Anandita Agarwala
- Center for Cardiovascular Disease Prevention Cardiovascular Division, Baylor Scott and White Health Heart Hospital Baylor Plano, Plano, TX, USA (Dr Agarwala).
| | - Dave L Dixon
- Department of Pharmacotherapy & Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USA (Dr Dixon); Center for Pharmacy Practice Innovation, Virginia Commonwealth University, Richmond, Virginia, USA (Dr Dixon)
| | - Eugenia Gianos
- Department of Cardiology, Northwell Health, New Hyde Park, Cardiovascular Institute, Lenox Hill Hospital Northwell, New York, NY, USA (Dr Gianos)
| | - Carol F Kirkpatrick
- Midwest Biomedical Research, Addison, IL, USA (Dr Kirkpatrick); Kasiska Division of Health Sciences, Idaho State University, Pocatello, ID, USA (Dr Kirkpatrick)
| | - Erin D Michos
- Division of Cardiology, Department of Medicine Johns Hopkins University School of Medicine Baltimore, MD, USA (Dr Michos)
| | - Priyanka Satish
- The University of Texas at Austin Dell School of Medicine, Ascension Texas Cardiovascular, Austin, TX, USA (Dr Satish)
| | - Kim K Birtcher
- University of Houston College of Pharmacy, Houston, TX, USA (Dr Birtcher)
| | - Lynne T Braun
- Rush University College of Nursing, Rush Heart Center for Women, Chicago, IL, USA (Dr Braun)
| | - Priyamvada Pillai
- Baylor Scott and White Health Heart Hospital Baylor Plano, Plano, TX, USA (Dr Pillai)
| | - Karol Watson
- Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA (Dr Watson)
| | - Robert Wild
- Oklahoma University Health Sciences Center, Oklahoma City, OK, USA (Dr Wild)
| | - Laxmi S Mehta
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA (Dr Mehta)
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Santos-Rocha R, Ferreira M, Pimenta N, Branco M, Oviedo-Caro M, Szumilewicz A. Understanding and Involving the Perspective of Pregnant Women as Users When Designing the Framework of e-Health and Exercise Interventions during Pregnancy: Preliminary Study. Healthcare (Basel) 2024; 12:1121. [PMID: 38891196 PMCID: PMC11172293 DOI: 10.3390/healthcare12111121] [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: 04/05/2024] [Revised: 05/25/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Health and exercise technology may promote a healthy lifestyle during pregnancy. The objective of this cross-sectional study was to understand and involve the perspective of pregnant women as users in the design of a framework for future e-health and exercise interventions during pregnancy. Pregnant women replied to a questionnaire aimed at understanding their physical activity patterns, needs, and preferences regarding the use of mobile applications (apps). The main results showed that one-third of the women did not practice any type of exercise during pregnancy. Women preferred to exercise in a gym, outdoors, or at home. The majority already had or were currently using a fitness app, but never used any pregnancy-specific app. Most women agreed that it was important to have a specific app for pregnancy to improve knowledge about recommendations on lifestyle, have direct contact with health and exercise professionals, have social interaction with other mothers, and have guidance on preparation for childbirth and postpartum recovery. Understanding and involving the perspective of pregnant women as users will allow researchers to improve the design of a pregnancy-specific app and future e-health and exercise interventions during pregnancy. These preliminary results will lead to the development of the "active pregnancy app" focused on the promotion of an active and healthy lifestyle during pregnancy and postpartum.
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Affiliation(s)
- Rita Santos-Rocha
- ESDRM—Department of Physical Activity and Health, Sport Sciences School of Rio Maior, Santarém Polytechnic University, 2040-413 Rio Maior, Portugal; (M.F.); (N.P.); (M.B.)
- SPRINT—Sport Physical Activity and Health Research and Innovation Center, 2040-413 Rio Maior, Portugal
- CIPER—Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics (FMH), University of Lisbon, 1499-002 Cruz Quebrada, Portugal
| | - Mariana Ferreira
- ESDRM—Department of Physical Activity and Health, Sport Sciences School of Rio Maior, Santarém Polytechnic University, 2040-413 Rio Maior, Portugal; (M.F.); (N.P.); (M.B.)
| | - Nuno Pimenta
- ESDRM—Department of Physical Activity and Health, Sport Sciences School of Rio Maior, Santarém Polytechnic University, 2040-413 Rio Maior, Portugal; (M.F.); (N.P.); (M.B.)
- SPRINT—Sport Physical Activity and Health Research and Innovation Center, 2040-413 Rio Maior, Portugal
- CIPER—Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics (FMH), University of Lisbon, 1499-002 Cruz Quebrada, Portugal
| | - Marco Branco
- ESDRM—Department of Physical Activity and Health, Sport Sciences School of Rio Maior, Santarém Polytechnic University, 2040-413 Rio Maior, Portugal; (M.F.); (N.P.); (M.B.)
- SPRINT—Sport Physical Activity and Health Research and Innovation Center, 2040-413 Rio Maior, Portugal
- CIPER—Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics (FMH), University of Lisbon, 1499-002 Cruz Quebrada, Portugal
| | - Miguel Oviedo-Caro
- Department of Physical Education and Sport, Faculty of Education Sciences, University of Seville, 41080 Seville, Spain;
| | - Anna Szumilewicz
- Faculty of Physical Education, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland;
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Al Zhranei R, Alsulami S, Alfaydi W, Alzahrani R, Alsulami M, Al Nufaiei ZF. The impact of body position on vital capacity among pregnant women in the second trimester. Front Med (Lausanne) 2024; 11:1351681. [PMID: 38863888 PMCID: PMC11165239 DOI: 10.3389/fmed.2024.1351681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/15/2024] [Indexed: 06/13/2024] Open
Abstract
Background Pregnancy introduces significant physiological changes, notably impacting respiratory dynamics, especially during the second trimester. Data remain inconclusive about how body posture might influence lung function in pregnant women. We aimed to examine the impact of body position on slow vital capacity in pregnant women during their second trimester. Methods This observational study was carried out at King Khalid Hospital in Saudi Arabia, involving pregnant women in their second trimester, from 14 to 26 weeks of gestation. We utilized the KoKo® Legend Portable Office Spirometer to measure slow vital capacity (SVC) in both sitting and standing positions. Participants' demographic details were recorded, ensuring a comprehensive analysis that accounted for age, BMI, and gestational age. Results 136 pregnant women participated in this study, a paired-sample t-test revealed no statistically significant difference between sitting (M = 2.31, SD = 0.49) and standing (M = 2.33, SD = 0.5) positions, p = 0.24, However; the mean value of SVC in sitting position was significantly different between 4th month of pregnancy (M = 2.17, SD = 0.44) and 6th month of pregnancy (M = 2.45, SD = 0.48), p = 0.016. Conclusion The performance of the SVC in both positions was not significantly affected. However, an increase in gestational age had a notable impact on SVC performance, particularly during sitting positions, due to the changes in respiratory physiology during pregnancy.
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Affiliation(s)
- Raid Al Zhranei
- Respiratory Therapy Department, College of Applied Medical Sciences-Jeddah, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Shatha Alsulami
- Respiratory Therapy Department, College of Applied Medical Sciences-Jeddah, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Weam Alfaydi
- Respiratory Therapy Department, College of Applied Medical Sciences-Jeddah, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Reem Alzahrani
- Respiratory Therapy Department, College of Applied Medical Sciences-Jeddah, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
| | - Maher Alsulami
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
- Emergency Medical Service, College of Applied Medical Sciences-Jeddah, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Ziyad F. Al Nufaiei
- Respiratory Therapy Department, College of Applied Medical Sciences-Jeddah, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
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Yang X, Wang G, Liu N, Wang Y, Zhang S, Lin H, Zhu C, Liu L, Sun Y, Ma L. Mediating effect of gestational weight gain on the preventive effect of exercise during pregnancy on macrosomia: a randomized clinical trial. BMC Pregnancy Childbirth 2024; 24:384. [PMID: 38778289 PMCID: PMC11112785 DOI: 10.1186/s12884-024-06527-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 04/17/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE We sought to investigate the impact of individualized exercise guidance during pregnancy on the incidence of macrosomia and the mediating effect of gestational weight gain (GWG). DESIGN A prospective randomized clinical trial. SETTING A Hospital in Xingtai District, Hebei Province. POPULATION Older than 20 years of age, mid-pregnancy, and singleton pregnant women without contraindications to exercise during pregnancy. METHODS A randomized clinical trial was conducted from December 2021 to September 2022 to compare the effects of standard prenatal care with individualized exercise guidance on the incidence of macrosomia. MAIN OUTCOME MEASURE Incidence of macrosomia. RESULTS In all, 312 singleton women were randomized into an intervention group (N = 162) or a control group (N = 150). Participants who received individualized exercise guidance had a significantly lower incidence of macrosomia (3.73% vs. 13.61%, P = 0.002) and infants large for gestational age (9.94% vs. 19.73%, P = 0.015). However, no differences were observed in the rate of preterm birth (1.86% vs. 3.40%, P = 0.397) or the average gestational age at birth (39.14 ± 1.51 vs. 38.69 ± 1.85, P = 0.258). Mediation analysis revealed that GWG mediated the effect of exercise on reducing the incidence of macrosomia. CONCLUSION Individualized exercise guidance may be a preventive tool for macrosomia, and GWG mediates the effect of exercise on reducing the incidence of macrosomia. However, evidence does not show that exercise increases the rate of preterm birth or affects the average gestational age at birth. TRIAL REGISTRATION The trial is registered at www.clinicaltrails.gov [registration number: NCT05760768; registration date: 08/03/2023 (retrospectively registered)].
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Affiliation(s)
- Xuanjin Yang
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Dongcheng, Beijing, 100370, China
| | - Guifang Wang
- Xingtai Xindu District Central Hospital, Hebei Xingtai, 054000, China
| | - Nana Liu
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Dongcheng, Beijing, 100370, China
| | - Yaxin Wang
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Dongcheng, Beijing, 100370, China
| | - Suhan Zhang
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Dongcheng, Beijing, 100370, China
| | - Hang Lin
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Dongcheng, Beijing, 100370, China
| | - Can Zhu
- Chinese Academy of Medical Sciences & Peking Union Medical College Nursing College, Beijing, 100144, China
| | - Li Liu
- Chinese Academy of Medical Sciences & Peking Union Medical College Nursing College, Beijing, 100144, China
| | - Yin Sun
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Dongcheng, Beijing, 100370, China.
| | - Liangkun Ma
- National Clinical Research Center for Obstetric & Gynecologic Diseases, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Dongcheng, Beijing, 100370, China.
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Brites-Lagos C, Maranhão C, Szumilewicz A, Santos-Rocha R. Development and validation of the physical exercise program "Active Mums" for postpartum recovery: application of the CReDECI-2 guidelines. BMC Pregnancy Childbirth 2024; 24:378. [PMID: 38769520 PMCID: PMC11103992 DOI: 10.1186/s12884-024-06387-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/02/2024] [Indexed: 05/22/2024] Open
Abstract
Postpartum physical activity is a public health issue. Reporting on the quality of exercise interventions designs must be ensured in view of the reproducibility and successful implementation of such studies. The objective was to develop and preliminary validate a physical exercise program for postpartum recovery, aiming to promote physical fitness and health of the new mothers. The study was carried out through the three stages of development, piloting, and evaluation. The Consensus on Exercise Reporting Template (CERT) was used to describe the postpartum exercise program. The Criteria for Reporting the Development and Evaluation of Complex Interventions in Healthcare (CReDECI2) was followed to develop and preliminary validate the program. A tailored postpartum exercise program was developed based on evidence-based international recommendations to be implemented by qualified exercise professionals. A pilot intervention of 16 weeks was carried out, engaging a group of postpartum women. The viability of the program was subsequently evaluated by all participants. The present work provided guidance to develop a study protocol with a larger sample in order to prove the effectiveness of a supervised postpartum exercise program on selected parameters of health.
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Affiliation(s)
- Carla Brites-Lagos
- ESDRM Sport Sciences School of Rio Maior - Santarem Polytechnic University, Rio Maior, Portugal
| | - Cristiana Maranhão
- ESDRM Sport Sciences School of Rio Maior - Santarem Polytechnic University, Rio Maior, Portugal
| | - Anna Szumilewicz
- Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Rita Santos-Rocha
- ESDRM Sport Sciences School of Rio Maior - Santarem Polytechnic University, Rio Maior, Portugal.
- SPRINT - Sport Physical Activity and Health Research and Innovation Center - Santarem Polytechnic University, Rio Maior, Portugal.
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O'Rourke N, Dervis S, da Silva DF, Geurts C, Haman F, Adamo KB. Heat production during exercise in pregnancy: discerning the contribution of total body weight. Pflugers Arch 2024; 476:769-778. [PMID: 38433124 DOI: 10.1007/s00424-024-02929-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/23/2023] [Accepted: 02/13/2024] [Indexed: 03/05/2024]
Abstract
Studies have reported enhanced thermoregulatory function as pregnancy progresses; however, it is unclear if differences in thermoregulation are attributed to weight gain or other physiological changes. This study aimed to determine if total body weight will influence thermoregulation (heat production (Hprod)), heart rate, and perceptual measurements in response to weight-bearing exercise during early to late pregnancy. A cross-sectional design of healthy pregnant women at different pregnancy time points (early, T1; middle, T2; late, T3) performed a 7-stage weight-bearing incremental exercise protocol. Measurements of Hprod, HR, and RPE were examined. Two experimental groups were studied: (1) weight matched and (2) non-weight matched, in T1, T2, and T3. During exercise, equivalent Hprod at T1 (326 ± 88 kJ), T2 (330 ± 43 kJ), and T3 (352 ± 52 kJ) (p = 0.504); HR (p = 0.830); and RPE (p = 0.195) were observed in the WM group at each time point. In the NWM group, Hprod (from stages 1-6 of the exercise) increased across pregnancy time points, T1 (291 ± 76 kJ) to T2 (347 ± 41 kJ) and T3 (385 ± 47 kJ) (p < 0.001). HR increased from T1 to T3 in the warm-up to stage 6 (p = 0.009). RPE did not change as pregnancy time point progressed (p = 0.309). Total body weight, irrespective of pregnancy time point, modulates Hprod and HR during exercise. Therefore, accounting for total body weight is crucial when comparing thermoregulatory function during exercise across pregnancy.
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Affiliation(s)
- Nicholas O'Rourke
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Lees Campus, 518E, 200 Lees Ave, Ottawa, ON, K1N 6N5, Canada
| | - Sheila Dervis
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Lees Campus, 518E, 200 Lees Ave, Ottawa, ON, K1N 6N5, Canada
| | - Danilo F da Silva
- Sports Studies Department, Faculty of Arts and Science, Bishop's University, Sherbrooke, QC, Canada
| | - Carla Geurts
- Fontys University of Applied Sciences, Venlo, Netherlands
| | - François Haman
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Lees Campus, 518E, 200 Lees Ave, Ottawa, ON, K1N 6N5, Canada
| | - Kristi Bree Adamo
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Lees Campus, 518E, 200 Lees Ave, Ottawa, ON, K1N 6N5, Canada.
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Gennaro S, Melnyk BM, Szalacha LA, Gibeau AM, Hoying J, O'Connor CM, Cooper AR, Aviles MM. Effects of Two Group Prenatal Care Interventions on Mental Health: An RCT. Am J Prev Med 2024; 66:797-808. [PMID: 38323949 PMCID: PMC11197933 DOI: 10.1016/j.amepre.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 01/09/2024] [Accepted: 01/09/2024] [Indexed: 02/08/2024]
Abstract
INTRODUCTION Perinatal depression and anxiety cost the U.S. health system $102 million annually and result in adverse health outcomes. Research supports that cognitive behavioral therapy improves these conditions, but barriers to obtaining cognitive behavioral therapy have prevented its success in pregnant individuals. In this study, the impact of a cognitive behavioral therapy-based intervention on anxiety, depression, stress, healthy lifestyle beliefs, and behaviors in pregnant people was examined. STUDY DESIGN This study used a 2-arm RCT design, embedded in group prenatal care, with one arm receiving a cognitive behavioral therapy-based Creating Opportunities for Personal Empowerment program and the other receiving health promotion content. SETTING/PARTICIPANTS Black and Hispanic participants (n=299) receiving prenatal care from 2018 to 2022 in New York and Ohio who screened high on 1 of 3 mental health measures were eligible to participate. INTERVENTION Participants were randomized into the manualized Creating Opportunities for Personal Empowerment cognitive behavioral therapy-based program, with cognitive behavioral skill-building activities delivered by advanced practice nurses in the obstetrical setting. MAIN OUTCOME MEASURES Outcomes included anxiety, depression, and stress symptoms using valid and reliable tools (Generalized Anxiety Disorder scale, Edinburgh Postnatal Depression Scale, and Perceived Stress Scale). The Healthy Lifestyle Beliefs and Behaviors Scales examined beliefs about maintaining a healthy lifestyle and reported healthy behaviors. RESULTS There were no statistically significant differences between groups in anxiety, depression, stress, healthy beliefs, and behaviors. There were significant improvements in all measures over time. There were statistically significant decreases in anxiety, depression, and stress from baseline to intervention end, whereas healthy beliefs and behaviors significantly increased. CONCLUSIONS Both cognitive behavioral therapy and health promotion content embedded in group prenatal care with advanced practice nurse delivery improved mental health and healthy lifestyle beliefs and behaviors at a time when perinatal mood generally worsens. TRIAL REGISTRATION This study is registered with clinicaltrials.gov NCT03416010.
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Affiliation(s)
- Susan Gennaro
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts
| | | | - Laura A Szalacha
- Morsani College of Medicine, University of South Florida, Tampa, Florida
| | | | | | - Caitlin M O'Connor
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts.
| | - Andrea R Cooper
- College of Nursing, The Ohio State University, Columbus, Ohio
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Hesketh KR, Wen F, Herring AH, Siega-Riz AM, Evenson KR. Perception and reality: The mismatch between absolute and relative physical activity intensity during pregnancy and postpartum in United States women. Prev Med 2024; 182:107948. [PMID: 38583604 PMCID: PMC11079917 DOI: 10.1016/j.ypmed.2024.107948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To explore whether a mismatch between absolute physical activity intensity (PAI) and relative self-reported PAI exists during pregnancy and postpartum. METHODS Women from the PIN3/Postpartum study completed physical activity questionnaires during pregnancy (n = 770; Trimester 2: T2, Trimester 3: T3) and postpartum (n = 181; 3 months: PP3, 12 months PP12) (2001-2005). Activities women engaged in were assigned Metabolic Equivalent (MET) values for absolute intensity; women self-reported perceived exertion (using the Borg scale) for each activity to provide relative intensity. Hierarchical regression models were used to determine whether a mismatch between absolute and relative PAI (for moderate or vigorous physical activity (MPA; VPA)) differed during pregnancy and postpartum. Models were adjusted for socio-demographic factors. RESULTS Women commonly overestimated the amount of MPA and VPA they engaged in [T2 MPA mean 60.5 min/week (49.1, 72.0), VPA 3.7 (-1.4, 8.8); T3: MPA 47.7 (38.9, 56.4), 2.9 (-1.7, 7.4); PP3: MPA 69.5 (43.9, 95.1), VPA 15.8 (1.8, 29.7); PP12: MPA 42.20 (26.8, 57.6), VPA 2.75 (-7.8, 12.9)]. Women overestimated both MPA and VPA to a lesser extent at T3 compared to T2 (MPA: β for difference:-12.6 [95%CI: -26.0, -0.9]; VPA: -0.9 [-6.4, 4.6]). Women continued to overestimate their MPA at PP3 and PP12. CONCLUSIONS Compared to absolute PAI, perceived PAI was greater for MPA compared to VPA and differences persisted from pregnancy through postpartum. Future research should focus on how perceptions relate to women's actual physiological capacity and whether this mismatch influences the amount of physical activity women engage in during the transition to motherhood.
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Affiliation(s)
- Kathryn R Hesketh
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; MRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
| | - Fang Wen
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Amy H Herring
- Department of Statistical Science, Duke University, Durham, NC, USA
| | - Anna Maria Siega-Riz
- Departments of Nutrition and Biostatistics & Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, MA, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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Petre I, Iurciuc S, Buleu F, Petre I, Moleriu RD, Popa D, Turi V, Bordianu A, Tasdemir R, Craciun LM, Marc L, Barna FM, Iurciuc M. The Impact of Medical Physical Training and a Structured Personalized Exercise Training Program on Hemodynamic Parameters and Arterial Stiffness in Pregnant Women. Biomedicines 2024; 12:986. [PMID: 38790947 PMCID: PMC11118944 DOI: 10.3390/biomedicines12050986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 04/23/2024] [Accepted: 04/29/2024] [Indexed: 05/26/2024] Open
Abstract
INTRODUCTION In developed countries, heart disease is the primary cause of maternal mortality during pregnancy. Arterial stiffness, an independent risk factor for atherosclerosis and a predictor of cardiovascular complications, can be assessed using the augmentation index (AIx) and pulse wave velocity (PWV). In this prospective study, we aimed to evaluate diverse hemodynamic parameters and arterial stiffness in pregnant women before and after participating in a structured, personalized exercise training program. MATERIALS AND METHODS Forty healthy pregnant women, non-smokers, who agreed to participate daily for 12 weeks in a physical exercise training program under the supervision of a team made up of an obstetrician, a cardiologist, and a physiotherapist were included. Anthropometric characteristics, arterial function, and physical activity data were collected from the participants at two different time points: at the beginning of the exercise training program (T0) and at the end, after 12 weeks (T1). RESULTS Upon conducting a statistical analysis, it was discovered that there were noteworthy disparities (p = 0.05) in body mass index, brachial AIx, systolic blood pressure, and pulse pressure values between the two time points. The regression analysis for the AIx brachial values and the PWVao values from Trim II (T0) and Trim III (T1) showed major differences between these two time points; the association between the AIx brachial values in the second and third trimesters of pregnancy revealed a strong direct significant correlation (p < 0.001), and the correlation between the PWVao values in the second (T0) and third trimester (T1) of pregnancy was weak and insignificant (p = 0.12). CONCLUSIONS The findings of our study indicate that a personalized exercise training program positively impacts the physical and psychological well-being of pregnant women, leading to a reduction in PWV.
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Affiliation(s)
- Izabella Petre
- Department XII of Obstetrics and Gynaecology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- County Emergency Clinical Hospital “Pius Brinzeu”, 300732 Timisoara, Romania; (F.B.); (R.T.)
| | - Stela Iurciuc
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.M.C.); (M.I.)
| | - Florina Buleu
- County Emergency Clinical Hospital “Pius Brinzeu”, 300732 Timisoara, Romania; (F.B.); (R.T.)
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.M.C.); (M.I.)
| | - Ion Petre
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.P.); (D.P.)
- Department of Functional Sciences, Medical Informatics and Biostatistics Discipline, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Radu Dumitru Moleriu
- Department of Functional Sciences, Medical Informatics and Biostatistics Discipline, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Daian Popa
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (I.P.); (D.P.)
- Department of Surgery, Emergency Discipline, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Vladiana Turi
- Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Anca Bordianu
- Department of Plastic Surgery and Reconstructive Microsurgery Bagdasar-Arseni, Emergency Hospital Bucharest, University of Medicine and Pharmacy “Carol Davila”, 010825 Bucharest, Romania;
| | - Rabia Tasdemir
- County Emergency Clinical Hospital “Pius Brinzeu”, 300732 Timisoara, Romania; (F.B.); (R.T.)
| | - Laura Maria Craciun
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.M.C.); (M.I.)
| | - Luciana Marc
- Centre for Molecular Research in Nephrology and Vascular Disease, Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Department of Internal Medicine II, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Flavia Mirela Barna
- Department of Finance, Faculty of Economics and Business Administration, West University of Timisoara, 300115 Timisoara, Romania;
| | - Mircea Iurciuc
- Department of Cardiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (L.M.C.); (M.I.)
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Huang S, Mao X, Li Y, Chen A, Qiu J. Are pelvic-abdominal mechanics exercises effective for cesarean delivery rate and postpartum pelvic floor function: A randomized controlled trial. J Sci Med Sport 2024:S1440-2440(24)00139-7. [PMID: 38991860 DOI: 10.1016/j.jsams.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 07/13/2024]
Abstract
OBJECTIVES To examine the effectiveness of pelvic-abdominal mechanics exercise in reducing cesarean section rates and preventing pelvic floor dysfunction in primiparous women. DESIGN Randomized controlled trial. METHODS A single-center prospective study was conducted among 200 primiparous participants (aged 18-38 years) who undertook formal card-issuing maternity tests between June 1, 2022, and June 30, 2023. Participants were divided into two groups: exercise (intervention) and control using the random number table method. Participants of the intervention group performed pelvic-abdominal mechanics exercise at least 1 h each time per week for three months. Participants of the control group did not perform any pelvic-abdominal mechanics exercise during pregnancy. This study conducted a comprehensive evaluation from three perspectives, including maternal and neonatal health outcomes during delivery, the recovery status of pelvic floor muscles at 42 days postpartum, and the quality of life during late pregnancy (36-38 weeks) and 42 days postpartum. RESULTS A significant difference was found in delivery outcomes. The cesarean section rates are significantly higher (p < 0.05) in the control group (36 %) than in the exercise group (19 %). At 42 days postpartum, pelvic floor assessment showed that the exercise group had significantly better results in pelvic floor muscle strength compared to the control group, with statistical significance (p < 0.05). CONCLUSIONS Pelvic-abdominal mechanics exercise lowers the rate of cesarean section and improves postpartum pelvic floor function.
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Affiliation(s)
- Suwan Huang
- Obstetrics and Gynecology Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, China; Wuxi School of Medicine, Jiangnan University, China
| | - Xiaoyan Mao
- Obstetrics and Gynecology Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Yueyue Li
- Obstetrics and Gynecology Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, China
| | - Aozheng Chen
- Obstetrics and Gynecology Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, China.
| | - Jin Qiu
- Obstetrics and Gynecology Department, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, China.
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Oros Ruiz M, Perejón López D, Serna Arnaiz C, Siscart Viladegut J, Àngel Baldó J, Sol J. Maternal and foetal complications of pregestational and gestational diabetes: a descriptive, retrospective cohort study. Sci Rep 2024; 14:9017. [PMID: 38641705 PMCID: PMC11031602 DOI: 10.1038/s41598-024-59465-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 04/11/2024] [Indexed: 04/21/2024] Open
Abstract
Gestational diabetes is characterized by hyperglycaemia diagnosed during pregnancy. Gestational and pregestational diabetes can have deleterious effects during pregnancy and perinatally. The baby's weight is frequently above average and might reach macrosomia (≥ 4 kg), which can reduce pregnancy time causing preterm births, and increase foetal-pelvic disproportion which often requires delivery by caesarean section. Foetal-pelvic disproportion due to the baby's weight can also cause foetal distress resulting in lower Apgar scores. To analyse the association between pregestational and gestational diabetes with maternal and foetal risk. We conducted a retrospective cohort study in women pregnant between 2012 and 2018 in the region of Lleida. Regression coefficients and 95% confidence intervals (CI) were used. The multivariate analysis showed statistically significant associations between pregestational diabetes and: prematurity (OR 2.4); caesarean section (OR 1.4); moderate (OR 1.3), high (OR 3.3) and very high (OR 1.7) risk pregnancies; and birth weight ≥ 4000 g (macrosomia) (OR 1.7). In getational diabetes the multivariate analysis show significant association with: caesarean section (OR 1.5); moderate (OR 1.7), high (OR 1.7) and very high (OR 1.8) risk pregnancies and lower 1-minuto Apgar score (OR 1.5). Pregestational and gestational diabetes increase: pregnancy risk, caesarean sections, prematurity, low Apgar scores, and macrosomia.
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Karwański M, Grzybowska U, Mierzejewska E, Szamotulska K. Archetype analysis and the PHATE algorithm as methods to describe and visualize pregnant women's levels of physical activity knowledge. BMC Public Health 2024; 24:1054. [PMID: 38622561 PMCID: PMC11020919 DOI: 10.1186/s12889-024-18355-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 03/13/2024] [Indexed: 04/17/2024] Open
Abstract
The knowledge of physical activity (PA) recommended for pregnant women and practical application of it has positive impact on the outcome. Nevertheless, it is estimated that in high-income countries over 40% of pregnant women are insufficiently physically active. One of the reasons is insufficient knowledge pregnant women have about allowed effort during pregnancy and both recommended and not recommended physical activities. Description of knowledge about physical activity the women have and distinguishing patterns of their knowledge is becoming an increasingly important issue. A common approach to handle survey data that reflect knowledge involves clustering methods or Principal Component Analysis (PCA). Nevertheless, new procedures of data analysis are still being sought. Using survey data collected by the Institute of Mother and Child Archetypal analysis has been applied to detect levels of knowledge reflected by answers given in a questionnaire and to derive patterns of knowledge contained in the data. Next, PHATE (Potential of Heat-diffusion for Affinity-based Trajectory Embedding) algorithm has been used to visualize the results and to get a deeper insight into the data structure. The results were compared with picture derived from PCA. Three archetypes representing three patterns of knowledge have been distinguished and described. The presentation of complex data in a low dimension was obtained with help of PHATE. The formations revealed by PHATE have been successfully described in terms of knowledge levels reflected by the survey. Finally, comparison of PHATE with PCA has been shown. Archetype analysis combined with PHATE provides novel opportunities in examining nonlinear structure of survey data and allows for visualization that captures complex relations in the data. PHATE has made it possible to distinguish sets of objects that have common features but were captured neither by Archetypal analysis nor PCA. Moreover, for our data, PHATE provides an image of data structure which is more detailed than interpretation of PCA.
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Affiliation(s)
- Marek Karwański
- Department of Applied Mathematics, University of Life Sciences-SGGW, Nowoursynowska 159, 02-776, Warsaw, Poland
| | - Urszula Grzybowska
- Department of Applied Mathematics, University of Life Sciences-SGGW, Nowoursynowska 159, 02-776, Warsaw, Poland.
| | - Ewa Mierzejewska
- Department of Epidemiology and Biostatistics, Institute of Mother and Child, Kasprzaka 17a, 01-211, Warsaw, Poland
| | - Katarzyna Szamotulska
- Department of Epidemiology and Biostatistics, Institute of Mother and Child, Kasprzaka 17a, 01-211, Warsaw, Poland
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Taliento C, Piccolotti I, Sabattini A, Tormen M, Cappadona R, Greco P, Scutiero G. Effect of Physical Activity during Pregnancy on the Risk of Hypertension Disorders and Gestational Diabetes: Evidence Generated by New RCTs and Systematic Reviews. J Clin Med 2024; 13:2198. [PMID: 38673471 PMCID: PMC11050519 DOI: 10.3390/jcm13082198] [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: 02/06/2024] [Revised: 04/01/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) are the most common medical complications in pregnancy. Physical exercise is considered to be safe and beneficial during pregnancy. Moreover, pregnancy could be considered as an opportunity for healthcare providers to promote positive lifestyle behavior and optimize the well-being of pregnant women. Since there are few up-to-date reviews evaluating the role of exercise and the risks of developing obstetrical complications, we performed a review to investigate the effects of physical activity and exercise during pregnancy compared to a control group, focusing on the risk of development of HDP and GDM. We searched Medline and Web of Science, including only randomized controlled trials (RCTs) and systematic reviews. This review supports a beneficial effect of exercise and provides evidence that it significantly decreases the risk of HDP and GDM.
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Affiliation(s)
- Cristina Taliento
- Department of Medical Sciences, Obstetrics and Gynecology Unit, University Hospital “Sant’Anna”, 44121 Ferrara, Italy; (C.T.); (I.P.); (A.S.); (M.T.); (R.C.); (G.S.)
- Department of Development and Regeneration—Woman and Child, KU Leuven, 3000 Leuven, Belgium
| | - Irene Piccolotti
- Department of Medical Sciences, Obstetrics and Gynecology Unit, University Hospital “Sant’Anna”, 44121 Ferrara, Italy; (C.T.); (I.P.); (A.S.); (M.T.); (R.C.); (G.S.)
| | - Arianna Sabattini
- Department of Medical Sciences, Obstetrics and Gynecology Unit, University Hospital “Sant’Anna”, 44121 Ferrara, Italy; (C.T.); (I.P.); (A.S.); (M.T.); (R.C.); (G.S.)
| | - Mara Tormen
- Department of Medical Sciences, Obstetrics and Gynecology Unit, University Hospital “Sant’Anna”, 44121 Ferrara, Italy; (C.T.); (I.P.); (A.S.); (M.T.); (R.C.); (G.S.)
| | - Rosaria Cappadona
- Department of Medical Sciences, Obstetrics and Gynecology Unit, University Hospital “Sant’Anna”, 44121 Ferrara, Italy; (C.T.); (I.P.); (A.S.); (M.T.); (R.C.); (G.S.)
| | - Pantaleo Greco
- Department of Medical Sciences, Obstetrics and Gynecology Unit, University Hospital “Sant’Anna”, 44121 Ferrara, Italy; (C.T.); (I.P.); (A.S.); (M.T.); (R.C.); (G.S.)
- Department of Medical Sciences, Institute of Obstetrics and Gynecology, University of Ferrara, Via Fossato di Mortara, 64/B, 44121 Ferrara, Italy
| | - Gennaro Scutiero
- Department of Medical Sciences, Obstetrics and Gynecology Unit, University Hospital “Sant’Anna”, 44121 Ferrara, Italy; (C.T.); (I.P.); (A.S.); (M.T.); (R.C.); (G.S.)
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Tong F, Wang Y, Gao Q, Zhao Y, Zhang X, Li B, Wang X. The epidemiology of pregnancy loss: global burden, variable risk factors, and predictions. Hum Reprod 2024; 39:834-848. [PMID: 38308812 DOI: 10.1093/humrep/deae008] [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: 08/21/2023] [Revised: 12/15/2023] [Indexed: 02/05/2024] Open
Abstract
STUDY QUESTION Is the incidence of pregnancy loss correlated with various geographic, socio-demographic, and age stratifications at the societal and national levels, and what are the risk factors associated with pregnancy loss at the individual level? SUMMARY ANSWER The epidemiological trends and disease burden of pregnancy loss were correlated with various geographic, socio-demographic, and age stratifications, and we identified that poor health condition, smoking, sedentary behaviour, lower educational level, and lower maternal birth weight may significantly increase the risk of pregnancy loss. WHAT IS KNOWN ALREADY Several studies have used national, regional, or single-centre data to describe trends in the burden of pregnancy loss, and previous observational studies have identified some variable factors possibly associated with pregnancy loss. However, a comprehensive analysis of global trends and predictions of pregnancy loss are lacking, and the conclusions have been inconsistent. STUDY DESIGN, SIZE, DURATION We have utilized the data from Global Burden of Disease (GBD) 2019 to provide an overview of the trends in pregnancy loss in 204 countries and regions worldwide from 1990 to 2019, and have made a forecast for the next 10 years. Moreover, we applied a variety of statistical genetics methods to analyse 34 239 pregnancy loss and 89 340 non-pregnancy loss cases from the FinnGen consortium to comprehensively assess the bidirectional causality of variable factors with pregnancy loss from an individual perspective. PARTICIPANTS/MATERIALS, SETTING, METHODS We analysed trends in the incidence, disability-adjusted life years (DALYs), and maternal mortality of pregnancy loss at global, regional, national, socio-demographic index (SDI), and age levels. The autoregressive integrated moving average (ARIMA) model was used to predict trends by 2030. Finally, we used two-sample Mendelian randomization (MR) and multivariate MR (MVMR) analyses to explore the relationship between the pregnancy loss and variables closely related to physical condition, physical activity, lifestyle, sleep conditions, basic conditions. MAIN RESULTS AND THE ROLE OF CHANCE In 2019, there were approximately 42.39 million cases of pregnancy loss worldwide. Globally, the incidence, DALYs, and mortality of pregnancy loss showed a decreasing trend between 1990 and 2019, although the number was increasing in some countries. The age-standardized incidence, DALYs, and mortality rate were negatively correlated with SDI level and show a further decline by 2030. Based on MR analyses, we confirmed that genetically predicted overall health rating (inverse-variance weighted (IVW) odds ratio (OR), 1.68; 95% CI, 1.34-2.13; P = 5.10 × 10-6), smoking initiation (IVW OR, 1.26; 95% CI, 1.16-1.38; P = 1.90 × 10-9), sedentary behaviour (IVW OR, 1.56; 95% CI, 1.20-2.01; P = 2.76 × 10-5), educational level (IVW OR, 0.64; 95% CI, 0.55-0.73; P = 6.56 × 10-10), and maternal birth weight (IVW OR, 0.70; 95% CI, 0.58-0.85; P = 2.98 × 10-4) were significantly related to the risk of pregnancy loss, whereas body mass index (IVW OR, 1.10; 95% CI, 1.03-1.17; P = 5.31 × 10-3), alcohol consumption (IVW OR, 1.74; 95% CI, 1.03-2.95; P = 0.04), insomnia (IVW OR, 1.66; 95% CI, 1.14-2.42; P = 7.00 × 10-3), and moderate-to-vigorous physical activity (IVW OR, 0.59; 95% CI, 0.37-0.95; P = 2.85 × 10-2) were suggestively associated with the risk of pregnancy loss. These results were supported by sensitivity and directional analyses. LIMITATIONS, REASONS FOR CAUTION Despite efforts to standardize GBD data from all over the world, uncertainties in data quality control regarding ascertainment of pregnancy loss, medical care accessibility, cultural differences, and socioeconomic status still exist. Furthermore, the population in the MRstudy was limited to Europeans, which means that the results may not be extrapolated to people of other origins. WIDER IMPLICATIONS OF THE FINDINGS Our study provides for the first time an overview of the epidemiological trends and disease burden of pregnancy loss related with SDI, region, country, and age, and predicts changes in future trends up to 2030. In addition, findings support that genetic susceptibility, smoking, health condition, and sedentary behaviour may be powerful indicators of an increased risk of pregnancy loss. These results would be beneficial for policy makers of different countries and regions to improve prevention implementation. STUDY FUNDING/COMPETING INTERESTS This work was supported by grants 2021JH2/10300093, from the Science and Technology Projects of Liaoning Province, China. All authors declare no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Fei Tong
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yue Wang
- Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qianqian Gao
- Department of Obstetrics, Weifang People's Hospital, Weifang, Shandong, China
| | - Yan Zhao
- Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xu Zhang
- Center for Reproductive Medicine, Women and Children's Hospital of Chongqing Medical University, China
| | - Baoxuan Li
- Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiaoyan Wang
- Department of Obstetrics and Gynaecology, Shengjing Hospital of China Medical University, Shenyang, China
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Vesting S, Gutke A, Fagevik Olsén M, Rembeck G, Larsson MEH. The Impact of Exercising on Pelvic Symptom Severity, Pelvic Floor Muscle Strength, and Diastasis Recti Abdominis After Pregnancy: A Longitudinal Prospective Cohort Study. Phys Ther 2024; 104:pzad171. [PMID: 38109793 PMCID: PMC11021861 DOI: 10.1093/ptj/pzad171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/25/2023] [Accepted: 10/16/2023] [Indexed: 12/20/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate whether early postpartum exercise is associated with changes in pelvic symptom severity, pelvic floor muscle strength, and diastasis recti abdominis (DRA) from 3 to 12 months postpartum. METHODS In this prospective cohort study, 504 participants with and without pelvic symptoms (pelvic girdle pain, stress urinary incontinence, vaginal heaviness) were followed. At 3, 6, 9, and 12 months postpartum, we assessed pelvic symptoms, exercise behavior (by questionnaires), pelvic floor muscle strength (by vaginal palpation), and DRA (by caliper measurement). Based on the 3-months questionnaire, participants were categorized as nonexercisers (n = 105), minimal low-impact exercisers (n = 249), regular low-impact exercisers (n = 117), and high-impact exercisers (n = 32). Between-group differences and within-group changes from 3 to 12 months were calculated using Chi-square tests, Kruskal-Wallis tests, and Friedman analysis of variance. RESULTS At 3 months, no differences in symptom prevalence were seen between the groups. Nonexercisers reported higher pelvic girdle pain severity and had weaker pelvic floor muscles. The within-group analysis showed that pelvic girdle pain severity did not change in nonexercisers or high-impact exercisers, but decreased in minimal and regular low-impact exercisers. Stress urinary incontinence increased in nonexercisers from 3 to 12 months, while it remained unchanged in regular low-impact and high-impact exercisers, and decreased in minimal low-impact exercisers. Across all groups, vaginal heaviness and DRA decreased, and pelvic floor strength increased from 3 to 12 months. CONCLUSION The study indicates that early low-impact exercising is associated with reduced pelvic girdle pain severity during the first postpartum year. Minimal low-impact exercisers also showed a slight reduction in stress urinary incontinence. Conversely, nonexercisers reported an increase in stress urinary incontinence between 3 and 12 months postpartum. IMPACT Physical therapists should encourage women to start with low-impact exercise early after pregnancy. LAY SUMMARY This study highlights the positive effects of starting gentle, low-impact exercise early after childbirth to reduce pelvic girdle pain and urinary incontinence.
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Affiliation(s)
- Sabine Vesting
- Närhälsan Gibraltar Rehabilitation, Gothenburg, Sweden
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Annelie Gutke
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Närhälsan Eriksberg Rehabilitation, Gothenburg, Sweden
| | - Monika Fagevik Olsén
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Physical Therapy and Occupational Therapy, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gun Rembeck
- Research, Education, Development and Innovation Primary Health Care, Region Västra Götaland, Borås, Sweden
- Primary Health Care, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Regional Health, Youth Guidance Centre, Borås, Sweden
| | - Maria E H Larsson
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre of Research and Education, Region Värmland, Karlstad, Sweden
- Region Västra Götaland, Research, Education, Development and Innovation, Primary Health Care, Gothenburg, Sweden
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Nose-Ogura S, Yoshino O, Nakamura-Kamoto H, Kanatani M, Harada M, Hiraike O, Saito S, Fujii T, Osuga Y. Medical issues for female athletes returning to competition after childbirth. PHYSICIAN SPORTSMED 2024; 52:147-153. [PMID: 36872580 DOI: 10.1080/00913847.2023.2188395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 03/01/2023] [Indexed: 03/07/2023]
Abstract
BACKGROUND In recent years, the number of athletes who aim to return to competition after childbirth has increased. However, few international reports have investigated complications during pregnancy, and changes in physical function after childbirth in many athletes. OBJECTIVE To conduct a retrospective investigation of medical problems during pregnancy, and postpartum, in female athletes who aim to return to competition after childbirth, and to identify the barriers and facilitators for their return. METHODS A voluntary web-based survey was aimed at former female athletes who became pregnant with their first child and gave birth during their active sports career. The survey items included respondent background, their exercise activities during and after childbirth, perinatal complications, mode of delivery, symptoms and physical function after childbirth. The participants were divided into a vaginal delivery group and a cesarean section group. RESULTS Three hundred and twenty-eight (29.1 ± 5.1 years old) former athletes were included in the analysis, and about half reported undertaking exercise during pregnancy. The most common perinatal complication was anemia (27.4%). The appearance of any symptoms after childbirth, including low back pain (44.2%) and urinary incontinence (39.9%), was reported by 80.5%. The rate of urinary incontinence may be higher in the vaginal delivery than in the cesarean section group (p = 0.05). The most common physical decline after childbirth was in muscular strength, followed by speed and endurance. CONCLUSION Addressing pregnancy-associated anemia and managing low back pain is critical for athletes aiming to return to competition after childbirth. Additionally, interventions to reduce the risk for and treat urinary incontinence are important. In addition, in order to return to competition after childbirth, it is important to strengthen muscles, especially the lower limbs and trunk, as well as to create a training program that takes into account the sport/events.
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Affiliation(s)
- Sayaka Nose-Ogura
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo, Japan
| | - Osamu Yoshino
- Department of Obstetrics and Gynecology, University of Yamanashi, Yamanashi, Japan
| | | | - Mayuko Kanatani
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo, Japan
| | - Miyuki Harada
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo, Japan
| | - Osamu Hiraike
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo, Japan
| | - Shigeru Saito
- Department of Obstetrics and Gynecology, University of Toyama, Toyama, Japan
| | - Tomoyuki Fujii
- Department of Obstetrics and Gynecology, Sanno Hospital, Tokyo, Japan
| | - Yutaka Osuga
- Department of Obstetrics and Gynecology, University of Tokyo, Tokyo, Japan
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Theodorsen NM, Bø K, Fersum KV, Haukenes I, Moe-Nilssen R. Pregnant women may exercise both abdominal and pelvic floor muscles during pregnancy without increasing the diastasis recti abdominis: a randomised trial. J Physiother 2024; 70:142-148. [PMID: 38472049 DOI: 10.1016/j.jphys.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/15/2024] [Accepted: 02/07/2024] [Indexed: 03/14/2024] Open
Abstract
QUESTION What is the effect of a 12-week abdominal and pelvic floor muscle exercise program during pregnancy on the inter-recti distance (IRD) in women with diastasis recti abdominis immediately after the 12-week intervention period and at follow-up 6 weeks postpartum? DESIGN An exploratory, parallel-group, randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. PARTICIPANTS Ninety-six pregnant women aged ≥ 18 years, either primigravida or multigravida, in gestation week 24 with an IRD of ≥ 28 mm measured at rest and/or a protrusion on initial assessment. INTERVENTION The experimental group participated in a 12-week abdominal and pelvic floor muscle exercise program during pregnancy. The control group received no intervention. OUTCOME MEASURES Change (mm) in IRD 2 cm above and below the umbilicus at rest from pre-intervention to immediately post-intervention and to 6 weeks follow-up measured with ultrasonography. RESULTS The IRD increased for both groups from baseline to immediately after the intervention and decreased from after the intervention to the follow-up at 6 weeks postpartum. The IRD was smallest for both groups at the follow-up. At 2 cm above the umbilicus, the intervention effect was 2 mm (95% CI -2 to 7) immediately after the intervention and -1 mm (95% CI -4 to 3) at follow-up. At 2 cm below the umbilicus, the intervention effect was -5 mm (95% CI -10 to 0) immediately after the intervention and 0 mm (95% CI -4 to 4) at follow-up. CONCLUSION Abdominal and pelvic floor muscle training during pregnancy have a negligible effect on the IRD immediately after 12 weeks of intervention and at 6 weeks post-partum. REGISTRATION NCT04960800.
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Affiliation(s)
| | - Kari Bø
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway; Akershus University Hospital, Department of Obstetrics and Gynecology, Lørenskog, Norway
| | - Kjartan Vibe Fersum
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Inger Haukenes
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Rolf Moe-Nilssen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Kouiti M, Lozano-Lorca M, Youlyouz-Marfak I, Mozas-Moreno J, González-Palacios Torres C, Olmedo-Requena R, Gea A, Jiménez-Moleón JJ. Replacement of watching television with physical activity and the change in gestational diabetes mellitus risk: A case-control study. Int J Gynaecol Obstet 2024; 165:335-342. [PMID: 37882498 DOI: 10.1002/ijgo.15209] [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: 03/11/2023] [Revised: 10/06/2023] [Accepted: 10/08/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE To evaluate the effect of replacing 1 h/week of watching television with 1 h/week of light to moderate (LMPA) or vigorous physical activity (VPA) before and during pregnancy on the risk of gestational diabetes mellitus (GDM). METHODS A case-control study was conducted in pregnant women. Physical activity and television watching before and during pregnancy were assessed using the Paffenbarger Physical Activity Questionnaire. Each type of activity was classified according to intensity (metabolic equivalent of task; MET): less than 6 METs is LMPA, 6 METs or more is VPA. The duration of physical activity and watching television was calculated, and logistic regression models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals for their association with GDM risk. The isotemporal substitution model was used to calculate the effect of replacing 1 h/week of watching television with the same duration of physical activity. RESULTS The GDM cases (n = 290) spent less time performing VPA than controls without GDM (n = 1175) and more time watching television during pregnancy (P < 0.05). During pregnancy, the risk of GDM increased for each hour of watching television (aOR = 1.02; 95% confidence interval 1.00-1.03). Women who spent more time watching television during pregnancy were likely to develop GDM (aOR>14 h/week vs. 0-6 h/week = 2.03; 95% confidence interval 1.35-3.08). Replacing 1 h/week of watching television with 1 h/week of VPA during pregnancy could decrease the chance of developing GDM (aOR = 0.66; 95% confidence interval 0.43-1.00). CONCLUSIONS A simple change of 1 h/week of watching television for 1 h/week of VPA in pregnant women may reduce the risk of GDM considerably.
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Affiliation(s)
- Malak Kouiti
- Departamento de Medicina Preventiva y Salud Publica, Universidad de Granada, Granada, Spain
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Macarena Lozano-Lorca
- Departamento de Medicina Preventiva y Salud Publica, Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, Granada, Spain
| | - Ibtissam Youlyouz-Marfak
- Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, Settat, Morocco
| | - Juan Mozas-Moreno
- Instituto de Investigación Biosanitaria ibs. Granada, Granada, Spain
- Consorcio Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departamento de Obstetricia y Ginecología, Universidad de Granada, Granada, Spain
- Obstetrics and Gynecology Service, Virgen de las Nieves University Hospital, Granada, Spain
| | | | - Rocío Olmedo-Requena
- Departamento de Medicina Preventiva y Salud Publica, Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, Granada, Spain
- Consorcio Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Alfredo Gea
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- Consortium for Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
| | - José Juan Jiménez-Moleón
- Departamento de Medicina Preventiva y Salud Publica, Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs. Granada, Granada, Spain
- Consorcio Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Ji M, Li R, Xu Y. Meta-analysis of the effect of different exercise modalities in the prevention and treatment of perinatal depression. J Affect Disord 2024; 350:442-451. [PMID: 38228277 DOI: 10.1016/j.jad.2024.01.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 12/24/2023] [Accepted: 01/04/2024] [Indexed: 01/18/2024]
Abstract
BACKGROUND The incidence of perinatal depression is increasing and has become a global public health problem to be addressed. OBJECTIVE To explore the prevention and treatment effects of different exercise methods on perinatal depression. METHODS A meta-analysis was conducted by searching databases for published "exercise interventions for perinatal depression "related randomized controlled trials, up to July 20, 2022. RESULTS 48 randomized controlled trials were included, with a total of 5282 pregnant women. (1) Exercise prevention of prenatal depression has a low effective stress intervention effect, ranking from high to low as yoga, aerobic+resistance. (2) Exercise therapy for prenatal depression has a significant intervention effect, followed by gymnastics, pelvic floor muscle training, aerobic exercise, aerobic+resistance, and yoga. (3) Exercise prevention of postpartum depression has a low effective intervention effect, followed by yoga, aerobic exercise, aerobic+resistance, and gymnastics. (4) Exercise has a moderate equivalent stress intervention effect on treating postpartum depression, followed by aerobic exercise, water exercise, yoga, fertility dance, and stroller walking. LIMITATIONS Due to the small number of included literature on single exercise modalities, and maternity is a special population, most of the trial procedures included in the text were not blinded, which has a certain risk of bias and affects the accuracy of the Meta-analysis results. CONCLUSIONS The therapeutic effect of exercise in the prevention and treatment of perinatal depression is superior to the preventive effect, and the effect of prenatal prevention and treatment is better than that of postpartum, with a moderate effect.
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Affiliation(s)
- Moufang Ji
- Postdoctoral Station of Physical Education, Central China Normal University, Wuhan, China; School of Physical Education, Hunan Institute of Science and Technology, Yueyang, China
| | - Ruobing Li
- School of Physical Education, Hunan Institute of Science and Technology, Yueyang, China
| | - Yizhe Xu
- School of Physical Education, Jianghan University, Wuhan, China.
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Alnaeem L, Alkulaib SS, Alatiyyah ZJ, Alrashed NR, Alnaim AA, Alnaim SS. Pregnant Women's Knowledge, Attitudes, and Associated Factors Toward Physical Exercise During Pregnancy in Al-Ahsa City, KSA. Cureus 2024; 16:e56063. [PMID: 38618327 PMCID: PMC11009555 DOI: 10.7759/cureus.56063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 04/16/2024] Open
Abstract
Introduction This research study aims to explore the understanding and perspective of pregnant women in Al-Ahsa regarding physical exercise during their pregnancy. Presently, there exists a deficiency in knowledge concerning the advantages of exercise for the well-being of both the expectant mother and the developing fetus within this area. The study endeavors to enlighten and empower pregnant women about the appropriate types and levels of exercise suitable for their individual physical activity during pregnancy, with the ultimate aim of attaining noteworthy health benefits. The proposed solution entails offering comprehensive education and guidance on the advantages and techniques of exercising during pregnancy. Methodology This is a cross-sectional study carried out in the city of Al-Al-Ahsa, located in Saudi Arabia. The data was collected through an online questionnaire. Subsequently, the collected data underwent a series of essential steps, including coding, thorough checking, and entry into an Excel spreadsheet. The final stage involved analyzing the data using the widely used statistical software SPSS. Results In this research conducted in Al-Ahsa City, the findings were based on a sample of 306 Saudi nationals. Several of the participants were aged over 45 (33.7%), married (81.4%), and had completed their college education (79.7%). In terms of their beliefs, the participants had an average score of 3.51 out of 7. Their level of awareness scored 5.13 out of 8, while their knowledge level scored 3.52 out of 5. A significant number of participants (68.3%) agreed on the importance of exercise during pregnancy, and a considerable percentage (72.9%) believed that any pregnant woman could exercise without seeking healthcare advice. When it came to accessing information about antenatal exercise, digital platforms, especially social media, were the primary source for the participants (63.4%). The most commonly practiced exercise type was walking (77.1%), and the main barriers reported were fatigue (64.4%) and time constraints (34.3%). Age was found to have a notable association with beliefs, awareness, and knowledge scores, while marital status and functional status showed marginal, insignificant associations. Conclusion This research underscores the significance of fostering optimistic beliefs, improving awareness, and addressing knowledge deficiencies through focused educational interventions. It emphasizes the crucial roles that healthcare professionals and digital platforms assume in spreading reliable information and assisting expectant mothers in making well-informed choices regarding their exercise routines. It is essential for future studies to investigate the efficacy of customized interventions and encompass diverse populations, thus deepening our comprehension of antenatal exercise behaviors and the factors that influence them.
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Affiliation(s)
| | | | | | | | | | - Shuaa S Alnaim
- College of Medicine, King Faisal University, Al-Ahsa, SAU
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Garland M, Wilbur J, Schoeny M, Reed M, Semanik P, Halloway S, Waters T. Determinants of Physical Activity Among Black Women During Pregnancy. J Obstet Gynecol Neonatal Nurs 2024; 53:172-184. [PMID: 38072009 DOI: 10.1016/j.jogn.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 01/21/2024] Open
Abstract
OBJECTIVE To describe associations among background determinants of physical activity, modifiable theoretical determinants of physical activity, and measures of physical activity during the second and third trimesters of pregnancy among Black women. DESIGN Longitudinal cohort. SETTING Medical center obstetric clinic. PARTICIPANTS Pregnant Black women (n = 40 in second trimester, n = 38 in third trimester) METHODS: We measured background determinants (demographic and pregnancy characteristics, discrimination, and neighborhood walkability) during the second trimester. We measured modifiable theoretical determinants (self-efficacy and social support) and physical activity using self-report and device measures during the second and third trimesters. We used paired t tests to determine differences in the modifiable theoretical determinants from the second trimester to third trimester and used Pearson correlations among background and modifiable determinants and physical activity measures during the second trimester. RESULTS Participants' physical activity levels were low during the second and third trimesters (32% and 22% met recommendation, respectively). We found no changes in self-efficacy or social support between trimesters and found no associations between these modifiable determinants and actual physical activity. We found a positive correlation between previous pregnancies and physical activity measured by devices, r(36) = .33, p = .048. Pregnancy-specific stress, r(38) = -.40, p = .013, was negatively correlated, and age, r(38) = .38, p = .017, was positively correlated with self-reported physical activity. CONCLUSIONS Low levels of physical activity during pregnancy coupled with the absence of an association with modifiable factors affecting pregnancy physical activity indicate a need to further examine the social, cultural, and environmental determinants of physical activity.
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Bagwell JJ, Avila E, Reynolds N, Smith JA, Valenzuela K, Katsavelis D. Running biomechanics differ during and after pregnancy compared to females who have never been pregnant. Gait Posture 2024; 109:277-283. [PMID: 38377744 DOI: 10.1016/j.gaitpost.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 01/16/2024] [Accepted: 02/03/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Perinatal running participation has increased recently; however, pregnancy related symptoms can limit activity. Perinatal running biomechanics could inform interventions to help perinatal individuals maintain an active lifestyle. RESEARCH QUESTION Are perinatal running biomaechanics and muscle activation different compared to nulligravida females? METHODS Sixteen pregnant participants completed self-selected velocity running during second trimester (2 T), third trimester (3 T), and postpartum (PP) and 16 matched controls completed these procedures once in this case control study. Kinematic, kinetic, and electromyography (EMG) data were collected using a motion capture system, force plates, and EMG electrodes. Peak trunk, pelvis, hip, knee, and ankle kinematics and hip, knee, and ankle moments during stance phase, and average and peak erector spinae (ES), gluteus maximus (GMax), and gluteus medius (GMed) EMG amplitude and duration of activation during stance and swing phases were calculated. Independent t-tests were used to compare 2 T, 3 T, and PP to control participants (α < 0.05). RESULTS Running velocity was slower during 3 T compared to control participants. At all pregnancy timepoints compared to the control group, peak trunk contralateral rotation was smaller. During 2 T and 3 T peak hip flexor moments were smaller. At 3 T pelvis contralateral rotation was smaller, ES average amplitude was greater during swing, GMax percent duration during stance and GMed percent duration during swing were smaller. At PP trunk flexion was smaller and knee abduction was greater (all p < 0.05). CONCLUSIONS Decreased running velocity may help offset increased demand during pregnancy. During 3 T, greater ES activation, smaller trunk and pelvis motion, and altered gluteal activation could indicate trunk rigidity combined with modified hip stabilizer muscle utilization. During PP, the rigid trunk combined with greater knee abduction may indicate hip and trunk strength deficits. Altered trunk and hip motion and activation could be relevant to pathologies such as perinatal low back, pelvic girdle, or knee pain.
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Affiliation(s)
- Jennifer J Bagwell
- Department of Physical Therapy, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA.
| | - Elizabeth Avila
- Department of Kinesiology, California State University Long Beach, 1250 Bellflower Blvd, Long Beach, CA 90840, USA
| | - Nicholas Reynolds
- Department of Biomechanics, University of Nebraska, Omaha, NE 68182, 6160 University Drive, Omaha, NE 68182, USA
| | - Jo Armour Smith
- Department of Physical Therapy, Chapman University, 9401 Jeronimo Road, Irvine, CA 92618, USA
| | - Kevin Valenzuela
- Department of Kinesiology, California State University Long Beach, 1250 Bellflower Blvd, Long Beach, CA 90840, USA
| | - Dimitrios Katsavelis
- Department of Exercise Science, Creighton University, 2500 California Plaza, Omaha, NE 68178, USA
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Aktaş Reyhan F. Determination of exercise attitudes of women of reproductive age in pregnancy. Eur J Obstet Gynecol Reprod Biol X 2024; 21:100294. [PMID: 38495928 PMCID: PMC10940935 DOI: 10.1016/j.eurox.2024.100294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/16/2024] [Accepted: 02/28/2024] [Indexed: 03/19/2024] Open
Abstract
Objective This study was conducted to evaluate the exercise attitudes of women of reproductive age during pregnancy. Method The descriptive study was conducted with 326 women who applied to the gynecology outpatient clinics of a state hospital between September and November 2023. Data were collected with the "Personal Information Form" and "Exercise Attitudes in Pregnant Women Scale". Statistical analyses were analyzed at p < .05 significance level with the independent samples t test method. Results Most of the participants (85.6%) stated that they did not know the benefits of exercise during pregnancy and did not exercise during pregnancy (89.6%). The mean exercise attitude scale score of the participants was 135.42 ± 25.90. A significant difference was found between the participants' education level, exercising outside pregnancy, attending a pregnancy school, knowing the benefits of exercise during pregnancy and exercising during pregnancy and all sub-dimension scores (p < .05). Conclusion In the study, it was observed that the participants had positive attitudes towards exercise during pregnancy, although their knowledge and behaviors were insufficient. Women's attitudes towards exercise should be determined by health professionals and women's positive attitudes, knowledge and behaviors should be improved by organizing trainings and exercise programs starting from pre-pregnancy.
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Laudańska-Krzemińska I, Krzysztoszek J. Physical activity promotion among pregnancy - the role of physician from the women's perspective. Front Public Health 2024; 12:1335983. [PMID: 38487188 PMCID: PMC10937457 DOI: 10.3389/fpubh.2024.1335983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Abstract
Objective The clear benefits of planned and supervised physical activity (PA) during pregnancy make it imperative that women are encouraged and educated about this activity. This study aimed to investigate how effectively physician promote physical activity and exercise among pregnant women. It also examines pro-health changes in selected health behaviours during pregnancy. Methods This cross-sectional study recruited a total of 353 pregnant women in Wielkopolskie Voivodship in Poland. An anonymous survey (on-line or in-paper) was used to assess physical activity before and during pregnancy (with Pregnancy Physical Activity Questionnaire), physical activity self-efficacy, well-being (WHO-5 Well-Being Index), and guidance received from physicians on physical activity during pregnancy. Results Only 41% of women surveyed followed WHO recommendations for PA before pregnancy, and they were much more likely to discuss safety and the need to change the intensity or type of PA with their doctor or gynaecologist. Only 23% of women were asked about their PA before pregnancy and less than 40% were encouraged to be active during pregnancy. We observed a higher probability of poor well-being among pregnant women who were inactive before pregnancy (OR = 1.873, 95%CI 1.026 to 3.421, p = 0.041). Conclusion Health professionals infrequently educate and motivate women to be physically active during pregnancy. Physician advice, as it is currently perceived by women, seems to be insufficient to help pregnant women meet the recommendations for PA during pregnancy.
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Affiliation(s)
- Ida Laudańska-Krzemińska
- Department of Physical Activity and Health Promotion Science, Poznan University of Physical Education, Poznan, Poland
| | - Jana Krzysztoszek
- Department of Didactics of Physical Activity, Poznan University of Physical Education, Poznan, Poland
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Xie W, Zhang L, Cheng J, Wang Y, Kang H, Gao Y. Physical activity during pregnancy and the risk of gestational diabetes mellitus: a systematic review and dose-response meta-analysis. BMC Public Health 2024; 24:594. [PMID: 38395913 PMCID: PMC10893683 DOI: 10.1186/s12889-024-18131-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 02/16/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Previous research has indicated the inverse association between physical activity (PA) and gestational diabetes mellitus (GDM). However, the dose-response relationship currently remains undetermined. This study aims to explore the dose-response relationship between PA during the first and second trimesters of pregnancy and GDM risk. METHODS Studies on the relationship between PA during pregnancy and GDM risk published before April 25, 2023, were searched for in six databases. According to the inclusion and exclusion criteria, all literature was screened for eligibility. The Newcastle-Ottawa Scale (NOS) was used to assess risk of bias. Publication bias was examined using funnel plots, Begg's and Egger's tests, as well as trim-and-fill analysis. We harmonized exposure estimates of PA during pregnancy to the common unit of the metabolic equivalent of task (MET)-h/week. Restricted cubic splines were used to model the dose-response relationship. The criteria from the World Cancer Research Fund were used to assess the certainty of evidence across outcomes. All analyses were performed using Stata 15.1. RESULTS The results indicated that in contrast with the lowest level of PA, promoting the highest PA level lowers the risk of GDM by 36% (RR = 0.64, 95%CI: 0.53 ~ 0.78). We found a curvilinear dose-response association between PA during the first trimester and incident GDM (Pnonlinearity = 0.012). Compared to inactive pregnant women, for those who achieved the guidelines-suggested minimum level (10 MET-h/week) of PA during the first trimester, the GDM risk was decreased by 13% (RR = 0.87, 95%CI: 0.79 ~ 0.96). A linear relationship was found between PA during the second trimester and the GDM risk (Pnonlinearity = 0.276). The results with a restricted cubic spline model suggested that pregnant women who accumulate 10 MET-h/week have a 1% reduced risk of GDM compared to completely inactive individuals. Twice (20 MET-h/week) or a higher amount of PA (50 MET-h/week) contributed to further reductions in GDM risk. CONCLUSION There is a dose-response relationship between higher levels of PA in both the first and second trimesters and reduced risk of GDM; the relationship is stronger in the first trimester. Increasing PA during pregnancy can prevent the development of GDM. PROSPERO REGISTRATION NUMBER CRD42023420564.
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Affiliation(s)
- Wanting Xie
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, 100084, China
| | - Liuwei Zhang
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, 100084, China.
- Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Beijing, 100084, China.
| | - Jiaoying Cheng
- Department of Obstetrics and Gynecology, China-Japan Friendship Hospital, Beijing, 100029, China.
| | - Yirui Wang
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, 100084, China
| | - Haixin Kang
- Department of Physical Fitness and Health, School of Sport Science, Beijing Sport University, Beijing, 100084, China
| | - Yi Gao
- School of Strength and Conditioning Training, Beijing Sport University, Beijing, 100084, China
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Schulz JM, Thornton JS. Infographic. Return to activity/sport postpartum: a summary of current recommendations. Br J Sports Med 2024:bjsports-2023-107856. [PMID: 38355283 DOI: 10.1136/bjsports-2023-107856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 02/16/2024]
Affiliation(s)
- Jenna M Schulz
- Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada
- Bone & Joint Institute, Western University, London, Ontario, Canada
| | - Jane S Thornton
- Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Fowler Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada
- Bone & Joint Institute, Western University, London, Ontario, Canada
- Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Kinesiology, Western University, London, Ontario, Canada
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