1
|
Pico ML, Rangel-Osuna F, Estrada MS, Granich A, Grunnet LG, Silvia CIR, Avila-Jimenez L, Christensen DL, Nielsen KK. "I have not been doing it because of my fear of something happening." Exploring perspectives on healthy dietary behaviors and physical activity in Mexican pregnant women and health care professionals: A qualitative study. Nutrition 2024; 126:112493. [PMID: 39018986 DOI: 10.1016/j.nut.2024.112493] [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: 01/10/2024] [Revised: 04/11/2024] [Accepted: 05/01/2024] [Indexed: 07/19/2024]
Abstract
OBJECTIVES Mexico exhibits one of the highest prevalence rates of overweight and obesity globally, accompanied by a surge in non-communicable diseases, which in turn leads to elevated mortality rates. Existing efforts to address rising obesity rates have shown limited effectiveness. Maternal weight, diet, and physical activity (PA) during pregnancy affect the mother's and offspring's health. Despite the importance of establishing and engaging in healthy behaviors during pregnancy, little is known about which factors impact these behaviors among pregnant women in Mexico. This study explored perspectives on factors impacting healthy dietary behaviors and PA in pregnancy from pregnant women and health care professionals in Mexico. METHODS We conducted semistructured interviews with 11 pregnant women and 12 health care professionals working in prenatal care. Data were analyzed using qualitative content analysis in a stepwise inductive approach. RESULTS Classifying factors at the 1) individual level, 2) relational level, and 3) health care system level, three overall themes emerged. At the individual level, challenges with lack of time and competing priorities as well as knowledge of healthy dietary behaviors and PA were identified. At the relational level, influencing factors encompassed financial, social, and emotional support along with descriptive norms. At the health care system level, guidelines for PA during pregnancy and the quality of care were noted. CONCLUSIONS This study identified factors impacting healthy dietary behaviors and PA in pregnancy in Mexico. Important considerations for future interventions include addressing sociocultural norms around healthy dietary behaviors and PA in pregnancy and involving pregnant women's families, closest social networks, and health care professionals working at the prenatal care unit.
Collapse
Affiliation(s)
- Majken Lillholm Pico
- Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Herlev, Denmark.
| | | | | | | | - Louise Groth Grunnet
- Steno Diabetes Center Copenhagen, Copenhagen University Hospital, Herlev, Denmark
| | | | | | | | | |
Collapse
|
2
|
Zhao J, Zhou X, Xu N, Liu S, Tang J. Current status and influencing factors of protective motivation for body mass management during pregnancy. Int J Gynaecol Obstet 2024. [PMID: 39244713 DOI: 10.1002/ijgo.15888] [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: 03/15/2024] [Revised: 07/25/2024] [Accepted: 08/22/2024] [Indexed: 09/10/2024]
Abstract
OBJECTIVE Excessive weight gain, obesity, or insufficient weight gain during pregnancy can adversely affect both the mother and her offspring. This study aims to investigate the relationship between pregnant women's self-perception and beliefs and their body weight management during pregnancy. METHODS A cross-sectional survey involving 350 pregnant women in Changsha City was conducted from July to September 2023. Instruments included a sociodemographic data sheet, protective motivation questionnaire for pregnancy body quality management, and scales measuring body image, anxiety, self-efficacy, and social support. Univariate analysis and multiple linear regression were employed to identify factors influencing protective motivation for body quality management during pregnancy. RESULTS The average score of the protective motivation questionnaire was 124 (SD = 13.07), suggesting a need for enhanced weight management. Key factors influencing protective motivation included household income, cooperation with healthcare workers, sources of pregnancy information, midnight snacking habits, prepregnancy exercise, body image, and self-efficacy (P < 0.05). CONCLUSION The study highlights significant factors influencing pregnant women's motivation for body quality management. These include economic status, healthcare collaboration, information accessibility, lifestyle habits, and psychological factors. The findings underscore the need for healthcare professionals to integrate these factors into pregnancy care programs to improve body quality management.
Collapse
Affiliation(s)
- Jingyi Zhao
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital and Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Xihong Zhou
- Clinical Nursing Teaching and Research Section and Department of Obstetrics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Nuo Xu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital and Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Sai Liu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital and Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jiajun Tang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital and Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| |
Collapse
|
3
|
Gallo Galán LM, Gallo Vallejo MÁ, Aguilar-Cordero MJ, Rojas-Carvajal AM, Gallo Vallejo JL. [Review of nutrition and hydration in relation to physical exercise during pregnancy]. NUTR HOSP 2024; 41:916-924. [PMID: 38967305 DOI: 10.20960/nh.05060] [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: 07/06/2024] Open
Abstract
Introduction Studies on nutritional recommendations for pregnant women who exercise are scarce. The objective of this article is not to focus on the diet of pregnant women as a whole, but to review those aspects of it that may be related to physical exercise. To this end, the nutritional and hydration recommendations contained in the main clinical practice guides on physical exercise during pregnancy are collected, including the first Spanish guides. Likewise, the energy requirements required by pregnant women who perform physical exercise during pregnancy for adequate gestational weight gain are addressed, aspects related to macronutrients in the aforementioned population group, and two specific topics, such as nutritional needs in the adolescent who practices physical exercise during pregnancy and eating disorders in pregnant athletes It is concluded by stating that pregnant women who exercise regularly should eat a varied and balanced diet, such as the Mediterranean diet, avoid long periods of fasting to avoid the appearance of hypoglycemia and maintain adequate fluid intake before, during and after physical exercise. Pregnant adolescents who engage in physical exercise require nutritional supervision to achieve adequate gestational weight gain. The pregnant athlete with an eating disorder has a higher risk of complications during pregnancy and childbirth, gynecological, fetal and neonatal, and, therefore, requires close monitoring by specialists in maternal-fetal medicine.
Collapse
Affiliation(s)
| | | | - María José Aguilar-Cordero
- Research Group CTS367. Departamento de Enfermería. Universidad de Granada. Complejo Hospitalario Universitario de Granada
| | | | - José Luis Gallo Vallejo
- Servicio de Obstetricia y Ginecología. Hospital Universitario Virgen de las Nieves. Granada. Departamento de Obstetricia y Ginecología. Universidad de Granada
| |
Collapse
|
4
|
McCarthy EK, Ní Riada C, O'Brien R, Minogue H, McCarthy FP, Kiely ME. Access to nutrition advice and knowledge, attitudes and practices of pregnant women in Ireland: A cross-sectional study. J Hum Nutr Diet 2024. [PMID: 38881396 DOI: 10.1111/jhn.13342] [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: 04/05/2024] [Accepted: 06/04/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Healthy nutritional status, appropriate gestational weight gain and a balanced diet are important predictors of perinatal health outcomes. However, gaps exist in the translation of nutrition recommendations into dietary practices of women before and during pregnancy. The present study explored the relationship between access to nutrition advice, nutrition knowledge, attitudes and practices among pregnant women. METHODS Pregnant women aged > 18 years in Ireland were eligible to complete a self-administered survey consisting of four subsections (demographics, nutrition knowledge, attitudes and practices) delivered online through Qualtrics. RESULTS In this convenience sample (n = 334, median [interquartile range] gestation, 25.0 [16.0, 34.0] weeks), 85% had at least an honours bachelor degree and 88.9% planned their pregnancy. Two out of five women received nutrition advice during their pregnancy, mostly from a midwife. Based on the percentage of correct answers (of 15 questions), women with previous nutrition education (e.g., school home economics) had better median [interquartile range] nutrition knowledge than those with none (80.0% [66.7, 86.7%] vs. 73.3% [60.0, 80.0%], p < 0.001). Those who received nutrition advice during pregnancy did not score higher than those who did not (73.3% [66.7, 80.0%] vs. 73.3% [66.7, 80.0%], p = 0.6). Over three-quarters of participants considered nutritional supplement use to be very or extremely important. Although 73.6% and 92.4% took supplements prior to and during pregnancy, only 25.7% reported compliance with periconceptional folic acid supplementation guidelines. Half of respondents considered healthy eating during pregnancy as very or extremely important. CONCLUSIONS Access to nutrition advice during pregnancy was inadequate with poor nutrition knowledge, attitudes and practices observed. Accessible, evidence-based nutrition education for women prior to and during pregnancy is required.
Collapse
Affiliation(s)
- Elaine K McCarthy
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
| | - Clodagh Ní Riada
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Roisin O'Brien
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Hannah Minogue
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Fergus P McCarthy
- INFANT Research Centre, University College Cork, Cork, Ireland
- Department of Obstetrics and Gynaecology, University College Cork, Cork, Ireland
| | - Mairead E Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
- INFANT Research Centre, University College Cork, Cork, Ireland
| |
Collapse
|
5
|
Chen L, Deng YF, Fan MQ, Yuan HB, Meng LR, Gao LL. Assisted reproductive technology and physical activity among Chinese pregnant women at high risk for gestational diabetes mellitus in early pregnancy: A cross-sectional study. Res Nurs Health 2024; 47:324-334. [PMID: 38229213 DOI: 10.1002/nur.22369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 12/10/2023] [Accepted: 12/29/2023] [Indexed: 01/18/2024]
Abstract
Currently, the number of pregnant women at high risk for gestational diabetes mellitus (GDM) and using assisted reproductive technology (ART) is increasing. The present study aims to explore the relationship between ART and physical activity in Chinese pregnant women at high risk for GDM in early pregnancy. A cross-sectional study was conducted in a regional teaching hospital in Guangzhou, China, between July 2022 and March 2023. Three hundred fifty-five pregnant women at high risk for GDM in early pregnancy completed the Chinese version of the Pregnant Physical Activity Questionnaire (PPAQ), the Pregnancy Physical Activity Knowledge Scale, the Pregnancy Physical Activity Self-Efficacy Scale, the Pregnancy Physical Activity Social Support Scale, and a sociodemographic and obstetric characteristics data sheet. Compared to women who conceived naturally, women who used ART were more likely to be 35 years or older, unemployed, primigravidae, and to have intentionally planned their pregnancies. Women who used ART had significantly lower levels of physical activity and self-efficacy compared to their counterparts who conceived naturally. Over half (55.6%) of women who used ART reported being physically inactive, and those with lower self-efficacy, as well as the unemployed, were significantly more likely to be inactive. Physical inactivity is a critical clinical issue among women who use ART, especially in the context of GDM risk. Future research should develop and test physical activity programs, including enhancing physical activity self-efficacy for women who use ART. Patient or public contribution: In this study, survey questionnaires were completed by participants among Chinese pregnant women at high risk for GDM in early pregnancy.
Collapse
Affiliation(s)
- Lu Chen
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Yong-Fang Deng
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Mei-Qiong Fan
- Department of Obstetrics and Gynecology, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hao Bin Yuan
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Rua de Luis Gonzaga Gomes, Macao, China
| | - Li-Rong Meng
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Rua de Luis Gonzaga Gomes, Macao, China
| | - Ling-Ling Gao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
6
|
Zhang W, Zhao R, Zhang L, Xie F, Xu P, Guo P, Mao M, Feng S. Theory-based interventions aimed at promoting physical activity in pregnant women: A systematic review and meta-analysis of randomized controlled trials. Int J Nurs Stud 2024; 154:104761. [PMID: 38593643 DOI: 10.1016/j.ijnurstu.2024.104761] [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: 11/08/2023] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVES The objectives were to assess (i) the quality of theory implementation, (ii) the application of behavior change techniques, and (iii) the effectiveness of theory-based interventions in promoting physical activity in pregnant women and improving maternal and neonatal outcomes. METHODS A systematic search was conducted across 8 databases (Cumulative Index to Nursing and Allied Health Literature, the Cochrane Library, EMBASE, MEDLINE, APA PsycINFO, PubMed, SPORTDiscus, and Web of Science) to identify randomized controlled trials published from database inception to 8 July 2023. The Cochrane risk-of-bias 2.0 tool was used to evaluate the quality of the included studies. The theory coding scheme was used to measure the quality of theory implementation, and behavior change techniques were coded according to behavior change taxonomy (version 1). The meta-analysis was performed using RevMan 5.3. The Grading of Recommendations, Assessment, Development, and Evaluation Approach was used to assess the certainty of evidence. RESULTS Eleven studies met the study criteria. Nine studies were based on one theory, while two studies were based on a combination of two theories. The quality of theory implementation was generally moderate. A total of 24 unique behavior change techniques were extracted. The most commonly used types of behavior change techniques were 'instruction on how to perform the behavior' (n = 9), 'goal setting' (behavior) (n = 8), 'action planning' (n = 7), and 'information about health consequences' (n = 7). Theory-based interventions significantly improved moderate-to-vigorous physical activity (standardized mean difference (SMD) = 0.17, 95 % confidence interval (CI) [0.04, 0.30], P = 0.01; moderate certainty of evidence), reduced the average gestational weight gain per week (mean difference (MD) = -0.06, 95 % CI [-0.11, -0.01], P = 0.02; moderate certainty of evidence), and decreased the incidence of gestational diabetes mellitus (risk ratio (RR) = 0.64, 95 % CI [0.46, 0.89], P = 0.008; high certainty of evidence). However, the effects of theory-based interventions on total physical activity, total gestational weight gain and the incidence of gestational hypertension and preterm delivery were unclear (P > 0.05). CONCLUSIONS (i) Most of the studies exhibited a moderate level of theory implementation quality. (ii) The use of theories varies, but common behavior change techniques were found across studies. (iii) Theory-based interventions can improve physical activity and maternal and neonatal outcomes and appear to be safe. Appropriate health behavior theories and behavior change techniques should be fully utilized in future interventions. REGISTRATION PROSPERO: CRD42023440886. TWEETABLE ABSTRACT Theory-based interventions can improve physical activity and maternal and neonatal outcomes and appear to be safe. Appropriate health behavior theories and behavior change techniques should be fully utilized in the development of future interventions.
Collapse
Affiliation(s)
- Wei Zhang
- School of Medicine, Zhejiang University, Hangzhou, China; Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
| | - Rujia Zhao
- School of Medicine, Zhejiang University, Hangzhou, China; Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
| | - Le Zhang
- Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
| | - Fang Xie
- School of Medicine, Zhejiang University, Hangzhou, China; Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
| | - Ping Xu
- School of Medicine, Zhejiang University, Hangzhou, China; Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
| | - Pingping Guo
- School of Medicine, Zhejiang University, Hangzhou, China; Department of Nursing, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
| | - Minna Mao
- School of Medicine, Zhejiang University, Hangzhou, China; Department of Nursing, 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.
| |
Collapse
|
7
|
Benson J, DeVries M, McLaurin-Jiang S, Garner CD. Experiences accessing nutritious foods and perceptions of nutritional support needs among pregnant and post-partum mothers with low income in the United States. MATERNAL & CHILD NUTRITION 2024:e13660. [PMID: 38812121 DOI: 10.1111/mcn.13660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 04/05/2024] [Accepted: 04/25/2024] [Indexed: 05/31/2024]
Abstract
Access to nutritious foods, a social determinant of health, contributes to disparities in maternal and infant health outcomes such as mental health, breastfeeding intensity and cardiometabolic risk. This study explored perceived nutrition access and intake among pregnant or post-partum women eligible for Medicaid. Qualitative, semistructured interviews were conducted with 18 women who were either currently pregnant (n = 4) or up to 12 months post-partum (n = 14) in 2021-2022. Mothers spoke English (n = 11) or Spanish (n = 7) and lived in the Texas Panhandle. Interviews were audio-recorded, transcribed, translated (Spanish to English) and verified. Two or more researchers coded each interview until consensus was reached using thematic analysis with ATLAS.ti software. The study revealed five drivers for nutrition access. (1) Social factors influenced nutrition; those with less support expressed limited ability to eat healthfully. (2) The Women, Infants and Children program was perceived as a helpful resource for some, while others faced challenges obtaining it. (3) Stress was bidirectionally related to unhealthy food choices, with food sometimes used as a coping mechanism. (4) Mothers prioritized their babies and others and had limited ability and time to prepare healthy meals. (5) Most participants felt they received inadequate nutrition guidance from their healthcare providers. Participants provided positive responses to a proposed nutritious home-delivered meal intervention. Low-income women may experience nutritional challenges specific to this life stage. Interventions that reduce stress and burden of household tasks (e.g. cooking) and improve education and access to nutritious foods may improve mothers' ability to consume nutritious foods.
Collapse
Affiliation(s)
- Jessie Benson
- School of Medicine, Texas Tech University Health Sciences Center, Amarillo, Texas, USA
| | - Matthew DeVries
- School of Medicine, Texas Tech University Health Sciences Center, Amarillo, Texas, USA
- Phoenix Children's Pediatric Residency Program Alliance, Phoenix, Arizona, USA
| | - Skye McLaurin-Jiang
- Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, Texas, USA
| | - Christine D Garner
- InfantRisk Center, Texas Tech University Health Sciences Center, Amarillo, Texas, USA
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Amarillo, Texas, United States
| |
Collapse
|
8
|
Saxe-Custack A, LaChance J, Kerver JM. A Fresh Fruit and Vegetable Prescription Program for Prenatal Patients in Flint, Michigan: Baseline Food Security and Dietary Intake. Nutrients 2024; 16:1234. [PMID: 38674924 PMCID: PMC11054465 DOI: 10.3390/nu16081234] [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: 02/05/2024] [Revised: 04/14/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Although adequate nutritional status during pregnancy is necessary to support optimal fetal development, many low-income women have poor access to fresh, high-nutrient foods. To address these challenges, a pediatric fruit and vegetable (FV) prescription program was expanded to include pregnant women, providing one prescription for fresh FVs worth 15 US dollars during each prenatal office visit for redemption at farmers'/mobile markets. This analysis describes baseline sociodemographic characteristics, food security, and dietary intake among 253 pregnant women in Flint, Michigan in 2022-23. Dietary recall data were collected and analyzed using the Automated Self-Administered 24-h Tool developed by the US National Cancer Institute, with nutrition output reported in relation to adherence to US Dietary Guidelines. Most participants (mean ± SD age 26.51 ± 4.90 years) identified as African American (53%) and were receiving publicly funded health insurance (66%). Most (75%) reported no food insecurity, yet the majority failed to meet dietary recommendations for whole grains (99.3%), vegetables (93.1%), dairy (93.1%), and fruits (69.4%). Moreover, most did not meet micronutrient recommendations through food sources, including vitamin D (100%), iron (98.6%), folic acid (98.6%), vitamin A (82.6%), calcium (68.8%), and vitamin C (62.5%). Results raise deep concerns regarding diet and nutrition among pregnant women in this US city.
Collapse
Affiliation(s)
- Amy Saxe-Custack
- Charles Stewart Mott Department of Public Health, Michigan State University-Hurley Children’s Hospital Pediatric Public Health Initiative, Flint, MI 48502, USA;
| | - Jenny LaChance
- Charles Stewart Mott Department of Public Health, Michigan State University-Hurley Children’s Hospital Pediatric Public Health Initiative, Flint, MI 48502, USA;
| | - Jean M. Kerver
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48823, USA;
| |
Collapse
|
9
|
McKay FH, Zinga J, van der Pligt P. Could commercial meal kits be part of the solution to food insecurity during pregnancy? An Australian exploratory study. Nutr Diet 2024; 81:228-236. [PMID: 37845189 DOI: 10.1111/1747-0080.12845] [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: 04/26/2023] [Revised: 09/06/2023] [Accepted: 09/10/2023] [Indexed: 10/18/2023]
Abstract
AIM To explore the nutritional content of meal kits from two main Australian companies over a 6-week period against healthy eating guidelines for pregnancy. METHOD Across the 6-week period, weekly meal kits from both Provider 1 and Provider 2 were purchased, 36 individual meals were assessed. All data were analysed for the development of a macronutrient and micronutrient profile of meals. Extracted data were macronutrient, vitamin, and mineral composition, which were compared against the healthy eating guidelines for pregnant women in Australia and New Zealand. RESULTS Meal kits include higher levels of sodium, and lower levels of dietary fibre, calcium, magnesium, zinc, iron, thiamin, riboflavin, grains, and dairy when compared against the guidelines for healthy eating for pregnant women in Australia and New Zealand. CONCLUSIONS AND IMPLICATIONS Meal kits may increase meals prepared and consumed in the home, and thanks to the clear instructions and pre-portioned ingredients, may reduce stress related to food preparation. They have the potential to provide nutritionally adequate meals to pregnant women as a way to mitigate food insecurity or hunger during pregnancy and may provide some nutritional benefits and have the potential to remove some of the challenges with maintaining an adequate diet when pregnant.
Collapse
Affiliation(s)
- Fiona H McKay
- Faculty of Health, School of Health and Social Development/Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Julia Zinga
- Faculty of Health, School of Health and Social Development/Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- Royal Women's Hospital, Parkville, Victoria, Australia
| | - Paige van der Pligt
- Faculty of Health, The Institute for Physical Activity and Nutrition (IPAN) and School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
- Department of Nutrition, Western Health, Footscray, Victoria, Australia
| |
Collapse
|
10
|
Xiang Z, Sun K, Han R, Chen L, Wang Z, Gao L. Predictors of physical inactivity among pregnant women. Nurs Health Sci 2024; 26:e13086. [PMID: 38356050 DOI: 10.1111/nhs.13086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 12/18/2023] [Accepted: 12/29/2023] [Indexed: 02/16/2024]
Abstract
It is recommended that pregnant women be physically active to promote maternal and child health. This study aimed to explore the prevalence of physical inactivity and its modifiable predictors in the three trimesters in Chinese pregnant women. Four hundred forty-four pregnant women completed the Pregnant Physical Activity Questionnaire in the first, second, and third trimesters. The prevalence of physical inactivity reached its highest (66.2%) in the first trimester and lowest (19.4%) in the second trimester. Pregnant women with inadequate physical activity knowledge and low self-efficacy were at higher risk for physical inactivity. Monitoring physical inactivity could be incorporated into antenatal care and start from the first trimester. Prenatal care professionals should take action to increase pregnant women's physical activity self-efficacy and knowledge to enhance their physical activity.
Collapse
Affiliation(s)
- Zhixuan Xiang
- School of Nursing, Xiangtan Medicine and Health Vocational College, Xiangtan, China
| | - Ke Sun
- Gynecology & Obstetrics Department, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Rongrong Han
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Lu Chen
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Zhong Wang
- Nursing Department, Dongguan Hospital of Integrated Traditional Chinese and Western Medicine, Dongguan, China
| | - Lingling Gao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
11
|
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.
Collapse
|
12
|
Shine D, Siriwardana H, Minehan M, Takito MY, Jani R, Knight-Agarwal CR. The knowledge, attitudes, and behaviours of pregnant women regarding seafood consumption during the antenatal period: a qualitative study. BMC Pregnancy Childbirth 2024; 24:80. [PMID: 38267938 PMCID: PMC10807157 DOI: 10.1186/s12884-023-06149-5] [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: 06/05/2023] [Accepted: 11/21/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Maternal nutrition impacts fetal growth and development. The Food Standards Australia New Zealand (FSANZ) guidelines recommend pregnant women consume 2-3 servings (224-336 g) of fish/seafood per week to support intake of long chain omega 3 fatty acids, given adequate consumption supports numerous health benefits including reduced risk of preterm and early preterm birth. Evidence indicates that pregnant women purposely lower their fish/seafood intake, largely due to fears of methylmercury exposure. The aim of this study was to explore pregnant women's knowledge, attitudes, and behaviours regarding their fish/seafood consumption during the antenatal period. METHODS Semi-structured interviews were conducted between October 2018 and December 2020 among a purposive sample of 12 pregnant women from the Australian Capital Territory (ACT). The interviews were recorded, transcribed verbatim, and analysed using an interpretative phenomenological approach. Themes were developed on the women's lived experience related to fish/seafood knowledge, attitudes, and consumption behaviour. RESULTS The most prominent finding was widespread non-adherence to fish/seafood consumption guidelines. This was largely owing to a lack of proactive health promotion related to the health benefits of fish/seafood throughout pregnancy, including the health promoting roles of long chain omega 3 fatty acids for fetal growth and development. Three themes were identified: nutrition knowledge; sources of health promotion; and barriers and enablers to fish/seafood consumption. CONCLUSIONS To support adequate maternal consumption of fish/seafood throughout pregnancy, emphasis should be placed on the benefits of consuming this food group regularly. Additionally, pregnant women should receive education about the health promoting role of long chain omega 3 fatty acids. Dietitians are well placed to provide this information.
Collapse
Affiliation(s)
- Danielle Shine
- Department of Nutrition and Dietetics, The University of Canberra, Locked Bag 1, ACT, Bruce, Bruce, Australia
| | - Heshani Siriwardana
- Department of Nutrition and Dietetics, The University of Canberra, Locked Bag 1, ACT, Bruce, Bruce, Australia
| | - Michelle Minehan
- Department of Nutrition and Dietetics, The University of Canberra, Locked Bag 1, ACT, Bruce, Bruce, Australia
| | - Monica Yuri Takito
- Department of Human Movement, The University of São Paulo, São Paulo, Brazil
| | - Rati Jani
- Department of Nutrition and Dietetics, The University of Canberra, Locked Bag 1, ACT, Bruce, Bruce, Australia
| | - Catherine R Knight-Agarwal
- Department of Nutrition and Dietetics, The University of Canberra, Locked Bag 1, ACT, Bruce, Bruce, Australia.
| |
Collapse
|
13
|
Fulgoni K, Fulgoni VL. Mango Consumption Was Associated with Higher Nutrient Intake and Diet Quality in Women of Childbearing Age and Older Adults. Nutrients 2024; 16:303. [PMID: 38276541 PMCID: PMC10820848 DOI: 10.3390/nu16020303] [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: 12/12/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Nutritional equity has been recognized as a priority in nutrition research, as reiterated by the new life-stage approach utilized by the Dietary Guidelines for Americans. Two of the life stages focused on are pregnant and lactating females as well as older adults, due to their unique nutritional needs and unique chronic health conditions. Both groups have low intakes of several nutrients, including those of public health concern, and suboptimal diet quality, underlining the importance to improve their dietary intakes. Incorporating fruit into their diets could help alleviate these gaps. Thus, the objective of the current study is to expand upon our current knowledge of the benefits of fruit within these two subgroups that DGA guidelines focus on and determine nutrient and food group intake as well as diet quality in women of childbearing age (WCA; as a proxy for pregnant and/or lactating females, n = 16,774) and older adult (n = 18,784) mango consumers compared with non-consumers, using NHANES 1988-1994 and 1999-2018. Both WCA and older adult mango consumers had greater than 20% higher intakes of fiber and vitamin C and WCA consumers had upwards of 10% higher folate, magnesium, and potassium intakes compared with non-consumers. Both groups of consumers had lower intake of saturated fat and older adults had lower intakes of protein and vitamin B12. Diet quality was 16 and 13% higher in WCA and older adult consumers compared with non-consumers, respectively. Additionally, mango consumers had lower beef, poultry, fish, and solid fat intakes and WCA consumers had higher whole grain intakes compared with non-consumers. This study suggests incorporating mango into the diet could increase select nutrient intake as well as diet quality in specific life stages of adult Americans.
Collapse
|
14
|
Li Q, Piaseu N, Phumonsakul S, Thadakant S. Effects of a Comprehensive Dietary Intervention Program, Promoting Nutrition Literacy, Eating Behavior, Dietary Quality, and Gestational Weight Gain in Chinese Urban Women with Normal Body Mass Index during Pregnancy. Nutrients 2024; 16:217. [PMID: 38257110 PMCID: PMC10820561 DOI: 10.3390/nu16020217] [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: 12/04/2023] [Revised: 01/02/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
In urban Chinese women with normal body weight during pregnancy, we implemented a comprehensive dietary intervention program aimed at enhancing nutrition literacy, dietary quality, and gestational weight gain. The methods included both online and offline health education on prenatal nutrition, weekly weight monitoring, family back education practices, and real-time dietary guidance. The intervention was delivered to randomly assigned control and intervention group participants from gestational week 12 to week 24. The intervention group (n = 44; 100% complete data) showed significant differences (mean (SD)) compared to the control group (n = 42; 95.5% complete data) in nutrition literacy (53.39 ± 6.60 vs. 43.55 ± 9.58, p < 0.001), restrained eating (31.61 ± 7.28 vs. 28.79 ± 7.96, p < 0.001), Diet Quality Distance (29.11 ± 8.52 vs. 40.71 ± 7.39, p < 0.001), and weight gain within the first 12 weeks of intervention (4.97 ± 1.33 vs. 5.98 ± 2.78, p = 0.029). However, there was no significant difference in the incidence of gestational diabetes (2 (4.5%) vs. 4 (9.5%), p = 0.629). Participants in the intervention group reported an overall satisfaction score of 4.70 ± 0.46 for the intervention strategy. These results emphasize the positive role of comprehensive dietary intervention in promoting a healthy diet during pregnancy.
Collapse
Affiliation(s)
- Qian Li
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Ratchathewi, Bangkok 10400, Thailand; (Q.L.); (S.P.); (S.T.)
- Ph.D. Candidate in the Doctor of Philosophy Program in Nursing Science (International Program), Faculty of Medicine Ramathibodi Hospital, Faculty of Nursing, Mahidol University, Salaya 73170, Thailand
| | - Noppawan Piaseu
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Ratchathewi, Bangkok 10400, Thailand; (Q.L.); (S.P.); (S.T.)
| | - Srisamorn Phumonsakul
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Ratchathewi, Bangkok 10400, Thailand; (Q.L.); (S.P.); (S.T.)
| | - Streerut Thadakant
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Ratchathewi, Bangkok 10400, Thailand; (Q.L.); (S.P.); (S.T.)
| |
Collapse
|
15
|
Zhang Y, Gao X, Zhu H, Sun S, Contento IR, Koch PA, Yu H. Lipid-focused dietary education intervention in pregnant women: study protocol for an open-label, parallel, randomised, intervention study addressing adverse pregnancy outcomes in China. BMJ Open 2024; 14:e076911. [PMID: 38176858 PMCID: PMC10773410 DOI: 10.1136/bmjopen-2023-076911] [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: 06/20/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
INTRODUCTION The incidence of infants who are large-for-gestational-age (LGA) is on the rise in China, and its detrimental effects on health have received increasing attention. Diet-based interventions have the potential to reduce adverse birth outcomes, particularly in decreasing the occurrence of LGA infants. We aim to evaluate the effect of lipid-focused diet education based on the theories of behaviour change in pregnant women on maternal and offspring outcomes through a randomised controlled trial. METHODS AND ANALYSIS We have designed an open-label, parallel, multicentre randomised controlled trial in collaboration with three hospitals in Beijing, China.Pregnant women will be recruited before reaching 12 weeks of gestation and will be randomised in a 1:1:1 ratio into three arms: (1) online education arm, (2) pregnancy nutrition checklist and 'one-page flyer' arm and (3) routine antenatal education. The primary outcome LGA will be recorded at birth. Demographic information, physical activity, sleep and medical history will be collected through questionnaires and case cards prior to enrolment. Questionnaires will also be used to collect dietary behaviours and psychosocial factors of pregnant women at enrolment, at 24-28 weeks and 34-36 weeks of gestation. Additionally, information on breastfeeding and complementary food supplementation for infants and young children will be obtained through questionnaires. Physical development indicators of children and taste tests will be assessed 3 years after delivery. ETHICS AND DISSEMINATION The study has received ethical approval from the Capital Medical University Ethics Committee and other collaborating study centres. Informed consent will be introduced to pregnant women, and their consent will be obtained. The findings will be reported in relevant national and international academic conferences and peer-reviewed publications. TRIAL REGISTRATION NUMBER ChiCTR2300071126.
Collapse
Affiliation(s)
- Yadi Zhang
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Xiaoge Gao
- Program in Nutrition, Department of Health Studies & Applied Educational Psychology, Teachers College, Columbia University, New York city, New York, USA
| | - Haiyan Zhu
- Department of Obstetrics and Gynecology, Capital Medical University, Beijing, China
| | - Shengzhi Sun
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Isobel R Contento
- Program in Nutrition, Department of Health Studies & Applied Educational Psychology, Teachers College, Columbia University, New York city, New York, USA
| | - Pamela Ann Koch
- Program in Nutrition, Department of Health Studies & Applied Educational Psychology, Teachers College, Columbia University, New York city, New York, USA
| | - Huanling Yu
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| |
Collapse
|
16
|
Fraga ACSA, Bastos MP, Theme-Filha MM. Increased consumption of ultra-processed foods during pregnancy is associated with sociodemographic, behavioral, and obstetric factors: A cohort study. Nutr Res 2024; 121:28-38. [PMID: 38039599 DOI: 10.1016/j.nutres.2023.10.006] [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: 05/19/2023] [Revised: 10/28/2023] [Accepted: 10/28/2023] [Indexed: 12/03/2023]
Abstract
A diet based on ultra-processed food (UPF) does not meet nutritional needs, especially during pregnancy. The aim of this study is to assess the change in UPF consumption from preconception to pregnancy and associated factors. Our hypothesis is that women tend to adopt a healthier eating pattern during pregnancy, decreasing the intake of UPF and increasing the intake of unprocessed/minimally processed foods. A prospective cohort study with 326 participants was carried out from 2016 to 2019 in 2 health units in Rio de Janeiro, Brazil. Pregestational food consumption assessed using the food frequency questionnaire in the prenatal interview in women up to 20 gestational weeks and gestational consumption in the interview 2 months after delivery. Food items classified according to the NOVA system. For the mean variation from preconception to gestational UPF consumption, we used the generalized estimating equations model with linear distribution. Control of confounding variables was based on the literature on factors associated with UPF consumption, using a 3-level hierarchical model. The proportion of UPF energy consumption was 28.9% in preconception and 33% during pregnancy. Older and more educated women had a lower mean variation in the consumption of UPF during the pregnancy. A higher average consumption of UPF observed among women physically inactive before pregnancy, who smoked during pregnancy, were multiparous, and with had a low pregestational weight. These results reflect similar behavior to that of the general population, aggravated by a significant increase during pregnancy. However, older and more educated women and those with healthy behaviors showed lower UPF intake in pregnancy.
Collapse
|
17
|
Filatava EJ, Overton NE, El Habbal N, Capotosto MP, Gregas M, Gregory KE. Women Who Give Birth Preterm Do Not Meet Dietary Guidelines During Pregnancy. MCN Am J Matern Child Nurs 2024; 49:44-51. [PMID: 37773146 DOI: 10.1097/nmc.0000000000000968] [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: 10/01/2023]
Abstract
PURPOSE To evaluate maternal dietary intake during pregnancy compared with the 2015-2020 and 2020-2025 Dietary Guidelines for Americans (DGA). STUDY DESIGN AND METHODS A retrospective observational study design was used. The cohort included women who gave birth to preterm infants between 25 1/7 weeks and 33 6/7 weeks of gestation. Within 2 weeks of birth, participants were asked to recall their diet in the last month of pregnancy using the Dietary Screener Questionnaire. Participants' dietary intakes were compared to current 2020-2025 DGA that include specific recommendations for pregnant women and prior 2015-2020 DGA that were in place during the study period but were not pregnancy-specific. RESULTS Forty-five women participated in the study. None met the 2015-2020 or 2020-2025 DGA recommended intake of all seven dietary components. When compared to both DGAs, 2.2% of participants met the recommended dairy intake, 26.7% met the calcium intake, 15.6% were below the threshold for added sugar, and none met the vegetable or whole grain intake. When compared to the 2015-2020 DGA, 28.9% met the fruit intake and 2.2% met the fiber intake. However, when compared to the 2020-2025 DGA, only 2.2% met the fruit intake and none met the fiber intake. CLINICAL IMPLICATION Women who gave birth preterm did not adhere to the 2015-2020 or 2020-2025 DGA recommendations in the last month of pregnancy. Nurses are uniquely positioned to provide pregnant women with nutritional screening and counseling as part of routine prenatal care.
Collapse
|
18
|
Ketchum K, Jevitt CM. Evidence-Based Eating Patterns and Behavior Changes to Limit Excessive Gestational Weight Gain: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:15. [PMID: 38276803 PMCID: PMC10815062 DOI: 10.3390/ijerph21010015] [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: 09/26/2023] [Revised: 11/02/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND International prenatal care guidelines set a standard for clinicians to discuss gestational weight gain with their patients along with the complications associated with prepregnancy obesity and excessive gestational weight gain. Clinicians often lack evidence-based eating, nutrition, and activity strategies to share with patients. METHODS This systematic review aimed to find eating patterns and behaviors that could be used safely during pregnancy to limit excessive gestational weight gain. PubMed, MEDLINE, and Web of Science were searched for research or systematic reviews performed in the United States or Canada and published in English from 2013 to 2023. Keyword search terms included weight, manage, behavior, strategy, strategies, gestational weight gain, and nutrition. Excluded research used pediatric or adolescent populations, restrictive diets, such as no carbohydrate or no fat diets, fasting, bariatric surgery, weight loss medications, private industry or profit-earning programs using food brands, or specific diet programs. RESULTS A total of 844 abstracts were retrieved, with 103 full-text studies reviewed. Behaviors had to be useful for maintaining a healthy gestational weight gain and had to be safe for use during pregnancy. Behaviors useful during pregnancy included meal planning, home meal preparation, portion control, using diets such as the Mediterranean diet, the low-glycemic index diet, and the Dietary Approaches to Stop Hypertension diet (DASH), regular physical activity, sleeping 6-7 h a night, mindful eating, intuitive eating, and regular seif-weighing. CONCLUSION The evidence-based strategies outlined in this review are safe for use during pregnancy and can assist patients in avoiding excessive gestational weight gain while maintaining the nutrition needed for healthy fetal growth.
Collapse
Affiliation(s)
| | - Cecilia M. Jevitt
- Midwifery Program, Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
| |
Collapse
|
19
|
Brændstrup N, Roland CB, de Place Knudsen S, Bendix JM, Clausen TD, Molsted S, Stallknecht B, Løkkegaard E, Jespersen AP. Counselling on physical activity in Danish antenatal care: A qualitative study of experiences from both the pregnant woman's and the care provider's perspective. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 38:100902. [PMID: 37660544 DOI: 10.1016/j.srhc.2023.100902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/14/2023] [Accepted: 08/19/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVES Physical activity during pregnancy is beneficial to maternal and fetal health, but most pregnant women do not achieve the recommended level of physical activity. To investigate how antenatal care can promote physical activity during pregnancy, this study explores experiences of physical activity counselling from the perspectives of pregnant women and antenatal care providers. METHODS In a qualitative design with an inductive approach individual semi-structured interviews with 19 pregnant women and seven antenatal care providers were performed and analyzed using thematic analysis. RESULTS The themes "Experiencing inadequate counselling", "Benefiting from individualized guidance", and "Voicing a need for enhanced support" cover the perspectives from the participating pregnant women. They often experienced insufficient physical activity counselling that left them insecure about proper physical activity during pregnancy. The pregnant women desired individualized and concrete advice and early and continuous support. From antenatal care providers the themes "Providers' perceived barriers in counselling", "Balancing the act of counselling", and "Acknowledging potential for enhanced counselling" were identified. They perceived barriers towards counselling including time restraints, lack of interest, and doubts about certain physical activity during pregnancy but expressed trying to adjust the counselling to meet the woman's individual situation. They acknowledged that continuous support during pregnancy and updated knowledge and increased focus among providers might improve physical activity counselling. CONCLUSIONS Pregnant women received scarce counselling on physical activity in antenatal care, while care providers described several barriers towards counselling on physical activity. Both pregnant women and antenatal care providers recognized opportunities for enhanced physical activity counselling.
Collapse
Affiliation(s)
- Nina Brændstrup
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Dyrehavevej 29, 3400 Hilleroed, Denmark
| | - Caroline Borup Roland
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Dyrehavevej 29, 3400 Hilleroed, Denmark; Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Signe de Place Knudsen
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Dyrehavevej 29, 3400 Hilleroed, Denmark; Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Jane M Bendix
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Dyrehavevej 29, 3400 Hilleroed, Denmark; Department of Clinical Research, Copenhagen University Hospital - North Zealand, Dyrehavevej 29, 3400 Hilleroed, Denmark
| | - Tine D Clausen
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Dyrehavevej 29, 3400 Hilleroed, Denmark
| | - Stig Molsted
- Department of Clinical Research, Copenhagen University Hospital - North Zealand, Dyrehavevej 29, 3400 Hilleroed, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Bente Stallknecht
- Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Ellen Løkkegaard
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Dyrehavevej 29, 3400 Hilleroed, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
| | - Astrid Pernille Jespersen
- The Saxo Institute, University of Copenhagen, Copenhagen Centre for Health Research in Humanities, Karen Blixens Plads 8, 2300 Copenhagen, Denmark.
| |
Collapse
|
20
|
Angrish K, Khan-Poulin Y, Mangat J, Mack DE, Nagpal TS. Culturally Tailored Strategies for Prenatal Physical Activity for South Asian Women: A Scoping Review. J Immigr Minor Health 2023; 25:1463-1481. [PMID: 37193874 DOI: 10.1007/s10903-023-01486-1] [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] [Accepted: 04/20/2023] [Indexed: 05/18/2023]
Abstract
Low levels of physical activity (PA) are reported in South Asian pregnant women. This scoping review summarizes culturally tailored strategies in prenatal PA studies for South Asian women and identifies barriers and facilitators. A search strategy was developed with the keywords "Physical Activity" AND Pregnant AND "South Asian" and was carried out on Medline, SportDiscus, EMBASE, Web of Science and Proquest Theses and Dissertations. Primary research studies were included. Forty-six studies were included of which 40 were from South Asian countries. No interventions were identified outside of South Asian countries. Offering material in different languages was the most common tailoring strategy. Reported barriers were possible social norms favouring inactivity, lack of awareness on safe exercises, and physical symptoms (e.g., fatigue). Facilitators included social support and relief from physical symptoms. Future PA interventions for South Asian pregnant women should account for population-specific barriers and facilitators to increase PA initiation and maintenance.
Collapse
Affiliation(s)
- Kirina Angrish
- Department of Kinesiology, Brock University, St. Catharine's, Canada
| | | | - Jasman Mangat
- Department of Kinesiology, Brock University, St. Catharine's, Canada
| | - Diane E Mack
- Department of Kinesiology, Brock University, St. Catharine's, Canada
| | - Taniya S Nagpal
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, 116 St & 85 Ave, Edmonton, AB, T6G 2R3, Canada.
| |
Collapse
|
21
|
Cronin E, McCallion M, Monaghan K. "The best of a bad situation?" A mixed methods survey exploring patients' perspectives on physiotherapy-led online group exercise programmes. Ir J Med Sci 2023; 192:2595-2606. [PMID: 37154996 PMCID: PMC10165280 DOI: 10.1007/s11845-023-03386-7] [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: 12/07/2022] [Accepted: 04/20/2023] [Indexed: 05/10/2023]
Abstract
INTRODUCTION The COVID-19 pandemic saw the migration of many physiotherapy-led group exercise programmes towards online platforms. This online survey aimed to ascertain the patients' views of online group exercise programmes (OGEP), including their satisfaction with various aspects of these programmes, the advantages and disadvantages and usefulness beyond the pandemic. METHODS A mixed-methods design was utilised with a cross-sectional national online survey of patients who had previously attended a physiotherapy-led OGEP in Ireland. The survey collected both qualitative and quantitative data. Descriptive statistics were used to summarise the ordinal and continuous data and conventional content analysis was used to analyse the free-text responses. RESULTS In total, 94 patients completed the surveys. Fifty percent of patients questioned would prefer in-person classes. Despite only a quarter of patient respondents preferring online classes going forward, satisfaction with the OGEPs was high with nearly 95% of respondents somewhat or extremely satisfied. Decreased travel and convenience were cited as the main benefits of OGEPs. Decreased social interaction and decreased direct observation by the physiotherapist were the main disadvantages cited. CONCLUSION Patients expressed high satisfaction rates overall with online classes, but would value more opportunities for social interaction. Although 50% of respondents would choose in-person classes in the future, offering both online and in-person classes beyond the pandemic may help to suit the needs of all patients and improve attendance and adherence.
Collapse
Affiliation(s)
- Eimear Cronin
- Atlantic Technological University, Neuroplasticity Research Group (NRG), Health & Biomedical Research Centre (HEAL), Sligo, Ash Lane, Ballytivnan, Sligo, Ireland.
- Physiotherapy Department, St. John's Hospital, Sligo, Ireland.
| | - Maire McCallion
- Atlantic Technological University, Neuroplasticity Research Group (NRG), Health & Biomedical Research Centre (HEAL), Sligo, Ash Lane, Ballytivnan, Sligo, Ireland
| | - Kenneth Monaghan
- Atlantic Technological University, Neuroplasticity Research Group (NRG), Health & Biomedical Research Centre (HEAL), Sligo, Ash Lane, Ballytivnan, Sligo, Ireland
| |
Collapse
|
22
|
van der Pligt PF, Kuswara K, McNaughton SA, Abbott G, Islam SMS, Huynh K, Meikle PJ, Mousa A, Ellery SJ. Maternal diet quality and associations with plasma lipid profiles and pregnancy-related cardiometabolic health. Eur J Nutr 2023; 62:3369-3381. [PMID: 37646831 PMCID: PMC10611854 DOI: 10.1007/s00394-023-03244-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 08/21/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE To assess the relationship of early pregnancy maternal diet quality (DQ) with maternal plasma lipids and indicators of cardiometabolic health, including blood pressure (BP), gestational diabetes mellitus (GDM) and gestational weight gain (GWG). METHODS Women (n = 215) aged 18-40 years with singleton pregnancies were recruited at 10-20 weeks gestation. Diet quality was assessed by the Dietary Guideline Index, calculated at early ([mean ± SD]) (15 ± 3 weeks) and late (35 ± 2 weeks) pregnancy. Lipidomic analysis was performed, and 698 species across 37 lipid classes were measured from plasma blood samples collected at early (15 ± 3 weeks) and mid (27 ± 3 weeks)-pregnancy. Clinical measures (BP, GDM diagnosis, weight) and blood samples were collected across pregnancy. Multiple linear and logistic regression models assessed associations of early pregnancy DQ with plasma lipids at early and mid-pregnancy, BP at three antenatal visits, GDM diagnosis and total GWG. RESULTS Maternal DQ scores ([mean ± SD]) decreased significantly from early (70.7 ± 11.4) to late pregnancy (66.5 ± 12.6) (p < 0.0005). At a false discovery rate of 0.2, early pregnancy DQ was significantly associated with 13 plasma lipids at mid-pregnancy, including negative associations with six triglycerides (TGs); TG(54:0)[NL-18:0] (neutral loss), TG(50:1)[NL-14:0], TG(48:0)[NL-18:0], TG(52:1)[NL-18:0], TG(54:1)[NL-18:1], TG(50:0)[NL-18:0]. No statistically significant associations were found between early pregnancy DQ and BP, GDM or GWG. CONCLUSION Maternal diet did not adhere to Australian Dietary Guidelines. Diet quality was inversely associated with multiple plasma TGs. This study provides novel insights into the relationship between DQ, lipid biomarkers and cardiometabolic health during pregnancy.
Collapse
Affiliation(s)
- Paige F van der Pligt
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, Australia.
- Department of Nutrition and Dietetics, Western Health, Footscray, Australia.
| | - Konsita Kuswara
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, Australia
| | - Gavin Abbott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, Australia
| | - Sheikh Mohammed Shariful Islam
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3220, Australia
| | - Kevin Huynh
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Peter J Meikle
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, 3168, Australia
| | - Stacey J Ellery
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia
- Department of Obstetrics and Gynaecology, Monash University, Clayton, VIC, Australia
| |
Collapse
|
23
|
Sun J, Piernicka M, Worska A, Szumilewicz A. A socio-ecological model of factors influencing physical activity in pregnant women: a systematic review. Front Public Health 2023; 11:1232625. [PMID: 38054068 PMCID: PMC10694207 DOI: 10.3389/fpubh.2023.1232625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/02/2023] [Indexed: 12/07/2023] Open
Abstract
Physical activity (PA) is safe for most pregnant women, improving both maternal fitness and birth outcomes. Despite evidence of benefits, most pregnant women eliminate or reduce PA during pregnancy. This systematic review aimed to analyze the factors affecting maternal PA during pregnancy with reference to a socio-ecological model. A systematic search of relevant published studies between 2001 and 2022 was conducted through PubMed, Scopus, Web of Science, Academic Search Ultimate, Medline, and SPORTDiscus with full text via the EBSCO platform. A total of 32 studies that met the inclusion criteria were reviewed. The findings revealed that various study designs can lead to different outcomes in terms of what is identified as a PA facilitator or barrier. The factors that positively influenced PA in pregnant women were: higher levels of education, knowledge, and skills, as well as access to mass media. Conversely, lower levels of education, lack of knowledge and skills, low income, pregnancy discomforts, limited time, safety concerns, and societal perceptions of PA in pregnancy acted as barriers. Additionally, family, colleagues/friends, and partners could either support or hinder PA. Factors affecting overall maternal PA were somewhat different from those affecting the moderate-to-vigorous intensity of PA. Pregnant women receive little organizational and policy support. There is an urgent need to provide accessible information and resource systems for pregnant women. Since most pregnant women are motivated to engage in PA and susceptible to family advice, interventions should not be limited only to pregnant women, but should involve a family member, especially partners. There is a need to take global, systemic actions to promote an active lifestyle in pregnancy. Addressing safety concerns related to PA during pregnancy should be a significant part of these promotional activities.
Collapse
Affiliation(s)
- Junjiang Sun
- Faculty of Physical Culture, Gdansk University of Physical Education and Sport, Gdansk, Poland
- Higher Vocational College, Yunnan College of Business Management, Kunming, China
| | - Magdalena Piernicka
- Faculty of Physical Culture, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Aneta Worska
- Faculty of Physical Culture, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Anna Szumilewicz
- Faculty of Physical Culture, Gdansk University of Physical Education and Sport, Gdansk, Poland
| |
Collapse
|
24
|
van Lonkhuijzen RM, Rustenhoven H, de Vries JHM, Wagemakers A. The role of the partner in the support of a pregnant woman's healthy diet: an explorative qualitative study. BMC Pregnancy Childbirth 2023; 23:760. [PMID: 37898778 PMCID: PMC10612286 DOI: 10.1186/s12884-023-06072-9] [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: 04/19/2023] [Accepted: 10/17/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Active partner involvement during pregnancy is an effective strategy to enhance both maternal and newborn health outcomes. The presence of a supportive partner equips women with a heightened sense of empowerment to deal with the challenges of pregnancy, including maintaining a healthy diet during pregnancy, which is important for the health of both the mother and child. However, little information exists regarding the partner's role in encouraging a pregnant woman's healthy dietary choices. This study aimed to explore the perspectives of pregnant women and their partners concerning the partner's role in promoting a healthy dietary intake during pregnancy. METHODS Sixteen semi-structured couple interviews were conducted in the Netherlands, involving expecting couples. Based on Berkman's social networks and support theory, we categorized various forms of support as emotional, instrumental, appraisal, and informational. The interviews were accurately recorded, transcribed verbatim, and analysed using an inductive approach. RESULTS In general, pregnant women reported being positive regarding the support they received from their partners. Partners primarily offered instrumental support to pregnant women, such as cooking, grocery shopping, and helping them avoid unsafe foods. Partners provided informational support, mainly about foods considered unsafe during pregnancy. Emotional support was relatively less common. The primary motives for giving support were pregnancy-related symptoms, the importance of the health of the mother and baby, and solidarity with the pregnant woman. Support from the partner was more willingly accepted by pregnant women if the support was perceived as being helpful, showing involvement, and positive. Conversely, partner support was not accepted if it was perceived as judgmental or unwanted. CONCLUSIONS The majority of pregnant women were satisfied with the support received from their partners, although there are opportunities for a partner to provide more support to improve the dietary intake of pregnant women. To optimise this support, partners are advised to tailor their support to the needs and expectations of pregnant women. Personalizing dietary support can be achieved by couples communicating their dietary wishes and expectations regarding support.
Collapse
Affiliation(s)
- Renske M van Lonkhuijzen
- Department of Social Sciences, Health and Society, Wageningen University & Research, Hollandseweg 1, bode 60, Wageningen, 6706, KN, The Netherlands.
- Department of Agrotechnology and Food Sciences, Human Nutrition & Health, Wageningen University & Research, Stippeneng 4, bode 62, Wageningen, 6708, WE, The Netherlands.
| | | | - Jeanne H M de Vries
- Department of Agrotechnology and Food Sciences, Human Nutrition & Health, Wageningen University & Research, Stippeneng 4, bode 62, Wageningen, 6708, WE, The Netherlands
| | - Annemarie Wagemakers
- Department of Social Sciences, Health and Society, Wageningen University & Research, Hollandseweg 1, bode 60, Wageningen, 6706, KN, The Netherlands
| |
Collapse
|
25
|
Xiang Z, Han R, Chen L, Gao L. Predictors of physical activity among Chinese pregnant women during the first trimester: A cross-sectional study. J Sports Sci 2023; 41:1883-1891. [PMID: 38234226 DOI: 10.1080/02640414.2024.2306448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 01/10/2024] [Indexed: 01/19/2024]
Abstract
Physical activity during pregnancy has numerous health benefits for the woman and the foetus. The current study investigated physical activity engagement and its predictors among pregnant Chinese women during the first trimester. A total of 687 pregnant women completed the Pregnancy Physical Activity Questionnaire. Bivariate and multivariate logistic regression were used to analyse the data. The current physical activity guidelines were not met by 64.3% of respondents. Women with higher levels of physical activity self-efficacy (aOR = 0.96; 95% CI: 0.92-0.99) and social support (aOR = 0.95; 95% CI: 0.94-0.97) had lower odds of not meeting the current physical activity guidelines. Women who were aged < 35 years (aOR = 1.85; 95% CI: 1.02-3.34), had lower education (aOR = 1.63; 95% CI: 1.04-2.55), were primiparous (aOR = 11.03; 95% CI: 6.98-17.44), were unsure of their delivery mode (aOR = 2.32; 95% CI: 1.95-5.64), and those who had higher levels of pregnancy-associated discomfort (aOR = 1.10; 95% CI: 1.03-1.19) had higher odds of not meeting the current physical activity guidelines. The current study suggests that healthcare professionals should assess physical activity engagement during routine antenatal care and increase efforts to strengthen pregnant women's self-efficacy and social support to promote physical activity engagement during the first trimester.
Collapse
Affiliation(s)
- Zhixuan Xiang
- School of Nursing, Xiangtan Medicine & Health Vocational College, Xiangtan, China
| | - Rongrong Han
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Lu Chen
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Lingling Gao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
26
|
Tornquist L, Tornquist D, Mielke GI, da Silveira MF, Hallal PC, Domingues MR. Maternal Physical Activity Patterns in the 2015 Pelotas Birth Cohort: From Preconception to Postpartum. J Phys Act Health 2023; 20:868-877. [PMID: 37558220 DOI: 10.1123/jpah.2022-0609] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 06/12/2023] [Accepted: 06/23/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Motherhood has been associated with reduced leisure-time physical activity (LTPA) levels. We aim to assess maternal LTPA patterns from preconception to 4 years postpartum. METHODS The study was developed with mothers from the Pelotas 2015 Birth Cohort, Southern Brazil (n = 4273). LTPA data were self-reported for preconception, antenatal, and 3, 12, 24, and 48 months postpartum. Information on LTPA referring to preconception (3 mo before pregnancy) and each gestational trimester was retrospectively collected in perinatal. The prevalence of active mothers was calculated according to recommendations (≥150 min/wk). We described changes in LTPA between follow-ups and estimated the probability of mothers being active according to previous LTPA. We used group-based trajectory analysis to identify patterns of LTPA throughout the follow-ups. RESULTS The prevalence of active mothers during leisure time decreased in pregnancy and postpartum compared with preconception. At 12 months postpartum, LTPA levels rose again, but at 48 months, the rates of active mothers still had not returned to preconception levels. Prior LTPA engagement was an important determinant of the maintenance of LTPA. Trajectory analysis identified 4 patterns of maternal LTPA, and ∼80% of mothers were allocated to the "always inactive" group. Higher education and income, working outside the home, multiple births, and participating in the PAMELA study intervention were associated with a higher probability of mothers not being included in this predominantly inactive group. CONCLUSIONS Motherhood is associated with declining rates of women meeting physical activity recommendations during pregnancy and early postpartum.
Collapse
Affiliation(s)
- Luciana Tornquist
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Debora Tornquist
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS,Brazil
| | - Gregore Iven Mielke
- School of Public Health, The University of Queensland, Brisbane, QLD,Australia
| | | | - Pedro Curi Hallal
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL,USA
| | | |
Collapse
|
27
|
Üzelpasaci E, Özdemir M, Gürşen C. Reliability and validity of the Turkish version of the pregnancy exercise self-efficacy scale. SEXUAL & REPRODUCTIVE HEALTHCARE 2023; 37:100899. [PMID: 37598520 DOI: 10.1016/j.srhc.2023.100899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/31/2023] [Accepted: 08/14/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE The aim of this study was to adapt the Pregnancy Exercise Self-Efficacy Scale (P-ESES) into Turkish, investigate its reliability and validity in Turkish pregnant women, and obtain a validated tool in order to assess the exercise self-efficacy during pregnancy. METHODS A total of 138 pregnant women participated in the present study. For the translation of the P-ESES into Turkish (P-ESES-T), a six-phase process was followed. The psychometric properties of the P-ESES-T were analyzed in respect of internal consistency, test-retest reliability, and criterion validity. To assess the validity of the P-ESES-T, the associations between the P-SES-T and the Pregnancy Physical Activity Questionnaire (PPAQ), the Sensewear Pro3 Armband (n = 31), and the Exercise Barries/Benefits Scale (EBBS) were analyzed. RESULTS Test-retest reliability for the P-ESES-T total score was found to be very strong (ICCs: 0.986, p < 0.001). Cronbach's α coefficient was 0.899. There were strong correlations between the total scores of the P-ESES-T and PPAQ, and EBBS (r = 0.780, r = 0.874; p < 0.001). However, no significant correlations were found between the total number of steps and energy expenditure obtained from the physical activity monitor and the P-ESES-T (p > 0.05). CONCLUSION The P-ESES-T is a reliable and valid tool that can be used to evaluate exercise self-efficacy, which is an important factor that affects exercise participation during pregnancy.
Collapse
Affiliation(s)
- Esra Üzelpasaci
- University of Health Science, Faculty of Gülhane Physiotherapy and Rehabilitation, Ankara, Turkey.
| | - Melike Özdemir
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, 06100 Samanpazarı, Ankara, Turkey.
| | - Ceren Gürşen
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, 06100 Samanpazarı, Ankara, Turkey.
| |
Collapse
|
28
|
Rizk J, Andreou E, Hileti D, Ghaddar A, Zampelas A. Assessing Health Care Providers' Knowledge and Practices of Nutrition during Pregnancy in Lebanon: A Cross-Sectional Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1471. [PMID: 37629760 PMCID: PMC10456354 DOI: 10.3390/medicina59081471] [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: 07/06/2023] [Revised: 08/02/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
Background and objectives: Health care professionals (HCPs) are well-positioned to discuss healthy behaviors during pregnancy, but the published research of prenatal healthcare providers' knowledge about the significance of nutrition during pregnancy in Lebanon is scarce. The purpose of this study was to explore the knowledge, attitudes, and practices of Lebanese prenatal healthcare providers towards nutrition during pregnancy. Materials and Methods: A cross-sectional study using an online questionnaire was conducted. Health care providers were contacted by phone and email to participate in the online survey. A list of all clinics providing antenatal health services was obtained from the Order of Physicians and the Order of Midwives. A multistage random sample was selected. In the first stage, it was stratified per region (Beirut center or suburbs, and the southern region). In the second phase, it was stratified per clinic type (private, primary healthcare center, or hospital). Gynecologists and midwives who are members of the Order of Physicians and the Order of Midwives (n = 1333), were included. Results: Two-hundred and six responses (55% males) were obtained. Approximately 44% of the HCP were aged 50 and older, and 68.4% had more than 10 years of work experience. HCPs from Beirut represented 41.3% of the respondents. Eighty-eight percent of the HCPs were physicians, and 11% were midwives. The majority of the participants considered nutrition during pregnancy to be very important. Furthermore, half of these participants considered their position in delivering nutrition information as very significant. Most of the respondents reported that they provide nutrition advice to pregnant women, and they also received nutrition education during their profession. However, they perceived their nutrition knowledge as inadequate. Conclusion: Health care providers' attitude towards the importance of maternal nutrition and their confidence in talking about nutrition-related topics with pregnant women were positive despite the lack of knowledge in several areas related to nutrition during pregnancy. Therefore, there is a need for continuing nutrition education for health care providers and the implementation of nutrition education programs to achieve better health outcomes.
Collapse
Affiliation(s)
- Jessy Rizk
- Department of Life Sciences, University of Nicosia, Nicosia CY-2417, Cyprus; (J.R.); (E.A.); (D.H.)
| | - Eleni Andreou
- Department of Life Sciences, University of Nicosia, Nicosia CY-2417, Cyprus; (J.R.); (E.A.); (D.H.)
| | - Dona Hileti
- Department of Life Sciences, University of Nicosia, Nicosia CY-2417, Cyprus; (J.R.); (E.A.); (D.H.)
| | - Ali Ghaddar
- Department of Biomedical Science, Lebanese International University, Beirut 146404, Lebanon;
- Public Health Research Group, University of Alicante, 03690 Alicante, Spain
| | - Antonis Zampelas
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, Agricultural University of Athens, 11855 Athens, Greece
| |
Collapse
|
29
|
Rial-Vázquez J, Vila-Farinas A, Varela-Lema L, Santiago-Pérez MI, Rey-Brandariz J, Candal-Pedreira C, Pérez-Ríos M. Actividad física en el embarazo y puerperio: prevalencia y recomendaciones de los profesionales sanitarios. Aten Primaria 2023; 55:102607. [PMID: 37001421 PMCID: PMC10073937 DOI: 10.1016/j.aprim.2023.102607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE To assess changes in physical activity (PA) during pregnancy and after giving birth and to explore this according to age and educational level. To analyze whether the health professionals gave recommendations on PA. DESIGN Observational study. SITE: Information is derived from the Galician Risk Behavior Information System. PARTICIPANTS The target population was Galician women (aged 18-49 years) who delivered between september-2015 and august-2016. MAIN MEASUREMENTS The prevalence of walking, physical exercise and PA recommendations were estimated for three moments (pre-pregnancy, pregnancy and after delivery). RESULTS Walking during pregnancy increased by 34,0% and the performance of physical exercise decreased by 21,0%. After delivery, walking decreased by 37,0% and physical exercise decreased by 32,0% compared to pregnancy. Women of younger age and lower educational level were those who performed less PA. 72,6% and 22,1% of women declared that a healthcare professional recommended PA during pregnancy and after delivery, respectively. CONCLUSION The PA performed by women during pregnancy is mainly walking, and there is a concern about the abandonment of PA practice after delivery. Healthcare professionals recommend PA mainly during pregnancy, but little is recommended after delivery. It may be desirable for the improvement of this prevalence to reinforce health action.
Collapse
|
30
|
Holliday K, Sames C, Hoose D, Wentz E. A Qualitative Exploration of Exercise During Pregnancy. Nurs Womens Health 2023; 27:190-200. [PMID: 37075808 DOI: 10.1016/j.nwh.2023.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/25/2023] [Accepted: 03/09/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE To explore the experience of women engaging in physical activity during pregnancy. DESIGN This was the qualitative arm of the Starting Pregnancy With Robustness for Optimal Upward Trajectories (SPROUT) pilot project. Thematic analysis was used to realize patterns of meaning and significance from data on participants' experiences in engaging in physical activity during pregnancy. SETTING One-on-one structured interviews via video conferencing. PARTICIPANTS Eighteen women in the first trimester of their pregnancy were recruited from local obstetric practices and randomized into one of three exercise groups. All three groups of women were followed for their entire pregnancy and for 6 months postpartum. METHODS Interviews were recorded and analyzed using thematic analysis. RESULTS Six major themes important for clinical practice resulted from the analysis: Physical Activity During Pregnancy Is Desirous for Health Benefits, Activity Monitors Provide Motivation, Human Connection HelpsSupportPhysical Activity, More Guidance Is Needed on How to Be Physically Active During Pregnancy, A Supervised Physical Activity Program Is Preferred if Available and Flexible, and Participants Would Choose to Be Physically Active in Subsequent Pregnancies. CONCLUSION Human interaction, education on physical activity guidelines, and exercise advice increased motivation, accountability, and confidence in the women. Using a tracking device such as an activity watch provided real-world feedback in addition to fostering motivation.
Collapse
|
31
|
Papežová K, Kapounová Z, Zelenková V, Riad A. Nutritional Health Knowledge and Literacy among Pregnant Women in the Czech Republic: Analytical Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3931. [PMID: 36900942 PMCID: PMC10001919 DOI: 10.3390/ijerph20053931] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Adequate nutrition and the nutritional status of pregnant women are critical for the health of both the mother and the developing foetus. Research has shown a significant impact of nutrition on the child's health and the future risk of developing chronic noncommunicable diseases (NCDs), such as obesity, diabetes, hypertension, and cardiovascular disease. There is currently no data on the level of nutritional knowledge of Czech pregnant women. This survey aimed to evaluate their level of nutritional knowledge and literacy. An analytical cross-sectional study was conducted in two healthcare facilities in Prague and Pilsen between April and June 2022. An anonymous self-administered paper-form questionnaire for assessing the level of nutritional knowledge (40 items) and the Likert scale for assessing nutrition literacy (5 items) were used. A total number of 401 women completed the questionnaire. An individual's nutritional knowledge score was calculated and compared with demographic and anamnestic characteristics using statistical methods. The results showed that only 5% of women achieved an overall nutritional score of 80% or more. University education (p < 0.001), living in the capital city (p < 0.001), experiencing first pregnancy (p = 0.041), having normal weight and being overweight (p = 0.024), and having NCDs (p = 0.044) were statistically significantly associated with a higher nutritional knowledge score. The lowest knowledge scores were found in the areas of optimal energy intake, optimal weight gain, and the role of micronutrients in diet during pregnancy. In conclusion, the study shows limited nutrition knowledge of Czech pregnant women in some areas of nutrition. Increasing nutritional knowledge and nutrition literacy in Czech pregnant women is crucial for supporting their optimal course of pregnancy and the future health of their offspring.
Collapse
Affiliation(s)
- Klára Papežová
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
- Department of Social Medicine, Department of Social and Assesment Medicine, Charles University, 323 00 Pilsen, Czech Republic
| | - Zlata Kapounová
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Veronika Zelenková
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| | - Abanoub Riad
- Department of Public Health, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
- Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of Excellence, Masaryk University GRADE Centre), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
| |
Collapse
|
32
|
Leung T, Pardo F, Moya J, Pino M, Rodríguez A, Araneda ME, Bertini A, Gutiérrez J. An mHealth Intervention to Reduce Gestational Obesity (mami-educ): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e44456. [PMID: 36790846 PMCID: PMC9978990 DOI: 10.2196/44456] [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: 11/19/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The World Federation of Obesity warns that the main health problem of the next decade will be childhood obesity. It is known that factors such as gestational obesity produce profound effects on fetal programming and are strong predictors of overweight and obesity in children. Therefore, establishing healthy eating behaviors during pregnancy is the key to the primary prevention of the intergenerational transmission of obesity. Mobile health (mHealth) programs are potentially more effective than face-to-face interventions, especially during a public health emergency such as the COVID-19 outbreak. OBJECTIVE This study aims to evaluate the effectiveness of an mHealth intervention to reduce excessive weight gain in pregnant women who attend family health care centers. METHODS The design of the intervention corresponds to a classic randomized clinical trial. The participants are pregnant women in the first trimester of pregnancy who live in urban and semiurban areas. Before starting the intervention, a survey will be applied to identify the barriers and facilitators perceived by pregnant women to adopt healthy eating behaviors. The dietary intake will be estimated in the same way. The intervention will last for 12 weeks and consists of sending messages through a multimedia messaging service with food education, addressing the 3 domains of learning (cognitive, affective, and psychomotor). Descriptive statistics will be used to analyze the demographic, socioeconomic, and obstetric characteristics of the respondents. The analysis strategy follows the intention-to-treat principle. Logistic regression analysis will be used to compare the intervention with routine care on maternal pregnancy outcome and perinatal outcome. RESULTS The recruitment of study participants began in May 2022 and will end in May 2023. Results include the effectiveness of the intervention in reducing the incidence of excessive gestational weight gain. We also will examine the maternal-fetal outcome as well as the barriers and facilitators that influence the weight gain of pregnant women. CONCLUSIONS Data from this effectiveness trial will determine whether mami-educ successfully reduces rates of excessive weight gain during pregnancy. If successful, the findings of this study will generate knowledge to design and implement personalized prevention strategies for gestational obesity that can be included in routine primary care. TRIAL REGISTRATION ClinicalTrials.gov NCT05114174; https://clinicaltrials.gov/ct2/show/NCT05114174. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44456.
Collapse
Affiliation(s)
| | - Fabian Pardo
- Metabolic Diseases Research Laboratory, Interdisciplinary Center for Research in Territorial Health of the Aconcagua Valley, Center for Biomedical Research, Universidad de Valparaíso, San Felipe, Chile.,School of Medicine, Campus San Felipe, Faculty of Medicine, Universidad de Valparaíso, San Felipe, Chile
| | - Jessica Moya
- School of Nutrition and Dietetics, Faculty of Sciences for Health Care, Universidad San Sebastián, Santiago, Chile
| | - Maricela Pino
- School of Obstetrics, Faculty of Sciences for Health Care, Universidad San Sebastián, Santiago, Chile
| | - Andrea Rodríguez
- School of Obstetrics, Faculty of Sciences for Health Care, Universidad San Sebastián, Santiago, Chile
| | | | - Ayleen Bertini
- Metabolic Diseases Research Laboratory, Interdisciplinary Center for Research in Territorial Health of the Aconcagua Valley, Center for Biomedical Research, Universidad de Valparaíso, San Felipe, Chile.,PhD Program Doctorado en Ciencias e Ingeniería para La Salud, Faculty of Medicine, Universidad de Valparaíso, Valparaíso, Chile
| | - Jaime Gutiérrez
- Cellular Signaling and Differentiation Laboratory, School of Medical Technology, Faculty of Medicine and Science, Universidad San Sebastián, Santiago, Chile
| |
Collapse
|
33
|
Gagnon M, Plante AS, Turcotte M, Bégin C, Michaud A, Provencher V, Morisset AS. Determinants of weight gain and body changes during pregnancy: A qualitative study of French-Canadian pregnant people. J Gynecol Obstet Hum Reprod 2023; 52:102519. [PMID: 36529367 DOI: 10.1016/j.jogoh.2022.102519] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE More than half of pregnant Canadian people exceed current gestational weight gain recommendations, which has been associated with adverse outcomes for both parent and child. Although the physiological causes of excessive gestational weight gain have been well investigated, few studies have evaluated the context of gestational weight gain and body changes through the perspective of pregnant people. Therefore, we aim to explore factors influencing body changes and weight gain during pregnancy as experienced by pregnant individuals. METHODS A total of three focus groups and six individual interviews were conducted with pregnant people (n=21) recruited in the 2nd or 3rd trimester. A semi-structured interview guide was developed according to a pre-existing conceptual model by Hill et al., 2013. Focus groups and interviews were recorded, transcribed, and thematically analysed using NVivo software. FINDINGS Results were categorized into four main themes, based on the conceptual model: (1) parental psychological, social and cognitive factors, (2) outcomes, (3) parental behaviors and (4) health behavior change constructs. Participants identified structural, social, professional, and especially partner support (1), health-related strategies (2), body image (1) and knowledge of gestational weight gain recommendations (3) as influent components of their body changes experience. CONCLUSIONS In this study, the themes addressed affect both pregnant individuals and their relatives. Enhanced knowledge of gestational weight gain recommendations in this population, support from relatives and quality of follow-up offered by health professionals must therefore be considered as possible avenues of intervention.
Collapse
Affiliation(s)
- Marianne Gagnon
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Quebec City, QC, Canada; School of Nutrition, Université Laval, Quebec City, QC, Canada; Endocrinology and Nephrology Unit, CHU of Quebec-Université Laval Research Center, Quebec City, QC, Canada
| | - Anne-Sophie Plante
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Quebec City, QC, Canada; Endocrinology and Nephrology Unit, CHU of Quebec-Université Laval Research Center, Quebec City, QC, Canada
| | - Mylène Turcotte
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Quebec City, QC, Canada
| | - Catherine Bégin
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Quebec City, QC, Canada; School of Psychology, Université Laval, Quebec City, Canada
| | - Andréanne Michaud
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Quebec City, QC, Canada; School of Nutrition, Université Laval, Quebec City, QC, Canada; Institut universitaire de cardiologie et de pneumologie de Québec (IUCPQ), Quebec City, QC, Canada
| | - Véronique Provencher
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Quebec City, QC, Canada; School of Nutrition, Université Laval, Quebec City, QC, Canada
| | - Anne-Sophie Morisset
- Centre Nutrition, santé et société (NUTRISS), Institut sur la nutrition et les aliments fonctionnels (INAF), Université Laval, Quebec City, QC, Canada; School of Nutrition, Université Laval, Quebec City, QC, Canada; Endocrinology and Nephrology Unit, CHU of Quebec-Université Laval Research Center, Quebec City, QC, Canada.
| |
Collapse
|
34
|
You H, Wang YY, Zhang C, Walker AN, Ge JJ, Zhao SQ, Peng XQ. Empirical validation of the information-motivation-behavioral skills model of gestational weight management behavior: a framework for intervention. BMC Public Health 2023; 23:130. [PMID: 36653762 PMCID: PMC9848710 DOI: 10.1186/s12889-023-15067-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 01/16/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Unhealthy gestational weight gain is a modifiable risk factor for adverse maternal and child health. Appropriate and effective intervention strategies that focus on behavioral change or maintenance are critical in weight management during pregnancy. Our aim was to uncover the influencing factors and psychosocial mechanisms of gestational weight control behavior, and to construct a behavioral model suitable for intervention based on Information-Motivation-Behavioral skills (IMB) model. METHODS A sample of 559 pregnant women from a municipal maternal and child healthcare facility in Jiangsu Province, China was enrolled in this cross-sectional empirical study. Partial least square structural equation modelling was used to verify the hypothesized model, and post hoc analyses was used to test the effect of parity and pre-pregnancy BMI on the model. RESULTS The IMB model elements can predict gestational weight management (GWM) behavior well, with information being the most influential factor. As predicted, information affects GWM directly (β = 0.325, p < 0.05) and indirectly (β = 0.054, p < 0.05) through behavioral skills. Likewise, motivation has direct (β = 0.461, p < 0.05) effects on GWM, and has indirect (β = 0.071, p < 0.05) effects through behavioral skills. Behavioral skills have a direct impact (β = 0.154, p < 0.05). The model had a goodness of fit (GOF = 0.421) and was robust when tested in subgroups of different parity or pre-pregnancy BMI. CONCLUSION Findings from this study supported the predictions of the IMB model for GWM behavior, and identified its modifiable determinants. The tested behavior model for GWM can serve as a new validated intervention strategy in weight management among pregnant women.
Collapse
Affiliation(s)
- Hua You
- School of Public Health, Nanjing Medical University, Nanjing, China
- Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing, China
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Yuan-Yuan Wang
- Jiangsu Health Development Research Center, Nanjing, China
| | - Chi Zhang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | | | - Jin-Jin Ge
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Shi-Qi Zhao
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xue-Qing Peng
- School of Public Health, Nanjing Medical University, Nanjing, China.
- Chengdu Center for Disease Control and Prevention, 4 Longxiang Road, Wuhou District, Chengdu, 610041, China.
| |
Collapse
|
35
|
Yu H, He J, Li K, Qi W, Lin J, Szumilewicz A. Quality assessment of pre- and postnatal nutrition and exercise mobile applications in the United States and China. Front Nutr 2023; 9:942331. [PMID: 36698473 PMCID: PMC9868741 DOI: 10.3389/fnut.2022.942331] [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: 05/12/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
Background Mobile applications (apps) are becoming increasingly prevalent as tools for improving maternal health behaviors. However, the recently updated content and quality of these apps remain unknown. This research investigated the fundamental characteristics, functional modules, and overall quality of maternal apps available in the United States and China to reveal critical nutrition and physical activity gaps. Methods A systematic search was performed in Android and iOS app stores (China and the United States). Apps were eligible if they targeted pregnant or postpartum women, focused on nutrition or physical activity, and had interfaces in English or Chinese. The basic characteristics, functional modules, and overall quality of the apps were evaluated, and differences between apps available in China or the United States were determined using analysis of variance and chi-square tests. Pearson correlations were utilized to investigate links between objective quality and user rating. Results A total of 65 maternity-related nutrition and physical activity apps (34 from China and 31 from the United States) were eligible. Among them, 68% (21/31) of US apps and 56% (19/34) of Chinese apps did not provide supporting evidence for their content. A greater number of Chinese apps provided app-based general education modules, namely food nutrition knowledge (n = 0, 0% in the United States vs. n = 30, 88.2% in China). Meanwhile, a greater number of US apps provided exercise modules, namely pregnancy yoga (n = 21, 67.7% in the United States vs. n = 2, 5.9% in China). The overall app quality rating in the United States was lower than it was in China (mean: 3.5, SD: 0.6 in China vs. mean: 3.4, SD: 0.7 in the United States). There was no relationship between the overall app quality rating and the user rating in either country (rho = 0.11 in China and rho = -0.13 in the United States). Conclusion The characteristics and functional modules of in-store apps for maternal nutrition and physical activity differed between the United States and China. Both countries' apps, especially Chinese apps, lacked evidence-based information, and there was no correlation between app quality and user rating. The results therefore suggest that user ratings cannot be used as an objective indicator of app quality and that it is necessary to improve the empirical basis and credibility of apps in both countries.
Collapse
Affiliation(s)
- Hongli Yu
- Department of Sport, Gdansk University of Physical Education and Sport, Gdańsk, Poland,Jiuling Primary School, Mianyang, Sichuan, China,*Correspondence: Hongli Yu,
| | - Juan He
- Department of Sport, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Keqiang Li
- Department of Sport, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Wen Qi
- Department of Sport, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| | - Jiahui Lin
- Football Academy, Beijing Sport University, Beijing, China
| | - Anna Szumilewicz
- Department of Sport, Gdansk University of Physical Education and Sport, Gdańsk, Poland
| |
Collapse
|
36
|
Killeen SL, Donnellan N, O'Reilly SL, Hanson MA, Rosser ML, Medina VP, Jacob CM, Divakar H, Hod M, Poon LC, Bergman L, O'Brien P, Kapur A, Jacobsson B, Maxwell CV, McIntyre HD, Regan L, Algurjia E, Ma RC, Adam S, McAuliffe FM. Using FIGO Nutrition Checklist counselling in pregnancy: A review to support healthcare professionals. Int J Gynaecol Obstet 2023; 160 Suppl 1:10-21. [PMID: 36635083 PMCID: PMC10108324 DOI: 10.1002/ijgo.14539] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
The period before and during pregnancy is increasingly recognized as an important stage for addressing malnutrition. This can help to reduce the risk of noncommunicable diseases in mothers and passage of risk to their infants. The FIGO Nutrition Checklist is a tool designed to address these issues. The checklist contains questions on specific dietary requirements, body mass index, diet quality, and micronutrients. Through answering these questions, awareness is generated, potential risks are identified, and information is collected that can inform health-promoting conversations between women and their healthcare professionals. The tool can be used across a range of health settings, regions, and life stages. The aim of this review is to summarize nutritional recommendations related to the FIGO Nutrition Checklist to support healthcare providers using it in practice. Included is a selection of global dietary recommendations for each of the components of the checklist and practical insights from countries that have used it. Implementation of the FIGO Nutrition Checklist will help identify potential nutritional deficiencies in women so that they can be addressed by healthcare providers. This has potential longstanding benefits for mothers and their children, across generations.
Collapse
Affiliation(s)
- Sarah Louise Killeen
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Niamh Donnellan
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Sharleen L O'Reilly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.,School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Mark A Hanson
- Institute of Developmental Sciences, University Hospital Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Mary L Rosser
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, New York, USA
| | - Virna P Medina
- Department of Obstetrics and Gynecology, Faculty of Health, Universidad del Valle, Clínica Imbanaco Quirón Salud, Universidad Libre, Cali, Colombia
| | - Chandni Maria Jacob
- Institute of Developmental Sciences, University Hospital Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | | | - Moshe Hod
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Liona C Poon
- Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Lina Bergman
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Patrick O'Brien
- Institute for Women's Health, University College London, London, UK
| | - Anil Kapur
- World Diabetes Foundation, Bagsvaerd, Denmark
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Genetics and Bioinformatics, Domain of Health Data and Digitalization, Institute of Public Health, Oslo, Norway
| | - Cynthia V Maxwell
- Maternal Fetal Medicine, Sinai Health and Women's College Hospital, University of Toronto, Toronto, Canada
| | - Harold David McIntyre
- Mater Health, University of Queensland, Mater Health Campus, South Brisbane, Queensland, Australia
| | | | - Esraa Algurjia
- The World Association of Trainees in Obstetrics & Gynecology, Paris, France.,Elwya Maternity Hospital, Baghdad, Iraq
| | - Ronald C Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.,Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sumaiya Adam
- Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Diabetes Research Centre, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | | |
Collapse
|
37
|
Kovell LC, Sibai D, Wilkie GL, Shankara S, Moinul S, Kaminsky L, Lemon SC, McManus DD. Identifying barriers, facilitators, and interventions to support healthy eating in pregnant women with or at risk for hypertensive disorders of pregnancy. CARDIOVASCULAR DIGITAL HEALTH JOURNAL 2022; 3:S1-S8. [PMID: 36589759 PMCID: PMC9795265 DOI: 10.1016/j.cvdhj.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background Heart-healthy diets are important in the prevention and treatment of hypertension (HTN), including among pregnant women. Yet, the barriers, facilitators, and beliefs/preferences regarding healthy eating are not well described in this population. Objective To identify barriers and facilitators to healthy diet, examine the prevalence of food insecurity, and determine interest in specific healthy diet interventions. Methods Pregnant women, aged 18-50 years (N = 38), diagnosed with HTN, hypertensive disorders in pregnancy (HDP), or risk factors for HDP, were recruited from a large academic medical center in central Massachusetts between June 2020 and June 2022. Participants completed an electronic survey using a 5-point Likert scale (strongly disagree to strongly agree). Results The mean age of participants was 31.6 years (SD 5.5) and 35.1% identified as Hispanic. Finances and time were major barriers to a healthy diet, reported by 42.1% and 28.9% of participants, respectively. Participants reported that their partners and families were supportive of healthy eating and preparing meals at home, though 30.0% of those with children considered their children's diet a barrier to preparing healthy meals. Additionally, 40.5% of the sample were considered food insecure. Everyone agreed that healthy diet was important for maternal and fetal health, and the most popular interventions were healthy ingredient grocery deliveries (89.4%) and meal deliveries (84.2%). Conclusion Time and cost emerged as major challenges to healthy eating in these pregnant women. Such barriers, facilitators, and preferences can aid in intervention development and policy-level changes to mitigate obstacles to healthy eating in this vulnerable patient population.
Collapse
Affiliation(s)
- Lara C. Kovell
- Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Diana Sibai
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Gianna L. Wilkie
- Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Sravya Shankara
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Sheikh Moinul
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Lila Kaminsky
- Department of Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Stephenie C. Lemon
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - David D. McManus
- Department of Medicine, Division of Cardiovascular Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| |
Collapse
|
38
|
Yu Y, Feng C, Bédard B, Fraser W, Dubois L. Diet quality during pregnancy and its association with social factors: 3D Cohort Study (Design, Develop, Discover). MATERNAL & CHILD NUTRITION 2022; 18:e13403. [PMID: 35821643 PMCID: PMC9480933 DOI: 10.1111/mcn.13403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 06/15/2022] [Accepted: 06/21/2022] [Indexed: 11/26/2022]
Abstract
Good diet quality during pregnancy provides adequate nutrition to support both the mothers and the fetus. The objective of this study is to describe the distribution of diet quality during pregnancy and to study the association between social factors and diet quality during pregnancy in a Canadian population. This study was based on 1535 pregnant women who provided dietary information in the 3D Cohort Study in Quebec, Canada. A 3‐day food record was used to collect dietary intake in the second trimester of pregnancy. A Canadian adaption of the Healthy Eating Index (HEI‐C) 2010 was used to quantify diet quality. Univariate and multiple linear regression models were used to calculate unadjusted and adjusted effect estimates and confidence intervals for the association between social factors and HEI‐C. The mean HEI‐C 2010 score in this study was 62.9 (SD: 11.2). Only 4.5% and 8.3% of the pregnant women consumed the recommended amounts of whole grains and ‘greens and beans’, respectively. Diet quality was lower in some subgroups of pregnant women. After multivariable adjustment, lower diet quality was observed in participants who were less educated, younger, overweight or obese before pregnancy, or parous. There was an interaction between ethnicity and immigration status on diet quality in pregnancy. These findings could be useful for health practitioners and policymakers in developing strategies to improve the diet quality of pregnant women. The diet of the women in Canada still needs improvement, especially regarding whole grains and ‘greens and beans’, where the majority of the women did not meet the recommendations. Pregnant women who were less educated, younger, overweight or obese before pregnancy, or parous should be targeted for improving diet quality in Canada. There was an interaction between ethnicity and immigration status on diet quality during pregnancy.
Collapse
Affiliation(s)
- Yamei Yu
- School of Epidemiology and Public Health, Faculty of Medicine University of Ottawa Ottawa Ontario Canada
| | - Cindy Feng
- School of Epidemiology and Public Health, Faculty of Medicine University of Ottawa Ottawa Ontario Canada
- Department of Community Health and Epidemiology Dalhousie University Halifax Nova Scotia Canada
| | - Brigitte Bédard
- School of Epidemiology and Public Health, Faculty of Medicine University of Ottawa Ottawa Ontario Canada
| | - William Fraser
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences Université de Sherbrooke, and the Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke (CRCHUS) Sherbrooke Quebec Canada
| | - Lise Dubois
- School of Epidemiology and Public Health, Faculty of Medicine University of Ottawa Ottawa Ontario Canada
| |
Collapse
|
39
|
McKay FH, Spiteri S, Zinga J, Sulemani K, Jacobs SE, Ranjan N, Ralph L, Raeburn E, Threlfall S, Bergmeier ML, van der Pligt P. Systematic Review of Interventions Addressing Food Insecurity in Pregnant Women and New Mothers. Curr Nutr Rep 2022; 11:486-499. [PMID: 35501553 PMCID: PMC9381473 DOI: 10.1007/s13668-022-00418-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2022] [Indexed: 10/27/2022]
Abstract
PURPOSE OF THE REVIEW Food insecurity can have a negative health impact for women during pregnancy and the postpartum period; however, there are a range of barriers to meeting nutritional guidelines during pregnancy. Food insecurity is associated with an increased risk of pregnancy complications and mental and physical health outcomes. This review aims to provide insight into programmes and interventions which have targeted food insecurity in pregnant and early postpartum women. The central research question for this review is as follows: What programmes and interventions have sought to address food insecurity among pregnant and postpartum women? A systematic search of five electronic databases including Medline, CINAHL, Global Health, Embase, and Cochrane was undertaken on August 2021. Key thematic areas searched were food insecurity, pregnancy, nutritional outcomes, and interventions or programmes. Only studies that were published since 2000 in English were considered. RECENT FINDINGS Eleven studies were included in this review. Studies employed a range of methods and outcomes measures. They were conducted in mostly low- and middle-income countries, and in general, focused on nutritional supplementation, with some studies also incorporating nutrition education or counselling. The findings of this review suggest that while there are a range of possible interventions that seek to address food insecurity and hunger among pregnant and postpartum women, the limited number of robust evaluations or long-term interventions mean that evidence for any one intervention type is limited. Furthermore, the programmes and interventions that do exist are generally embedded within a single context or structure, and as such, may not be able to be widely implemented. (Prospero Registration CRD42022245787).
Collapse
Affiliation(s)
- Fiona H McKay
- School of Health and Social Development/Institute for Health Transformation, Faculty of Health, Deakin University, Victoria, Australia.
| | - Sheree Spiteri
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Julia Zinga
- School of Health and Social Development/Institute for Health Transformation, Faculty of Health, Deakin University, Victoria, Australia
| | - Kineta Sulemani
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Samantha E Jacobs
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Nithi Ranjan
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Lauren Ralph
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Eliza Raeburn
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Sophie Threlfall
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Midina L Bergmeier
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Paige van der Pligt
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
- Department of Nutrition and Dietetics, Western Health, Footscray, Australia
| |
Collapse
|
40
|
Brink LR, Bender TM, Davies R, Luo H, Miketinas D, Shah N, Loveridge N, Gross G, Fawkes N. Optimizing Maternal Nutrition: The Importance of a Tailored Approach. Curr Dev Nutr 2022; 6:nzac118. [PMID: 36157850 PMCID: PMC9492153 DOI: 10.1093/cdn/nzac118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/08/2022] [Accepted: 07/20/2022] [Indexed: 11/17/2022] Open
Abstract
Improving nutritional status during pregnancy is a global interest. Frequently, women either fail to meet or exceed nutrient recommendations. Current strategies to improve maternal nutrition focus on a "one-size-fits-all" approach and fail to consider individual factors that affect the mother's overall nutritional status. The objectives of this review were to determine the importance of key nutrients for optimal maternal and fetal health, to explore to what extent current recommendations consider individual factors, and to explore novel strategies to close the gap between current guidelines and real-world challenges through more personalized approaches. This review intercalated different nutritional guidelines and recent scientific publications and research initiatives related to maternal nutrition. Based on that, an overview of current recommendations, challenges related to present approaches, and perspectives for future directions are described. Current guidelines are not optimally supporting adequate nutrient intake and health of expectant mothers and their offspring. Existing recommendations are not consistent and do not sufficiently take into account how interindividual variation leads to differences in nutrient status. Personalized nutrition offers women the opportunity to improve their health by using strategies that are tailored to their unique nutritional needs. Such strategies can include personalized supplementation, holistic lifestyle interventions, digital and application-based technologies, and dietary assessment through blood biomarker and genetic analysis. However, these approaches warrant further investigation and optimization. More personalized approaches have the potential to optimize mothers' and their offspring's health outcomes more appropriately to their nutritional needs before, during, and after pregnancy. Moving away from a generalized "one-size-fits-all" approach can be achieved through a variety of means. Future aims should be to provide supporting evidence to create customized subpopulation-based or individualized recommendations, improve nutrition education, and develop novel approaches to improve adherence to dietary and lifestyle interventions.
Collapse
Affiliation(s)
- Lauren R Brink
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Evansville, IN, USA
| | - Tonya M Bender
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Evansville, IN, USA
| | - Rosalind Davies
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Slough, UK
| | | | - Derek Miketinas
- Nutrition and Food Sciences, Texas Woman's University, Houston, TX, USA
| | - Neil Shah
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Slough, UK
| | - Nik Loveridge
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Slough, UK
| | - Gabriele Gross
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Nijmegen, The Netherlands
| | - Neil Fawkes
- Medical and Scientific Affairs, Reckitt/Mead Johnson Nutrition Institute, Slough, UK
| |
Collapse
|
41
|
Newson L, Bould K, Aspin‐Wood B, Sinclair L, Ikramullah Z, Abayomi J. The lived experiences of women exploring a healthy lifestyle, gestational weight gain and physical activity throughout pregnancy. Health Expect 2022; 25:1717-1729. [PMID: 35514097 PMCID: PMC9327828 DOI: 10.1111/hex.13514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/13/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Weight gain is inevitable during pregnancy. However, high prepregnancy body mass index and excessive gestational weight gain are associated with poor pregnancy outcomes. Understanding the experiences, social influences and decisions women make to maintain a healthy lifestyle during pregnancy are essential to consider how to improve services and interventions to help women engage in a healthy diet and physical activity (PA) behaviours. OBJECTIVE The study investigated women's opinions and lived experiences of engaging in a healthy diet, promoting optimal gestational weight gain and PA during and after pregnancy. DESIGN AND METHODS Twenty-two pregnant women contributed to qualitative data collection for this Grounded Theory (GT) study. Nineteen women completed semi-structured interviews and three patient and public involvement (PPI) representatives sought to validate the analysis and GT framework. RESULTS Two substantive categories were constructed: (1) Evolving from 'I' to 'we', as informed by two subcategories and (2) the power of information and guidance, as informed by three subcategories. These categories informed the core category, 'A navigational journey and evolution of the pregnant self'. The navigational journey involves constantly searching for knowledge and information to support and balance the interests of personal beliefs, the health of their unborn baby, their social circle and the wider world. A woman's psychological capability (e.g., their knowledge of a healthy lifestyle and confidence to implement such knowledge) is continuously tested. CONCLUSIONS Pregnancy may create a 'teachable moment' but there is a need for appropriate guidance from professionals to assist with lifestyle choices during pregnancy. The findings showed a significant influence of online resources, and lack of guidance on behaviour during pregnancy and may highlight areas of focus for future research and intervention. PUBLIC CONTRIBUTION Three pregnant women were recruited to act as PPI representatives to assist with the validation of the analytical findings and aid the final theoretical saturation of the GT framework. Commentary from these PPI representatives was used to validate the analysis and support the interpretation of the data. In addition, these PPI representatives were also invited to provide commentary on the draft manuscript and those involved in this later process have been included as coauthors.
Collapse
Affiliation(s)
- Lisa Newson
- School of Psychology, Faculty of HealthLiverpool John Moores UniversityLiverpoolUK
| | - Kathryn Bould
- School of Psychology, Faculty of HealthLiverpool John Moores UniversityLiverpoolUK
| | - Bronte Aspin‐Wood
- School of Psychology, Faculty of HealthLiverpool John Moores UniversityLiverpoolUK
| | - Lauren Sinclair
- School of Psychology, Faculty of HealthLiverpool John Moores UniversityLiverpoolUK
| | - Zainab Ikramullah
- Patient and Public Involvement Representative, Member of the PublicServiceuser of Mamafit interventionLiverpoolUK
| | - Julie Abayomi
- School of Applied Health and Social Care, Faculty of Health, Social Care and MedicineEdge Hill UniversityOrmskirkUK
| |
Collapse
|
42
|
Cilar Budler L, Budler M. Physical activity during pregnancy: a systematic review for the assessment of current evidence with future recommendations. BMC Sports Sci Med Rehabil 2022; 14:133. [PMID: 35842718 PMCID: PMC9288689 DOI: 10.1186/s13102-022-00524-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/12/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Physical activity is essential to maternal and infant health. Healthcare professionals should inform pregnant women about benefits of physical activity to prevent possible health issues. Those recommendations should elaborate on relevant contemporary evidence. The aim of this study was to review evidence-based recommendations for physical activity during pregnancy. METHODS A systematic search, analysis and synthesis of conducted randomised controlled trials (RCTs) was conducted from October 2021 to June 2022 in following databases: PubMed, CINAHL, ScienceDirect and Web of Science. Literature was searched using inclusion and exclusion criteria and following PRISMA recommendations. RESULTS Benefits for pregnant-women health and well-being were reported while performing aerobic exercise, lumbar stabilization and stretching exercise, water exercise, nerve and tendon-slip exercise, resistance training and strength training. For all exercise modalities it is recommended to perform moderate intensity activities during the whole time of pregnancy. CONCLUSIONS This systematic literature review supplements current knowledge on physical activity of pregnant women. Exercise interventions are listed and suggested in an integrative model with physical-fitness components to contextualize and promote physical activity among pregnant women.
Collapse
Affiliation(s)
- Leona Cilar Budler
- Faculty of Health Sciences, University of Maribor, Zitna ulica 15, 2000, Maribor, Slovenia.
| | - Marko Budler
- School of Economics and Business, University of Ljubljana, Kardeljeva ploscad 17, 1000, Ljubljana, Slovenia
- Fitness Association of Slovenia, Cesta 24. junija 23, 1231, Ljubljana, Slovenia
| |
Collapse
|
43
|
McKeough R, Blanchard C, Piccinini-Vallis H. Pregnant and Postpartum Women's Perceptions of Barriers to and Enablers of Physical Activity During Pregnancy: A Qualitative Systematic Review. J Midwifery Womens Health 2022; 67:448-462. [PMID: 35621324 DOI: 10.1111/jmwh.13375] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 03/29/2022] [Accepted: 04/03/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Physical activity throughout pregnancy has been shown to have health benefits for the pregnant person, including reductions in the risk of preeclampsia and gestational weight gain and improvements in blood pressure regulation. Despite the benefits, many pregnant women do not meet the guidelines for physical activity throughout pregnancy. Therefore, it is important to determine what influences women's activity levels during pregnancy. This systematic review of the qualitative literature aimed to determine pregnant and postpartum women's perceptions of barriers to and enablers of physical activity, specifically during pregnancy. METHODS MEDLINE, PsycINFO, CINAHL, and Embase were searched systematically to identify qualitative studies investigating pregnant or postpartum women's perceptions of barriers to and enablers of physical activity during pregnancy. Included studies were limited to populations of pregnant or postpartum women, the majority of whom were aged 18 to 40 years, and studies published from 1985 onward. Data quality was assessed using the Critical Appraisal Skills Programme Qualitative Studies Checklist. Data were extracted using NVivo software and subsequently mapped on the COM-B framework. RESULTS Twenty-five qualitative studies were included in this systematic review. Sixteen themes were identified that mapped onto 6 components of the COM-B framework. Commonly reported barriers to physical activity during pregnancy included pregnancy symptoms, lack of knowledge of what constitutes safe activity, and the opinions of women's social circles. Commonly reported enablers of physical activity during pregnancy were social support and the experienced benefits, including physiologic, psychological, and social benefits. DISCUSSION The results of this systematic review have clinical implications for perinatal care providers, as the overall benefits of physical activity during pregnancy have been well documented in previous studies. The authors recommend clinicians aim to explore pregnant women's perspectives on physical activity during pregnancy in order to be able to address their perceived barriers to and enablers of physical activity during pregnancy.
Collapse
Affiliation(s)
- Regan McKeough
- Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
| | - Christopher Blanchard
- Department of Medicine, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
| | - Helena Piccinini-Vallis
- Department of Family Medicine, Dalhousie University Faculty of Medicine, Halifax, Nova Scotia, Canada
| |
Collapse
|
44
|
Lorenz L, Krebs F, Nawabi F, Alayli A, Stock S. Preventive Counseling in Routine Prenatal Care-A Qualitative Study of Pregnant Women's Perspectives on a Lifestyle Intervention, Contrasted with the Experiences of Healthcare Providers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6122. [PMID: 35627659 PMCID: PMC9140722 DOI: 10.3390/ijerph19106122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/10/2022] [Accepted: 05/16/2022] [Indexed: 11/22/2022]
Abstract
Maternal lifestyle during pregnancy and excessive gestational weight gain can influence maternal and infant short and long-term health. As part of the GeMuKi intervention, gynecologists and midwives provide lifestyle counseling to pregnant women during routine check-up visits. This study aims to understand the needs and experiences of participating pregnant women and to what extent their perspectives correspond to the experiences of healthcare providers. Semi-structured interviews were conducted with 12 pregnant women and 13 multi-professional healthcare providers, and were analyzed using qualitative content analysis. All interviewees rated routine check-up visits as a good setting in which to focus on lifestyle topics. Women in their first pregnancies had a great need to talk about lifestyle topics. None of the participants were aware of the link between gestational weight gain and maternal and infant health. The healthcare providers interviewed attributed varying relevance regarding the issue of weight gain and, accordingly, provided inconsistent counseling. The pregnant women expressed dissatisfaction regarding the multi-professional collaboration. The results demonstrate a need for strategies to improve multi-professional collaboration. In addition, health care providers should be trained to use sensitive techniques to inform pregnant women about the link between gestational weight gain and maternal and infant health.
Collapse
Affiliation(s)
- Laura Lorenz
- Institute of Health Economics and Clinical Epidemiology (IGKE), Faculty of Medicine and University Hospital Cologne, University of Cologne, 50935 Cologne, Germany; (F.K.); (F.N.); (A.A.); (S.S.)
| | | | | | | | | |
Collapse
|
45
|
Ehrhardt C, Deibert C, Flöck A, Merz WM, Gembruch U, Bockler A, Dötsch J, Joisten C, Ferrari N. Impact of Diet Quality during Pregnancy on Gestational Weight Gain and Selected Adipokines-Results of a German Cross-Sectional Study. Nutrients 2022; 14:nu14071515. [PMID: 35406128 PMCID: PMC9003101 DOI: 10.3390/nu14071515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/28/2022] [Accepted: 04/02/2022] [Indexed: 11/16/2022] Open
Abstract
While nutrition during pregnancy is critical for the health of both mother and child, little is known about the diet quality of women during pregnancy, its correlation with gestational weight gain (GWG)/body composition, and chosen maternal adipokines. Therefore, we evaluated the Healthy Eating Index (HEI) of 110 pregnant women and analyzed its correlation with GWG/body composition, physical activity, leptin, resistin, adiponectin, and interleukin 6 (IL-6), respectively. Diet quality was medium in 63% of women, characterized by a high intake of animal-based products. HEI was negatively influenced by pre-pregnancy obesity (β = −0.335, p = 0.004), and positively influenced by higher age (>35 yrs., β = 0.365, p ≤ 0.001), upper arm circumference (β = 0.222, p = 0.052), and total activity during the third trimester (β = 0.258, p = 0.008). GWG was associated with pre-pregnancy obesity (β = −0.512, p ≤ 0.001), thigh circumference (β = 0.342, p = 0.007), upper arm fat area (β = 0.208, p = 0.092), and maternal age group (>35 yrs. β = −0.166, p = 0.082), but not with HEI. Leptin and IL-6 displayed associations with variables representative of body composition, such as pre-pregnancy BMI, thigh circumference, upper arm fat area, and upper arm circumference, but were not influenced by HEI. Neither were adiponectin and resistin. IL-6 was also associated with total activity. In conclusion, GWG, leptin, and IL-6 were influenced by nutritional status (body composition/pre-pregnancy BMI), not by maternal diet. Physical activity level also had an impact on IL-6. Thus, efforts should be intensified to improve diet quality and participation in sports before and during pregnancy, particularly in overweight or obese women.
Collapse
Affiliation(s)
- Christina Ehrhardt
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany;
- Correspondence:
| | - Clara Deibert
- Department of Pediatric, DRK Hospital Kirchen, Bahnhofstraße 24, 57548 Kirchen, Germany;
| | - Anne Flöck
- Department of Obstetrics and Prenatal Medicine, Venusberg-Campus 1, University Bonn Medical School, 53127 Bonn, Germany; (A.F.); (W.M.M.); (U.G.)
| | - Waltraut M. Merz
- Department of Obstetrics and Prenatal Medicine, Venusberg-Campus 1, University Bonn Medical School, 53127 Bonn, Germany; (A.F.); (W.M.M.); (U.G.)
| | - Ulrich Gembruch
- Department of Obstetrics and Prenatal Medicine, Venusberg-Campus 1, University Bonn Medical School, 53127 Bonn, Germany; (A.F.); (W.M.M.); (U.G.)
| | - Adeline Bockler
- Department of General Internal Medicine/Cardiology, Marienhof Hospital, Rudolf-Virchow-Str. 7–9, 56073 Koblenz, Germany;
| | - Jörg Dötsch
- Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, University Hospital Cologne and University of Cologne, Robert-Koch-Str. 16, 50931 Cologne, Germany;
| | - Christine Joisten
- Department for Physical Activity in Public Health, Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany;
| | - Nina Ferrari
- Cologne Center for Prevention in Childhood and Youth/Heart Center Cologne, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany;
| |
Collapse
|
46
|
Okafor UB, Goon DT. Uncovering Barriers to Prenatal Physical Activity and Exercise Among South African Pregnant Women: A Cross-Sectional, Mixed-Method Analysis. Front Public Health 2022; 10:697386. [PMID: 35433615 PMCID: PMC9010665 DOI: 10.3389/fpubh.2022.697386] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe barriers to prenatal physical activity and exercise have been widely reported in the literature, highlighting context-specific challenges. However, generally, research on prenatal physical activity and exercise among pregnant women in South Africa is rare; and particularly concerning the barriers to their prenatal physical activity practice. This study assessed the barriers to physical activity participation among pregnant women in the Eastern Cape, South Africa.MethodsThis was a sequential explanatory mixed method, predominantly quantitative study involving 1,082 pregnant women. A structured self-administered questionnaire on perceived barriers to physical participation was applied to collect quantitative data; while a subset of 15 pregnant women participated in individual in-depth semi-structured interviews to augment quantitative data. Quantitative and qualitative data were analyzed using descriptive statistics and thematic analysis, respectively.ResultsThe results of the quantitative analysis presented major barriers: lack of advice on prenatal physical activity and inadequate or conflicting information about prenatal physical activity; tiredness; work commitments; discomfort; lack of time; low energy; non-accessibility to physical activity; lack of financial resources, and safety concerns for the mother and the baby. Qualitatively, the barriers identified relate to four main themes: individual, lack of information, lack of resources, and environmental barriers.ConclusionThe major barriers cited by the women were tiredness, lack of time, discomfort, and low energy. They also include lack of support, advice and information about prenatal physical activity. The multiple constraining factors responsible for low or non-prenatal physical activity of pregnant women in this setting highlight the need to tailor interventions to address their individual uniquely perceived barriers.
Collapse
Affiliation(s)
- Uchenna Benedine Okafor
- Department of Nursing Science, University of Fort Hare, Alice, South Africa
- *Correspondence: Uchenna Benedine Okafor
| | - Daniel Ter Goon
- Department of Public Health, University of Fort Hare, Alice, South Africa
| |
Collapse
|
47
|
Hayman MJ, Alfrey KL, Waters K, Cannon S, Mielke GI, Keating SE, Mena GP, Mottola MF, Evenson KR, Davenport MH, Barlow SA, Budzynski-Seymour E, Comardelle N, Dickey M, Harrison CL, Kebbe M, Moholdt T, Moran LJ, Nagpal TS, Schoeppe S, Alley S, Brown WJ, Williams S, Vincze L. Evaluating Evidence-Based Content, Features of Exercise Instruction, and Expert Involvement in Physical Activity Apps for Pregnant Women: Systematic Search and Content Analysis. JMIR Mhealth Uhealth 2022; 10:e31607. [PMID: 35044318 PMCID: PMC8811692 DOI: 10.2196/31607] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 10/01/2021] [Accepted: 11/17/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Guidelines for physical activity and exercise during pregnancy recommend that all women without contraindications engage in regular physical activity to improve both their own health and the health of their baby. Many women are uncertain how to safely engage in physical activity and exercise during this life stage and are increasingly using mobile apps to access health-related information. However, the extent to which apps that provide physical activity and exercise advice align with current evidence-based pregnancy recommendations is unclear. OBJECTIVE This study aims to conduct a systematic search and content analysis of apps that promote physical activity and exercise in pregnancy to examine the alignment of the content with current evidence-based recommendations; delivery, format, and features of physical activity and exercise instruction; and credentials of the app developers. METHODS Systematic searches were conducted in the Australian App Store and Google Play Store in October 2020. Apps were identified using combinations of search terms relevant to pregnancy and exercise or physical activity and screened for inclusion (with a primary focus on physical activity and exercise during pregnancy, free to download or did not require immediate paid subscription, and an average user rating of ≥4 out of 5). Apps were then independently reviewed using an author-designed extraction tool. RESULTS Overall, 27 apps were included in this review (Google Play Store: 16/27, 59%, and App Store: 11/27, 41%). Two-thirds of the apps provided some information relating to the frequency, intensity, time, and type principles of exercise; only 11% (3/27) provided this information in line with current evidence-based guidelines. Approximately one-third of the apps provided information about contraindications to exercise during pregnancy and referenced the supporting evidence. None of the apps actively engaged in screening for potential contraindications. Only 15% (4/27) of the apps collected information about the user's current exercise behaviors, 11% (3/27) allowed users to personalize features relating to their exercise preferences, and a little more than one-third provided information about developer credentials. CONCLUSIONS Few exercise apps designed for pregnancy aligned with current evidence-based physical activity guidelines. None of the apps screened users for contraindications to physical activity and exercise during pregnancy, and most lacked appropriate personalization features to account for an individual's characteristics. Few involved qualified experts during the development of the app. There is a need to improve the quality of apps that promote exercise in pregnancy to ensure that women are appropriately supported to engage in exercise and the potential risk of injury, complications, and adverse pregnancy outcomes for both mother and child is minimized. This could be done by providing expert guidance that aligns with current recommendations, introducing screening measures and features that enable personalization and tailoring to individual users, or by developing a recognized system for regulating apps.
Collapse
Affiliation(s)
- Melanie J Hayman
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Kristie-Lee Alfrey
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Kim Waters
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Summer Cannon
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Gregore I Mielke
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Shelley E Keating
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Gabriela P Mena
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Michelle F Mottola
- R Samuel McLaughlin Foundation Exercise and Pregnancy Laboratory, School of Kinesiology, University of Western Ontario, London, ON, Canada
- Department of Anatomy & Cell Biology, University of Western Ontario, London, ON, Canada
- Children's Health Research Institute, University of Western Ontario, London, ON, Canada
| | - Kelly R Evenson
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United States
| | - Margie H Davenport
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - S Ariel Barlow
- Reproductive Endocrinology & Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Emily Budzynski-Seymour
- Faculty of Sport, Health and Social Sciences, Solent University, Southampton, United Kingdom
| | - Natalie Comardelle
- Reproductive Endocrinology & Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Madison Dickey
- Reproductive Endocrinology & Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Maryam Kebbe
- Reproductive Endocrinology & Women's Health Laboratory, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, United States
| | - Trine Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Women's Clinic, St. Olavs University Hospital, Trondheim, Norway
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Taniya S Nagpal
- Faculty of Applied Health Sciences, School of Kinesiology, Brock University, Niagara Region, ON, Canada
| | - Stephanie Schoeppe
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Stephanie Alley
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Wendy J Brown
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia
| | - Susan Williams
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Lisa Vincze
- School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
- Menzies Health Institute Queensland, Griffith Health Centre, Gold Coast, Australia
| |
Collapse
|
48
|
Ruart S, Sinnapah S, Hue O, Janky E, Antoine-Jonville S. Association Between Maternal Body Mass and Physical Activity Counseling During Pregnancy. Front Psychol 2021; 12:612420. [PMID: 34899448 PMCID: PMC8656300 DOI: 10.3389/fpsyg.2021.612420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
Aims: The antenatal period provides an important opportunity for giving advice on healthy lifestyle choices. However, the prevalence of maternal obesity is increasing, and women report that they do not receive counseling. We investigated the information given to pregnant women on gestational weight gain, physical activity, and nutrition during pregnancy in relation with their initial weight status, current gestational weight gain and diagnoses of either pre-pregnancy overweight/obesity or excessive gestational weight gain. Methods: Cross-sectional survey using a questionnaire. Pregnant participants (n = 141) were recruited from a midwife center. They completed a structured questionnaire on the information they received during their pregnancy and we assessed its relationship with their weight. Results: We found that many pregnant women did not receive advice about physical activity, gestational weight gain and nutrition (37.5, 53.2, and 66.2%, respectively). Women with weight problems (pre-pregnancy overweight/obesity and excessive gestational weight gain) were less targeted for counseling, although more than 80% of the women viewed receiving information on these topics as positive. Also, being informed of a weight problem was associated with a greater chance of receiving information about physical activity, gestational weight gain and nutrition (all p < 0.05). However, verbalization of the weight problems was low (14.0% of women with pre-pregnancy overweight were informed of their status). Conclusion: Health professionals should dispense more information, especially on PA and particularly for women with weight problems. Verbalization of the weight problem seems associated with more frequent transmission of information.
Collapse
Affiliation(s)
- Shelly Ruart
- Laboratoire Adaptations au Climat Tropical Exercices et Santé (ACTES) (EA 3596), Université des Antilles, Pointe-à-Pitre, France
| | - Stéphane Sinnapah
- Laboratoire Adaptations au Climat Tropical Exercices et Santé (ACTES) (EA 3596), Université des Antilles, Pointe-à-Pitre, France
| | - Olivier Hue
- Laboratoire Adaptations au Climat Tropical Exercices et Santé (ACTES) (EA 3596), Université des Antilles, Pointe-à-Pitre, France
| | - Eustase Janky
- Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire de la Guadeloupe, Pointe-à-Pitre, France
| | - Sophie Antoine-Jonville
- Laboratoire Adaptations au Climat Tropical Exercices et Santé (ACTES) (EA 3596), Université des Antilles, Pointe-à-Pitre, France
| |
Collapse
|
49
|
Mehrabi F, Ahmaripour N, Jalali-Farahani S, Amiri P. Barriers to weight management in pregnant mothers with obesity: a qualitative study on mothers with low socioeconomic background. BMC Pregnancy Childbirth 2021; 21:779. [PMID: 34789171 PMCID: PMC8597093 DOI: 10.1186/s12884-021-04243-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 11/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternal obesity is a public health issue that could affect both women's and children's health. This qualitative study aimed to identify barriers to weight management of pregnant women with obesity and low socioeconomic backgrounds. METHODS The current qualitative study has been conducted using a grounded theory approach by analyzing data collected from in-depth interviews with clients of Tehran's public health care centers for prenatal care. The criteria for selecting participants were excessive weight gain during the first two trimesters of pregnancy, low socioeconomic status, and willingness to share their experiences. A semi-structured guide consisting of open-ended questions was asked in a private room. Open, axial, and selective coding were applied to the data. FINDINGS Four main themes emerged from data, each of which has some subcategories: 1) personal factors (unpleasant emotions and feelings, personal tastes/hobbies, workload and responsibilities, and history of diseases), 2) pregnancy status (unintended and high-risk pregnancy), 3) interpersonal relationships and support (lack of a spouse's support and unhealthy role modeling of relatives), 4) socio-cultural factors/influences (social norms and values, lack of access to health services, and unreliable information channels). CONCLUSIONS This study provides an overview of the barriers to the weight management of pregnant women from low socioeconomic backgrounds. The results could help develop appropriate health strategies for low socioeconomic women with obesity. Also, health care providers for this group of women could use these findings as a guide to consider their conditions and background.
Collapse
Affiliation(s)
- Fahimeh Mehrabi
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran
| | - Najva Ahmaripour
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran
| | - Sara Jalali-Farahani
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran
| | - Parisa Amiri
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O.Box: 19395-4763, Tehran, Iran.
| |
Collapse
|
50
|
Okafor UB, Goon DT. Development and Validation of Prenatal Physical Activity Intervention Strategy for Women in Buffalo City Municipality, South Africa. Healthcare (Basel) 2021; 9:healthcare9111445. [PMID: 34828491 PMCID: PMC8622375 DOI: 10.3390/healthcare9111445] [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: 08/24/2021] [Revised: 10/12/2021] [Accepted: 10/23/2021] [Indexed: 11/24/2022] Open
Abstract
Women rarely participate in physical activity during pregnancy, despite scientific evidence emphasising its importance. This study sought to develop an intervention strategy to promote prenatal physical activity in Buffalo City Municipality, Eastern Cape Province, South Africa. A multi-stage approach was utilised. The Strength, Weakness, Opportunity and Threat (SWOT) approach was applied to the interfaced empirical findings on prenatal physical activity in the setting. Subsequently, the Build, Overcome, Explore and Minimise model was then used to develop strategies based on the SWOT findings. A checklist was administered to key stakeholders to validate the developed strategies. Key strategies to promote prenatal physical activity include the application of the Mom-Connect (a technological device already in use in South Africa to promote maternal health-related information for pregnant women) in collaboration with cellphone and network companies; the South African government to integrate prenatal physical activity and exercise training in the medical and health curricula to empower the healthcare providers with relevant knowledge and skills to support pregnant women in prenatal physical activity counselling; provision of increased workforce and the infrastructure necessary in antenatal sessions and antenatal physical exercise classes and counselling; the government, in partnership with various stakeholders, to provide periodical prenatal physical activity campaigns based in local, community town halls and clinics to address the lack of awareness, misrepresentations and concerns regarding the safety and benefits of physical activity during pregnancy. The effective implementation of this developed prenatal physical activity by policymakers and health professionals may help in the promotion of physical activity practices in the context of women in the setting.
Collapse
Affiliation(s)
- Uchenna Benedine Okafor
- Department of Nursing Science, University of Fort Hare, East London 5201, South Africa
- Correspondence:
| | - Daniel Ter Goon
- Department of Public Health, University of Fort Hare, East London 5201, South Africa;
| |
Collapse
|