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Paley JL, Jones MA, Catov JM, Whitaker KM, Kozai AC, Barone Gibbs B. Associations of Physical Activity and Sedentary Behaviors with Depressive Symptoms and Mood Disturbance Throughout Pregnancy. J Womens Health (Larchmt) 2024; 33:1128-1138. [PMID: 38324012 DOI: 10.1089/jwh.2023.0419] [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] [Indexed: 02/08/2024] Open
Abstract
Purpose: Mental health is critical for a healthy pregnancy, yet few studies have evaluated its associations with best practice, objectively measured moderate- to vigorous-intensity physical activity (MVPA) or sedentary behavior (SED). This study evaluated associations of MVPA and SED with mental health across pregnancy. Materials and Methods: Two cohort studies (total n = 125, mean [standard deviation] 31 [5] years, and 14.4% Black) measured MVPA (waist-worn ActiGraph GT3X) and SED (thigh-mounted activPAL) as well as self-reported depressive symptoms and mood disturbance in each trimester. Associations of group-based trajectories of MVPA and SED with depressive symptoms and mood disturbance were analyzed using regression analyses, both overall and by trimester. Results: Overall, the medium versus low trajectory of MVPA was associated with lower levels of depressive symptoms (B = -1.82, 95% confidence interval [CI] -2.97 to -0.68). In the second trimester, women in either the medium or high MVPA trajectories had lower levels of depressive symptoms compared with women in the low MVPA trajectory (B = -8.73, 95% CI -15.74 to -1.71; and B = -2.18, 95% CI -3.80 to -0.56). SED trajectories were not associated with depressive symptoms. Higher trajectories of MVPA and lower trajectories of SED were associated with lower total mood disturbance, with significant associations in the second trimester for MVPA and the first and second trimesters for SED. Higher MVPA trajectories were associated with higher tension, fatigue, and confusion subscales, while higher SED trajectories were associated with higher anger and fatigue and lower esteem and vigor subscales. Conclusions: MVPA and SED levels appear to affect mental health during pregnancy, although larger prospective studies are warranted. Clinical Trail Registration Number: NCT03084302.
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Affiliation(s)
- Joshua L Paley
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Melissa A Jones
- Department of Human Movement Science, Oakland University, Rochester, Michigan, USA
| | - Janet M Catov
- Department of Ob/Gyn and Reproductive Sciences, Magee-Womens Research Institute and Clinical and Translational Sciences Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kara M Whitaker
- Department of Human Movement Science, Oakland University, Rochester, Michigan, USA
- Department of Epidemiology, The University of Iowa, Iowa City, Iowa, USA
| | - Andrea C Kozai
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Bethany Barone Gibbs
- Department of Epidemiology and Biostatistics, West Virginia University School of Public Health, Morgantown, WV, USA
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Evenson KR, Brown WJ, Brinson AK, Budzynski-Seymour E, Hayman M. A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:472-483. [PMID: 38158180 PMCID: PMC11184298 DOI: 10.1016/j.jshs.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The period following pregnancy is a critical time window when future habits with respect to physical activity (PA) and sedentary behavior (SB) are established; therefore, it warrants guidance. The purpose of this scoping review was to summarize public health-oriented country-specific postpartum PA and SB guidelines worldwide. METHODS To identify guidelines published since 2010, we performed a (a) systematic search of 4 databases (CINAHL, Global Health, PubMed, and SPORTDiscus), (b) structured repeatable web-based search separately for 194 countries, and (c) separate web-based search. Only the most recent guideline was included for each country. RESULTS We identified 22 countries with public health-oriented postpartum guidelines for PA and 11 countries with SB guidelines. The continents with guidelines included Europe (n = 12), Asia (n = 5), Oceania (n = 2), Africa (n = 1), North America (n = 1), and South America (n = 1). The most common benefits recorded for PA included weight control/management (n = 10), reducing the risk of postpartum depression or depressive symptoms (n = 9), and improving mood/well-being (n = 8). Postpartum guidelines specified exercises to engage in, including pelvic floor exercises (n = 17); muscle strengthening, weight training, or resistance exercises (n = 13); aerobics/general aerobic activity (n = 13); walking (n = 11); cycling (n = 9); and swimming (n = 9). Eleven guidelines remarked on the interaction between PA and breastfeeding; several guidelines stated that PA did not impact breast milk quantity (n = 7), breast milk quality (n = 6), or infant growth (n = 3). For SB, suggestions included limiting long-term sitting and interrupting sitting with PA. CONCLUSION Country-specific postpartum guidelines for PA and SB can help promote healthy behaviors using a culturally appropriate context while providing specific guidance to public health practitioners.
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Affiliation(s)
- Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8050, USA.
| | - Wendy J Brown
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Alison K Brinson
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3115, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8120, USA
| | | | - Melanie Hayman
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
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Gibbs BB, Kozai AC, McAdoo SN, Davis KD, Savidge MB, Paley JL, Hauspurg A, Catov JM. The sedentary behavior reduction in pregnancy intervention (SPRING) pilot and feasibility randomized trial. BMC Pregnancy Childbirth 2024; 24:261. [PMID: 38605328 PMCID: PMC11007988 DOI: 10.1186/s12884-024-06474-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/31/2024] [Indexed: 04/13/2024] Open
Abstract
Pregnant individuals rarely achieve moderate-to-vigorous intensity physical activity recommendations.Purpose The sedentary behavior reduction in pregnancy intervention (SPRING) pilot and feasibility randomized trial aimed to demonstrate feasibility, acceptability, and initial efficacy of a lower intensity intervention targeting reduced sedentary behavior and increased standing and steps.Methods First trimester pregnant individuals at risk for high sedentary behavior and adverse pregnancy outcomes (APO) were randomized 2:1 to a multi-component sedentary behavior reduction intervention or no-contact control. Intervention components included biweekly remote health coaching, wearable activity monitor, height-adjustable workstation, and a private Facebook group. Evidence-based behavioral targets included sedentary time < 9 h/day, increasing standing by 2-3 h/day, and ≥ 7500 steps/day. Participants completed all-remote assessments (baseline, second trimester, third trimester) of sedentary behavior and activity (thigh-worn activPAL) along with exploratory pregnancy health outcomes abstracted from medical records. Intervention effects vs. control were evaluated using generalized mixed models and an intention-to-treat approach. Intervention participants also provided feedback on perceived benefits and acceptability.Results Participants (34 intervention; 17 control) had mean age 32 years, were 83% White, with mean pre-pregnancy BMI 28 kg/m2. Retention was high (90% and 83% at second and third trimester follow-up visits). Intervention participants decreased sedentary time (-0.84 h/day, p = 0.019) and increased standing (+0.77 h/day, p = 0.003), but did not increase steps/day (+710, p = 0.257) compared to controls. Intervention participants reported many perceived benefits and identified the wearable, height-adjustable workstation, and behavioral lessons as most useful.Conclusion For pregnant individuals at risk for high sedentary behavior and APOs, a sedentary behavior reduction intervention is feasible, acceptable, and may offer a viable alternative to more intense physical activity recommendations during pregnancy. Further testing in a fully powered clinical trial is warranted.Trial registration NCT05093842 on clinicaltrials.gov.
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Affiliation(s)
- Bethany Barone Gibbs
- Department of Epidemiology and Biostatistics, West Virginia University School of Public Health, PO Box 9190, 64 Medical Center Drive, Morgantown, WV, 26506, USA.
| | - Andrea C Kozai
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shannon N McAdoo
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kelliann D Davis
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA
| | - Meghan B Savidge
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Joshua L Paley
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alisse Hauspurg
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, and Magee Women's Research Institute, Pittsburgh, PA, USA
| | - Janet M Catov
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, and Magee Women's Research Institute, Pittsburgh, PA, USA
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Garland M, Wilbur J, Schoeny M, Reed M, Semanik P, Halloway S, Waters T. Determinants of Physical Activity Among Black Women During Pregnancy. J Obstet Gynecol Neonatal Nurs 2024; 53:172-184. [PMID: 38072009 DOI: 10.1016/j.jogn.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 11/06/2023] [Accepted: 11/10/2023] [Indexed: 01/21/2024] Open
Abstract
OBJECTIVE To describe associations among background determinants of physical activity, modifiable theoretical determinants of physical activity, and measures of physical activity during the second and third trimesters of pregnancy among Black women. DESIGN Longitudinal cohort. SETTING Medical center obstetric clinic. PARTICIPANTS Pregnant Black women (n = 40 in second trimester, n = 38 in third trimester) METHODS: We measured background determinants (demographic and pregnancy characteristics, discrimination, and neighborhood walkability) during the second trimester. We measured modifiable theoretical determinants (self-efficacy and social support) and physical activity using self-report and device measures during the second and third trimesters. We used paired t tests to determine differences in the modifiable theoretical determinants from the second trimester to third trimester and used Pearson correlations among background and modifiable determinants and physical activity measures during the second trimester. RESULTS Participants' physical activity levels were low during the second and third trimesters (32% and 22% met recommendation, respectively). We found no changes in self-efficacy or social support between trimesters and found no associations between these modifiable determinants and actual physical activity. We found a positive correlation between previous pregnancies and physical activity measured by devices, r(36) = .33, p = .048. Pregnancy-specific stress, r(38) = -.40, p = .013, was negatively correlated, and age, r(38) = .38, p = .017, was positively correlated with self-reported physical activity. CONCLUSIONS Low levels of physical activity during pregnancy coupled with the absence of an association with modifiable factors affecting pregnancy physical activity indicate a need to further examine the social, cultural, and environmental determinants of physical activity.
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Whitaker KM, Jones MA, Smith K, Catov J, Feghali M, Kline CE, Santillan M, Santillan D, Zimmerman B, Gibbs BB. Study Design and Protocol of the Multisite Pregnancy 24/7 Cohort Study. Am J Epidemiol 2024; 193:415-425. [PMID: 37939072 DOI: 10.1093/aje/kwad208] [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: 02/12/2023] [Revised: 05/29/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023] Open
Abstract
Hypertensive disorders of pregnancy and other adverse pregnancy outcomes (APOs) are associated with an increased risk of future maternal cardiovascular disease. Physical activity during pregnancy reduces the risk of these APOs, yet few meet physical activity guidelines during pregnancy. Little is known about the role of sedentary behavior or sleep in APOs, a critical gap in knowledge given these behaviors comprise the majority of a 24-hour day. To address this knowledge gap, the Pregnancy 24/7 cohort study (2020-2025) uses 2 devices for 24-hour activity assessment in each trimester of pregnancy to examine associations of sedentary behavior, sleep, and the 24-hour activity cycle (composition of sedentary behavior, physical activity, and sleep) with hypertensive disorders and other APOs. Participants (n = 500) are recruited from the University of Iowa, University of Pittsburgh, and West Virginia University in early pregnancy and followed through delivery. The activPAL3 micro and Actiwatch Spectrum Plus are worn in each trimester for 7 days of 24-hour wear to assess the 24-hour activity cycle. APOs are abstracted from medical charts. This study will provide critical data to fuel future research examining how modifying the 24-hour activity cycle in pregnancy can improve maternal health.
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Thrower A, Quinn T, Jones M, Whitaker KM, Barone Gibbs B. Occupational physical activity as a determinant of daytime activity patterns and pregnancy and infant health. PLoS One 2023; 18:e0296285. [PMID: 38134005 PMCID: PMC10745165 DOI: 10.1371/journal.pone.0296285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
Though physical activity (PA) is recommended during pregnancy, it remains unclear how occupational physical activity (OPA) and sedentary behavior (SB) contribute to activity patterns and health during pregnancy. The purpose of this secondary analysis was to determine if OPA pattern is a determinant of all-day PA and evaluate associations with pregnancy/infant health outcomes. Data was from two prospective cohorts with study visits each trimester: MoM Health (Pittsburgh, PA; n = 120) and PRAMS (Iowa City, Iowa; n = 20). Using employment status/job hours (self-reported in demographic questionnaires) and OPA from the Pregnancy Physical Activity Questionnaire, latent class analysis identified three groups: sitting (n = 61), part-time mixed (n = 9), and active (n = 29). A fourth group included non-working participants (n = 32). Device-based PA (ActiGraph GT3X), SB (activPAL3 micro), and blood pressure were measured each trimester. Glucose screening test, gestational age, gestational weight gain, adverse pregnancy outcomes (APOs: gestational hypertension, preeclampsia, eclampsia, gestational diabetes, intrauterine growth restriction, and preterm birth), and infant outcomes (length, weight, and sex) were abstracted from medical records. Associations between groups with APOs and pregnancy/infant health were calculated using linear/logistic regression with adjustment for age, pre-pregnancy BMI, education, and race. Self-reported participant characteristics were similar across groups, except education which was higher in the sitting versus other groups. All-day device-based PA differed across groups; for example, the sitting group had the highest SB across trimester (all p<0.01) while the active group had the highest steps per day across trimesters (all p<0.01). Pregnancy/infant health did not differ between groups (all p>0.09). Compared to the non-working group, the risk of any APO was non-significantly higher in the sitting (OR = 2.27, 95%CI = 0.63-8.18) and active groups (OR = 2.40, 95%CI = 0.66-9.75), though not the part-time mixed (OR = 0.86, 95%CI = 0.08-9.1). OPA pattern is a determinant of all-day PA during pregnancy. Future studies with larger samples should examine associations between pregnancy OPA patterns and pregnancy/infant health.
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Affiliation(s)
- Alexis Thrower
- Department of Pathophysiology, Rehabilitation, and Performance, West Virginia University, Morgantown, West Virginia, United States of America
| | - Tyler Quinn
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, West Virginia, United States of America
| | - Melissa Jones
- Department of Human Movement Science, Oakland University, Rochester, Michigan, United States of America
| | - Kara M. Whitaker
- Department of Health and Human Physiology, Department of Epidemiology, University of Iowa, Iowa City, Iowa, United States of America
| | - Bethany Barone Gibbs
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, West Virginia, United States of America
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Howie EK, Nelson A, McVeigh JA, Andres A. Physical Activity, Sedentary and Sleep Phenotypes in Women During the First Trimester of Pregnancy. Matern Child Health J 2023; 27:1834-1845. [PMID: 37436642 DOI: 10.1007/s10995-023-03745-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVES Patterns of physical behaviors including physical activity, sedentary time, and sleep are unknown during pregnancy, but are likely to influence health outcomes. The purpose was to first identify "physical behavior phenotypes" from accelerometer-measured physical behaviors in pregnant women during the first trimester and secondly, to explore the associations between the identified phenotypes with demographic variables and body-mass-index (BMI). METHODS Data were from the Glowing Study (gov ID: NCT01131117), collected between 2011 and 2017 with accelerometer-measured physical behaviors of women in their 12th week of pregnancy. Latent class analysis was used to identify patterns of total physical activity, sleep time, sedentary time, and variation in physical activity. Maternal Body-Mass-Index (BMI). BMI and sociodemographic characteristics were compared between physical behavior phenotypes. RESULTS A total of 212 pregnant women were included in the study (mean age 30.2 years (range 22.1 to 42.4), mean days wear 4.3 (SD 0.7)). Three physical behavior phenotypes were identified from the four physical behavior constructs: low sedentary and stable activity (n = 136, 64%), variable activity (n = 39, 18%), high sedentary and low sleep (n = 37, 17%). BMI, race, and education were significantly different between the three phenotypes, with the low sedentary and stable activity phenotype having the lowest BMI and a higher percentage of white and college educated women. CONCLUSIONS FOR PRACTICE Total physical activity and physical behavior phenotypes during the first trimester were associated with early-pregnancy BMI, race, and education. Future research should examine whether these physical behavior phenotypes are associated with maternal and child health outcomes.
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Affiliation(s)
- Erin K Howie
- Department of Health, Human Performance and Recreation, University of Arkansas, HPER 308I, Fayetteville, AR, 72701, USA.
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia.
| | - Alexander Nelson
- Department of Computer Science and Computer Engineering, University of Arkansas, Fayetteville, AR, USA
| | - Joanne A McVeigh
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
- Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
| | - Aline Andres
- Arkansas Children's Nutrition Center & Arkansas Children's Research Institute, Little Rock, AR, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Barone Gibbs B, Kozai AC, McAdoo SN, Bastyr MC, Davis KD, Hauspurg A, Catov JM. Rationale, Design, and Methods for the Sedentary Behavior Reduction in Pregnancy Intervention (SPRING): Protocol for a Pilot and Feasibility Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e48228. [PMID: 37314845 DOI: 10.2196/48228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 04/29/2023] [Accepted: 04/30/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND Adverse pregnancy outcomes (APOs) identify cardiovascular disease risk, but few effective interventions are available. High sedentary behavior (SED) has recently been associated with APOs, but very few randomized controlled trials (RCTs) have tested SED reduction in pregnancy. OBJECTIVE The Sedentary Behavior Reduction in Pregnancy Intervention (SPRING) pilot and feasibility RCT addresses this gap by testing the feasibility, acceptability, and preliminary pregnancy health effects of an intervention to reduce SED in pregnant women. The objective of this manuscript is to describe the rationale and design of SPRING. METHODS Pregnant participants (n=53) in their first trimester, who are at risk for high SED and APO and without contraindications, are randomized in a 2:1 ratio to an intervention or control group. SED (primary outcome) and standing durations, and steps per day, are measured objectively in each trimester for 1 week with a thigh-mounted activPAL3 accelerometer. SPRING also seeks to demonstrate feasibility and acceptability while estimating preliminary effects on maternal-fetal health outcomes assessed during study visits and abstracted from medical records. The pregnancy-customized intervention promotes daily behavioral targets of less than 9 hours of SED and at least 7500 steps, achieved via increased standing and incorporating light-intensity movement breaks each hour. The multicomponent intervention provides a height-adjustable workstation, a wearable activity monitor, behavioral counseling every 2 weeks (through videoconference), and membership in a private social media group. Herein, we review the rationale, describe recruitment and screening processes, and detail the intervention, assessment protocols, and planned statistical analyses. RESULTS This study was funded by the American Heart Association (20TPA3549099), with a funding period of January 1, 2021, and until December 31, 2023. Institutional review board approval was obtained on February 24, 2021. Participants were randomized between October 2021 and September 2022, with final data collection planned for May 2023. Analyses and submission of results are expected for winter of 2023. CONCLUSIONS The SPRING RCT will provide initial evidence on the feasibility and acceptability of an SED-reduction intervention to decrease SED in pregnant women. These data will inform the design of a large clinical trial testing SED reduction as a strategy to reduce APO risk. TRIAL REGISTRATION ClincialTrials.gov NCT05093842; https://clinicaltrials.gov/ct2/show/NCT05093842. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/48228.
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Affiliation(s)
- Bethany Barone Gibbs
- Department of Epidemiology and Biostatistics, West Virginia University School of Public Health, Morgantown, WV, United States
| | - Andrea C Kozai
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, United States
| | - Shannon N McAdoo
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, United States
| | - Meghan C Bastyr
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Kelliann D Davis
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, United States
| | - Alisse Hauspurg
- Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, PA, United States
- Magee-Womens Research Institute, Pittsburgh, PA, United States
| | - Janet M Catov
- Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, PA, United States
- Magee-Womens Research Institute, Pittsburgh, PA, United States
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Zhang J, Zhang R, Chi J, Li Y, Bai W. Pre-pregnancy body mass index has greater influence on newborn weight and perinatal outcome than weight control during pregnancy in obese women. Arch Public Health 2023; 81:5. [PMID: 36639806 PMCID: PMC9838058 DOI: 10.1186/s13690-023-01025-2] [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: 03/12/2022] [Accepted: 01/06/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The pre-pregnancy weight and gestational weight gain (GWG) are closely related to perinatal maternal and infant complications, but the relationship between pre-pregnancy weight and GWG and the pattern of interaction have not been reported. This study investigated the influence of weight control during pregnancy on the perinatal maternal and infant outcomes. METHODS A total of 835 singleton pregnant women who were hospitalized between January 2018 and December 2018 were retrospectively included in this study and divided into two groups: the diet guidance (DG) group (n = 167) and the control group (n = 668). The pre-pregnancy body mass index (BMI), GWG, and perinatal outcomes of the women and infants were determined in two groups. RESULTS The dietary modification and reasonable exercise during pregnancy effectively reduced the GWG, and even some women with pre-pregnancy obesity achieved weight loss during pregnancy. The GWG in the DG group was significantly lower than in the control group, especially in the second and third trimesters. GWG was positively related to birth weight. The birth weight in the DG group was significantly lower than in the control group when their mothers had similar GWG. In women with pre-pregnancy obesity, GWG seemed to be negatively related to birth weight. However, after adjusting the mean BMI, the pre-pregnancy BMI and GWG were positively related to the birth weight. Compared with the control group, the incidences of dystocia, postpartum hemorrhage, macrosomia, small for gestational age infants and neonatal complications significantly reduced in the DG group, and the preterm birth rate was comparable between two groups. Some women with pre-pregnancy obesity lose weight during pregnancy, but there was no premature birth or small for gestational age infant. The incidences of macrosomia, postpartum hemorrhage, dystocia, cesarean section and gestational diabetes increased significantly with the increase of pre-pregnancy BMI. CONCLUSION For women with increased pre-pregnancy BMI, strict weight control is required to reduce obesity-related complications of the mother and infant. The weight control in the second and third trimesters is especially important and most likely to prevent GWG. Compared with GWG, pre-pregnancy BMI has greater influence on the birth weight and maternal and infant complications, and may even compromise the benefits of weight control during pregnancy. Thus, weight control is recommended before pregnancy.
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Affiliation(s)
- Jin Zhang
- grid.24696.3f0000 0004 0369 153XDepartment of Obstetrics and Gynaecology, Beijing Shijitan Hospital, Capital Medical University, Haidian, Beijing, 100038 China
| | - Rui Zhang
- grid.24696.3f0000 0004 0369 153XDepartment of Obstetrics and Gynaecology, Beijing Shijitan Hospital, Capital Medical University, Haidian, Beijing, 100038 China
| | - Jingjing Chi
- grid.24696.3f0000 0004 0369 153XDepartment of Obstetrics and Gynaecology, Beijing Shijitan Hospital, Capital Medical University, Haidian, Beijing, 100038 China
| | - Ya Li
- grid.24696.3f0000 0004 0369 153XDepartment of Obstetrics and Gynaecology, Beijing Shijitan Hospital, Capital Medical University, Haidian, Beijing, 100038 China
| | - Wenpei Bai
- grid.24696.3f0000 0004 0369 153XDepartment of Obstetrics and Gynaecology, Beijing Shijitan Hospital, Capital Medical University, Haidian, Beijing, 100038 China
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Badon SE, Ferrara A, Gabriel KP, Avalos LA, Hedderson MM. Changes in 24-Hour Movement Behaviors From Early to Late Pregnancy in Individuals With Prepregnancy Overweight or Obesity. J Phys Act Health 2022; 19:842-846. [PMID: 36370700 PMCID: PMC11023622 DOI: 10.1123/jpah.2022-0333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 09/14/2022] [Accepted: 09/25/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Understanding how sleep, sedentary behavior (SED), and physical activity (PA) (24-h movement profile) changes across pregnancy in individuals with prepregnancy overweight or obesity and how parity (previous births) impacts these changes can help inform interventions. METHODS In 155 participants, movement was measured using wrist-worn accelerometers, and sleep was self-reported in early (8-15 wk) and late (29-38 wk) pregnancy. The 24-hour movement profiles were analyzed using compositional analyses. RESULTS Nulliparous participants (no previous births) spent 33.95%, 38.14%, 25.32%, and 2.58% of the 24-hour day in early pregnancy in sleep, SED, light-intensity PA, and moderate/vigorous-intensity PA, respectively. Multiparous participants (≥1 previous birth) spent 2.50 percentage points less in SED (mean log-ratio difference = -0.068; 95% confidence interval [CI], -0.129 to -0.009) and 2.73 percentage points more in light-intensity PA (mean log-ratio difference = 0.102; 95% CI, 0.035 to 0.180). From early to late pregnancy, participants decreased the proportion of the 24-hour day spent asleep by 1.67 percentage points (mean log-ratio difference = -0.050; 95% CI, -0.092 to -0.011) and increased light-intensity PA by 1.56 percentage points (mean log-ratio difference = 0.057; 95% CI, 0.003 to 0.108), with no change in other behaviors. CONCLUSIONS Nulliparous and multiparous individuals with prepregnancy overweight or obesity both had high levels of SED, with no change across pregnancy, and may require interventions to reduce SED.
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Affiliation(s)
- Sylvia E Badon
- Kaiser Permanente Northern California Division of Research, Oakland, CA,USA
| | - Assiamira Ferrara
- Kaiser Permanente Northern California Division of Research, Oakland, CA,USA
| | | | - Lyndsay A Avalos
- Kaiser Permanente Northern California Division of Research, Oakland, CA,USA
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Wallace MK, Jones MA, Whitaker K, Barone Gibbs B. Patterns of physical activity and sedentary behavior before and during pregnancy and cardiometabolic outcomes. Midwifery 2022; 114:103452. [PMID: 35969919 PMCID: PMC9588711 DOI: 10.1016/j.midw.2022.103452] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/13/2022] [Accepted: 08/05/2022] [Indexed: 10/31/2022]
Abstract
OBJECTIVE To assess how physical activity and sedentary behavior change from pre-pregnancy to pregnancy, and if pre-pregnancy and pregnancy physical activity and sedentary behavior are related to gestational weight gain, blood pressure, or blood glucose across pregnancy. DESIGN Secondary analysis of two prospective cohort studies. SETTING Prenatal research centers in Pittsburgh, PA and Iowa City, IA. PARTICIPANTS Pregnant individuals (n=131), 18-45 years old, of any BMI, with no medical condition limiting physical activity or use of hypertension/diabetes medications. METHODS Participants self-reported physical activity and sedentary behavior pre-pregnancy and in each trimester using validated questionnaires. Blood pressure, blood glucose, and weight were obtained from study visits and/or electronic medical records. Multivariable regression examined associations between pre-pregnancy, trimester-specific, and changes in physical activity and sedentary behavior with weight gain and blood pressure outcomes in each trimester, and blood glucose in the second trimester. RESULTS Compared to pre-pregnancy, physical activity was lower in each trimester, and sedentary behavior was higher in each trimester (p<0.05). Increasing physical activity from pre-pregnancy levels was associated with lower first trimester SBP (p<0.05). Unexpectedly, higher pre-pregnancy physical activity was associated with higher SBP in the first trimester (p=0.02) and higher weight gain in the third trimester (p=0.02). Higher and increasing sedentary behavior was associated with greater weight gain in the third trimester (p=0.03). CONCLUSION Future research should investigate the opportune time (before or during pregnancy) to deliver behavior modification interventions that could prevent excessive gestational weight gain or elevated blood pressure to improve maternal health outcomes.
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Affiliation(s)
- McKenzie K Wallace
- Department of Health Promotion and Development, University of Pittsburgh, School of Nursing, Pittsburgh, PA.
| | - Melissa A Jones
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA
| | - Kara Whitaker
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA; Department of Epidemiology- University of Iowa, Iowa City, IA
| | - Bethany Barone Gibbs
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University
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Whitaker KM, Jones MA, Dziewior J, Anderson M, Anderson C, Gibbs BB, Carr LJ. Feasibility, acceptability, and preliminary efficacy of a single-arm, remotely-delivered health coaching intervention to increase physical activity and reduce sedentary behavior during pregnancy. BMC Pregnancy Childbirth 2022; 22:740. [PMID: 36184599 PMCID: PMC9526811 DOI: 10.1186/s12884-022-05073-4] [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: 06/14/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background Interventions targeting physical activity and sedentary behavior concurrently in pregnancy may be an ideal strategy to reduce the risk of pregnancy complications. We assessed the feasibility, acceptability, and preliminary efficacy of a single-arm, remotely-delivered health coaching intervention to promote physical activity and reduce sedentary behavior in pregnancy. Methods Women (n = 34) between 8 and 12 weeks gestation were recruited to take part in the INcreasing Steps in PREgnancy (INSPiRE) study. Participants were given an activity tracker (Fitbit Inspire) and met virtually with their health coach throughout the second and third trimesters of pregnancy. Feasibility was based on enrollment, retention, and adherence rates. Acceptance was assessed using a process evaluation survey. Intervention efficacy was based on activPAL data obtained at baseline and the end of the second trimester. Results Feasibility objectives were met, with greater than 70% enrollment, 97% retention, and 99% adherence. All participants reported high levels of satisfaction with the program. ActivPAL data indicated statistically significant increases in daily steps (+ 1715.8 steps/day, Cohen’s d = 0.97), stepping time (+ 1.9%, d = 0.75), standing time (+ 2.3%, d = 0.29), and decreases in total sedentary time (− 4.2%, d = 0.43) and sedentary bouts of 30 minutes (− 4.1%, d = 0.36) from baseline to the end of the second trimester, all p < 0.05. Decreases were also observed in sedentary bouts of 60 minutes (− 3.9%, d = 0.40), but this was not statistically significant. Conclusions The INSPiRE study demonstrated feasibility, high acceptability, and preliminary efficacy for improving movement behaviors in women during pregnancy, supporting future testing in a randomized controlled trial.
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Affiliation(s)
- Kara M Whitaker
- Department of Health and Human Physiology, University of Iowa, 225 S. Grand Ave, Iowa City, IA, 52242, USA. .,Department of Epidemiology, University of Iowa, Iowa City, USA.
| | - Melissa A Jones
- Department of Health and Human Physiology, University of Iowa, 225 S. Grand Ave, Iowa City, IA, 52242, USA
| | - Jaclyn Dziewior
- Department of Health and Human Physiology, University of Iowa, 225 S. Grand Ave, Iowa City, IA, 52242, USA
| | - Megan Anderson
- Department of Health and Human Physiology, University of Iowa, 225 S. Grand Ave, Iowa City, IA, 52242, USA
| | - Chelsie Anderson
- Department of Health and Human Physiology, University of Iowa, 225 S. Grand Ave, Iowa City, IA, 52242, USA
| | - Bethany Barone Gibbs
- Department of Epidemiology and Biostatistics, West Virginia University, Morgantown, USA
| | - Lucas J Carr
- Department of Health and Human Physiology, University of Iowa, 225 S. Grand Ave, Iowa City, IA, 52242, USA
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Patterns in Prenatal Physical Activity and Sedentary Behavior: Associations With Blood Pressure and Placental Features in the MoMHealth Cohort. J Phys Act Health 2022; 19:658-665. [PMID: 36049747 DOI: 10.1123/jpah.2021-0585] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 05/13/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Moderate to vigorous physical activity (MVPA) and sedentary behavior (SED) are associated with blood pressure (BP) and adverse pregnancy outcomes. The authors investigated associations of prenatal MVPA and SED patterns with BP and with placental malperfusion features. METHODS Women enrolled in this prospective cohort study in the first trimester. MVPA, SED, and BP were measured objectively each trimester. MVPA and SED trajectories were constructed. Placental examinations were conducted in a subset. Associations of trajectories with BPs were assessed with linear regression adjusted for age, race, education, prepregnancy body mass index, and gestational age. Associations with placental malperfusion lesions and weight were adjusted for key covariates. RESULTS One hundred eleven participants were included; placental exams were available in 50. Participants with high (vs low) SED were younger and more likely to have adverse pregnancy outcomes. High SED (vs low) was associated with higher first trimester systolic (β = 5.3; 95% confidence interval, 0.0 to 10.6) and diastolic (β = 5.0; 95% confidence interval, 1.4 to 8.6) and higher second trimester diastolic (β = 4.9; 95% confidence interval, 1.6 to 8.2) BP. Medium and high MVPA groups were associated with lower postpartum diastolic BP. Trajectories were not associated with placental malperfusion. CONCLUSIONS MVPA and SED patterns were differentially associated with prenatal and postpartum BP. Encouraging favorable levels of both might help women achieve lower BP during and after pregnancy.
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Jones MA, Diesel SJ, Gibbs BB, Whitaker KM. Concurrent Agreement Between ActiGraph and activPAL for Measuring Physical Activity in Pregnant Women and Office Workers. JOURNAL FOR THE MEASUREMENT OF PHYSICAL BEHAVIOUR 2022; 5:69-75. [PMID: 36340243 PMCID: PMC9635580 DOI: 10.1123/jmpb.2021-0050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Current best practice for objective measurement of sedentary behavior and moderate-to-vigorous intensity physical activity (MVPA) requires two separate devices. This study assessed concurrent agreement between the ActiGraph GT3X and the activPAL3 micro for measuring MVPA to determine if activPAL can accurately measure MVPA in addition to its known capacity to measure sedentary behavior. METHODS Forty participants from two studies, including pregnant women (n = 20) and desk workers (n = 20), provided objective measurement of MVPA from waist-worn ActiGraph GT3X and thigh-worn activPAL micro3. MVPA from the GT3X was compared with MVPA from the activPAL using metabolic equivalents of task (MET)- and step-based data across three epochs. Intraclass correlation coefficient and Bland-Altman analyses, overall and by study sample, compared MVPA minutes per day across methods. RESULTS Mean estimates of activPAL MVPA ranged from 22.7 to 35.2 (MET based) and 19.7 to 25.8 (step based) minutes per day, compared with 31.4 min/day (GT3X). MET-based MVPA had high agreement with GT3X, intraclass correlation coefficient ranging from .831 to .875. Bland-Altman analyses revealed minimal bias between 15- and 30-s MET-based MVPA and GT3X MVPA (-3.77 to 8.63 min/day, p > .10) but with wide limits of agreement (greater than ±27 min). Step-based MVPA had moderate to high agreement (intraclass correlation coefficient: .681-.810), but consistently underestimated GT3X MVPA (bias: 5.62-11.74 min/day, p < .02). For all methods, activPAL appears to better estimate GT3X at lower quantities of MVPA. Results were similar when repeated separately by pregnant women and desk workers. CONCLUSION activPAL can measure MVPA in addition to sedentary behavior, providing an option for concurrent, single device monitoring. MET-based MVPA using 30-s activPAL epochs provided the best estimate of GT3X MVPA in pregnant women and desk workers.
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Affiliation(s)
- Melissa A Jones
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
| | - Sara J Diesel
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Bethany Barone Gibbs
- Department of Health and Human Development and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kara M Whitaker
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
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Associations of objectively measured physical activity and sedentary time with pregnancy-specific health-related quality of life. Midwifery 2022; 104:103202. [PMID: 34801955 PMCID: PMC8671341 DOI: 10.1016/j.midw.2021.103202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 10/25/2021] [Accepted: 11/06/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE To examine associations of objectively measured moderate-to-vigorous-intensity physical activity (MVPA) and sedentary behavior (SED) with pregnancy-specific health-related quality of life (QoL) across pregnancy trimesters. MATERIALS AND METHODS Women (N=131, mean age 30.9 years ± 4.9) were recruited from two large health care systems in the United States. MVPA and SED were estimated using a waist-worn ActiGraph GT3X and thigh-worn activPAL3 micro, respectively, for seven days in each trimester of pregnancy. Questionnaires were administered in each trimester to assess pregnancy-specific health-related QoL using the Nausea and Vomiting of Pregnancy Specific health Related Quality of Life (NVPQoL) questionnaire. Mixed effects linear regression examined associations of MVPA and SED with the NVPQoL total score and domain-specific scores (physical symptoms, fatigue, emotions, and limitations) across trimesters. RESULTS The NVPQoL total score and domain-specific scores significantly varied across trimesters, with highest scores (indicating worse QoL) observed in the first trimester and lowest scores (indicating better QoL) in the second trimester. A 1-standard deviation (SD) increment in MVPA (16.0 min/day or 1.8%) was associated with better QoL as indicated by the lower NVPQoL total score (β=-4.06, p=0.024) and limitations score (β = -2.80, p<0.001). A 1-SD increment in SED (1.5 hr/day or 10.0%) was associated with worse QoL as indicated by the higher fatigue score (β = 0.82, p=0.041). CONCLUSIONS Pregnancy-specific health-related QoL varies across trimesters. Both lower SED, and to a greater extent higher MVPA are potential behavioral targets for improving pregnancy-specific health-related QoL.
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Gibbs BB, Jones MA, Whitaker KM, Ross ST, Davis KK. Measurement of Barriers, Attitudes, and Expectations for Sitting Less in Pregnancy. Am J Health Behav 2021; 45:956-970. [PMID: 34969408 DOI: 10.5993/ajhb.45.6.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Our objective was to develop, validate, and describe findings from an instrument to measure barriers, attitudes, and outcome expectations of sitting less in pregnant women. METHODS This validation (sub-study 1) and descriptive study (sub-study 2) evaluated a new questionnaire measuring sedentary time in pregnant women (N=131) in each trimester. RESULTS In sub-study 1, construct validity was supported by associations between device-measured sedentary time and questionnaire scores. An optimized questionnaire removed infrequently reported and non-correlated items. The original and optimized questionnaires with scoring instructions are provided. In sub-study 2, physical symptoms and work were most commonly reported as major reasons for sitting in pregnancy, followed by leisure, family, and social activities. Some women reported limiting sitting due to boredom/restlessness, to improve energy or health, and to control weight. In the third trimester, some women reported sitting more/less due to pain and encouragement from family, friends, and co-workers. Few women reported household chores or pregnancy risks as reasons to sit, felt sitting was healthy or necessary during pregnancy, or were encouraged to sit by healthcare providers. CONCLUSIONS The developed questionnaire demonstrated validity and identified barriers to and expectations of sitting less during pregnancy. Prenatal interventions to reduce sitting should address general and pregnancy-specific barriers.
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Affiliation(s)
- Bethany Barone Gibbs
- Healtth and Physical Activity, University of Pittsburgh, Pittsburgh, PA, United States;,
| | - Melissa A. Jones
- Health and Human Physiology, University of Iowa, Iowa City, IA, United States
| | - Kara M. Whitaker
- Health and Human Physiology University of Iowa, Iowa City, IA, United States
| | - Sharon Taverno Ross
- Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kelliann K. Davis
- Kelliann K. Davis, Health and Human Development, University of Pittsburgh, Pittsburgh, PA, United States
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Jones MA, Whitaker KM, Taverno Ross SE, Davis K, Libertus K, Barone Gibbs B. Maternal Sedentary Behavior and Physical Activity across Pregnancy and Early Childhood Motor Development. CHILDREN (BASEL, SWITZERLAND) 2021; 8:549. [PMID: 34201936 PMCID: PMC8304240 DOI: 10.3390/children8070549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 12/05/2022]
Abstract
Early childhood motor development is an important indicator of short- and long-term health. In utero exposures impact offspring health across the lifespan; however, whether maternal activity during pregnancy may impact early childhood motor development remains unknown. This prospective cohort study measured the motor development skills of n = 70 children born to mothers from a previously conducted cohort study which objectively measured activity profile, (sedentary behavior (SED) and moderate-to-vigorous intensity physical activity (MVPA), across pregnancy. Mothers reported the motor development of their child using the Early Motor Questionnaire (EMQ). Linear regression models examined associations between maternal activity profile and EMQ scores. Maternal SED and MVPA were analyzed in two ways: trimester-specific and across pregnancy using trajectory groups. Children were 12-30 months of age, majority white (82%), and 52% male. Maternal SED during pregnancy was not associated with any EMQ domains (gross motor, fine motor, and perception action). Higher maternal MVPA, across pregnancy by trajectory group and in the first and second trimesters, was significantly associated with moderate-sized effects of more advanced fine motor and perception action scores. Higher MVPA in early pregnancy appears to be related to more advanced early childhood motor development. Therefore, maternal MVPA may be a modifiable behavior by which short- and long-term offspring health may be impacted.
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Affiliation(s)
- Melissa A. Jones
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA;
| | - Kara M. Whitaker
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA 52242, USA;
- Department of Epidemiology, University of Iowa, Iowa City, IA 52241, USA
| | - Sharon E. Taverno Ross
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA 15260, USA; (S.E.T.R.); (K.D.); (B.B.G.)
| | - Kelliann Davis
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA 15260, USA; (S.E.T.R.); (K.D.); (B.B.G.)
| | - Klaus Libertus
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA;
| | - Bethany Barone Gibbs
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA 15260, USA; (S.E.T.R.); (K.D.); (B.B.G.)
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