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Li S, Wupuer T, Hou R. Factors Influencing Delayed Onset of Lactogenesis: A Scoping Review. Int J Gen Med 2024; 17:2311-2326. [PMID: 38799202 PMCID: PMC11127660 DOI: 10.2147/ijgm.s452108] [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: 11/28/2023] [Accepted: 04/28/2024] [Indexed: 05/29/2024] Open
Abstract
Purpose Delayed onset of lactogenesis is a significant barrier to achieving the WHO-recommended 50% exclusive breastfeeding rate in the first six months. This study maps the main factors influencing this condition, addressing gaps in the current research landscape. Methods Following Arksey and O'Malley's scoping review framework, databases such as PubMed, Web of Science (WOS), Embase, Cochrane Library, CINAHL plus with full text, China National Knowledge Infrastructure (CNIK), Weipu Chinese Journal Service Platform (VIP), Wanfang Data Knowledge Service Platform, and China Biomedical Literature Database (CBM) were searched on February 1, 2023. Studies in Chinese and English involving pregnant and postpartum women, focusing on delayed onset of lactogenesis, were included without restrictions on publication date or geography. Results Forty-six studies published between 2002 and 2022 met the inclusion criteria, revealing variable incidences of delayed lactogenesis among different groups. Thirty-four influencing factors were identified and organized into five themes: maternal-infant characteristics, perinatal mental state, physical activity participation during pregnancy, breastfeeding behaviors, and medical staff interventions. Within eighteen major factors highlighted, factors such as age, pre-pregnancy BMI, gestational weight gain, average LATCH score within 24 hours postpartum, labor analgesia, sleep, frequency of postpartum breastfeeding, and timing of initial breast suckling/pumping showed inconsistent or conflicting conclusions. Conclusion High and variable incidences of delayed lactogenesis underline its multifactorial nature. Effective interventions require strong advocacy from healthcare professionals and adherence by pregnant women. Further research using standardized methods is essential to clarify inconsistent or conflicting findings on the influencing factors.
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Affiliation(s)
- Sen Li
- Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing, People’s Republic of China
| | - Tajiguli Wupuer
- School of Nursing, Peking University, Beijing, People’s Republic of China
| | - Rui Hou
- School of Nursing, Peking University, Beijing, People’s Republic of China
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2
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Ji M, Li R, Xu Y. Meta-analysis of the effect of different exercise modalities in the prevention and treatment of perinatal depression. J Affect Disord 2024; 350:442-451. [PMID: 38228277 DOI: 10.1016/j.jad.2024.01.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 12/24/2023] [Accepted: 01/04/2024] [Indexed: 01/18/2024]
Abstract
BACKGROUND The incidence of perinatal depression is increasing and has become a global public health problem to be addressed. OBJECTIVE To explore the prevention and treatment effects of different exercise methods on perinatal depression. METHODS A meta-analysis was conducted by searching databases for published "exercise interventions for perinatal depression "related randomized controlled trials, up to July 20, 2022. RESULTS 48 randomized controlled trials were included, with a total of 5282 pregnant women. (1) Exercise prevention of prenatal depression has a low effective stress intervention effect, ranking from high to low as yoga, aerobic+resistance. (2) Exercise therapy for prenatal depression has a significant intervention effect, followed by gymnastics, pelvic floor muscle training, aerobic exercise, aerobic+resistance, and yoga. (3) Exercise prevention of postpartum depression has a low effective intervention effect, followed by yoga, aerobic exercise, aerobic+resistance, and gymnastics. (4) Exercise has a moderate equivalent stress intervention effect on treating postpartum depression, followed by aerobic exercise, water exercise, yoga, fertility dance, and stroller walking. LIMITATIONS Due to the small number of included literature on single exercise modalities, and maternity is a special population, most of the trial procedures included in the text were not blinded, which has a certain risk of bias and affects the accuracy of the Meta-analysis results. CONCLUSIONS The therapeutic effect of exercise in the prevention and treatment of perinatal depression is superior to the preventive effect, and the effect of prenatal prevention and treatment is better than that of postpartum, with a moderate effect.
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Affiliation(s)
- Moufang Ji
- Postdoctoral Station of Physical Education, Central China Normal University, Wuhan, China; School of Physical Education, Hunan Institute of Science and Technology, Yueyang, China
| | - Ruobing Li
- School of Physical Education, Hunan Institute of Science and Technology, Yueyang, China
| | - Yizhe Xu
- School of Physical Education, Jianghan University, Wuhan, China.
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3
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Wang J, Carru C, Sedda S, Fiori PL, Li Z, Chen Z. Comparative impact of exercise-based interventions for postpartum depression: A Bayesian network meta-analysis. Int J Gynaecol Obstet 2024; 165:67-75. [PMID: 37688384 DOI: 10.1002/ijgo.15091] [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: 06/13/2023] [Revised: 08/02/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE The current study aimed to address and rank which exercise-based interventions are preferable to standard care/no therapy or another exercise intervention for postpartum depression (PPD) management and provide estimates for future definitive evidence. METHODS The authors systematically searched PubMed, Embase, the Web of Science, PsycInfo, and ClinicalTrails.gov for randomized controlled trials (RCTs) on exercise-based interventions for PPD from their inception to May 9, 2023. Included were RCTs of exercise-based interventions for PPD with at least 4 weeks' duration. The pooled effects of intervention comparisons were generated by the Bayesian random-effects model, and the quality of evidence was evaluated by the Grading of Recommendations, Assessment, Development, and Evaluations framework. RESULTS Twelve RCTs (1260 women; mean age, 20-35 years) comparing exercise-based interventions with usual care/no therapy were included. Exercise effectively treats depressive symptoms (standard mean difference [SMD], -0.81 [95% confidence interval (CI), -1.20 to -0.42], P < 0.001). Pram walking was significantly associated with a reduction of depressive symptoms during the postpartum period (SMD, -1.00 [95% CI, -2.60 to -0.10], P = 0.020), as well as yoga (SMD, -0.73 [95% CI, -1.84 to -0.43], P < 0.001) and supervised mixed exercise (SMD, -0.77 [95% CI, -1.67 to -0.01], P = 0.041) compared with usual care/no therapy. In indirect comparisons, pram walking (surface under the cumulative ranking curve, 58.9%) was better than yoga (SMD, -0.28 [95% CI, -1.86 to 1.22], P = 0.322) and supervised mixed exercise (SMD, -0.23 [95% CI, -1.59 to 1.12], P = 0.358). However, the difference was not statistically significant. The confidence in evidence was very low to moderate. CONCLUSION In women with PPD, all commonly prescribed physical exercises were effective alternative or complementary treatments. However, pram walking may perform better in improving the symptoms of PPD.
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Affiliation(s)
- Jing Wang
- Department of Obstetrics and Gynecology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Stefania Sedda
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Pier Luigi Fiori
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Zhi Li
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Zhichao Chen
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
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4
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Laudańska-Krzemińska I, Krzysztoszek J. Physical activity promotion among pregnancy - the role of physician from the women's perspective. Front Public Health 2024; 12:1335983. [PMID: 38487188 PMCID: PMC10937457 DOI: 10.3389/fpubh.2024.1335983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Abstract
Objective The clear benefits of planned and supervised physical activity (PA) during pregnancy make it imperative that women are encouraged and educated about this activity. This study aimed to investigate how effectively physician promote physical activity and exercise among pregnant women. It also examines pro-health changes in selected health behaviours during pregnancy. Methods This cross-sectional study recruited a total of 353 pregnant women in Wielkopolskie Voivodship in Poland. An anonymous survey (on-line or in-paper) was used to assess physical activity before and during pregnancy (with Pregnancy Physical Activity Questionnaire), physical activity self-efficacy, well-being (WHO-5 Well-Being Index), and guidance received from physicians on physical activity during pregnancy. Results Only 41% of women surveyed followed WHO recommendations for PA before pregnancy, and they were much more likely to discuss safety and the need to change the intensity or type of PA with their doctor or gynaecologist. Only 23% of women were asked about their PA before pregnancy and less than 40% were encouraged to be active during pregnancy. We observed a higher probability of poor well-being among pregnant women who were inactive before pregnancy (OR = 1.873, 95%CI 1.026 to 3.421, p = 0.041). Conclusion Health professionals infrequently educate and motivate women to be physically active during pregnancy. Physician advice, as it is currently perceived by women, seems to be insufficient to help pregnant women meet the recommendations for PA during pregnancy.
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Affiliation(s)
- Ida Laudańska-Krzemińska
- Department of Physical Activity and Health Promotion Science, Poznan University of Physical Education, Poznan, Poland
| | - Jana Krzysztoszek
- Department of Didactics of Physical Activity, Poznan University of Physical Education, Poznan, Poland
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5
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Hu J, Liu B, Cui H, Liu Y, Wan N, Li L, Zheng L, Wang X, Yang Z, Ma Y, Liu C, Qiao C, Wen D. Dose-response associations of maternal prenatal noise exposure duration with antepartum depression status. BMC Pregnancy Childbirth 2024; 24:7. [PMID: 38166840 PMCID: PMC10759523 DOI: 10.1186/s12884-023-06200-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Antepartum depression has been reported to be associated with the intensity of maternal prenatal noise exposure; however, the association between noise exposure duration and the development of antepartum depression has not been established. This study aimed to determine the total and trimester-specific association of prenatal noise exposure duration with the development of antepartum depression. METHODS From May 2018 to June 2021, we recruited 2,166 pregnant women from Shengjing Hospital, northeast China. We used a standardized questionnaire to assess women's prenatal noise exposure and used the Edinburgh Postnatal Depression Scale to assess pregnant women's antepartum depression during the 1st -, 2nd -, and 3rd - trimesters. We calculated a cumulative noise exposure score ranging from 0 to 3, with a higher score reflecting higher frequency and longer duration of noise exposure during pregnancy. RESULTS Women who were exposed to noise for ≥ 15 min per day had an increased risk of antepartum depression compared with women who were not exposed to noise during pregnancy [odds ratio (OR) = 1.83, 95%CI:1.18, 2.83]. Noise exposure in a specific trimester was associated with higher risk of depression in the same trimester and subsequent trimesters. We observed increases in antepartum depression risk with increasing cumulative noise exposure scores (P for trend < 0.05 for all). Pregnant women with the highest scores had the highest risk of antepartum depression during the first (OR = 1.30, 95%CI:1.02, 1.65), second (OR = 1.75, 95%CI:1.23, 2.50) trimesters. Women with a cumulative noise exposure score of 2 had the highest risk of antepartum depression during the third trimester (OR = 1.79, 95%CI:1.14, 2.80), as well as during the whole pregnancy (OR = 1.94, 95%CI:1.14, 3.30). CONCLUSIONS Maternal prenatal noise exposure duration was positively associated with antepartum depression risk in a dose-response manner. It is necessary to develop strategies by which pregnant women can avoid excessive exposure to noise to prevent antepartum depression.
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Affiliation(s)
- Jiajin Hu
- Health Sciences Institute, China Medical University, Shenyang, 110122, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
- Division of Chronic Disease Research across the Lifecourse, Department of Population Medicine, Harvard Medical School, Boston, MA, 02215, USA
| | - Borui Liu
- Health Sciences Institute, China Medical University, Shenyang, 110122, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
| | - Hong Cui
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, China Medical University, Shenyang, 110004, China
| | - Yilin Liu
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, China Medical University, Shenyang, 110004, China
| | - Ningyu Wan
- Health Sciences Institute, China Medical University, Shenyang, 110122, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
| | - Lin Li
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
- Department of Developmental Pediatrics, Shengjing Hospital of China Medical University, China Medical University, Shenyang, 110004, China
| | - Lu Zheng
- Health Sciences Institute, China Medical University, Shenyang, 110122, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
| | - Xiaochuan Wang
- Health Sciences Institute, China Medical University, Shenyang, 110122, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
| | - Zhe Yang
- Health Sciences Institute, China Medical University, Shenyang, 110122, China
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China
| | - Yanan Ma
- Department of Epidemiology and Health Statistics, School of Public Health, China Medical University, Shenyang, 110122, China
| | - Caixia Liu
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China.
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, China Medical University, Shenyang, 110004, China.
| | - Chong Qiao
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China.
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, China Medical University, Shenyang, 110004, China.
| | - Deliang Wen
- Health Sciences Institute, China Medical University, Shenyang, 110122, China.
- Research Center of China Medical University Birth Cohort, China Medical University, Shenyang, 110122, China.
- Liaoning Key Laboratory of Obesity and Glucose/Lipid Associated Metabolic Diseases, Shenyang, 110122, China.
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6
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Fernández-Buhigas I, Martin Arias A, Vargas-Terrones M, Brik M, Rolle V, Barakat R, Muñoz-Gonzalez MD, Refoyo I, Gil MM, Santacruz B. Fetal and maternal Doppler adaptation to maternal exercise during pregnancy: a randomized controlled trial. J Matern Fetal Neonatal Med 2023; 36:2183759. [PMID: 36889747 DOI: 10.1080/14767058.2023.2183759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
BACKGROUND Regular and supervised exercise during pregnancy is worldwide recommended due to its proven benefits, but, during exercise, maternal blood flow is redirected from the viscera to the muscles and how fetal wellbeing may be affected by this redistribution is still not well known. OBJECTIVE To analyze the longitudinal effect of a supervised moderate physical exercise program during pregnancy on uteroplacental and fetal Doppler parameters. METHODS This is a planned secondary analysis of an randomized controlled trial (RCT), performed at Hospital Universitario de Torrejón, Madrid, Spain, including 124 women randomized from 12+0 to 15+6 weeks of gestation to exercise vs. control group. Fetal umbilical artery (UA), middle cerebral artery, and uterine artery pulsatility index (PI), were longitudinally collected by Doppler ultrasound assessment throughout gestation, and derived cerebroplacental ratio (normalized by z-score), and maternal mean PI in the uterine arteries (normalized by multiplies of the median). Obstetric appointments were scheduled at 12 (baseline, 12+0 to 13+5), 20 (19+0 to 24+2), 28 (26+3 to 31+3) and 35 weeks (32+6 to 38+6) of gestation. Generalized estimating equations were adjusted to assess longitudinal changes in the Doppler measurements according to the randomization group. RESULTS No significant differences in the fetal or maternal Doppler measurements were found at any of the different checkup time points studied. The only variable that consistently affected the Doppler standardized values was gestational age at the time of assessment. The evolution of the UA PI z-score during the pregnancy was different in the two study groups, with a higher z-score in the exercise group at 20 weeks and a subsequent decrease until delivery while in the control group it remained stable at around zero. CONCLUSIONS A regular supervised moderate exercise program during pregnancy does not deteriorate fetal or maternal ultrasound Doppler parameters along the pregnancy, suggesting that the fetal well-being is not compromised by the exercise intervention. Fetal UA PI z-score decreases during pregnancy to lower levels in the exercise group compared with the control group.
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Affiliation(s)
- Irene Fernández-Buhigas
- Obstetrics and Gynecology Department, Hospital Universitario de Torrejón, Madrid, Spain.,School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Aranzazu Martin Arias
- Obstetrics and Gynecology Department, Hospital Universitario de Torrejón, Madrid, Spain.,School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Marina Vargas-Terrones
- AFIPE Research Group, Faculty of Sciences for Physical Activity and Sport, INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Maia Brik
- Obstetrics and Gynecology Department, Hospital Universitario de Torrejón, Madrid, Spain.,School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Valeria Rolle
- Biostatistics and Epidemiology Platform at Fundación para la Investigación e Innovación Biosanitaria del Principado de Asturias, Oviedo, Spain
| | - Rubén Barakat
- AFIPE Research Group, Faculty of Sciences for Physical Activity and Sport, INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - María D Muñoz-Gonzalez
- Obstetrics and Gynecology Department, Hospital Universitario de Torrejón, Madrid, Spain.,School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Ignacio Refoyo
- AFIPE Research Group, Faculty of Sciences for Physical Activity and Sport, INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Maria M Gil
- Obstetrics and Gynecology Department, Hospital Universitario de Torrejón, Madrid, Spain.,School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | - Belén Santacruz
- Obstetrics and Gynecology Department, Hospital Universitario de Torrejón, Madrid, Spain.,School of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
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Pouranayatihosseinabad M, Taylor M, Hawrelak J, Peterson GM, Veal F, Ling T, Williams M, Whatley M, Ahdieh K, Mirkazemi C. Maternal Antibiotic Exposure and the Risk of Developing Antenatal or Postpartum Depressive Symptoms: The Maternal Experience Study Protocol. Methods Protoc 2023; 6:98. [PMID: 37888030 PMCID: PMC10609134 DOI: 10.3390/mps6050098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 10/28/2023] Open
Abstract
Limited epidemiological evidence suggests a link between antibiotic use and developing depression. This study seeks to investigate this association in depth, using a cohort of pregnant individuals. The primary aim is to explore any association between the use of antibiotics during pregnancy and the development of antenatal depressive symptoms up to the third trimester, as well as the use of antibiotics during pregnancy and within 12 months postpartum and the development of postpartum depressive symptoms. A national prospective, observational, longitudinal cohort study has been designed to examine these relationships. A sample size of 1500 pregnant individuals has been sought for this study, assuming 10 potential predictor variables (including antibiotic use) in the final multiple logistic regression model and allowing for a 30% drop-out rate. The development of depressive symptoms is considered either a diagnosis by a medical doctor and/or a scoring 13 or higher on the Edinburgh Postnatal Depression Scale. Data will be collected during the third trimester and at 6 weeks, 6 months, and 12 months postpartum. These surveys include variables previously identified as associated with antenatal and postpartum depression (e.g., level of social support, experience of intimate partner abuse, and obstetric complications), as well as antibiotic and probiotic use. This study will provide an update on the prevalence of the symptoms of depression during pregnancy and postpartum and its associated risk factors. It will also, for the first time, comprehensively explore the potential association between antibiotic use during pregnancy and up to 12 months postpartum and the development of depressive symptoms.
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Affiliation(s)
- Mahsa Pouranayatihosseinabad
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Maggie Taylor
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Jason Hawrelak
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Gregory M. Peterson
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Felicity Veal
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Tristan Ling
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Mackenzie Williams
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Megan Whatley
- Department of Obstetrics and Gynaecology, Royal Hobart Hospital, Hobart, TAS 7000, Australia
| | - Kyan Ahdieh
- Launceston Medical Centre, Health Hub, Launceston, TAS 7250, Australia
| | - Corinne Mirkazemi
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
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Barbier M, Blanc J, Faust C, Baumstarck K, Ranque-Garnier S, Bretelle F. Standardized Stretching Postural postures to treat low-back pain in pregnancy: the GEMALODO randomized clinical trial. Am J Obstet Gynecol MFM 2023; 5:101087. [PMID: 37437692 DOI: 10.1016/j.ajogmf.2023.101087] [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: 05/17/2023] [Revised: 07/02/2023] [Accepted: 07/06/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Two-thirds of pregnant women suffer from low-back pain during pregnancy, which leads to negative effects on quality of everyday life. According to the literature, an 8- to 12-week program of adapted physical activity during pregnancy has proven its efficacy in treatment of low-back pain and functional disability. Stretching Postural is a nondynamic technique using muscular contractions and stretches that act mainly on the back and that can be practiced alone. OBJECTIVE This study aimed to assess the effect of an 8-week program of standardized Stretching Postural postures in low-risk pregnant women suffering from low-back pain. STUDY DESIGN This was an open-label, randomized, controlled trial in 1 French university hospital. Women with a singleton low-risk pregnancy between 15 and 32 weeks of gestation and with back, lumbar, or sacroiliac pain were randomly assigned (1:1) to either undergo an 8-week program of standardized Stretching Postural with basic advice (intervention group) or to receive basic advice only (control group). Both groups received ergonomic advice and encouragement to practice physical activity. The primary endpoint was the pain assessment at 8 weeks (defined by the mean pain level estimated by women in the previous week, scored on a numeric scale from 0 to 10). Secondary endpoints were pain after 4 weeks of follow-up, quality of life (12-item Short Form Survey), satisfaction (Patient Global Impression of Change), and delivery outcomes. The main analysis was intention-to-treat. RESULTS From January 2019 to August 2020, 60 women were randomized: 30 were assigned to the intervention group and 30 to the control group. The mean level of pain at 8 weeks was significantly lower in the intervention group than in the control group (1.6±1.4 vs 4.1±2.2; P<.01). The mean 12-item Short Form Survey scores were significantly higher in the posture group than in the control group (Physical Component Score, 45.7±7.8 vs 37.4±8.5; P<.01; Mental Component Score, 54.3±5.8 vs 50.4±7.1; P=.04), and the Patient Global Impression of Change score was also significantly higher (6.1±1.5 vs 3.9±2.3; P<.01). No adverse effects were found. CONCLUSION Stretching Postural appears to be a safe and efficient nondrug therapy to treat low-back pain during low-risk pregnancy.
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Affiliation(s)
- Magalie Barbier
- Department of Obstetrics and Gynecology, Nord Hospital, Assistance Publique - Hôpitaux de Marseille, Aix-Marseille University (Drs Barbier, Blanc, and Bretelle), Marseille, France.
| | - Julie Blanc
- Department of Obstetrics and Gynecology, Nord Hospital, Assistance Publique - Hôpitaux de Marseille, Aix-Marseille University (Drs Barbier, Blanc, and Bretelle), Marseille, France; Centre d'études et de recherche sur les services de santé et la qualité de vie (CEReSS), Health Service Research and Quality of Life Center, Aix-Marseille University (Dr Blanc), Marseille, France
| | - Cindy Faust
- Service d'Épidémiologie et Economie de la Santé, Assistance Publique - Hôpitaux de Marseille (Ms Faust and Dr Baumstarck), Marseille, France
| | - Karine Baumstarck
- Service d'Épidémiologie et Economie de la Santé, Assistance Publique - Hôpitaux de Marseille (Ms Faust and Dr Baumstarck), Marseille, France
| | - Stephanie Ranque-Garnier
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire Timone, Assistance Publique - Hôpitaux de Marseille (Dr Ranque-Garnier), Marseille, France; Centre national de la recherche scientifique, École Centrale de Marseille, Institut Fresnel, Aix-Marseille Université, Marseille (Dr Ranque-Garnier), France
| | - Florence Bretelle
- Department of Obstetrics and Gynecology, Nord Hospital, Assistance Publique - Hôpitaux de Marseille, Aix-Marseille University (Drs Barbier, Blanc, and Bretelle), Marseille, France; Institut national de la santé et de la recherche médicale, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Aix-Marseille University, Institut Hospitalo-Universitaire-Méditerranée Infection (Dr Bretelle), Marseille, France; Department of Obstetrics and Gynecology, Conception Hospital, Assistance Publique - Hôpitaux de Marseille, Aix-Marseille University (Dr Bretelle), Marseille, France
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9
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Longoria KD, Nguyen TC, Franco-Rocha O, Garcia SR, Lewis KA, Gandra S, Cates F, Wright ML. A sum of its parts: A systematic review evaluating biopsychosocial and behavioral determinants of perinatal depression. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.02.23293552. [PMID: 37577597 PMCID: PMC10418297 DOI: 10.1101/2023.08.02.23293552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
Introduction Depression is one of the most common yet underdiagnosed perinatal complications and our understanding of the pathophysiology remains limited. Though perinatal depression is considered to have a multifactorial etiology, integrative approaches to investigation are minimal. This review takes an integrative approach to systematically evaluate determinants and potential interactions among determinants of perinatal depression across four domains (i.e., biological, behavioral, environmental, social) and appraise the quality of methods applied. Methods Four databases (i.e., PubMed, CINAHL, APA PsycInfo, and Web of Science) were systematically searched to identify studies examining determinants of perinatal depression in adult perinatal persons (≥ 18 years). Articles were excluded if the outcomes were not focused on perinatal persons and depression or depression symptoms, the evaluation of depression was specific to a discrete facet of the perinatal period with probable psychological consequences (e.g., abortion, fetal/infant loss, adoption), or was considered grey literature. The Critical Appraisal Skills Programme and AXIS tools were used to guide and standardize quality appraisal assessments and determine the level of risk of bias. Results Of the 454 articles identified, 25 articles were included for final review. A total of 14 categories of determinants were investigated: biological (5), behavioral (4), social and environmental (5). Though only 28% of studies simultaneously considered determinants under more than one domain, a pattern of interactions with the tryptophan pathway emerged when determinants across domains were aggregated. Concerns for risk of bias were noted or were unclear for three types of bias: 13 (52%) selection bias, 3 (12%) recall bias, and 24 (96%) measurement bias. Conclusions Future research is needed to explore interactions among determinants and the tryptophan pathway; to strengthen the methods applied to this area of inquiry; and to generate evidence for best practices in reporting, selecting, and applying methods for measuring determinants and perinatal depression.
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Affiliation(s)
- Kayla D. Longoria
- School of Nursing, University of Texas at Austin, Austin, Texas, USA
| | - Tien C. Nguyen
- College of Natural Sciences, University of Texas at Austin, Austin, Texas, USA
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | | | - Sarina R. Garcia
- College of Natural Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Kimberly A. Lewis
- School of Nursing, University of Texas at Austin, Austin, Texas, USA
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco
| | - Sreya Gandra
- College of Natural Sciences, University of Texas at Austin, Austin, Texas, USA
- College of Liberal Arts, University of Texas at Austin, Austin, Texas, USA
| | - Frances Cates
- College of Liberal Arts, University of Texas at Austin, Austin, Texas, USA
| | - Michelle L. Wright
- School of Nursing, University of Texas at Austin, Austin, Texas, USA
- Department of Women’s Health, Dell Medical School at The University of Texas at Austin, Austin, Texas, USA
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Kowalska J. The Level of Stress and Anxiety in Pregnant Women Depending on Social Support and Physical Activity. J Clin Med 2023; 12:jcm12093143. [PMID: 37176585 PMCID: PMC10179597 DOI: 10.3390/jcm12093143] [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: 12/30/2022] [Revised: 04/14/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
Social support and physical activity are mentioned among the numerous factors affecting the emotional state of pregnant women. Therefore, the aim of the study was to assess the level of perceived stress and anxiety in pregnant women depending on social support and their physical activity both before and during pregnancy and find the factors that affected the level of perceived stress. METHODS A total of 373 pregnant women were qualified for the study. The Perceived Stress Scale (PSS-10), the State-Trait Anxiety Inventory (STAI), and a self-administered questionnaire were used. RESULTS In the study group, a high level of stress and anxiety were noted. A comparative analysis showed that physically active women before pregnancy, women attending childbirth classes and remaining in a relationship, were characterized by a lower level of stress and anxiety compared to physically inactive women, women who did not participate in childbirth classes and were single. A multiple linear regression analysis showed that participation in childbirth classes, physical activity before pregnancy, the level of anxiety as a trait, and women's age had the most significant impact on the stress level of surveyed women. CONCLUSIONS Further research among pregnant women and women in the postpartum period is needed to confirm the benefits of physical activity and to identify as many factors as possible that may affect the emotional state of pregnant women.
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Affiliation(s)
- Joanna Kowalska
- Faculty of of Physiotherapy, Wroclaw University of Health and Sport Sciences, 51-612 Wroclaw, Poland
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11
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Putnick DL, Bell EM, Ghassabian A, Mendola P, Sundaram R, Yeung EH. Maternal antenatal depression's effects on child developmental delays: Gestational age, postnatal depressive symptoms, and breastfeeding as mediators. J Affect Disord 2023; 324:424-432. [PMID: 36565964 PMCID: PMC9885303 DOI: 10.1016/j.jad.2022.12.059] [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: 09/14/2022] [Revised: 12/12/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Maternal antenatal depression experienced around conception or during pregnancy may adversely affect child development. This study explores three potential mechanisms of the effects of antenatal depression on children's developmental delays at 2-3 years: gestational age of the child, continued depressive symptoms postnatally, and interrupted breastfeeding practices. METHODS Mothers (N = 2888) of 3450 children, including 2303 singletons and 1147 multiples from the Upstate KIDS cohort provided data. Linked hospital discharge data was combined with mothers' reports to identify women with moderate to severe antenatal depression. Gestational age was extracted from birth certificates. Mothers completed a depression screener at 4 months postpartum, reported about their breastfeeding practices from 4 to 12 months postpartum, and completed a developmental delay screener when children were 24, 30, and 36 months. RESULTS In unadjusted path analysis models, mothers with antenatal depression had more postnatal depressive symptoms and breastfed fewer months, which translated into children being more likely to have developmental delays. Gestational age was not a mediator. Effects were similar across girls and boys and singletons and twins, and largely held when adjusting for covariates. LIMITATIONS Main limitations were the relatively advantaged sample and reliance on maternal report. CONCLUSIONS Maternal antenatal depression may impact child development through continued depressive symptoms in the postpartum period and through reduced breastfeeding duration suggesting additional targets for intervention.
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Affiliation(s)
- Diane L Putnick
- Epidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, USA.
| | - Erin M Bell
- Department of Environmental Health Sciences, University at Albany School of Public Health, USA
| | - Akhgar Ghassabian
- Departments of Pediatrics, Environmental Medicine, and Population Health, New York University Grossman School of Medicine, USA
| | - Pauline Mendola
- Department of Epidemiology and Environmental Health, University at Buffalo School of Public Health and Health Professions, USA
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, USA
| | - Edwina H Yeung
- Epidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, USA
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12
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He L, Soh KL, Huang F, Khaza'ai H, Geok SK, Vorasiha P, Chen A, Ma J. The impact of physical activity intervention on perinatal depression: A systematic review and meta-analysis. J Affect Disord 2023; 321:304-319. [PMID: 36374719 DOI: 10.1016/j.jad.2022.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/23/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND No meta-analysis has analyzed the effect of physical activity level, period of physical activity intervention, and duration of intervention, on perinatal depression. This study was to evaluate the impact of physical activity intensity, dose, period, and duration on perinatal depression. METHODS The literature was searched via the PubMed, Embase, Cochrane Library, and Web of Science databases. Weighted mean difference (WMD) or the risk ratio (RR) was used as the effect indicator, and the effect size was represented by the 95 % confidence interval (CI). Subgroup analysis based on the perinatal stage, physical activity intensity, physical activity equivalent, and intervention duration was performed. RESULTS Totally, 35 studies including 5084 women were included. Physical activity could reduce the incidence and severity of depression in perinatal women. Among depressed women with prenatal depression, low-intensity physical activity, with metabolic equivalents (METs)-min/week being <450, was associated with lower levels of depression. In the general population, the risk of postpartum depression was lower in the physical activity group when the duration of intervention was ≥12 weeks, being II, III stage, and ≥450 METs-min/week. Both low and moderate-intensity physical activity were beneficial to an improved depression severity among depressed women with postpartum depression, and moderate exercise intervention could decrease the risk of postpartum depression in general pregnant women. LIMITATIONS Different types of physical activities may affect the effectiveness of interventions. CONCLUSION Our study indicated physical activity specifically targeted at pregnant women could reduce depression risk and severity.
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Affiliation(s)
- Liping He
- Department of Nursing and Rehabilitations, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia; Department of Nursing, Chang Zhi Medical College, Changzhi 046000, PR China.
| | - Kim Lam Soh
- Department of Nursing and Rehabilitations, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia.
| | - Feifei Huang
- School of nursing, Fujian Medical University, Fuzhou 350000, PR China
| | - Huzwah Khaza'ai
- Department of Biomedical Science, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Soh Kim Geok
- Department of Sport Studies, Faculty of Education, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - Ponpun Vorasiha
- College of Nursing and Health, Suan Sunandha Rajabhat University, Bangkok 10300, Thailand
| | - Aixiang Chen
- Department of Nursing, Chang Zhi Medical College, Changzhi 046000, PR China
| | - Jiangping Ma
- Department of Nursing, Chang Zhi Medical College, Changzhi 046000, PR China
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Palacio M, Mottola MF. Activity Restriction and Hospitalization in Pregnancy: Can Bed-Rest Exercise Prevent Deconditioning? A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1454. [PMID: 36674214 PMCID: PMC9859130 DOI: 10.3390/ijerph20021454] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/16/2022] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
Evidence suggests that exercise during pregnancy is beneficial to both parent and fetus. However, there are high-risk pregnancy conditions that may warrant hospitalization. In our narrative review, we first describe the clinical implications for activity restriction in pregnancy, the effects of hospitalization, and the impact of bed rest on non-pregnant individuals. We provide examples of a 30 min bed-rest exercise program for hospitalized pregnant patients using the principal of suggested frequency, intensity, time (duration) of activity, and type of activity (FITT) using a resistance tool while in bed. If the individual is able to ambulate, we recommend short walks around the ward. Every minute counts and activity should be incorporated into a program at least 3 times per week, or every day if possible. As in all exercise programs, motivation and accountability are essential. Flexibility in timing of the exercise intervention is important due to the scheduling of medical assessments that may occur throughout the day for these hospitalized patients. Evidence suggests that by improving physical and emotional health through a bed-rest exercise program during a hospitalized pregnancy may help the individual resume demanding daily activity in the postpartum period and improve quality of life once birth has occurred. More research is necessary to improve the health of those individuals who are hospitalized during pregnancy, with follow up and support into the postpartum period.
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Affiliation(s)
- Montse Palacio
- Senior Consultant, Maternal-Fetal Medicine, Hospital Clínic Barcelona (BCNatal Fetal Medicine Research Center), Universitat de Barcelona, 08028 Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi I Sunyer, 08036 Barcelona, Spain
- Centre for Biomedical Research on Rare Diseases (CIBERER), 08001 Barcelona, Spain
| | - Michelle F. Mottola
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Children’s Health Research Institute, The University of Western Ontario, London, ON N6A 3K7, Canada
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14
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Maternal Pre-Pregnancy BMI and Gestational Weight Gain Modified the Association between Prenatal Depressive Symptoms and Toddler's Emotional and Behavioral Problems: A Prospective Cohort Study. Nutrients 2022; 15:nu15010181. [PMID: 36615838 PMCID: PMC9824574 DOI: 10.3390/nu15010181] [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: 12/20/2022] [Revised: 12/26/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
Background: Maternal prenatal depressive symptoms and abnormal pre-pregnancy BMI have been scarcely reported to play interactive effects on child health. In this prospective cohort, we aimed to examine the interactive effects of maternal prenatal depressive symptoms and pre-pregnancy BMI as well as gestational weight gain (GWG) on offspring emotional and behavioral problems (EPBs). Methods: The study samples comprised 1216 mother−child pairs from Shanghai Maternal−Child Pairs Cohort recruited from 2016 to 2018. Maternal pre-pregnancy BMI and GWG were obtained from medical records, and maternal depressive symptoms were assessed via the Center for Epidemiological Studies Depression Scale (CES-D) at 32−36 gestational weeks. The child completed the behavioral measurement via the Strengths and Difficulties Questionnaire (SDQ) at 24 months postpartum. Results: There were 12.01% and 38.65% women with prenatal depressive symptoms and sub-threshold depressive symptoms during late pregnancy. Both maternal depressive symptoms and prenatal sub-threshold depressive symptoms were associated with higher internalizing (OR = 1.69, 95% CI, 1.05−2.72; OR = 1.48, 95% CI, 1.06−2.07) and externalizing (OR = 2.06, 95% CI, 1.30−3.25; OR = 1.42, 95% CI, 1.02−1.99) problems in children. Maternal pre-pregnancy BMI and GWG modified the association between prenatal depressive symptoms and child externalizing or total difficulties problems (p < 0.10 for interaction). Among the overweight/obese pregnant women, maternal prenatal depressive symptoms were associated with a higher risk of externalizing problems (OR = 2.75, 95% CI, 1.06−7.11) in children. Among the women who gained inadequate GWG, maternal prenatal sub-threshold depressive symptoms were associated with 2.85-fold (95% CI 1.48−5.48) risks for child externalizing problems, and maternal depressive symptoms were associated with higher externalizing and total difficulties problems (OR = 4.87, 95% CI, 2.03−11.70 and OR = 2.94, 95% CI, 1.28−6.74, respectively), but these associations were not significant in the appropriate or excessive GWG group. Conclusions: Both maternal prenatal sub-threshold depressive symptoms and depressive symptoms increased the risks of child internalizing and externalizing problems at 24 months of age, while the effects on child externalizing problems were stronger among overweight/obese or inadequate GWG pregnant women. Our study highlights the importance of simultaneously controlling the weight of pregnant women before and throughout pregnancy and prompting mental health in pregnant women, which might benefit their offspring’s EBPs.
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Wilczyńska D, Walczak-Kozłowska T, Radzimiński Ł, Oviedo-Caro MÁ, Santos-Rocha R, Szumilewicz A. Can we hit prenatal depression and anxiety through HIIT? The effectiveness of online high intensity interval training in pregnant women during the COVID-19 pandemic: a randomized controlled trial. BMC Sports Sci Med Rehabil 2022; 14:215. [PMID: 36550564 PMCID: PMC9773485 DOI: 10.1186/s13102-022-00610-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND In recent years high intensity interval training (HIIT) has grown in popularity. However, it rarely represents training interventions in experimental studies in pregnant populations. Therefore, in this study we aimed to assess changes in depressive symptoms, fear of childbirth, fear of Covid-19 and quality of life after an 8-week supervised online HIIT program, compared to an educational (self-performed physical activity) program. METHODS We conducted a randomized control trial among 54 Caucasian women in uncomplicated, singleton pregnancy (age 32 ± 4 years, 22 ± 4 week of gestation; mean ± SD). There were 34 women in the experimental group, who participated in an 8-week high intensity interval training program (HIIT group). The comparative group was constituted of 20 pregnant women who attended 8-week educational program (EDU group). RESULTS The most important finding was that mental health improved somewhat in both groups after the intervention, but only the HIIT group improved statistically significantly. The positive trends in lowering the severity of depressive symptoms, fear of childbirth, and fear of Covid-19 were observed in both groups. However, the positive response to the intervention was stronger in the EDU group. As a secondary outcome, there was a significant decrease in cardiorespiratory fitness level in the EDU group, while the HIIT group maintained unchanged level of maximal oxygen uptake. CONCLUSIONS HIIT seems to be beneficial for women with uncomplicated pregnancies to maintain adequate quality of life and mental health. However, more research is needed to determine the effectiveness of prenatal HIIT in pregnant women in various psychological conditions. TRIAL REGISTRATION We conducted this study in Poland, in 2021. It was approved by the Bioethics Commission at the District Medical Chamber in Gdansk (KB-8/21). The full study protocol was registered in ClinicalTrials.gov (NCT05009433).
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Affiliation(s)
- Dominika Wilczyńska
- grid.445131.60000 0001 1359 8636Department of Physical Culture, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Tamara Walczak-Kozłowska
- grid.8585.00000 0001 2370 4076Department of Neuropsychology, Institute of Psychology, University of Gdansk, Gdansk, Poland
| | - Łukasz Radzimiński
- grid.445131.60000 0001 1359 8636Department of Physical Culture, Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Miguel Ángel Oviedo-Caro
- grid.9224.d0000 0001 2168 1229Department of Physical Education and Sport, University of Seville, Seville, Spain
| | - Rita Santos-Rocha
- grid.410927.90000 0001 2171 5310Sport Sciences School of Rio Maior (ESDRM), Polytechnic Institute of Santarém, Rio Maior, Portugal ,grid.9983.b0000 0001 2181 4263Interdisciplinary Centre for the Study of Human Performance (CIPER), Faculty of Human Kinetics (FMH), University of Lisbon, lisboa, Portugal
| | - Anna Szumilewicz
- grid.445131.60000 0001 1359 8636Department of Physical Culture, Gdansk University of Physical Education and Sport, Gdansk, Poland
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Liu X, Wang G, Cao Y. Physical exercise interventions for perinatal depression symptoms in women: A systematic review and meta-analysis. Front Psychol 2022; 13:1022402. [PMID: 36582320 PMCID: PMC9792692 DOI: 10.3389/fpsyg.2022.1022402] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/24/2022] [Indexed: 12/15/2022] Open
Abstract
Background The previous meta-analysis indicated that physical exercise could play a crucially therapeutic role in reducing perinatal depression symptoms in women. However, the efficacy varies across different exercise types, forms, intensities, and duration. Aim The purpose of this study was to review and evaluate the effects of different types, forms, intensities, and duration of exercise for improving perinatal depressive symptoms. Design A systematic review and meta-analysis. Methods Randomized controlled trials until December 2021 were searched from seven databases, including PubMed, EMBASE, Medline, CINAHL, Web of Science, Cochrane Library, and PsycINFO. The risk of bias in eligible trials was evaluated using the Cochrane Risk of Bias tool. When high heterogeneity was tested, we used random-effects models. A funnel plot was used to assess the publication bias. This review was performed under the PRISMA guidelines, Consensus on Exercise Reporting (CERT) checklist and Cochrane Handbook. The certainty of the body of evidence was assessed using the GRADE method. Results Of 1,573 records, 20 trials were identified in this study. The results of this review revealed that women with perinatal depression symptoms gained benefits from physical exercise [OR = 0.62, 95% CI (0.45, 0.86), P = 0.004; MD = -0.57, 95% CI (-0.83, -0.30), P < 0.0001]. Type of walking [SMD = -1.06, 95% CI (-1.92, -0.19), P < 0.00001], form of "Individual + group-based"exercise [SMD = -0.91, 95% CI (-0.80, -0.03), P = 0.04], intensity of ≥150 min per week [SMD = -0.84, 95% CI (-1.53, -0.15), P = 0.02], and ≥12 weeks duration [SMD = -0.53, 95% CI (-0.75, -0.31), P < 0.00001] seemed to generate more prominent improvement on perinatal depression symptoms. Conclusion Physical exercise showed a significant effect on reducing perinatal depressive symptoms. This meta-analysis provides an important update on exercise's efficacy in treating perinatal depression. Further higher quality and large-scale trials are needed to substantiate our findings. Systematic review registration [https://www.crd.york.ac.uk/prospero/], identifier [CRD42022296230].
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Affiliation(s)
- Xueyan Liu
- School of Nursing and Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Guangpeng Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Yingjuan Cao
- Qilu Hospital, Shandong University, Jinan, Shandong, China,*Correspondence: Yingjuan Cao,
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The prevalence and associated factors of prenatal depression and anxiety in twin pregnancy: a cross-sectional study in Chongqing, China. BMC Pregnancy Childbirth 2022; 22:877. [DOI: 10.1186/s12884-022-05203-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 11/09/2022] [Indexed: 11/28/2022] Open
Abstract
Abstract
Background
Pregnant women expecting twins are more likely to experience stress, which can lead to anxiety and depression. Our aim was to investigate the prevalence of prenatal anxiety and depressive symptoms in women with twin pregnancies and the associated factors.
Methods
In a cross-sectional survey, 210 women with twin pregnancies who satisfied the inclusion and exclusion criteria in two tertiary centers in Southwestern China were asked to complete a basic information form, the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). To compare statistics with normal distribution in distinct characteristic groups, a paired t-test, and one-way ANOVA were utilized. Binary logistic step regression was used to analyze the associated factors of antenatal anxiety and depressive symptoms.
Results
The 210 women with twin pregnancies (age = 30.8 ± 4.2 years) were between 7 and 37 gestational weeks (29.2 ± 1.2 weeks), were typically well-educated (72.4% had a post-high-school degree), and reasonably affluent (88.1% were above the low-income cutoff). Among them, 34.8% had symptoms associated with clinical levels of anxiety, and 37.1% had symptoms indicating possible depression. The prevalence of co-morbid anxiety and depressive symptoms was 24.3%. Binary stepwise logistic regression analysis showed that previous health status and sleep disturbance during pregnancy were the associated factors of anxiety symptoms in women with twin pregnancies (P < 0.05), whereas age, previous health status, negative life events, and physical activity during pregnancy were the associated factors of depressive symptoms in women with twin pregnancies (P < 0.05).
Conclusion
About one-third of women with twin pregnancies had symptoms of anxiety or depression; these were most strongly predicted by some modifiable factors, suggesting that early preventive mind-body interventions may be a promising strategy to protect against mental health issues for women with twin pregnancies.
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Kowalska J, Dulnik M, Guzek Z, Strojek K. The emotional state and social support of pregnant women attending childbirth classes in the context of physical activity. Sci Rep 2022; 12:19295. [PMID: 36369355 PMCID: PMC9652312 DOI: 10.1038/s41598-022-23971-7] [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: 06/25/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
Abstract
Childbirth classes combined with elements of psychoprophylaxis and psychoeducation prepare women and their partners for childbirth and influence the level of their perceived stress and mood disorders. Participation in these classes may come as a form of support for pregnant women, or an opportunity to build self-efficacy and commence regular physical activity. The aim of this study was assess the emotional state, social support and self-efficacy of pregnant women attending childbirth classes, in the context of physical activity undertaken. The study included 101 pregnant women. The Berlin Social Support Scale (BSSS), the General Self-Efficacy Scale (GSES), the Perceived Stress Scale (PSS-10) and the State-Trait Anxiety Inventory (STAI) were used during their first day of attendance at the childbirth classes (initial survey; T1) and after 10 weeks of participation in these classes (final survey; T2). After 10 weeks of childbirth classes, there was a statistically significant change in the BSSS, specifically in the area of Perceived Available Support, GSES, PSS-10, and STAI X-2. There was no significant relationship established between the emotional state and the physical activity undertaken before and during pregnancy or with the social support received.
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Affiliation(s)
- Joanna Kowalska
- Faculty of Physiotherapy, University of Health and Sport Sciences, Paderewskiego 35 Street, 51-612 Wrocław, Poland
| | - Małgorzata Dulnik
- Ślęza Recreational Center, Błękitna 2, 55-040 Bielany Wrocławskie, Poland
| | - Zbigniew Guzek
- Department of Neurological Rehabilitation, University Hospital in Zielona Góra, 65‐046 Zielona Góra, Poland
| | - Kinga Strojek
- Faculty of Physiotherapy, University of Health and Sport Sciences, Paderewskiego 35 Street, 51-612 Wrocław, Poland
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Flor-Alemany M, Migueles JH, Alemany-Arrebola I, Aparicio VA, Baena-García L. Exercise, Mediterranean Diet Adherence or Both during Pregnancy to Prevent Postpartum Depression-GESTAFIT Trial Secondary Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14450. [PMID: 36361335 PMCID: PMC9657805 DOI: 10.3390/ijerph192114450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/24/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
Targeting lifestyle behaviors during pregnancy is crucial to prevent the highly prevalent postpartum depression and its consequences. In these secondary analyses of an intervention trial to investigate the effects of concurrent exercise training on postpartum depression, we aimed to investigate the potential role of Mediterranean diet (MD) adherence on the exercise effects. A total of 85 pregnant women met the per-protocol criteria (exercise n = 46, control n = 39). The exercise program was delivered in 60 min sessions, 3 days/week, from the 17th gestational week until birth. Women's dietary habits were assessed with a food frequency questionnaire. The Mediterranean Food Pattern (an MD index) was derived from it to assess MD adherence. We used the Edinburgh Postnatal Depression Scale to assess postpartum depression. The postpartum depression score was not statistically different between control and exercise groups (p > 0.05). A higher consumption of fruits (β = -0.242, p = 0.022), lower intake of red meat and subproducts (β = 0.244, p = 0.020), and a greater MD adherence (β = -0.236, p = 0.027) were associated with lower levels of postpartum depression. Greater adherence to the MD during pregnancy was associated with fewer depressive symptoms and a lower risk of postpartum depression. Postnatal depression was not reduced by prenatal exercise. Promoting fruit consumption while controlling the intake of red meat during pregnancy might prevent postnatal depression.
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Affiliation(s)
- Marta Flor-Alemany
- Department of Physiology, University of Granada, 18071 Granada, Spain
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain
| | - Jairo H. Migueles
- Department of Biosciences and Nutrition, Karolinska Institutet, 141 52 Huddinge, Sweden
- PROFITH “Promoting FITness and Health through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
| | - Inmaculada Alemany-Arrebola
- Department of Developmental and Educational Psychology, Faculty of Education and Sports Sciences, University of Granada, 52005 Melilla, Spain
| | - Virginia A. Aparicio
- Department of Physiology, University of Granada, 18071 Granada, Spain
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain
| | - Laura Baena-García
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain
- Department of Nursing, Faculty of Health Sciences, University of Granada, 51001 Ceuta, Spain
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20
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Guinhouya BC, Duclos M, Enea C, Storme L. Beneficial Effects of Maternal Physical Activity during Pregnancy on Fetal, Newborn, and Child Health: Guidelines for Interventions during the Perinatal Period from the French National College of Midwives. J Midwifery Womens Health 2022; 67 Suppl 1:S149-S157. [PMID: 36480665 PMCID: PMC10107927 DOI: 10.1111/jmwh.13424] [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: 04/12/2022] [Accepted: 05/10/2022] [Indexed: 12/13/2022]
Abstract
The objective of this work is to synthesize current knowledge about the effects of maternal physical activity during pregnancy on children's health. During the prenatal and postnatal periods, maternal physical activity has protective effects against the risks of macrosomia, obesity, and other associated cardiometabolic disorders. Even though longitudinal studies in humans are still necessary to validate them, these effects have been consistently observed in animal studies. A remarkable effect of maternal physical activity is its positive role on neurogenesis, language development, memory, and other cognitive functions related to learning.
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Affiliation(s)
| | - Martine Duclos
- Department of Sport Medicine and Functional Explorations, University-Hospital (CHU), G. Montpied Hospital, Clermont-Ferrand, Clermont-Ferrand, F-63003, France.,INRAE, UNH, CRNH Auvergne, Clermont-Ferrand, F-63000, France.,Clermont University, University of Auvergne, UFR Médecine, BP 10448, Clermont-Ferrand, F-63000, France
| | - Carina Enea
- Laboratoire MOVE (EA6314), Université de Poitiers, Faculté des sciences du sport, 8 allée Jean Monnet - TSA 31113 - 96073 Poitiers cedex 9
| | - Laurent Storme
- Univ. Lille, ULR 2694 METRICS, Lille, F-59000, France.,Department of Neonatology, CHU Lille, Lille, F-59000, France
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21
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L’Heveder A, Chan M, Mitra A, Kasaven L, Saso S, Prior T, Pollock N, Dooley M, Joash K, Jones BP. Sports Obstetrics: Implications of Pregnancy in Elite Sportswomen, a Narrative Review. J Clin Med 2022; 11:jcm11174977. [PMID: 36078907 PMCID: PMC9456821 DOI: 10.3390/jcm11174977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 08/01/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
Increasing numbers of females are participating in elite sports, with a record number having competed at the Tokyo Olympic Games. Importantly, the ages of peak performance and fertility are very likely to coincide; as such, it is inevitable that pregnancy will occur during training and competition. Whilst there is considerable evidence to promote regular exercise in pregnancy, with benefits including a reduction in hypertensive disorders, gestational diabetes, and reduced rates of post-natal depression, few studies have been conducted which include elite athletes. Indeed, there are concerns that high-intensity exercise may lead to increased rates of miscarriage and preterm labour, amongst other pregnancy-related complications. There is minimal guidance on the obstetric management of athletes, and consequently, healthcare professionals frequently adopt a very conservative approach to managing such people. This narrative review summarises the evidence on the antenatal, intrapartum, and postpartum outcomes in elite athletes and provides recommendations for healthcare providers, demonstrating that generally, pregnant athletes can continue their training, with a few notable exceptions. It also summarises the physiological changes that occur in pregnancy and reviews the literature base regarding how these changes may impact performance, with benefits arising from pregnancy-associated cardiovascular adaptations at earlier gestations but later changes causing an increased risk of injury and fatigue.
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Affiliation(s)
- Ariadne L’Heveder
- Department of Surgery & Cancer, Imperial College London, London W12 0NN, UK
- Correspondence: ; Tel.: +44-07989356191
| | - Maxine Chan
- Department of Surgery & Cancer, Imperial College London, London W12 0NN, UK
- Queen Charlotte’s and Chelsea Hospital, Imperial College NHS Trust, Du Cane Road, London W12 0HS, UK
| | - Anita Mitra
- Department of Surgery & Cancer, Imperial College London, London W12 0NN, UK
- Queen Charlotte’s and Chelsea Hospital, Imperial College NHS Trust, Du Cane Road, London W12 0HS, UK
| | - Lorraine Kasaven
- Department of Surgery & Cancer, Imperial College London, London W12 0NN, UK
- Queen Charlotte’s and Chelsea Hospital, Imperial College NHS Trust, Du Cane Road, London W12 0HS, UK
| | - Srdjan Saso
- Department of Surgery & Cancer, Imperial College London, London W12 0NN, UK
- Queen Charlotte’s and Chelsea Hospital, Imperial College NHS Trust, Du Cane Road, London W12 0HS, UK
| | - Tomas Prior
- Queen Charlotte’s and Chelsea Hospital, Imperial College NHS Trust, Du Cane Road, London W12 0HS, UK
| | - Noel Pollock
- Institute of Sport, Exercise & Health, University College London, London W1T 7HA, UK
- British Athletics, National Performance Institute, Loughborough, LE11 3TU, UK
| | | | - Karen Joash
- Queen Charlotte’s and Chelsea Hospital, Imperial College NHS Trust, Du Cane Road, London W12 0HS, UK
| | - Benjamin P. Jones
- Department of Surgery & Cancer, Imperial College London, London W12 0NN, UK
- Queen Charlotte’s and Chelsea Hospital, Imperial College NHS Trust, Du Cane Road, London W12 0HS, UK
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22
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Wang Y, Liu H, Zhang C, Li C, Xu JJ, Duan CC, Chen L, Liu ZW, Jin L, Lin XH, Zhang CJ, Zhang HQ, Yu JL, Li T, Dennis CL, Li H, Wu YT. Antepartum sleep quality, mental status, and postpartum depressive symptoms: a mediation analysis. BMC Psychiatry 2022; 22:521. [PMID: 35918689 PMCID: PMC9344627 DOI: 10.1186/s12888-022-04164-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor sleep quality and maternal mood disturbances are common during pregnancy and may play pivotal roles in the development of postpartum depression. We aim to examine the trajectories of sleep quality and mental health in women from early pregnancy to delivery and explore the mediating effects of sleep quality and mental status on the link between antepartum depressive symptoms and postpartum depressive symptoms. METHODS In an ongoing prospective birth cohort, 1301 women completed questionnaires in the first, second and third trimesters and at 6 weeks postpartum. In each trimester, sleep quality was measured utilizing the Pittsburgh Sleep Quality Index (PSQI), and mental health was assessed with the Center for Epidemiologic Studies Depression Scale (CES-D), the Self-Rating Anxiety Scale (SAS) and the Perceived Stress Scale (PSS). Postpartum depressive symptoms were evaluated by the Edinburgh Postnatal Depression Scale (EPDS). The bootstrap method was used to test the mediation effect. RESULTS The PSQI, CES-D, and SAS scores presented U-shaped curves across the antenatal period while the PSS score followed a descending trend. Antenatal sleep quality, depressive symptoms, anxiety symptoms and perceived stress all predicted depressive symptoms at 6 weeks postpartum. The influence of antepartum depressive symptoms on postpartum depressive symptoms was mediated by antepartum sleep quality and anxiety symptoms, which accounted for 32.14%, 39.25% and 31.25% in the first, second and third trimesters (P = 0.002, P = 0.001, P = 0.001, respectively). CONCLUSIONS Poor sleep quality and anxiety symptoms in pregnancy mediated the relationship between antepartum depressive symptoms and postpartum depressive symptoms. Interventions aimed at detecting and managing sleep quality and elevated anxiety among depressed women in pregnancy warrant further investigation as preventative strategies for postpartum depression.
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Affiliation(s)
- Yu Wang
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Han Liu
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China
| | - Chen Zhang
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.8547.e0000 0001 0125 2443Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, 200011 China
| | - Cheng Li
- grid.8547.e0000 0001 0125 2443Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, 200011 China
| | - Jing-Jing Xu
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Chen-Chi Duan
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Lei Chen
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China
| | - Zhi-Wei Liu
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China
| | - Li Jin
- grid.8547.e0000 0001 0125 2443Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, 200011 China
| | - Xian-Hua Lin
- grid.8547.e0000 0001 0125 2443Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, 200011 China
| | - Chen-Jie Zhang
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Han-Qiu Zhang
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Jia-Le Yu
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Tao Li
- grid.16821.3c0000 0004 0368 8293School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030 China ,grid.16821.3c0000 0004 0368 8293Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, 200030 China
| | - Cindy-Lee Dennis
- grid.17063.330000 0001 2157 2938Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Hong Li
- School of Medicine, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University, 910, Hengshan Rd., Shanghai, 200030, China.
| | - Yan-Ting Wu
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, 200011, China. .,Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences (No. 2019RU056), Shanghai, China.
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23
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Gómez-Baya D, Gómez-Gómez I, Domínguez-Salas S, Rodríguez-Domínguez C, Motrico E. The influence of lifestyles to cope with stress over mental health in pregnant and postpartum women during the COVID-19 pandemic. CURRENT PSYCHOLOGY 2022; 42:1-20. [PMID: 35729900 PMCID: PMC9200375 DOI: 10.1007/s12144-022-03287-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2022] [Indexed: 11/23/2022]
Abstract
The COVID-19 pandemic affected daily life routines and lifestyles of pregnant and postpartum women and increased their stress and risk of suffering from mental health problems. The aim of this study was to analyse which sociodemographic variables, COVID-19 exposure variables and lifestyles to cope with stress variables predicted anxiety, depression, and PTSD symptoms in pregnant and postpartum women during the COVID-19 pandemic. A cross-sectional design was performed with a sample of 3356 Spanish women participating in the Riseup-PPD-COVID-19 study. These participants completed an online survey composed of measures of anxiety (GAD-7), depression (EPDS), and PTSD related to COVID-19 (Checklist DSM-5), as well as demographics, exposure to COVID-19, and lifestyles to cope with stress. Regarding results, 47.2% showed depression and a third reported anxiety, whereas moderate scores were observed in PTSD symptoms. The most commonly used strategies to cope with stress in the COVID-19 pandemic were talking with friends and family and increasing time with social networks. Better results in mental health were associated with coping strategies such as talking with family and friends or participating in family activities, physical activity, sleeping well at night, eating healthier, and increasing personal care. Furthermore, poor results in mental health were observed in those participants who increased time with screens, ate fast food, reported substance use, and talked more frequently with health professionals. More symptoms were also observed in younger women, primiparous women, and those who reported more exposure to COVID-19. The results underline the need to strengthen the mental health of pregnant and postpartum women. Trial registration: ClinicalTrials.gov Identifier: NCT04595123.
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Affiliation(s)
- Diego Gómez-Baya
- Department of Social, Developmental and Educational Psychology, Universidad de Huelva, Huelva, Spain
| | - Irene Gómez-Gómez
- Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Seville Spain
| | - Sara Domínguez-Salas
- Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Seville Spain
| | | | - Emma Motrico
- Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Seville Spain
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24
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Jarbou NS, Newell KA. Exercise and yoga during pregnancy and their impact on depression: a systematic literature review. Arch Womens Ment Health 2022; 25:539-559. [PMID: 35286442 DOI: 10.1007/s00737-021-01189-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 10/11/2021] [Indexed: 12/24/2022]
Abstract
It is well established that exercise can improve depressive symptoms in the general population; however, it is not clear if these benefits are also seen in pregnancy. This review aimed to synthesize the evidence that examines whether exercise during pregnancy impacts depressive and associated symptoms (e.g. anxiety) during the perinatal period. The review was conducted in accordance with PRISMA guidelines and reporting criteria; literature was searched using PubMed, Scopus and Web of Science database engines. Clinical trials published in English evaluating the effects of a defined exercise protocol during pregnancy on depressive and/or anxiety symptoms during the perinatal period were included. Studies without a control group were excluded. Risk of bias was conducted by Cochrane assessment to appraise the quality of the included studies. Twenty-seven articles, between 1994 and 2019, were included. Of these, only 5 specifically recruited women with depression (n = 334), which all assessed a yoga-based intervention; 4 of these studies showed a statistically significant improvement in depressive and/or anxiety symptoms in the intervention group compared to baseline; however, 2 of these studies also showed an improvement in the control group. The remaining 22 studies used various exercise interventions in pregnant women (n = 4808) with 20 studies reporting that exercise during pregnancy has the ability to improve depressive and/or anxiety measures in the perinatal period compared to either baseline or control. The evidence suggests that exercise of various types in pregnancy can reduce depressive and/or anxiety symptoms in the perinatal period in otherwise healthy women. Specifically in women with antenatal depression, the incorporation of yoga in pregnancy can improve depressive/anxiety symptoms in the perinatal period; however, this is based on a small number of studies, and it is not clear whether this is superior to non-exercise controls. Further studies are needed to determine the potential therapeutic effects of exercise of various types during pregnancy on symptoms of antenatal depression.
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Affiliation(s)
- Noor S Jarbou
- Molecular Horizons and School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia.,Illawarra Health and Medical Research Institute, Wollongong, NSW, 2522, Australia
| | - Kelly A Newell
- Molecular Horizons and School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 2522, Australia. .,Illawarra Health and Medical Research Institute, Wollongong, NSW, 2522, Australia.
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25
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de Castro R, Antunes R, Mendes D, Szumilewicz A, Santos-Rocha R. Can Group Exercise Programs Improve Health Outcomes in Pregnant Women? An Updated Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4875. [PMID: 35457743 PMCID: PMC9024782 DOI: 10.3390/ijerph19084875] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/09/2022] [Accepted: 04/15/2022] [Indexed: 02/06/2023]
Abstract
Current scientific evidence supports the recommendation to initiate or continue physical exercise in healthy pregnant women. Group exercise programs have positive effects on improving health, well-being, and social support. In 2015, a systematic review was provided to evaluate the evidence on the effectiveness of group exercise programs in improving pregnant women's and newborns' health outcomes and to assess the content of the programs. This review aims to update this knowledge between 2015 and 2020. The exercise program designs were analyzed with the Consensus of Exercise Reporting Template (CERT) model, the compliance with the current guidelines, and effectiveness in the maternal health and fitness parameters. Three databases were used to conduct literature searches. Thirty-one randomized control trials were selected for analysis. All studies followed a supervised group exercise program including aerobic, resistance, pelvic floor training, stretching, and relaxation sections. Group interventions during pregnancy improved health and fitness outcomes for the women and newborns, although some gaps were identified in the interventions. Multidisciplinary teams of exercise and health professionals should advise pregnant women that group exercise improves a wide range of health outcomes for them and their newborns.
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Affiliation(s)
- Rebeca de Castro
- ESECS—Polytechnic Institute of Leiria, 2411-901 Leiria, Portugal; (R.d.C.); (D.M.)
| | - Raul Antunes
- ESECS—Polytechnic Institute of Leiria, 2411-901 Leiria, Portugal; (R.d.C.); (D.M.)
- Life Quality Research Centre (CIEQV), 2040-413 Leiria, Portugal
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2410-541 Leiria, Portugal
| | - Diogo Mendes
- ESECS—Polytechnic Institute of Leiria, 2411-901 Leiria, Portugal; (R.d.C.); (D.M.)
- Life Quality Research Centre (CIEQV), 2040-413 Leiria, Portugal
| | - Anna Szumilewicz
- Department of Fitness, Faculty of Physical Culture, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland;
| | - Rita Santos-Rocha
- ESDRM Sport Sciences School of Rio Maior—Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal;
- CIPER Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics (FMH), University of Lisbon, 1499-002 Cruz Quebrada, Portugal
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26
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Silva-Jose C, Nagpal TS, Coterón J, Barakat R, Mottola MF. The 'new normal' includes online prenatal exercise: exploring pregnant women's experiences during the pandemic and the role of virtual group fitness on maternal mental health. BMC Pregnancy Childbirth 2022; 22:251. [PMID: 35337280 PMCID: PMC8953965 DOI: 10.1186/s12884-022-04587-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/11/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Prenatal anxiety and depressive symptoms have significantly increased since the onset of the coronavirus (COVID-19) pandemic In addition, home confinement regulations have caused a drastic increase in time spent sedentary. Online group fitness classes may be an effective strategy that can increase maternal physical activity levels and improve mental health outcomes by providing an opportunity for social connectedness. The present study explores the experiences of pregnant women who participated in an online group exercise program during the pandemic and identifies relationships with maternal mental health and well-being. In addition, we present person-informed recommendations on how to improve the delivery of future online prenatal exercise programs. METHODS Semi-structured interviews were conducted with pregnant women (8-39 weeks of pregnancy) who participated in an online group exercise program, from March to October 2020 in Spain. A phenomenological approach was taken, and open-ended questions were asked to understand women's experiences throughout the pandemic and the role the online exercise classes may have had on their physical activity levels, mental health, and other health behaviours such as diet. A thematic analysis was performed to evaluate data. In addition, women completed the State-Trait Anxiety Inventory and these data supplemented qualitative findings. RESULTS Twenty-four women were interviewed, and the anxiety scores were on average 32.23 ± 9.31, ranging from low to moderate levels. Thematic analysis revealed that women felt safe exercising from home, an increased availability of time to schedule a structured exercise class, and consequently an improvement in their adherence to the program and other behaviours (i.e., healthier diet). Women emphasized feeling connected to other pregnant women when they exercised online together, and overall, this had a positive effect on their mental well-being. Women suggested that future online exercise programs should include flexible options, detailed instructions and facilitation by a qualified exercise professional. CONCLUSION Pregnant women are receptive to online group exercise classes and expressed that they are an accessible option to accommodating physical activity during the pandemic. In addition, the online group environment provides an important sense of connectivity among pregnant women exercising together and this may mitigate the detrimental effect of COVID-19 on maternal mental health.
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Affiliation(s)
| | - Taniya S Nagpal
- Kinesiology, Faculty of Applied Health Sciences, Brock University St. Catharines, St. Catharines, Canada
| | - Javier Coterón
- AFIPE Research Group, Universidad Politécnica de Madrid, Madrid, Spain.
| | - Ruben Barakat
- AFIPE Research Group, Universidad Politécnica de Madrid, Madrid, Spain
| | - Michelle F Mottola
- School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, London, Canada.,Children's Health Research Institute, University of Western Ontario, London, Canada.,Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Canada
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27
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Pregnancy Activity Levels and Impediments in the Era of COVID-19 Based on the Health Belief Model: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063283. [PMID: 35328974 PMCID: PMC8954454 DOI: 10.3390/ijerph19063283] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/04/2022] [Accepted: 03/09/2022] [Indexed: 02/06/2023]
Abstract
Physical activity (PA) and exercise benefit both the mother and the fetus. Many pregnant women avoid or severely limit PA, leading to complications before and after delivery. This study elucidated the precise effect of each moderator variable on prenatal physical activity (PPA) by examining demographic factors, the PPA-related health belief level (HBL), and the current PPA level. The health belief model (HBM) in conjunction with the international prenatal physical activity questionnaire was used. The HBL in pregnant parous women (PPW) (3.42) was significantly higher than that in nonpregnant nulliparous women (NNW) (3.06). The PPA level in pregnant nulliparous women (PNW) (5.67 metabolic equivalent-hours per week (MET-h/week)) was lower than in the PPW (6.01 MET-h/week). All HBM dimensions (except for perceived barriers) were positively correlated with exercise expenditure in both PNW and PPW. According to the regression tree, participants in PNW aged ≤ 23 years with annual household incomes > CNY 100,001−150,000 had the highest energy expenditure (10.75 MET-h/week), whereas participants in PPW with a perceived benefit score of >4 had the highest energy expenditure (10 MET-h/week). The results demonstrated that the HBL in all groups was acceptable, whereas the PPA level was lower than the recommended PA level. In both PPW and PNW, the HBL was most strongly correlated with exercise expenditure. There is an urgent need to organize public-interest courses to alleviate household expenditure, raise the HBL about PPA in pregnant and NNW, and ensure personal health in the context of COVID-19.
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28
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Morres ID, Tzouma NA, Hatzigeorgiadis A, Krommidas C, Kotronis KV, Dafopoulos K, Theodorakis Y, Comoutos N. Exercise for perinatal depressive symptoms: A systematic review and meta-analysis of randomized controlled trials in perinatal health services. J Affect Disord 2022; 298:26-42. [PMID: 34728280 DOI: 10.1016/j.jad.2021.10.124] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 09/14/2021] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Exercise improves perinatal depressive (PD) symptoms, but reports call for more robust evidence. This systematic review and meta-analysis aimed at synthesizing evidence exclusively from randomized controlled trials (RCTs) examining the effects of exercise on PD symptoms in women recruited through perinatal health services. METHODS Nine e-databases and fifteen systematic reviews were searched for relevant RCTs. Exercise-specific tools extracted/coded data. A meta-analysis using a random effects model (Standardized Mean Difference [SMD]) investigated the effects of exercise on PD scores post-intervention. RESULTS From 285 records, 14 RCTs (2.025 participants) were considered eligible including two RCTs with clinically diagnosed PD women. Exercise showed a statistically significant, small, overall antidepressant effect (SMD = -0.21, 95% CI = -0.31, -0.11, p = 0.0001) with low/non-significant heterogeneity (Q = 17.82, I 2 = 16%, p = 0.27). Only the fail-safe criterion recorded marginally significant publication bias, but trim-fill analysis added no study. Sensitivity analyses increased the overall effect in RCTs showing lower risk of bias or delivering ≥150 min/week moderate intensity aerobic exercise. Subgroup analyses revealed significant antidepressant effects for exercise across various settings, delivery formats, depressive symptoms severities and outcome measures used. Heterogeneity was low/non-significant in all analyses (I 2 ≤ 50%). Hedges' g corrections did not influence the results. LIMITATIONS Study limitations include the small number of available trials and clinically diagnosed PD samples and the variety of exercise modalities. CONCLUSIONS Exercise improved PD symptoms, especially in RCTs with lower risk of bias or with ≥150 min/day moderate intensity aerobic exercise interventions. Findings are clinically useful but more RCTs for clinically diagnosed PD women are needed for firmer conclusions.
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Affiliation(s)
- Ioannis D Morres
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece.
| | - Natalia-Antigoni Tzouma
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece
| | - Antonis Hatzigeorgiadis
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece
| | - Charalampos Krommidas
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece
| | | | - Konstantinos Dafopoulos
- Department of Obstetrics and Gynecology, School of Health Sciences, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Yannis Theodorakis
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece
| | - Nikolaos Comoutos
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece
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Sitzberger C, Hansl J, Felberbaum R, Brössner A, Oberhoffer-Fritz R, Wacker-Gussmann A. Physical Activity in High-Risk Pregnancies. J Clin Med 2022; 11:jcm11030703. [PMID: 35160151 PMCID: PMC8836910 DOI: 10.3390/jcm11030703] [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: 11/29/2021] [Revised: 01/07/2022] [Accepted: 01/24/2022] [Indexed: 01/11/2023] Open
Abstract
It is known that physical activity before and during pregnancy is associated with health benefits for both the mother and fetus. The WHO recommends a minimum of 150 min per week of moderate-intensity aerobic physical activity for pregnant women. However, the majority of pregnant woman seem not to be physically active in pregnancy as recommended. In addition, the WHO recommendations do not include information on physical activity (PA) for specific target groups. This might be particularly problematic in women with assisted reproduction technologies (ART) or those who have received the fetal diagnosis of congenital heart defects (CHD). The aim of our study was to elaborate on whether assisted reproduction technologies (ART) and/or the diagnosis of fetal congenital heart defects (CHD) influence the level of PA in pregnant women, and to determine if there is a difference between PA behavior before and during pregnancy. In addition, we will evaluate whether high-risk pregnant women also reach the WHO recommendations. A non-interventional, cross-sectional, monocentric study based on two standardized questionnaires on physical activity was conducted. In total, n = 158 pregnant women were included. All of the participants were recruited from the outpatient clinics of the German Heart Center, Munich, and the Klinikverbund Kempten-Oberallgäu, Germany. Pregnant women after ART (n = 18), with fetal CHD (n = 25) and with both ART and CHD (n = 8) could be included. A total of 107 pregnant women served as healthy controls. Women, after ART, showed a significantly reduced level of physical activity (p = 0.014) during pregnancy compared to women who became pregnant naturally. Additionally, less (p < 0.001) and lighter (p = 0.002) physical activity was observed in all groups during pregnancy compared to those before pregnancy. An increase in maternal age increases the likelihood of CHD (p < 0.001) and decreases the level of physical activity before pregnancy (p = 0.012). The overall level of physical activity decreased in healthy and high-risk pregnancies, and only a quarter (26.49%) of all pregnant women reached the WHO recommendations. Further research for the specific target groups is highly recommended in order to promote and increase physical activity in ART and CHD pregnancies.
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Affiliation(s)
- Christina Sitzberger
- Institute of Preventive Pediatrics, Faculty of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany; (J.H.); (R.O.-F.); (A.W.-G.)
- Correspondence:
| | - Juliane Hansl
- Institute of Preventive Pediatrics, Faculty of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany; (J.H.); (R.O.-F.); (A.W.-G.)
| | - Ricardo Felberbaum
- Klinikverbund Kempten(Allgäu), Kinderwunschzentrum, 87439 Kempten (Allgäu), Germany; (R.F.); (A.B.)
| | - Anke Brössner
- Klinikverbund Kempten(Allgäu), Kinderwunschzentrum, 87439 Kempten (Allgäu), Germany; (R.F.); (A.B.)
| | - Renate Oberhoffer-Fritz
- Institute of Preventive Pediatrics, Faculty of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany; (J.H.); (R.O.-F.); (A.W.-G.)
- German Heart Centre, Department of Paediatric Cardiology and Congenital Heart Defects, 80636 Munich, Germany
| | - Annette Wacker-Gussmann
- Institute of Preventive Pediatrics, Faculty of Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany; (J.H.); (R.O.-F.); (A.W.-G.)
- German Heart Centre, Department of Paediatric Cardiology and Congenital Heart Defects, 80636 Munich, Germany
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Al Hassan R, Ali RR, Alsheikh MSK. The Effect of Physical Activity during Pregnancy on Childbirth. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Active pregnant women have fewer physical problems and gain weight during pregnancy, and this often leads to fewer complications as exercise also increases self-confidence and reduces the risk of mood swings after childbirth (postpartum) and depression, and “it is not only the women who benefits from being active.” Studies have shown that exercise during pregnancy has a “training effect” on the baby, and this is reflected in increased heart rate variability and a decrease in the fetus’s resting heart rate. Aim of this study is known Effect of Physical Activity during Pregnancy on Childbirth. 155 patients were collected from Bint Al-Huda Maternity & Children Hospital, Thi-Qar, Iraq, and the samples were divided into two groups (90 women who practiced exercise and 65 for control). All demographic information about patients was obtained through the distribution of questionnaires, and several techniques were used to analyze the results, including the statistical analysis program in evaluating physical activity on childbirth and analyzing the effects generated during pregnancy and the duration of the stage of labor and Positive results were found in the assessment of physical activity on pregnant women, and the results were in another way related to age and body mass index.
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31
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Yuan M, Chen H, Chen D, Wan D, Luo F, Zhang C, Nan Y, Bi X, Liang J. Effect of physical activity on prevention of postpartum depression: A dose-response meta-analysis of 186,412 women. Front Psychiatry 2022; 13:984677. [PMID: 36405921 PMCID: PMC9672674 DOI: 10.3389/fpsyt.2022.984677] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 09/06/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Physical activity (PA) is considered a favorable preventive intervention for postpartum depression (PPD), but evidence defining a corresponding dose-response relationship is lacking. This meta-analysis was conducted to assess the protective effects of PA on PPD and define a potential dose-response relationship between them. METHODS PubMed, Medline, Embase, and Web of Science were searched from 1968 to May 2022. Only randomized control trials (RCTs) and prospective studies were considered, and the PICOS tool was used to identify eligible articles based on the inclusion and exclusion criteria. Effect-size estimates were unified as odds ratio (OR) and 95% confidence interval (CI). We calculated the ORs and their 95% CI for studies that did not report them using the Practical Meta-Analysis Effect Size Calculator. RESULTS A total of 23 studies were eligible, including 14 RCTs and 9 prospective cohort studies. The overall analysis showed a statistically significant positive association between PA and PPD prevention (adjusted OR = 0.73; 95% CI: 0.61-0.87; P < 0.001). Subgroup analyses indicated that studies conducted in Europe demonstrated a significant correlation between PA and reduced PPD risk (adjusted OR = 0.85, 95% CI: 0.76-0.95, P = 0.004). Concerning PA type, sports activity was associated with relieving PPD symptoms (adjusted OR = 0.89, 95% CI: 0.78 to 1.00, P < 0.001), while work (adjusted OR = 1.05, 95% CI: 0.37-2.97, P = 0.065) and household activities (adjusted OR = 1.16, 95% CI: 0.89-1.52, P = 0.986) contributed to a greater risk of PPD. Our dose-response analysis revealed a reverse J-shaped trend between ascending PA duration and PPD incidence. CONCLUSION This meta-analysis identified PA as a potential intervention to reduce the risk of PPD. The dose-response analysis revealed that at least 90 min of PA per week could efficiently decrease the risk of PPD. SYSTEMATIC REVIEW REGISTRATION https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022335731.
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Affiliation(s)
- Mengqi Yuan
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Department of Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Hongyang Chen
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Department of Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Dongmei Chen
- Department of Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Donggui Wan
- Department of Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Fan Luo
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Department of Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Chenyang Zhang
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Department of Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Yunxin Nan
- Graduate School, Beijing University of Chinese Medicine, Beijing, China.,Department of Oncology, China-Japan Friendship Hospital, Beijing, China
| | - Xiaoning Bi
- Department of Obstetrics and Gynecology, China-Japan Friendship Hospital, Beijing, China
| | - Jing Liang
- Department of Obstetrics and Gynecology, China-Japan Friendship Hospital, Beijing, China
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Prenatal Anxiety and Exercise. Systematic Review and Meta-Analysis. J Clin Med 2021; 10:jcm10235501. [PMID: 34884202 PMCID: PMC8658622 DOI: 10.3390/jcm10235501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 01/12/2023] Open
Abstract
The prevalence of prenatal anxiety has increased during the COVID-19 pandemic. Anxiety is associated with other cardiovascular, physiological, and mental illnesses, resulting in adverse health effects for the mother and foetus. The purpose of this study was to evaluate the effects of physical activity (PA) during pregnancy on the prevalence of prenatal anxiety or symptoms of anxiety. A systematic review and two meta-analyses were performed (Registration No. CRD42021275333). Peer-reviewed articles reporting the effect of a PA intervention on anxiety during pregnancy were included. The first meta-analysis (MA) included 10 studies reporting final scores of prenatal anxiety. A negative association between moderate PA during pregnancy and prenatal anxiety was found in this analysis (z = −2.62, p < 0.01; ES = −0.46, 95% CI = −0.80, −12, I2 = 84%, Pheterogeneity = 0.001). The second MA included eight studies in which measures both before and after a PA intervention were reported. The findings of this analysis revealed a positive association between exercise practice during pregnancy and a decrease in prenatal anxiety scores (z = −3.39, p < 0.001; ES = −0.48, 95% CI = −0.76, −0.20, I2 = 71%, Pheterogeneity = 0.001). Supervised PA during pregnancy could prevent and reduce prenatal anxiety and anxiety symptoms.
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Bellón JÁ, Conejo-Cerón S, Sánchez-Calderón A, Rodríguez-Martín B, Bellón D, Rodríguez-Sánchez E, Mendive JM, Ara I, Moreno-Peral P. Effectiveness of exercise-based interventions in reducing depressive symptoms in people without clinical depression: systematic review and meta-analysis of randomised controlled trials. Br J Psychiatry 2021; 219:578-587. [PMID: 33533706 DOI: 10.1192/bjp.2021.5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND In most trials and systematic reviews that evaluate exercise-based interventions in reducing depressive symptoms, it is difficult to separate treatment from prevention. AIMS To evaluate the effectiveness of exercise-based interventions in reducing depressive symptoms in people without clinical depression. METHOD We searched PubMed, PsycINFO, Embase, WOS, SPORTDiscus, CENTRAL, OpenGrey and other sources up to 25 May 2020. We selected randomised controlled trials (RCTs) that compared exclusively exercise-based interventions with control groups, enrolling participants without clinical depression, as measured using validated instruments, and whose outcome was reduction of depressive symptoms and/or incidence of new cases of people with depression. Pooled standardised mean differences (SMDs) were calculated using random-effect models (registration at PROSPERO: CRD42017055726). RESULTS A total of 14 RCTs (18 comparisons) evaluated 1737 adults without clinical depression from eight countries and four continents. The pooled SMD was -0.34 (95% CI -0.51 to -0.17; P < 0.001) and sensitivity analyses confirmed the robustness of this result. We found no statistical evidence of publication bias and heterogeneity was moderate (I2 = 54%; 95% CI 22-73%). Only two RCTs had an overall low risk of bias and three had long-term follow-up. Multivariate meta-regression found that a larger sample size, country (Asia) and selective prevention (i.e. people exposed to risk factors for depression) were associated with lower effectiveness, although only sample size remained significant when adjustment for multiple tests was considered. According to the Grading of Recommendations Assessment, Development and Evaluation tool, the quality of evidence was low. CONCLUSIONS Exercise-based interventions have a small effect on the reduction of depressive symptoms in people without clinical depression. It could be an alternative to or complement psychological programmes, although further higher-quality trials with larger samples and long-term follow-up are needed.
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Affiliation(s)
- Juan Ángel Bellón
- 'El Palo' Health Centre, Health District of Primary Care Málaga-Guadalhorce, Andalusian Health Service (SAS); Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III (ISCIII); Biomedical Research Institute of Malaga (IBIMA); and Faculty of Medicine, Department of Public Health and Psychiatry, University of Málaga (UMA), Spain
| | - Sonia Conejo-Cerón
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III (ISCIII); and Biomedical Research Institute of Malaga (IBIMA), Spain
| | | | - Beatriz Rodríguez-Martín
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III (ISCIII); and Faculty of Health Sciences, Talavera de la Reina, Toledo, University of Castilla-La Mancha (UCLM), Spain
| | - Darío Bellón
- Faculty of Sport Sciences, University of Castilla-La Mancha (UCLM), Spain
| | - Emiliano Rodríguez-Sánchez
- Prevention and Health Promotion Research Network (redIAPP); Institute of Biomedical Research of Salamanca (IBSAL); Primary Care Research Unit of Salamanca (APISAL); and Department of Medicine, University of Salamanca, Spain
| | - Juan Manuel Mendive
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III (ISCIII); and 'La Mina' Health Centre, Institute of Health Català (ICS), Spain
| | - Ignacio Ara
- Faculty of Sport Sciences, University of Castilla-La Mancha (UCLM); GENUD Toledo Research Group, University of Castilla-La Mancha (UCLM), Spain; and CIBER of Frailty and Healthy Aging (CIBERFES), Spain
| | - Patricia Moreno-Peral
- Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III (ISCIII); and Biomedical Research Institute of Malaga (IBIMA), Spain
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34
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Marín-Jiménez N, Castro-Piñero J, Rodríguez-Ayllón M, Marchán-Rubio A, Delgado-Fernández M, Aparicio VA. The favourable association of self-reported physical fitness with depression and anxiety during pregnancy. The GESTAFIT project. Eur J Sport Sci 2021; 22:1932-1940. [PMID: 34559596 DOI: 10.1080/17461391.2021.1986141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
We explored the association of self-reported physical fitness with depressive symptoms and anxiety levels during pregnancy. One hundred fifty-five pregnant women (32.9 ± 4.7 years old) participated in the study. Self-reported physical fitness was assessed with the International Fitness Scale, depressive symptoms and state anxiety levels with the Center for Epidemiological Studies-Depression Scale and the State Trait Anxiety Index, respectively, at the 16 and 34 weeks of gestation. In model 1 (adjusted for age and gestational weight gain), greater overall self-reported physical fitness was associated with fewer depressive symptoms at the 16 weeks (p = .004). Greater self-reported cardiorespiratory fitness and muscular strength were associated with lower anxiety levels at the 16 weeks (all, p > .05). Greater overall self-reported physical fitness, cardiorespiratory fitness and speed-agility were associated with lower anxiety levels at the 34 weeks (all, p > .05). These results were also confirmed in model 2 (additionally adjusted for the exercise intervention, sleep quality, educational level, working status and cohabitating), except for cardiorespiratory fitness and anxiety levels at the 16 weeks (p = .09). Greater self-reported physical fitness was associated with lower psychological ill-being during pregnancy. Specifically, at the 16 weeks, greater self-reported overall physical fitness was associated with fewer depressive symptoms, greater self-reported muscular strength with lower anxiety levels; greater self-reported overall physical fitness and speed-agility with lower anxiety levels at the 34 weeks and greater self-reported cardiorespiratory fitness with lower anxiety levels during the pregnancy. Screening of physical fitness may reduce the risk of depression and anxiety and generally improve pregnancy mental health-related quality of life.HighlightsMaternal depression and anxiety have prevalence rates between 8 and 36%.Physical fitness enhancement during pregnancy results in less depression and anxiety.Greater physical fitness may provide benefits for the mother mental health.Self-reported physical fitness screening during pregnancy may be useful in clinical settings.
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Affiliation(s)
- Nuria Marín-Jiménez
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), Granada, Spain.,GALENO Research Group, Department of Physical Education. Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Cádiz, Spain
| | - José Castro-Piñero
- GALENO Research Group, Department of Physical Education. Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Cádiz, Spain
| | - María Rodríguez-Ayllón
- Department of Physical Education and Sports, Faculty of Sport Sciences, PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Alba Marchán-Rubio
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Virginia A Aparicio
- Sport and Health University Research Institute (iMUDS), Granada, Spain.,Department of Physiology, Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM) and Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
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Paz Fernández N, González González Y, Alonso Calvete A, Da Cuña Carrera I. Efectos del ejercicio en la depresión durante el embarazo y el posparto. Una revisión sistemática. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2021. [DOI: 10.1016/j.gine.2021.100683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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36
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Ekelöf K, Andersson O, Holmén A, Thomas K, Almquist Tangen G. Depressive symptoms postpartum is associated with physical activity level the year prior to giving birth - A retrospective observational study. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 29:100645. [PMID: 34274857 DOI: 10.1016/j.srhc.2021.100645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 06/22/2021] [Accepted: 07/05/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To examine physical activity level prior to pregnancy, during pregnancy and postpartum and investigate the association with depressive symptoms postpartum among women in Sweden. STUDY DESIGN Retrospective observational study including 532 women on self-assessment of physical activity level before pregnancy, during pregnancy and postpartum, depressive symptoms postpartum as well as stressful life events in the past two years. MAIN OUTCOME MEASURES Level and change of physical activity before pregnancy, during pregnancy and postpartum and depressive symptoms postpartum. RESULTS Almost two-thirds of the women in the study reported that they were inactive or performed light physical activity (62.9%; n = 331) in the year prior to giving birth. Women with a sedentary lifestyle or performing light physical activity level reported depressive symptoms postpartum to a greater extent than active women. CONCLUSIONS A higher level of physical activity during pregnancy was associated with a lower level of depressive symptoms postpartum. Physical activity is a contributing factor to promote a healthier lifestyle and can contribute to improve mental health for pregnant women, newly become mothers and their children.
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Affiliation(s)
- Katarina Ekelöf
- Department of Research and Development, Region Halland, Halmstad, Sweden; Department of Medical and Health Sciences, Linköping University, Sweden.
| | - Ola Andersson
- Department of Clinical Sciences Lund, Pediatrics, Lund University, Lund, Sweden; Department of Neonatology, Skåne University Hospital, Malmö/Lund, Sweden
| | - Anders Holmén
- Department of Research and Development, Region Halland, Halmstad, Sweden
| | - Kristin Thomas
- Department of Medical and Health Sciences, Linköping University, Sweden
| | - Gerd Almquist Tangen
- Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Sánchez-Polán M, Franco E, Silva-José C, Gil-Ares J, Pérez-Tejero J, Barakat R, Refoyo I. Exercise During Pregnancy and Prenatal Depression: A Systematic Review and Meta-Analysis. Front Physiol 2021; 12:640024. [PMID: 34262468 PMCID: PMC8273431 DOI: 10.3389/fphys.2021.640024] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/24/2021] [Indexed: 12/25/2022] Open
Abstract
Background: Prenatal depression is associated with an increased risk of physical, physiological, cardiovascular, and psychological diseases for mothers and future newborns. Prenatal depression and depressive symptoms could have negative effects on the cognitive, emotional, social, and behavioral development of children. Objective: This study aimed to examine the influence of exercise during pregnancy on the prevalence of prenatal depression and depressive symptoms in the scientific literature. Data Sources: A search was carried out examining different online databases up to November 2020. Methods of Study Selection: A systematic review with random effects meta-analysis was performed. Only randomized controlled trials published in English or Spanish with pregnant populations and interventions with exercise programs carried out during pregnancy were included. The scores obtained by the tools that measured the emotional state and depressive symptoms as well as the number and percentage of depressed women of the study groups were analyzed. Tabulation, Integration, and Results: We analyzed 15 studies and found a negative association between moderate exercise during pregnancy and prenatal depression (ES = -0.36, 95% CI = -0.58, -13, I 2 = 80.2%, Pheterogeneity = 0.001). In addition, the studies also showed that women who were inactive during pregnancy had a 16% higher probability of suffering prenatal depression [RR = 0.84 (95% IC = 0.74, 0.96) I 2 = 61.9%, Pheterogeneity = 0.010]. Conclusion: Supervised exercise during pregnancy may be useful for the prevention and reduction of prenatal depression and depressive symptoms. Systematic Review Registration: Registered in PROSPERO (Registration No. CRD42020164819).
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Affiliation(s)
| | - Evelia Franco
- Department of Education, Research Methods and Evaluation, Comillas Pontifical University, Madrid, Spain
| | | | - Javier Gil-Ares
- AFIPE Research Group, Universidad Politécnica de Madrid, Madrid, Spain
- Department of Physical Activity, Sports and Leisure Social Sciences, Universidad Politécnica de Madrid, Madrid, Spain
| | - Javier Pérez-Tejero
- AFIPE Research Group, Universidad Politécnica de Madrid, Madrid, Spain
- Department of Health and Human Performance, Universidad Politécnica de Madrid, Madrid, Spain
| | - Rubén Barakat
- AFIPE Research Group, Universidad Politécnica de Madrid, Madrid, Spain
- Department of Physical Activity, Sports and Leisure Social Sciences, Universidad Politécnica de Madrid, Madrid, Spain
| | - Ignacio Refoyo
- Department of Sports, Universidad Politécnica de Madrid, Madrid, Spain
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Navas A, Carrascosa MDC, Artigues C, Ortas S, Portells E, Soler A, Yañez AM, Bennasar-Veny M, Leiva A. Effectiveness of Moderate-Intensity Aerobic Water Exercise during Pregnancy on Quality of Life and Postpartum Depression: A Multi-Center, Randomized Controlled Trial. J Clin Med 2021; 10:jcm10112432. [PMID: 34070842 PMCID: PMC8198819 DOI: 10.3390/jcm10112432] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/03/2021] [Accepted: 05/27/2021] [Indexed: 12/16/2022] Open
Abstract
Background: The global prevalence of postpartum depression is about 20%. This disease has serious consequences for women, their infants, and their families. The aim of this randomized clinical trial was to analyze the effectiveness and safety of a moderate-intensity aerobic water exercise program on postpartum depression, sleep problems, and quality of life in women at one month after delivery. Methods: This was a multi-center, parallel, randomized, evaluator blinded, controlled trial in a primary care setting. Pregnant women (14–20 weeks gestational age) who had low risk of complications and were from five primary care centers in the area covered by the obstetrics unit of Son Llatzer Hospital (Mallorca, Spain) were invited to participate. A total of 320 pregnant women were randomly assigned to two groups, an intervention group (moderate aquatic aerobic exercise) and a control group (usual prenatal care). One month after birth, sleep quality (MOS sleep), quality of life (EQ-5D), and presence of anxiety or depression (EPDS) were recorded. Findings: Women in the intervention group were less likely to report anxiety or depression on the EQ5D (11.5% vs. 22.7%; p < 0.05) and had a lower mean EPDS score (6.1 ± 1.9 vs. 6.8 ± 2.4, p < 0.010). The two groups had no significant differences in other outcomes, maternal adverse events, and indicators of the newborn status. Conclusion: Moderate-intensity aquatic exercise during pregnancy decreased postpartum anxiety and depressive symptoms in mothers and was safe for mothers and their newborns.
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Affiliation(s)
- Araceli Navas
- Hospital Comarcal de Inca, Balearic Islands Health Services, 07300 Inca, Spain;
| | - María del Carmen Carrascosa
- Mallorca Primary Health Care, Balearic Islands Health Services, 07002 Palma, Spain; (M.d.C.C.); (C.A.); (S.O.); (E.P.)
| | - Catalina Artigues
- Mallorca Primary Health Care, Balearic Islands Health Services, 07002 Palma, Spain; (M.d.C.C.); (C.A.); (S.O.); (E.P.)
| | - Silvia Ortas
- Mallorca Primary Health Care, Balearic Islands Health Services, 07002 Palma, Spain; (M.d.C.C.); (C.A.); (S.O.); (E.P.)
| | - Elena Portells
- Mallorca Primary Health Care, Balearic Islands Health Services, 07002 Palma, Spain; (M.d.C.C.); (C.A.); (S.O.); (E.P.)
| | - Aina Soler
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, 07002 Palma, Spain; (A.S.); (A.L.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Aina M. Yañez
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Nursing and Physiotherapy Department, Balearic Islands University, 07122 Palma, Spain
- Correspondence: (A.M.Y.); (M.B.-V.); Tel.: +34-9711-72914 (A.M.Y.); Tel.: +34-9711-72367 (M.B.-V.)
| | - Miquel Bennasar-Veny
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Nursing and Physiotherapy Department, Balearic Islands University, 07122 Palma, Spain
- Correspondence: (A.M.Y.); (M.B.-V.); Tel.: +34-9711-72914 (A.M.Y.); Tel.: +34-9711-72367 (M.B.-V.)
| | - Alfonso Leiva
- Primary Care Research Unit of Mallorca, Balearic Islands Health Services, 07002 Palma, Spain; (A.S.); (A.L.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
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39
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Okafor UB, Goon DT. Physical Activity Advice and Counselling by Healthcare Providers: A Scoping Review. Healthcare (Basel) 2021; 9:609. [PMID: 34069474 PMCID: PMC8159082 DOI: 10.3390/healthcare9050609] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/11/2021] [Accepted: 05/12/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Despite scientific evidence on prenatal physical activity and exercise, synthesized evidence is lacking on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers. The scoping review seeks to fill this gap by synthesizing available literature on the provision of prenatal physical activity and exercise advice and counselling by prenatal healthcare providers to women during antenatal visits. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) search framework for scoping reviews was applied to retrieve original research articles on the prenatal physical activity and exercise practices of healthcare providers with pregnant women, published between 2010-2020, and available in English. The search databases included Google Scholar, PubMed, Science Direct, Scopus, EMBASE, The Cumulative Index for Nursing and Allied Health Literature (CINAHL), BIOMED Central, Medline and African Journal Online. Studies that fulfilled the eligibility criteria were retrieved for analysis. Results: Out of the 82 articles that were retrieved for review, 13 met the eligibility criteria. Seven of the articles were quantitative, four qualitative, one mixed-method and one controlled, non-randomised study, respectively. Three themes emerged as major findings. Healthcare providers affirmed their responsibility in providing prenatal physical activity advice and counselling to pregnant women; however, they seldom or rarely performed this role. Major barriers to prenatal physical activity and exercise included insufficient time, lack of knowledge and skills, inadequate or insufficient training, and lack of resources. Conclusion: This review highlights salient features constraining the uptake of prenatal physical activity and exercise advice/counselling by prenatal healthcare providers in both community and clinical settings. Prenatal physical activity advice and counselling are key components to the promotion of physical activity adherence during and post-partum pregnancy; this requires adequate knowledge of physical activity prescriptions and recommendations, which are personalised and contextual to environment. Research is needed to examine the prenatal physical activity advice and counselling from prenatal healthcare providers on issues hindering effective delivery of the aforementioned in the context of promoting prenatal physical activity in clinical or community settings.
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Affiliation(s)
- Uchenna Benedine Okafor
- Department of Nursing Science, University of Fort Hare, 50 Church Street, East London 5021, South Africa
| | - Daniel Ter Goon
- Department of Public Health, University of Fort Hare, 5 Oxford Street, East London 5021, South Africa;
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Ana Y, Lewis MG, van Schayck OCP, Babu GR. Is physical activity in pregnancy associated with prenatal and postnatal depressive symptoms?: Results from MAASTHI cohort study in South India. J Psychosom Res 2021; 144:110390. [PMID: 33740554 PMCID: PMC7611353 DOI: 10.1016/j.jpsychores.2021.110390] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Physical inactivity leads to depression and other adverse health consequences. Pregnant women are an important subgroup to study the health consequences due to physical inactivity since it can lead to adverse outcomes in pregnancy and even after delivery. Therefore, we aimed at understanding the level of physical activity among pregnant women, prevalence of prenatal and postnatal depressive symptoms and whether level of physical activity is associated with prenatal and postnatal depressive symptoms. METHODS In an ongoing cohort study, we measured the physical activity using a validated Physical Activity Level (PAL) questionnaire. We administered the Edinburgh Postnatal Depression Scale (EPDS) during pregnancy and within seven days of delivery to assess depressive symptoms in 1406 women. Associations were adjusted for potential confounders such as maternal age, education, socioeconomic status, gravida, EPDS score during pregnancy, social support, skinfold thickness, blood pressure, blood sugar level. RESULTS We found that 7.2% of pregnant women had low levels of physical activity. The prevalence of prenatal and postnatal depressive symptoms was 9.0% and 31.9% respectively. Pregnant women with a low level of physical activity had significantly higher odds of developing postpartum depressive symptoms (OR = 3.15, CI: 1.98-5.02, p < 0.001) when adjusted for potential confounders. CONCLUSIONS Moderate level of physical activity among pregnant mothers is essential and has its association with postnatal depressive symptoms. Health care professionals need to counsel pregnant women to assess depressive symptoms at both the prenatal and postpartum period and inform them about the importance of the optimal level of physical activity.
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Affiliation(s)
- Yamuna Ana
- Indian Institute of Public Health-Bangalore, Public Health Foundation of India (PHFI), Bangalore, India.
| | - Melissa Glenda Lewis
- Indian Institute of Public Health-Hyderabad, Public Health Foundation of India (PHFI), Hyderabad, India.
| | - Onno C P van Schayck
- Care, and Public Health Research Institute, Maastricht University, Maastricht, Limburg, the Netherlands.
| | - Giridhara R Babu
- Lifecourse Epidemiology, Indian Institute of Public Health-Bangalore, Public Health Foundation of India (PHFI), Bangalore, India; Public health and clinical medicine, Wellcome Trust/DBT India Alliance, New Delhi, India.
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Nakahara K, Michikawa T, Morokuma S, Ogawa M, Kato K, Sanefuji M, Shibata E, Tsuji M, Shimono M, Kawamoto T, Ohga S, Kusuhara K. Influence of physical activity before and during pregnancy on infant's sleep and neurodevelopment at 1-year-old. Sci Rep 2021; 11:8099. [PMID: 33854123 PMCID: PMC8046980 DOI: 10.1038/s41598-021-87612-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 03/10/2021] [Indexed: 12/27/2022] Open
Abstract
The aim of this study was to investigate the association between maternal physical activity (PA) before and during pregnancy and sleep and developmental problems in 1-year-old infants. We used data from a nationwide cohort study in Japan that registered 103,062 pregnancies between 2011 and 2014. Participants were asked about their PA before and during pregnancy, and the sleep and development of their children at the age of 1 year. Maternal PA was estimated using the International Physical Activity Questionnaire and was expressed in METs per week. We defined scores below the cut-off points of the Ages and Stages Questionnaire (ASQ) as abnormal for infant development. Based on the levels of PA before or during pregnancy, the participants were divided into five groups. In mothers with higher PA levels, the risk ratio for bedtime after 22:00 or abnormal ASQ scores in their 1-years-old infants were lower. These associations were observed for PA before and during pregnancy. Higher levels of maternal PA, both before and during pregnancy, may reduce sleep and developmental problems in infants.
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Affiliation(s)
- Kazushige Nakahara
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takehiro Michikawa
- Department of Environmental and Occupational Health, School of Medicine, Toho University, Tokyo, Japan
| | - Seiichi Morokuma
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan. .,Research Center for Environmental and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Masanobu Ogawa
- Research Center for Environmental and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kiyoko Kato
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Research Center for Environmental and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masafumi Sanefuji
- Research Center for Environmental and Developmental Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eiji Shibata
- Japan Environment and Children's Study, UOEH Subunit Center, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.,Department of Obstetrics and Gynecology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Mayumi Tsuji
- Japan Environment and Children's Study, UOEH Subunit Center, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.,Department of Environmental Health, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Masayuki Shimono
- Japan Environment and Children's Study, UOEH Subunit Center, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.,Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Toshihiro Kawamoto
- Japan Environment and Children's Study, UOEH Subunit Center, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Shouichi Ohga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koichi Kusuhara
- Japan Environment and Children's Study, UOEH Subunit Center, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan.,Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
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Okafor UB, Goon DT. Physical Activity in Pregnancy: Beliefs, Benefits, and Information-Seeking Practices of Pregnant Women in South Africa. J Multidiscip Healthc 2021; 14:787-798. [PMID: 33859477 PMCID: PMC8043848 DOI: 10.2147/jmdh.s287109] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 11/20/2020] [Indexed: 12/23/2022] Open
Abstract
Background Notwithstanding the benefits of physical activity (PA) during pregnancy, anecdotal evidence suggests ignorance, unscientific beliefs, and lack of awareness about PA among pregnant South African women. Aim This study examined the beliefs, perceived benefits, and sources of information on PA during pregnancy. Methods A cross-sectional descriptive study was employed between June and September 2019 using an interviewer-administered questionnaire with 1,082 pregnant women. These women were attending antenatal primary health–care clinics in Buffalo City, Eastern Cape, South Africa. A self-designed questionnaire solicited information on beliefs, benefits, and sources of information regarding PA during pregnancy. Results A majority of the participants held positive beliefs concerning PA during pregnancy. They maintained that PA was safe for mother and fetus, improved labor and delivery (93.1%), promoted energy (89.0%), and should be discontinued when tired (76.6%). Most held negative convictions that PA during pregnancy increased body temperature (64.5%) and that pregnancy was a time to rest and refrain from PA (56.5%). Predominantl sources of information received about PA during pregnancy were television, the radio, and other media (70.2%). Most participants were aware of the benefits of PA during pregnancy —— reduction in infant weight (61.4%), lessening of moodiness (90.4), and decreased risk of gestational diabetes mellitus (92.9%), pregnancy-induced hypertension (92.5%), and complications at birth (97.8%), while common negative perceptions included musculoskeletal discomfort (82.7%), and back pain (85.7%). An overwhelming majority affirmed that PA improved self-image (95.7%), sleep patterns (94.2%), and respiratory function (95.8%). Conclusion Our findings suggested that women hold positive beliefs and perceive PA as beneficial to their health and the baby; however, they received most of their information from the Internet. Most women regarded pregnancy as a period to relax and rest. Interventions to promote PA during pregnancy are needed.
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Affiliation(s)
| | - Daniel Ter Goon
- Department of Public Health, University of Fort Hare, East London, South Africa
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Zuccolo PF, Xavier MO, Matijasevich A, Polanczyk G, Fatori D. A smartphone-assisted brief online cognitive-behavioral intervention for pregnant women with depression: a study protocol of a randomized controlled trial. Trials 2021; 22:227. [PMID: 33757591 PMCID: PMC7985923 DOI: 10.1186/s13063-021-05179-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/10/2021] [Indexed: 12/28/2022] Open
Abstract
Background Pregnancy is strongly associated with increased risk for depression. Approximately 25% of pregnant women develop depression. Treatment for depression during pregnancy has several complexities: the use of psychiatric medications during pregnancy might result in developmental problems in the child and must be used with caution. Psychosocial interventions are effective, but they require specialized professionals. Low- and middle-income countries (LMIC) such as Brazil do not have enough mental health professionals needed to meet this demand. In this context, smartphone-based interventions show immense potential. We developed Motherly, a smartphone application (app) designed to treat maternal depression. We aim to test the efficacy of Motherly in addition to brief cognitive-behavioral therapies (CBT) to treat maternal depression. Methods We will conduct a 2-arm parallel-randomized controlled clinical trial in which 70 pregnant women aged between 16 and 40 years with depression will be randomized to intervention or active control. The intervention group will have access to Motherly, a smartphone app based on three concepts: psychoeducation, behavior monitoring, and gaming elements. Motherly is composed of a package of interventions composed of modules: mental health, sleep, nutrition, physical activity, social support, prenatal/postnatal support, and educational content. The main focus of Motherly is delivering behavioral activation (BA), a brief and structured psychological treatment. The app allows participants to schedule and engage in, and monitor activities according to a plan to avoid acting exclusively according to their mood. The active control group will have access to a simplified version of the app consisting of educational content about various aspects of pregnancy, maternal physical and mental health, and infant development (BA, activity scheduling, sleep hygiene, among other functionalities, will not be present in this version). Both groups will receive four sessions of brief CBT in 8 weeks. Participants will be evaluated by assessors blind to randomization and allocation status. Assessments will occur at baseline (T0), midpoint (T1, week 4–5), posttreatment (T2, week 8), and follow-up (T3, when the child is 2 months old). Maternal mental health (prenatal anxiety, psychological well-being, perceived stress, depression, depression severity, and sleep quality), quality of life, physical activity levels, and infant developmental milestones and social/emotional problems will be measured. Our primary outcome is the change in maternal prenatal depression from baseline to posttreatment (8 weeks). Discussion The potential of digital technology to deliver mental health interventions has been increasingly recognized worldwide. There is a growing literature on interventions using smartphone applications to promote mental health, both with or without the intermediation of a mental health professional. Our study adds to the literature by testing whether an app providing an intervention package, including CBT, psychoeducation, nutrition, physical activity, and social support, can promote maternal and child health and well-being. In particular, we aim to treat depression, for which the use of digital technologies is still scarce. Smartphone applications designed to treat maternal depression are especially relevant because of the potential to circumvent barriers that prevent pregnant women from accessing mental health care. Trial registration ClinicalTrials.gov NCT04495166. Prospectively registered on July 29, 2020.
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Affiliation(s)
- Pedro Fonseca Zuccolo
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil.
| | - Mariana O Xavier
- Department of Social Medicine, Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Department of Preventive Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Guilherme Polanczyk
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Daniel Fatori
- Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil
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Vargas-Terrones M, Nagpal TS, Perales M, Prapavessis H, Mottola MF, Barakat R. Physical activity and prenatal depression: going beyond statistical significance by assessing the impact of reliable and clinical significant change. Psychol Med 2021; 51:688-693. [PMID: 32102723 DOI: 10.1017/s0033291719003714] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Previous literature supports exercise as a preventative agent for prenatal depression; however, treatment effects for women at risk for prenatal depression remain unexplored. The purpose of the study was to examine whether exercise can lower depressive symptoms among women who began pregnancy at risk for depression using both a statistical significance and reliable and clinically significant change criteria. METHODS This study is a secondary analysis of two randomized controlled trials that followed the same exercise protocol. Pregnant women were allocated to an exercise intervention group (IG) or control group (CG). All participants completed the Center for Epidemiological Depression (CES-D) scale at gestational week 9-16 and 36-38. Women with a baseline score ⩾16 were included. A clinically reliable cut-off was calculated as a 7-point change in scores from pre- to post-intervention. RESULTS Thirty-six women in the IG and 25 women in the CG scored ⩾16 on the CES-D at baseline. At week 36-38 the IG had a statistically significant lower CES-D score (14.4 ± 8.6) than the CG (19.4 ± 11.1; p < 0.05). Twenty-two women in the IG (61%) had a clinically reliable decrease in their post-intervention score compared to eight women in the CG (32%; p < 0.05). Among the women who met the reliable change criteria, 18 (81%) in the IG and 7 (88%) in the CG had a score <16 post-intervention, with no difference between groups (p > 0.05). CONCLUSIONS A structured exercise program might be a useful treatment option for women at risk for prenatal depression.
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Affiliation(s)
- Marina Vargas-Terrones
- AFIPE Research Group, Faculty of Sciences for Physical Activity and Sport, INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Taniya S Nagpal
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
- Exercise and Health Psychology Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
| | - Maria Perales
- Camilo José Cela University, Madrid, Spain
- Research Institute of Hospital 12 de Octubre (i+12), Madrid, Spain
| | - Harry Prapavessis
- Exercise and Health Psychology Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
| | - Michelle F Mottola
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Laboratory, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
- Children's Health Research Institute, The University of Western Ontario, London, Ontario, Canada
| | - Ruben Barakat
- AFIPE Research Group, Faculty of Sciences for Physical Activity and Sport, INEF, Universidad Politécnica de Madrid (UPM), Madrid, Spain
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Gildner TE, Laugier EJ, Thayer ZM. Exercise routine change is associated with prenatal depression scores during the COVID-19 pandemic among pregnant women across the United States. PLoS One 2020; 15:e0243188. [PMID: 33347484 PMCID: PMC7751871 DOI: 10.1371/journal.pone.0243188] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 11/18/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has negatively affected physical and mental health worldwide. Pregnant women already exhibit an elevated risk for depression compared to the general public, a pattern expected to be exacerbated by the pandemic. Certain lifestyle factors, including moderate exercise, may help support mental health during pregnancy, but it is unclear how the pandemic may impact these associations across different locations. Here, we test whether: (i) reported exercise routine alterations during the pandemic are associated with depression scores; and, (ii) the likelihood of reporting pandemic-related exercise changes varies between women living in metro areas and those in non-metro areas. METHODS This cross-sectional study used data from the COVID-19 And Reproductive Effects (CARE) study, an online survey of pregnant women in the United States. Participants were recruited April-June 2020 (n = 1,856). Linear regression analyses assessed whether reported COVID-19-related exercise change was associated with depression score as measured by the Edinburgh Postnatal Depression Survey. Logistic regression analyses tested whether a participant's Rural-Urban Continuum Code classification of "metro" was linked with higher odds of reporting exercise changes compared to a "non-metro" classification. RESULTS Women who reported exercise changes during the pandemic exhibited significantly higher depression scores compared to those reporting no changes. Moreover, individuals living in metro areas of all sizes were significantly more likely to report exercise changes compared to women living in non-metro areas. CONCLUSIONS These results suggest that the ability to maintain an exercise routine during the pandemic may help support maternal mental health. It may therefore be prudent for providers to explicitly ask patients how the pandemic has impacted their exercise routines and consider altered exercise routines a potential risk factor for depression. An effort should also be made to recommend exercises that are tailored to individual space restrictions and physical health.
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Affiliation(s)
- Theresa E. Gildner
- Department of Anthropology, Dartmouth College, Hanover, New Hampshire, United States of America
- Department of Anthropology, Washington University, St. Louis, Missouri, United States of America
| | - Elise J. Laugier
- Department of Anthropology, Dartmouth College, Hanover, New Hampshire, United States of America
- Ecology, Evolution, Environment & Society Program, Dartmouth College, Hanover, New Hampshire, United States of America
| | - Zaneta M. Thayer
- Department of Anthropology, Dartmouth College, Hanover, New Hampshire, United States of America
- Ecology, Evolution, Environment & Society Program, Dartmouth College, Hanover, New Hampshire, United States of America
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Okafor UB, Goon DT. Physical activity and exercise during pregnancy in Africa: a review of the literature. BMC Pregnancy Childbirth 2020; 20:732. [PMID: 33238920 PMCID: PMC7691114 DOI: 10.1186/s12884-020-03439-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 11/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pregnancy is an important phase in a woman's life, with health status at this stage affecting both the woman and her child's life. Global evidence suggests that many women engage in low levels of physical activity (PA) and exercise during pregnancy despite its beneficial effects. This is particularly the case in Africa. METHODS This article reviews the literature on levels of PA and exercise among pregnant women in Africa, highlighting the level of PA or exercise participation during pregnancy in Africa, including types of PA, factors affecting PA, beliefs about and benefits of prenatal activity, advice or counselling on PA during pregnancy in Africa, and PA interventions proposed to promote the uptake of prenatal PA. Electronic search databases used were Google Scholar, Science Direct, Scopus, EMBASE, ERIC, Medline, Web of Science, EBSCOhost, PubMed, BIOMED Central, and African Journal Online. The basic search terms were: 'Physical activity', 'Exercise', 'Pregnancy', 'Pregnant women' and 'Africa'. A total of 40 references were found. On the basis of an analysis of titles, abstracts and the language of publication (other than English), 11 articles were rejected, and 29 articles were fully read, although two had to be rejected due to a lack of access to the full version. Finally, 27 references were included in the review. RESULTS Few studies exist on PA during pregnancy in Africa. The limited data available suggests that, compared to the Western world, pregnant women in Africa do not adhere to the recommendations for PA during pregnancy. Levels of participation in PA during pregnancy are low and decline as the pregnancy progresses. The majority of the studies used direct, objective measures to assess PA during pregnancy. Personal and environmental factors such as lack of time, lack of knowledge, inadequate information from healthcare providers, feelings of tiredness and an absence of social support constituted the main barriers to PA during pregnancy. The types of PA participation among pregnant women varied across studies and geographical settings. CONCLUSIONS While published data is limited, it seems clear that the participation of pregnant women in PA during pregnancy in Africa is low and declines with advancing pregnancy. There is a need for more studies to examine the dynamics of PA during pregnancy in Africa to guide contextual interventions to improve and promote maternal health on the continent.
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Affiliation(s)
- Uchenna Benedine Okafor
- Department of Nursing Science, University of Fort Hare, 50 Church Street, 5201, East London, South Africa.
| | - Daniel Ter Goon
- Department of Public Health, University of Fort Hare, 05 Oxford Street, East London, South Africa
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Qiu W, Hodges TE, Clark EL, Blankers SA, Galea LAM. Perinatal depression: Heterogeneity of disease and in animal models. Front Neuroendocrinol 2020; 59:100854. [PMID: 32750403 DOI: 10.1016/j.yfrne.2020.100854] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/14/2020] [Accepted: 07/21/2020] [Indexed: 12/15/2022]
Abstract
Perinatal depression (PND) can have either an antepartum or postpartum onset. Although the greatest risk factor for PND is previous depression history,de novoPND occurs with the majority of cases occurring in the postpartum. Timing of depression can impact etiology, prognosis, and response to treatment. Thus, it is crucial to study the impact of the heterogeneity of PND for better health outcomes. In this review, we outline the differences between antepartum and postpartum depression onset of PND. We discuss maternal physiological changes that differ between pregnancy and postpartum and how these may differentially impact depression susceptibility. We highlight changes in the maternal steroid and peptide hormone levels, immune signalling, serotonergic tone, metabolic factors, brain morphology, and the gut microbiome. Finally, we argue that studying the heterogeneity of PND in clinical and preclinical models can lead to improved knowledge of disease etiopathology and treatment outcomes.
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Affiliation(s)
- Wansu Qiu
- Graduate Program in Neuroscience, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada
| | - Travis E Hodges
- Department of Psychology, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada
| | - Emily L Clark
- Graduate Program in Neuroscience, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada
| | - Samantha A Blankers
- Graduate Program in Neuroscience, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada
| | - Liisa A M Galea
- Graduate Program in Neuroscience, University of British Columbia, Canada; Department of Psychology, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada.
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Nagpal TS, Bhattacharjee J, da Silva DF, Souza SCS, Mohammad S, Puranda JL, Abu-Dieh A, Cook J, Adamo KB. Physical activity may be an adjuvant treatment option for substance use disorders during pregnancy: A scoping review. Birth Defects Res 2020; 113:265-275. [PMID: 32940021 DOI: 10.1002/bdr2.1803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 08/27/2020] [Accepted: 09/01/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Substance abuse in pregnancy increases the chance of physical and neurobehavioral disabilities as well as many other undesirable fetal outcomes. In nonpregnant populations, physical exercise has shown to be an effective adjunctive therapy option for substance use disorders. Given the known positive maternal and fetal physiological and mental health benefits associated with prenatal exercise, perhaps exercise during pregnancy may also be a viable adjuvant therapy option for women with substance use disorders. The purpose of this scoping review was to summarize the available literature that has assessed the relationship between prenatal exercise and substance use disorders. METHODS A search strategy was developed combining the terms pregnancy, exercise/physical activity, and substance use. A systematic search was completed in the following databases: Medline/PubMed, SPORTDiscus, and ProQuest. Substances eligible for inclusion included illicit drugs, alcohol, and cannabis. Retrieved data were categorized as animal or human model studies, and were summarized narratively. RESULTS Eight studies were included in this review (five human studies, three animal model studies). Studies in humans suggest that pregnant women with substance use disorders are interested in engaging in physical activity interventions; however, known acute metabolic and physiological responses to prenatal exercise may be impaired in this population. Rodent models show preliminary evidence for improved mental health outcomes following prenatal exercise for substance use disorders. CONCLUSION The findings from this review may inform the development of future clinical trials to test the effect of structured exercise programs as an adjunctive treatment option for pregnant women with substance use disorders.
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Affiliation(s)
- Taniya S Nagpal
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
- Society of Obstetricians and Gynaecologists of Canada, Ottawa, Canada
| | | | | | - Sara C S Souza
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Shuhiba Mohammad
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | | | - Anas Abu-Dieh
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Jocelynn Cook
- Society of Obstetricians and Gynaecologists of Canada, Ottawa, Canada
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada
| | - Kristi B Adamo
- Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
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Okafor UB, Goon DT. Developing a Physical Activity Intervention Strategy for Pregnant Women in Buffalo City Municipality, South Africa: A Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6694. [PMID: 32937983 PMCID: PMC7557735 DOI: 10.3390/ijerph17186694] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 09/02/2020] [Accepted: 09/05/2020] [Indexed: 02/06/2023]
Abstract
Despite global awareness about the importance and health benefits of physical activity (PA) during pregnancy, several studies have reported a low prevalence of PA participation among pregnant women in both developed and developing countries. This means that most pregnant women do not meet the current PA recommended guideline of 150 min of moderate intensity PA per week. The global call to prioritise PA participation levels in the general population necessitates evaluating the factors affecting PA practice. Seemingly, pregnant women mostly from low-to-middle income countries like South Africa are often predisposed to adverse pregnancy outcomes, possibly because of limited access to, and knowledge of, improved pregnancy and health outcomes as a result of PA participation. Physical activity has been sparsely studied among pregnant South African women, and specifically, there is no known study that assesses the PA levels, patterns, beliefs, sources of information, perceived benefits, barriers, attitudes of pregnant women concerning PA and exercise participation; nor one that explores the perspectives of healthcare providers regarding prenatal PA in the Eastern Cape Province. In addition, no PA intervention strategy exists to promote PA participation in the region. This study, in attempting to fill these gaps in knowledge, adopts two phases. In Phase I, a concurrent mixed-method (quantitative and qualitative) approach assesses the following factors related to PA participation in pregnant women: participation levels, beliefs, attitudes, perceived benefits, barriers to uptake and sources of information. It further ascertains if healthcare professionals are sufficiently informed about PA and if they are advising pregnant women about the need for PA participation during pregnancy. Data will be collected through a structured questionnaire, interviews and focus group discussions. Information on socio-demographic and maternal characteristics will be obtained, and the Pregnancy Physical Activity Questionnaire (PPAQ) will assess PA during pregnancy. A sample size of 384 pregnant women is the required minimum sample for an infinite population at a confidence level of 95%, a precision level of ± 5% and at a prevalence of PA or exercise during pregnancy of 50% (p < 0.05); however, a sample size larger than the minimum number necessary will be recruited to account for possible attrition and to protect against possible data loss. Data will be analysed using a multiple logistic regression to determine the factors that predict sedentary or moderate PA levels and chi-squared analysis to determine the associations between the PA levels of the participants and socio-demographic and clinical variables. The study will assess the data collected on the above-mentioned variables and draw conclusions based on patterns and themes that emerge during analysis. Phase II of the study focuses on strategy development and validation to facilitate the promotion of PA during pregnancy. The developed strategy will be validated through the application of the Delphi technique and the administration of a checklist to selected key stakeholders through organised workshops. Understanding the level and correlates of PA participation among this special population is fundamental to designing intervention strategies to enhance their understanding of, and participation in, PA and exercise. Furthermore, this study's findings will inform facility-based healthcare providers about the need to integrate health education on PA and pregnancy into antenatal and postnatal care visits in the setting.
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Affiliation(s)
- Uchenna Benedine Okafor
- Department of Nursing Sciences, University of Fort Hare, 50 Church Street, East London 5201, South Africa
| | - Daniel Ter Goon
- Department of Public Health, University of Fort Hare, 5 Oxford Street, East London 5201, South Africa;
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Barakat R. An exercise program throughout pregnancy: Barakat model. Birth Defects Res 2020; 113:218-226. [PMID: 32613735 DOI: 10.1002/bdr2.1747] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 06/05/2020] [Indexed: 01/19/2023]
Abstract
The physiologic processes of pregnancy and childbirth can determine the future well-being of mothers and children due to the great quantity and quality of modifications that these processes require in all areas of the female body and fetus. Recent evidence has confirmed that modern unhealthy lifestyles negatively affect pregnancy outcomes. Engaging in unhealthy habits during pregnancy increases the risk of chronic disease in both the mother and the fetus. Regarding physical exercise during pregnancy, throughout history, many professionals and scientists have reported the best gestational conditions for the mother, fetus, and newborn. The perspectives and advice have changed over time, including periods of strong conservatism. This history has affected the recommendations for the type and amount of exercise that a healthy woman should perform during pregnancy. The aim of this article is to determine the basic aspects that physical exercise programs during pregnancy should define in the near future. Additionally, from the results of this article, we propose an exercise program model that includes many exercises spanning throughout pregnancy (3 blocks = until 20 weeks, until 30 weeks and until the end of the pregnancy). An exercise session model divided into seven parts and recommendations of operative position to exercise during pregnancy are also provided.
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Affiliation(s)
- Ruben Barakat
- AFIPE Research Group, Universidad Politécnica de Madrid, Madrid, Spain
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