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Rute-Larrieta C, Mota-Cátedra G, Carmona-Torres JM, Mazoteras-Pardo V, Barroso-Corroto E, Navarrete-Tejero C, Zografakis-Sfakianakis M, Patelarou A, Martins MM, Faria ADCA, Laredo-Aguilera JA. Physical Activity during Pregnancy and Risk of Gestational Diabetes Mellitus: A Meta-Review. Life (Basel) 2024; 14:755. [PMID: 38929738 PMCID: PMC11204808 DOI: 10.3390/life14060755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/07/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Nowadays, pregnant women require more individualized attention in their assistance process during pregnancy. One of the aspects that requires the most focus is the suitability of carrying out physical activity. The objective of this meta-review is to find out the effects of physical activity during pregnancy on the incidence of GDM compared to women who do not perform physical activity. METHODS A search was conducted in Cochrane, CSIC, Ebscohost, Proquest, Pubmed, Scielo, and Scopus. The search focused on systematic reviews and meta-analyses published in the last five years. The AMSTAR-2 scale was used as a quality assessment tool for the final sample. RESULTS A total of 18 systematic reviews and meta-analyses were included. Sixteen of them found out that physical activity during pregnancy has preventive effects for GDM compared with women who lacked physical activity. Among the studies, we found a reduction in the risk of GDM of between 24% and 38% and odds ratios ranging between 0.39 and 0.83 calculated for a 95% CI. Only two studies did not find statistically significant effects. Other variables such as type and duration of physical activity, overweight and obesity, gestational age, etc., were also considered. CONCLUSIONS Physical activity prevents the incidence of GDM. The main characteristics that enhance this preventive effect are starting at the initial stages of pregnancy and maintaining during the whole pregnancy as well as combining strength and aerobic exercise at a low to moderate intensity.
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Affiliation(s)
| | | | - Juan Manuel Carmona-Torres
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, 45071 Toledo, Spain; (E.B.-C.); (J.A.L.-A.)
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Campus Tecnológico Fábrica de Armas, Edificio 6. Despacho 1.4, Avd. Carlos III s/n, 45071 Toledo, Spain;
| | - Victoria Mazoteras-Pardo
- Facultad de Enfermería de Ciudad Real, Universidad de Castilla-La Mancha, 13071 Ciudad Real, Spain;
| | - Esperanza Barroso-Corroto
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, 45071 Toledo, Spain; (E.B.-C.); (J.A.L.-A.)
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Campus Tecnológico Fábrica de Armas, Edificio 6. Despacho 1.4, Avd. Carlos III s/n, 45071 Toledo, Spain;
| | - Carlos Navarrete-Tejero
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Campus Tecnológico Fábrica de Armas, Edificio 6. Despacho 1.4, Avd. Carlos III s/n, 45071 Toledo, Spain;
| | - Michail Zografakis-Sfakianakis
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71401 Crete, Greece; (M.Z.-S.); (A.P.)
| | - Athina Patelarou
- Department of Nursing, Faculty of Health Sciences, Hellenic Mediterranean University, 71401 Crete, Greece; (M.Z.-S.); (A.P.)
| | - Maria Manuela Martins
- Abel Salazar Biomedical Sciences Institute, University of Porto, 4099-002 Porto, Portugal; (M.M.M.); (A.d.C.A.F.)
| | | | - José Alberto Laredo-Aguilera
- Grupo de Investigación Multidisciplinar en Cuidados, Universidad de Castilla-La Mancha, 45071 Toledo, Spain; (E.B.-C.); (J.A.L.-A.)
- Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Campus Tecnológico Fábrica de Armas, Edificio 6. Despacho 1.4, Avd. Carlos III s/n, 45071 Toledo, Spain;
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2
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Kytö M, Hotta S, Niinistö S, Marttinen P, Korhonen TE, Markussen LT, Jacucci G, Sievänen H, Vähä-Ypyä H, Korhonen I, Virtanen S, Heihonen S, Koivusalo SB. Periodic mobile application (eMOM) with self-tracking of glucose and lifestyle improves treatment of diet-controlled gestational diabetes without human guidance: a randomized controlled trial. Am J Obstet Gynecol 2024:S0002-9378(24)00416-2. [PMID: 38432415 DOI: 10.1016/j.ajog.2024.02.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 02/13/2024] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Digitalization with minimal human resources could support self-management among women with gestational diabetes and improve maternal and neonatal outcomes. OBJECTIVE This study aimed to investigate if a periodic mobile application (eMOM) with wearable sensors improves maternal and neonatal outcomes among women with diet-controlled gestational diabetes without additional guidance from healthcare personnel. STUDY DESIGN Women with gestational diabetes were randomly assigned in a 1:1 ratio at 24 to 28 weeks' gestation to the intervention or the control arm. The intervention arm received standard care in combination with use of the periodic eMOM, whereas the control arm received only standard care. The intervention arm used eMOM with a continuous glucose monitor, an activity tracker, and a food diary 1 week/month until delivery. The primary outcome was the change in fasting plasma glucose from baseline to 35 to 37 weeks' gestation. Secondary outcomes included capillary glucose, weight gain, nutrition, physical activity, pregnancy complications, and neonatal outcomes, such as macrosomia. RESULTS In total, 148 women (76 in the intervention arm, 72 in the control arm; average age, 34.1±4.0 years; body mass index, 27.1±5.0 kg/m2) were randomized. The intervention arm showed a lower mean change in fasting plasma glucose than the control arm (difference, -0.15 mmol/L vs -2.7 mg/mL; P=.022) and lower capillary fasting glucose levels (difference, -0.04 mmol/L vs -0.7 mg/mL; P=.002). The intervention arm also increased their intake of vegetables (difference, 11.8 g/MJ; P=.043), decreased their sedentary behavior (difference, -27.3 min/d; P=.043), and increased light physical activity (difference, 22.8 min/d; P=.009) when compared with the control arm. In addition, gestational weight gain was lower (difference, -1.3 kg; P=.015), and there were less newborns with macrosomia in the intervention arm (difference, -13.1 %; P=.036). Adherence to eMOM was high (daily use >90%), and the usage correlated with lower maternal fasting (P=.0006) and postprandial glucose levels (P=.017), weight gain (P=.028), intake of energy (P=.021) and carbohydrates (P=.003), and longer duration of the daily physical activity (P=.0006). There were no significant between-arm differences in terms of pregnancy complications. CONCLUSION Self-tracking of lifestyle factors and glucose levels without additional guidance improves self-management and the treatment of gestational diabetes, which also benefits newborns. The results of this study support the use of digital self-management and education tools in maternity care.
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Affiliation(s)
- Mikko Kytö
- IT Management, Helsinki University Hospital, Helsinki, Finland; Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
| | - Shinji Hotta
- Department of Computer Science, Aalto University, Espoo, Finland; Fujitsu Limited, Japan
| | - Sari Niinistö
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Pekka Marttinen
- Department of Computer Science, Aalto University, Espoo, Finland
| | - Tuuli E Korhonen
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Lisa T Markussen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Giulio Jacucci
- Department of Computer Science, University of Helsinki, Helsinki, Finland
| | - Harri Sievänen
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Henri Vähä-Ypyä
- The UKK Institute for Health Promotion Research, Tampere, Finland
| | - Ilkka Korhonen
- Faculty of Biomedical and Health Sciences, Tampere University, Tampere, Finland
| | - Suvi Virtanen
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland; Faculty of Social Sciences, Tampere University, Tampere, Finland; Research, Development and Innovation Center, Tampere University Hospital, Tampere, Finland; Center for Child Health Research, Tampere University Hospital and Tampere University, Tampere, Finland
| | - Seppo Heihonen
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Saila B Koivusalo
- Shared Group Services, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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Alomairah SA, Knudsen SDP, Roland CB, Molsted S, Clausen TD, Bendix JM, Løkkegaard E, Jensen AK, Larsen JE, Jennum P, Stallknecht B. Effects of Two Physical Activity Interventions on Sleep and Sedentary Time in Pregnant Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5359. [PMID: 37047973 PMCID: PMC10094525 DOI: 10.3390/ijerph20075359] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 06/19/2023]
Abstract
Pregnancy is often associated with poor sleep and high sedentary time (SED). We investigated the effect of physical activity (PA) interventions on sleep and SED in pregnant women. A secondary analysis of a randomized controlled trial (n = 219) explored the effect of structured supervised exercise training (EXE) or motivational counseling on PA (MOT) compared to standard prenatal care (CON) on sleep and SED during pregnancy. Three times during pregnancy, sleep was determined by the Pittsburgh Sleep Quality Index (PSQI) and SED by the Pregnancy Physical Activity Questionnaire (PPAQ). Also, a wrist-worn consumer activity tracker measured sleep and SED continuously. Data from the activity tracker confirmed that sleep time decreases, and SED increases by approx. 30 and 24 min/day, respectively, from baseline (maximum gestational age (GA) week 15) to delivery. Compared to CON, the global PSQI score was better for EXE in GA week 28 (-0.8 [-1.5; -0.1], p = 0.031) and for both EXE and MOT in GA week 34 (-1 [-2; -0.5], p = 0.002; -1 [-2; -0.1], p = 0.026). In GA week 28, SED (h/day) from PPAQ was lower in EXE compared to both CON and MOT (-0.69 [-1; -0.0], p = 0.049; -0.6 [-1.0; -0.02], p = 0.042). In conclusion, PA interventions during pregnancy improved sleep quality and reduced SED.
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Affiliation(s)
- Saud Abdulaziz Alomairah
- Public Health Department, College of Health Sciences, Saudi Electronic University, Riyadh 13316, Saudi Arabia
- Department of Biomedical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | | | - Caroline Borup Roland
- Department of Biomedical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Stig Molsted
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hilleroed, Denmark
| | - Tine D. Clausen
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Gynaecology and Obstetrics, Nordsjaellands Hospital, 3400 Hilleroed, Denmark
| | - Jane M. Bendix
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hilleroed, Denmark
- Department of Gynaecology and Obstetrics, Nordsjaellands Hospital, 3400 Hilleroed, Denmark
| | - Ellen Løkkegaard
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Gynaecology and Obstetrics, Nordsjaellands Hospital, 3400 Hilleroed, Denmark
| | - Andreas Kryger Jensen
- Department of Clinical Research, Copenhagen University Hospital—North Zealand, 3400 Hilleroed, Denmark
- Department of Public Health, Section of Biostatistics, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Jakob Eg Larsen
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, 2800 Kongens Lyngby, Denmark
| | - Poul Jennum
- Department of Clinical Medicine, University of Copenhagen, 2200 Copenhagen, Denmark
- Danish Center for Sleep Medicine, Department of Clinical Neurophysiology, 2200 Copenhagen, Denmark
| | - Bente Stallknecht
- Department of Biomedical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
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4
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Mollard E, Cottrell C. Lifestyle and the hypertensive disorders of pregnancy in nulliparous women in the United States: a secondary data analysis of the nuMom2b. BMC Pregnancy Childbirth 2023; 23:201. [PMID: 36959650 PMCID: PMC10035211 DOI: 10.1186/s12884-023-05522-8] [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: 09/19/2022] [Accepted: 03/15/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Hypertensive disorders of pregnancy are a leading cause of maternal and fetal morbidity and mortality and a significant risk factor for future cardiovascular disease development in women. This study aimed to explore lifestyle wellness-related variables and how they impact the risk of hypertension in pregnancy. METHODS This is a secondary analysis of data from the prospective cohort study Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be (nuMoM2b). Data was collected through questionnaires, clinical evaluations, and medical records review at 8 academic medical centers in the United States. Four study visits were scheduled throughout the participant's pregnancy (visits one-four): 60-136, 160-216, and 220-296 weeks gestation and birth. A series of statistical modeling and logistical regression were performed using 15 lifestyle variables related to sleep, nutrition, resilience, illness avoidance, and physical activity were selected as predictor variables with an outcome variable of hypertension. RESULTS Of 9289 nulliparous participants considered for inclusion in our analyses, 1464 had any HDP during study participation, and 554 participants had complete data available for the study and were included in our final sample. Results were statistically significant at a level of p < 0.05. Of the sleep variables, snoring at visit 1 increased the risk of hypertension in pregnancy. Greater vegetable consumption reported at visit one decreased risks of hypertension in pregnancy. Physical activity reported at visit two and visit three were associated with decreased risk of hypertension. Physical activity reported at visit three combined with more hours of sleep each night, or through napping habit reported at visit one decreased hypertension risk. Increased fish oil consumption combined with more hours of sleep at visit one increased odds of hypertension in pregnancy. CONCLUSIONS Our results support that lifestyle wellness-related variables relating to sleep, physical activity and nutrition affect hypertension in pregnancy. The studied variables and others should be considered in future research and intervention development to reduce hypertension in pregnancy and improve maternal wellness.
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Affiliation(s)
- Elizabeth Mollard
- College of Nursing, University of Nebraska Medical Center, 550 North 19Th St, # 357, Lincoln, NE, 68588-0620, USA.
| | - Constance Cottrell
- Office of Nursing Research and Innovation, Cleveland Clinic, 9500 Euclid Ave/T4, Cleveland, OH, 44195, USA
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5
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Bauer J, Steinbrückner M, Dörr M, Bahls M, Schmidt T, Ulbricht S. [Fit for Two - A Study of Sedentary Behavior and Physical Activity During Pregnancy]. Z Geburtshilfe Neonatol 2023; 227:36-41. [PMID: 35995072 DOI: 10.1055/a-1850-2329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
BACKGROUND In the pilot study sedentary behavior and physical activity were measured in pregnant women using an accelerometer. METHODS A total of 32 pregnant women were enrolled in the study; eleven of them were included in the first trimester. The defined wearing periods for the accelerometer in the first, second and third trimester were weeks 9-12, 23-26, and 36-39, respectively. A self-administered survey was carried out after a 7-day measurement. RESULTS The pregnant women were on average 30 years old, 50% were nulliparous, and 68.8% had a high school diploma. The accelerometer was worn on average of 13 hours per day. Sedentary behavior was recorded more than half of the wearing time for all trimesters. The proportion of time spent in moderate-to-vigorous activity was highest at 4.7% in the second trimester, compared to 2.5% in the first and 3.8% in the third. A proportion of women, ranging from 32% in the first, 54% in the second, and 58% in the third trimester did reach the levels of PA recommended by the guidelines. Nulliparous women in the second and third trimester spent twice as much time in moderate-to-vigorous activities compared to multiparous women. CONCLUSION Pregnant women spent more than half of the monitored day in sedentary behaviors. Half of them did meet the recommendations for physical activity in the second and third trimester. The results show that sedentary behavior and physical activity should be considered more in clinical practice and research to motivate pregnant women to adopt a physically active lifestyle.
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Affiliation(s)
- Juliane Bauer
- Abteilung für Präventionsforschung und Sozialmedizin, Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Madlén Steinbrückner
- Abteilung für Präventionsforschung und Sozialmedizin, Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Marcus Dörr
- Deutsches Zentrum für Herz-Kreislauf-Forschung e. V., Standort Greifswald, Germany.,Klinik und Poliklinik für Innere Medizin B, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Martin Bahls
- Deutsches Zentrum für Herz-Kreislauf-Forschung e. V., Standort Greifswald, Germany.,Klinik und Poliklinik für Innere Medizin B, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Thorsten Schmidt
- Supportivangebote Sport- und Bewegungstherapie, Universitäres Cancer Center Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Sabina Ulbricht
- Abteilung für Präventionsforschung und Sozialmedizin, Institut für Community Medicine, Universitätsmedizin Greifswald, Greifswald, Germany.,Deutsches Zentrum für Herz-Kreislauf-Forschung e. V., Standort Greifswald, Germany
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6
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Taousani E, Savvaki D, Tsirou E, Grammatikopoulou MG, Tarlatzis BC, Vavilis D, Goulis DG. Effect of Exercise on the Resting Metabolic Rate and Substrate Utilization in Women with Gestational Diabetes Mellitus: Results of a Pilot Study. Metabolites 2022; 12:metabo12100998. [PMID: 36295900 PMCID: PMC9611075 DOI: 10.3390/metabo12100998] [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: 09/18/2022] [Revised: 10/13/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Regular physical activity during pregnancy has a positive effect on the mother and fetus. However, there is scarce data regarding the effect of exercise in pregnancies complicated by gestational diabetes mellitus (GDM). The aim of the present parallel, non-randomized, open-label, pilot, clinical study was to examine the effect of two exercise programs on the resting metabolic rate (RMR) and substrate utilization in pregnancies complicated by GDM, compared with usual care (advice for the performance of exercise). Forty-three pregnant women diagnosed with GDM between the 24th and 28th gestational week, volunteered to participate. Three groups were formed: Usual care (n = 17), Walking (n = 14), and Mixed Exercise (n = 12). The Usual care group was given advice on maintaining habitual daily activities without any additional exercise. The Walking group exercised regularly by walking, in addition to the habitual daily activities. Finally, the Mixed Exercise group participated in a program combining aerobics and strength exercises. Training intensity was monitored continuously using lightweight, wearable monitoring devices. The Walking and Mixed Exercise groups participated in the training programs after being diagnosed with GDM and maintained them until the last week of gestation. RMR and substrate utilization were analyzed using indirect calorimetry for all participants twice: between 27th and 28th gestational week and as close as possible before delivery. No differences were observed between groups regarding body composition, age, and medical or obstetrical parameters before or after the exercise programs. RMR was increased after the completion of the exercise interventions in both the Walking (p = 0.001) and the Mixed Exercise arms (p = 0.002). In contrast, substrate utilization remained indifferent. In conclusion, regular exercise of moderate intensity (either walking, or a combination of aerobic and strength training) increases RMR in women with GDM compared to the lack of systematic exercise. However, based on the present, pilot data, these exercise regimes do not appear to alter resting substrate utilization.
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Affiliation(s)
- Eleftheria Taousani
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, GR-56429 Thessaloniki, Greece
- Department of Midwifery, Faculty of Health Sciences, International Hellenic University, Alexander Campus, Sindos, GR-57400 Thessaloniki, Greece
| | - Dimitra Savvaki
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, GR-56429 Thessaloniki, Greece
- School of Physical Education and Sports Science, Democritus University of Thrace, GR-69100 Komotini, Greece
| | - Efrosini Tsirou
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, GR-56429 Thessaloniki, Greece
| | - Maria G. Grammatikopoulou
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, GR-56429 Thessaloniki, Greece
- Department of Rheumatology and Clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece
- Correspondence: (M.G.G.); (D.G.G.)
| | - Basil C. Tarlatzis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, GR-56429 Thessaloniki, Greece
| | - Dimitrios Vavilis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, GR-56429 Thessaloniki, Greece
- Medical School, University of Cyprus, 93rd Agiou Nicolaou Street, Engomi, Nicosia 2408, Cyprus
| | - Dimitrios G. Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, GR-56429 Thessaloniki, Greece
- Correspondence: (M.G.G.); (D.G.G.)
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7
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Christie HE, Chang CR, Jardine IR, Francois ME. Three short postmeal walks as an alternate therapy to continuous walking for women with gestational diabetes. Appl Physiol Nutr Metab 2022; 47:1031-1037. [PMID: 35985050 DOI: 10.1139/apnm-2021-0619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to determine whether postmeal walking (breaking up exercise into short bouts after meals) is an effective and feasible alternate to continuous walking for the management of gestational diabetes. Forty-one women with gestational diabetes were randomised between wk 28-30 gestation to either standard-care (30-min continuous exercise) or standard-care with postmeal walking (10-min of walking after breakfast, lunch and dinner). Continuous glucose and activity monitors were worn to measure glycaemic control and adherence during three-days of standard-care (baseline) followed by three-days of postmeal or continuous walking. A linear mixed model analysed the changes from baseline between postmeal and continuous walking, as an average of the three-day periods. Thirty-two women (postmeal walking n=17: control n=15, 33±5 y, body mass index 25±4 kg.m2) completed the trial. Postprandial and overnight glucose concentrations were similar between postmeal walking and control, both interventions improved from baseline. There was no difference in adherence between groups, however postmeal walking completed more minutes of prescribed physical activity across baseline and intervention days compared to the continuous walking standard-care group. Preliminary findings from this proof-of-concept study suggest postmeal walking could be a promising alternative to, and work interchangeably with, traditional advice to perform continuous moderate-intensity physical activity, in women with gestational diabetes. Novelty bullets -Three ten-minute postmeal walks may be comparable to thirty minutes continuous walking for glucose control in women with gestational diabetes - Accumulating activity in short bouts after meals is a feasible alternate to continuous exercise for women with gestational diabetes.
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Affiliation(s)
- Hannah E Christie
- University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia;
| | - Courtney R Chang
- University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia;
| | | | - Monique E Francois
- University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia;
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8
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Silva-Jose C, Sánchez-Polán M, Barakat R, Gil-Ares J, Refoyo I. Level of Physical Activity in Pregnant Populations from Different Geographic Regions: A Systematic Review. J Clin Med 2022; 11:jcm11154638. [PMID: 35956253 PMCID: PMC9369818 DOI: 10.3390/jcm11154638] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/23/2022] [Accepted: 08/05/2022] [Indexed: 12/05/2022] Open
Abstract
The aim of this study was to examine the level of physical activity during pregnancy in different populations worldwide. An intensive search was carried out from February until May 2021. The inclusion criteria were original studies of healthy pregnant women, and the main study variable was the assessment of physical activity. A total of 110 out of 1451 studies were assessed for inclusion, using the Newcastle–Ottawa Scale for quality, and for the risk of bias. The 44 analyzed articles were divided into 5 tables according to the characteristics of the intervention and the validated instrument used to measure physical activity (PA). A total of 59.09% of the studies indicated that participants had a low level of physical activity during pregnancy. In addition, the median quality score of the studies was 7.12, and 77.27% of the studies were cataloged as having a high-quality score. Although international guidelines recommend that women without a contraindication engage in prenatal physical activity, the results of the present study show that the level of PA is too low for women to achieve scientifically proven maternal-fetal benefits. Failure to achieve the recommended levels of weekly physical activity could pose significant risks to maternal well-being.
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Affiliation(s)
- Cristina Silva-Jose
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-913364120
| | - Rubén Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Javier Gil-Ares
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Ignacio Refoyo
- Sports Department, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
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9
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A Delphi Study to Identify Research Priorities Regarding Physical Activity, Sedentary Behavior and Sleep in Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052909. [PMID: 35270601 PMCID: PMC8909963 DOI: 10.3390/ijerph19052909] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/12/2022] [Accepted: 02/17/2022] [Indexed: 12/10/2022]
Abstract
This study aimed to produce a list of the top 10 research priorities regarding physical activity, sedentary behavior, and sleep in pregnancy. Using the Delphi methodology, pregnant/postpartum individuals (N = 118), exercise professionals and healthcare providers (N = 55) listed up to 10 questions perceived as unanswered regarding physical activity, sedentary behavior, and sleep in pregnancy (Round 1). Respondents rated the proposed questions on a Likert importance scale (Round 2), and the sum of ratings received were totaled. Questions of priority regarding physical activity among pregnant/postpartum individuals (N = 67), healthcare providers and exercise professionals (N = 22) pertained to exercise prescription, impact of exercise on maternal and fetal outcomes and impact of exercise on pregnancy conditions, special population groups and clinical education and access to information. Sedentary behavior priorities included the impact of sedentary behavior on maternal and fetal outcomes, sedentary recommendations and exercise and sedentary positioning. Sleep research priorities included the impact of pregnancy on sleep, safety, sleeping aids and the effect of exercise on sleep. Pregnant/postpartum women, healthcare providers and exercise professionals prioritized questions that have in part been addressed by existing research, highlighting a need for improved knowledge translation from research to practice. They have also identified novel questions that warrant prioritization within future research.
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Garnweidner-Holme L, Henriksen L, Bjerkan K, Lium J, Lukasse M. Factors associated with the level of physical activity in a multi-ethnic pregnant population - a cross-sectional study at the time of diagnosis with gestational diabetes. BMC Pregnancy Childbirth 2022; 22:1. [PMID: 34979996 PMCID: PMC8722186 DOI: 10.1186/s12884-021-04335-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 12/13/2021] [Indexed: 12/14/2022] Open
Abstract
Background Regular physical activity during pregnancy can prevent several adverse health outcomes during this period of a woman’s life. Previous studies have shown that many women do not meet national recommendations for physical activity. This study aims to examine factors associated with sufficient leisure-time physical activity (LTPA) in a multicultural sample of pregnant women recently diagnosed with gestational diabetes mellitus (GDM). Methods We performed a cross-sectional study among 238 pregnant women. The women were recruited at diabetes outpatient clinics in the Oslo region of Norway from October 2015 to April 2017. The participants reported their activity levels using the Pregnancy Physical Activity Questionnaire (PPAQ). Pearson’s chi-square tests were used to assess differences in socio-demographic, health and pregnancy-related characteristics in relation to sufficient and insufficient LTPA, and logistic regression modelling was employed to predict the likelihood of insufficient LTPA. Results Less than half of the women in the sample (44.5%) had sufficient LTPA according to the minimum of ≥600 Met minutes per week. The majority of women were motivated to be physically active during pregnancy (84.9%). A low joint family income and being over 38 years of age increased the odds of not having sufficient LTPA. Women with sufficient LTPA had significantly higher scores of perceived health (p = 0.007). Conclusions The study indicates that pregnant women need to be better informed about the positive effects of physical activity on individually perceived health. To address the low levels of LTPA among pregnant women, communication strategies must be tailored towards women with low socio-economic backgrounds. Trial registration:https://clinicaltrials.gov/ct2/show/NCT02588729 Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04335-x.
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Affiliation(s)
- L Garnweidner-Holme
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
| | - L Henriksen
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.,Division of General Gynaecology and Obstetrics, Oslo University Hospital, Oslo, Norway
| | - K Bjerkan
- Department for diabetes, Aker Hospital, Oslo University Hospital, Oslo, Norway
| | - J Lium
- Faculty for medicine, University of Bergen, Bergen, Norway
| | - M Lukasse
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.,Faculty of Health and Social Sciences, University of South-Eastern Norway, Campus Vestfold, Notodden, Norway
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11
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Associations of objectively measured physical activity and sedentary time with pregnancy-specific health-related quality of life. Midwifery 2022; 104:103202. [PMID: 34801955 PMCID: PMC8671341 DOI: 10.1016/j.midw.2021.103202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 10/25/2021] [Accepted: 11/06/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE To examine associations of objectively measured moderate-to-vigorous-intensity physical activity (MVPA) and sedentary behavior (SED) with pregnancy-specific health-related quality of life (QoL) across pregnancy trimesters. MATERIALS AND METHODS Women (N=131, mean age 30.9 years ± 4.9) were recruited from two large health care systems in the United States. MVPA and SED were estimated using a waist-worn ActiGraph GT3X and thigh-worn activPAL3 micro, respectively, for seven days in each trimester of pregnancy. Questionnaires were administered in each trimester to assess pregnancy-specific health-related QoL using the Nausea and Vomiting of Pregnancy Specific health Related Quality of Life (NVPQoL) questionnaire. Mixed effects linear regression examined associations of MVPA and SED with the NVPQoL total score and domain-specific scores (physical symptoms, fatigue, emotions, and limitations) across trimesters. RESULTS The NVPQoL total score and domain-specific scores significantly varied across trimesters, with highest scores (indicating worse QoL) observed in the first trimester and lowest scores (indicating better QoL) in the second trimester. A 1-standard deviation (SD) increment in MVPA (16.0 min/day or 1.8%) was associated with better QoL as indicated by the lower NVPQoL total score (β=-4.06, p=0.024) and limitations score (β = -2.80, p<0.001). A 1-SD increment in SED (1.5 hr/day or 10.0%) was associated with worse QoL as indicated by the higher fatigue score (β = 0.82, p=0.041). CONCLUSIONS Pregnancy-specific health-related QoL varies across trimesters. Both lower SED, and to a greater extent higher MVPA are potential behavioral targets for improving pregnancy-specific health-related QoL.
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Skjold I, Benvenuti MB, Haakstad LAH. Why do so many pregnant women give up exercise? An Italian cross-sectional study. WOMEN'S HEALTH 2022; 18:17455057221117967. [PMID: 36124367 PMCID: PMC9490457 DOI: 10.1177/17455057221117967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: Current exercise guidelines recommend women to exercise throughout pregnancy, and the benefits are well documented. Still, there is an increasing decline of exercise levels during pregnancy and a high percentage of them are sedentary. It is well established that individual attitudes and perception of barriers may influence the ability to engage in sufficient amount of exercise. This has, however, not been examined in an Italian pregnant population. Hence, the aims of the present study were to increase knowledge of facilitators and barriers to regular exercise in Italian pregnant women and to report their social support in regard to maternal exercise. Methods: Healthy, pregnant women (n = 513) were allocated from Fatebenefratelli San Giovanni Calibita, a public hospital in Rome, and four antenatal clinics in Rome and Modena. The participants completed a validated self-administrated questionnaire, the Physical Activity Pregnancy Questionnaire, in gestational week 36. In line with current American College of Obstetricians and Gynecologists guidelines (2020), participants were categorized as “regular exercisers” (⩾150 min/week) and “not regular exercisers” (< 150 min/week). Results: Only 4.6% of the women engaged in regular physical activity/exercise in the third trimester. “Insufficient time” (54%) were the only barrier negatively associated with exercise. The facilitators “relaxation/recreation” (18%), “prevention of health complaints” (15%), “enjoyment” (10%), and “prevention of gestational weight gain” (4%) were associated with achieving the recommendations of exercise. This study found no association between achieving the recommendations and childhood exercise/having social modeling, or exercising network/milieu (p = 0.294 and p = 0.123). Nevertheless, exercising together with others was a significant predictor for regular maternal exercise (p < 0.001). Most women did not receive any advice on exercise during pregnancy from their doctor or midwife (60.0 %). Yet, those who received such advice were significantly more likely to exercise regularly compared to those who did not (75.0% vs 38.2%; p < 0.001). Conclusion: Italian pregnant women mainly reported internal facilitators for their willingness to participate in regular maternal exercise, while barriers were primarily related to inconveniences (such as insufficient time and difficulty combining with work/studies). The study addresses the positive association between achieving the recommended amount of exercise and social support in terms of exercising with others and getting advice from health professions. Because women respect their doctor and have regular prenatal checkups, this health care setting can play a pivotal role in the initiation and maintenance of exercise behavior during pregnancy.
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Affiliation(s)
| | | | - Lene AH Haakstad
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
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13
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Adeoye IA. Pattern and correlates of physical activity and sedentary behaviours of pregnant women in Ibadan, Nigeria: Findings from Ibadan pregnancy cohort study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001153. [PMID: 36962637 PMCID: PMC10021993 DOI: 10.1371/journal.pgph.0001153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/14/2022] [Indexed: 11/07/2022]
Abstract
Globally, physical inactivity is the fourth leading risk factor for premature death. Pregnancy is associated with reduced physical activity because of physiological and anatomical changes and socio-cultural barriers. Even though physical activity provides many benefits, such as improved insulin sensitivity and reduced cardiometabolic risk, it is not emphasized among pregnant women in Nigeria. This study described the pattern of physical activity and sedentary behaviours of pregnant women from the Ibadan Pregnancy Cohort Study in Ibadan, Nigeria. The Ibadan Pregnancy Cohort Study (IbPCS) is a prospective cohort study investigating the associations between maternal obesity, lifestyle factors on glycaemia control, gestational weight gain, pregnancy and postpartum outcomes among pregnant women in Ibadan. The Pregnancy Physical Activity Questionnaire (PPAQ) was used to assess physical activity and sedentary behaviour. Sedentary time was estimated from the time spent watching television, sitting at work and the computer. Bivariate and multivariate logistic regression analyses were done to investigate associations at a 5% level of statistical significance. None of the pregnant women met the WHO recommendation of 150mins of moderate-intensity activity per week. The average time spent engaged in moderate-intensity activity was 26.3 ± 22.9 mins. The mean daily sedentary time was 6.5 ± 4.2 hours. High parity para ≥ 4: [AOR 0.57 95% CI: (0.36-0.89) p = 0.014] and being employed [AOR 0.23 95% CI: (0.15-0.33) p <0.001] reduced the odds of having inadequate physical activity. Correlates of sedentary behavior after adjusting for confounders were high parity: para 1-3 AOR 0.73, 95% CI: (0.58-0.91) p = 0.004], tertiary education: AOR 2.39 95% CI: (1.16-4.91) p = 0.018] and earning a higher income: AOR 1.40: 95% CI: (1.11-1.78) p = 0.005]. Pregnant women's physical activity and sedentary behaviours are emerging public health issues, especially in Nigeria. The level of physical activity was inadequate among pregnant women, while the sedentary time was high. There is a need to implement programmes that promote physical activity and discourage sedentary behaviour among pregnant women in Nigeria.
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Affiliation(s)
- Ikeola A Adeoye
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Consortium for Advanced Research in Africa (CARTA), Nairobi, Kenya
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Fazzi C, Denison FC, Saunders DH, Norman JE, Reynolds RM. Options in Pregnancy to Increase ActiveLy Sitting (OPALS) Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5673. [PMID: 34073151 PMCID: PMC8197813 DOI: 10.3390/ijerph18115673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/22/2021] [Accepted: 04/28/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND A negative association between obesity and pregnancy outcomes has been described, as well as between time sedentary and pregnancy outcomes. Most interventions based on physical activity involving obese pregnant women have failed in improving pregnancy outcomes. Exchanging time spent in sedentary activities with time spent in light-intensity activities, performed in a home-based setting, might help morbidly obese pregnant women. We aimed to assess the feasibility of an exercise intervention. METHODS An exercise intervention for morbidly obese pregnant women was designed involving morbidly obese pregnant women. Pregnant women with BMI ≥ 40 kg/m² with 20 or less weeks of gestation were invited to take part in the OPALS Feasibility Study. A home-based approach was employed. Participants were asked to perform the intervention for at least 12 weeks, and to register their performance in an activity diary. After the intervention, participants were asked to return the activity diary and answer a feasibility questionnaire. RESULTS In the intervention, 28 participants took part. Six women completed the intervention for 12 weeks or more. All declared they intended to keep on doing the intervention. All women reported that the exercises made them feel better. CONCLUSION Empowering, and involving morbidly obese pregnant women in taking care of themselves and giving them realistic tasks to do on their own and around their environment helps to increase commitment, as does avoiding the effect of their own weight whilst exercising. A 20% of compliance was observed in this study, which might be explained by the difficulties that pregnancy and excess weight mean. Thus, for future studies, we suggest adding a supervision plan to increase that number.
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Affiliation(s)
- Caterina Fazzi
- Tommy’s Centre for Maternal and Fetal Health, MRC Centre for Reproductive Health, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK; (C.F.); (F.C.D.)
- Department of Physical Education, Sports and Recreation, Metropolitan University of Educational Sciences, Santiago 7760197, Chile
| | - Fiona C. Denison
- Tommy’s Centre for Maternal and Fetal Health, MRC Centre for Reproductive Health, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK; (C.F.); (F.C.D.)
| | - David H. Saunders
- Physical Activity for Health Research Centre (PAHRC), Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Edinburgh EH8 8AQ, UK;
| | - Jane E. Norman
- Health Sciences Faculty Office, University of Bristol, Bristol BS8 1UD, UK;
| | - Rebecca M. Reynolds
- Tommy’s Centre for Maternal and Fetal Health, MRC Centre for Reproductive Health, Queen’s Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK; (C.F.); (F.C.D.)
- The British Heart Foundation/University of Edinburgh Centre for Cardiovascular Science, University of Edinburgh, Edinburgh EH8 8AQ, UK
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15
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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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Whitaker KM, Zhang D, Kline CE, Catov J, Barone Gibbs B. Associations of Sleep With Sedentary Behavior and Physical Activity Patterns Across Pregnancy Trimesters. Womens Health Issues 2021; 31:366-375. [PMID: 33715925 DOI: 10.1016/j.whi.2021.02.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 02/06/2021] [Accepted: 02/09/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Sleep, sedentary behavior, and moderate-to-vigorous physical activity (MVPA) are altered in pregnancy and may affect pregnancy health; however, how these behaviors are associated with each other is unclear. METHODS Pregnant women (N = 120) completed the Pittsburgh Sleep Quality Index and wore an activPAL3 micro and ActiGraph GT3X for 7 days in each trimester to assess sleep, sedentary behavior, and MVPA, respectively. Latent trajectories described patterns of sleep duration, efficiency, and quality as well as sedentary behavior and MVPA. Multinomial logistic regression examined associations of sleep patterns with sedentary behavior and MVPA patterns and, in exploratory analyses, with adverse pregnancy outcomes. RESULTS Trajectories were identified for sleep duration (consistently short, 20.7% of sample; consistently adequate, 79.3%), efficiency (consistently low, 17.5%; consistently high, 82.5%), and quality (consistently poor, 15.1%; worsening, 23.5%; and consistently good, 61.5%). Compared with those in more optimal sleep groups, women in the short duration, low efficiency, and worsening quality groups had lower odds of being in the moderate and/or high sedentary behavior group (odds ratio range, 0.21-0.31; 95% confidence interval range, 0.09-0.65). Women in the worsening quality group had greater odds of being in the low MVPA group (odds ratio, 2.51; 95% confidence interval, 1.18-5.38). Trends were observed with women in less optimal sleep groups having greater odds of adverse pregnancy outcomes and lower odds of excessive gestational weight gain. CONCLUSIONS Less optimal sleep patterns in pregnancy are associated with less sedentary behavior and MVPA; additional research is needed to confirm associations between sleep and pregnancy outcomes.
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Affiliation(s)
- Kara M Whitaker
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa; Department of Epidemiology, University of Iowa, Iowa City, Iowa.
| | - Dong Zhang
- Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa
| | - Christopher E Kline
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Janet Catov
- Department of Ob/Gyn and Reproductive Sciences, Magee-Women's Research Institute and Clinical and Translational Science Institute, University of Pittsburgh, Pennsylvania
| | - Bethany Barone Gibbs
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, Pennsylvania; Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
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Meander L, Lindqvist M, Mogren I, Sandlund J, West CE, Domellöf M. Physical activity and sedentary time during pregnancy and associations with maternal and fetal health outcomes: an epidemiological study. BMC Pregnancy Childbirth 2021; 21:166. [PMID: 33639879 PMCID: PMC7913456 DOI: 10.1186/s12884-021-03627-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/08/2021] [Indexed: 02/07/2023] Open
Abstract
Background Physical activity is generally considered safe for the pregnant woman as well as for her fetus. In Sweden, pregnant women without contraindications are recommended to engage in physical activity for at least 30 min per day most days of the week. Physical activity during pregnancy has been associated with decreased risks of adverse health outcomes for the pregnant woman and her offspring. However, there are at present no recommendations regarding sedentary behavior during pregnancy. The aim was to examine the level of physical activity and sedentary time in a representative sample of the pregnant population in Sweden, and to explore potential effects on gestational age, gestational weight gain, birth weight of the child, mode of delivery, blood loss during delivery/postpartum, self-rated health during pregnancy and risk of pregnancy-induced hypertension and preeclampsia. Methods This was an epidemiological study using data from the prospective, population-based NorthPop study in Northern Sweden and information on pregnancy outcomes from the national Swedish Pregnancy Register (SPR). A questionnaire regarding physical activity and sedentary time during pregnancy was answered by 2203 pregnant women. Possible differences between categories were analyzed using one-way Analysis of variance and Pearson’s Chi-square test. Associations between the level of physical activity/sedentary time and outcome variables were analyzed with univariable and multivariable logistic regression and linear regression. Results Only 27.3% of the included participants reported that they reached the recommended level of physical activity. A higher level of physical activity was associated with a reduced risk of emergency caesarean section, lower gestational weight gain, more favorable self-rated health during pregnancy, and a decreased risk of exceeding the Institute of Medicine’s recommendations regarding gestational weight gain. Higher sedentary time was associated with a non-favorable self-rated health during pregnancy. Conclusions Our study showed that only a minority of pregnant women achieved the recommended level of physical activity, and that higher physical activity and lower sedentary time were associated with improved health outcomes. Encouraging pregnant women to increase their physical activity and decrease their sedentary time, may be important factors to improve maternal and fetal/child health outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03627-6.
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Affiliation(s)
- Lina Meander
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Maria Lindqvist
- Department of Nursing, Umeå University, Umeå, Sweden.,Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Ingrid Mogren
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, Umeå, Sweden
| | - Jonas Sandlund
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Christina E West
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Magnus Domellöf
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
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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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Okafor UB, Goon DT. Physical Activity Level during Pregnancy in South Africa: A Facility-Based Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7928. [PMID: 33137931 PMCID: PMC7663401 DOI: 10.3390/ijerph17217928] [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] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/25/2020] [Accepted: 10/26/2020] [Indexed: 11/17/2022]
Abstract
Physical activity participation during pregnancy confers many maternal and foetal health benefits to the woman and her infant and is recommended by various health bodies and institutions. However, in South Africa, scant information exists about the physical activity status and its determinants among pregnant women. The aim of this study was to assess the physical activity level and associated factors among pregnant women. This cross-sectional study enrolled 1082 pregnant women attending public health facilities in Buffalo City Municipality, Eastern Cape, South Africa. Information on socio-demographic and maternal characteristics were obtained, and the Pregnancy Physical Activity Questionnaire was used to assess physical activity during pregnancy. Multiple logistic regression analyses were used to assess associations between physical activity and the predictor variables during pregnancy. Adjusted odds ratios with 95% confidence interval were applied to estimate factors associated with physical activity levels. Statistical significance was set at p < 0.05. Only 278 of the women (25.7%) met recommendations for prenatal activity (≥150 min moderate intensity exercise per week). The average time spent in moderate-vigorous physical activity was 151.6 min (95% CI: 147.2-156.0). Most of the women participated in light exercises with a mean of 65.9% (95% CI: 64.8-67.0), and 47.6% (95% CI: 46.3-48.9) participated in household activities. The majority of the women did not receive physical activity advice during prenatal care sessions (64.7%). Factors negatively associated with prenatal physical activity were lower age (<19 years) (adjusted odd ratio (AOR) = 0.3; CI: 0.16-0.76), semi-urban residence (AOR = 0.8; CI: 0.55-1.03), lower educational level (AOR = 0.5; CI: 0.20-0.71), unemployment (AOR = 0.5; CI: 0.29-0.77) and nulliparity (AOR = 0.6; CI: 0.28-1.31). However, prenatal physical activity was positively associated with starting physical activity in the first trimester (AOR = 1.9; CI: 1.06-3.31) compared to other trimesters. The findings of this study demonstrated low levels of physical activity during pregnancy in South Africa. The majority of women did not meet the recommendation of 150 min of moderate intensity activity per week. Light intensity and household activities were the most preferred form of activity. The factors affecting physical activity of women in this present study include lower age, semi-urban setting, low educational level, unemployment and nulliparity. In order to increase activity levels, future work should seek to improve knowledge, access and support for physical activity in pregnant women in South Africa. This should include education and advocacy regarding physical activity for professionals involved in maternal health provision.
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Affiliation(s)
- Uchenna Benedine Okafor
- Department of Nursing Science, 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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Román-Gálvez MR, Amezcua-Prieto C, Salcedo-Bellido I, Olmedo-Requena R, Martínez-Galiano JM, Khan KS, Bueno-Cavanillas A. Physical activity before and during pregnancy: A cohort study. Int J Gynaecol Obstet 2020; 152:374-381. [PMID: 32978781 DOI: 10.1002/ijgo.13387] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/17/2020] [Accepted: 09/18/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To estimate physical activity (PA) in healthy women before and during pregnancy and to evaluate the features associated with moderate PA (MPA). METHODS A prospective cohort study was conducted on women selected 14 weeks of pregnancy during 2013-2015 in primary public health service centers in southern Spain. Type, duration, and frequency of PA (IPAQ questionnaire in first, second, and third trimesters [T1, T2, T3]) were measured. Variables associated with MPA were evaluated using multiple logistic regressions controlling for age, pre-pregnancy obesity, level of education, number of living children, pre-pregnancy PA, and adherence to Mediterranean diet (AMD). RESULTS Out of 463 women, MPA was estimated in 64% pre-pregnancy, and 54%, 61%, and 59% in T1, T2, and T3, respectively. MPA was associated with greater AMD in T2 (adjusted odds ratio [aOR] 1.17, 95% confidence interval [CI] 1.04-1.33) and T3 (aOR 1.16, 95% CI 1.02-1.31), previous PA (aOR 13.5, 95% CI 8.12-22.5 in T1; aOR 2.61, 95% CI 1.72-3.96 in T2; aOR 2.59, 95% CI 1.65-4.05 in T3), and pre-pregnancy obesity (aOR 2.97, 95% CI 1.28-6.89 in T1; aOR 2.69, 95% CI 1.23-3.60 in T3). CONCLUSION PA decreased at the beginning of pregnancy, but compliance remained over 50%. MPA was associated with diet, pre-pregnancy PA, and obesity.
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Affiliation(s)
- María Rosario Román-Gálvez
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Unidad de Gestión Clínica Churriana de la Vega, Andalusian Health Service, Granada, Spain
| | - Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Inmaculada Salcedo-Bellido
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Rocío Olmedo-Requena
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
| | - Juan Miguel Martínez-Galiano
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Department of Nursing, University of Jaén, Jaén, Spain
| | - Khalid S Khan
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Women's Health Research Unit, Barts and the London, School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain
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21
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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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22
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Matin ZS, Khayat S, Navidian A, Fanaei H. Comparing the effect of group training and telemedicine on exercise during pregnancy: An application of the health belief model. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:187. [PMID: 32953913 PMCID: PMC7482701 DOI: 10.4103/jehp.jehp_88_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 03/24/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Many women refuse to exercise during pregnancy due to lack of awareness and not receiving training. The aim of this study was to investigate and compare the effect of group and telemedicine education on exercise during pregnancy by using the health belief model (HBM). MATERIALS AND METHODS This quasi-experimental study was carried out in 2019 in Zahedan, and a total of 135 pregnant women participated in it. Samples were randomly assigned to the following three groups: group training (n = 45), telemedicine (n = 45), and control (n = 45). Group training was presented in three sessions, and the telemedicine group received the educational content through mobile applications. The samples completed the HBM questionnaire before and 6 weeks after the intervention. In addition, within 6 weeks after the intervention, they completed the exercise activity schedule. SPSS software Ver. 16 (IBM Corp, Armonk, NY, USA) was used for analysis, and data were analyzed by ANOVA, Tukey's post-hoc test, Kruskal-Wallis test, and Mann-Whitney test. RESULTS After intervention, the scores of HBM constructs and exercise levels in group training, telemedicine group, and control group, respectively, were as follows: perceived susceptibility 25.91 ± 3.24, 25.51 ± 1.97, and 22.55 ± 3.78; perceived severity 27.48 ± 2.27, 25.13 ± 2.29, and 22.51 ± 3.88; perceived benefits 27.28 ± 2.97, 25.68 ± 3, and 22.8 ± 3.05; perceived barriers 10.69 ± 2.69, 10.66 ± 3.19, and 14.17 ± 3.14; cues to action 24.71 ± 4.35, 23.9 ± 2.48, and 22.84 ± 3.02; self-efficacy 26.17 ± 3.05, 25.2 ± 2.82, and 22.51 ± 3.38; and exercise levels 70.99 ± 20.43, 56.51 ± 21.99, and 37.62 ± 29.66. Group training and telemedicine led to significant improvement in all HBM constructs and exercise levels (P < 0.05, P < 0.0001, and P = 0.003, respectively). Group training provided more improvement than telemedicine in the scores of perceived severity (P < 0.0001), perceived benefits (P = 0.001), cues to action (P = 0.02), and mean exercise time (P = 0.001). CONCLUSION The results of this study showed that the HBM is a proper model for exercise education in pregnant women. It is recommended to use HBM as a group training and telehealth in promoting the rate of exercise in pregnant women.
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Affiliation(s)
- Zahra Sheibani Matin
- Department of Midwifery, School of Nursing and Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Samira Khayat
- Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ali Navidian
- Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Hamed Fanaei
- Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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23
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Dieberger AM, Desoye G, Stolz E, Hill DJ, Corcoy R, Simmons D, Harreiter J, Kautzky-Willer A, Dunne F, Devlieger R, Wender-Ozegowska E, Zawiejska A, Lapolla A, Dalfra MG, Bertolotto A, Galjaard S, Adelantado JM, Jensen DM, Andersen LL, Tanvig M, Damm P, Mathiesen ER, Snoek FJ, Jelsma JGM, van Poppel MNM. Less sedentary time is associated with a more favourable glucose-insulin axis in obese pregnant women-a secondary analysis of the DALI study. Int J Obes (Lond) 2020; 45:296-307. [PMID: 32661292 PMCID: PMC7840500 DOI: 10.1038/s41366-020-0639-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 07/03/2020] [Indexed: 12/29/2022]
Abstract
Background/objectives Obese pregnant women are at high risk of developing gestational diabetes mellitus (GDM), which might be reduced by sufficient physical activity (PA) and reduced sedentary time (ST). We assessed whether PA and ST are longitudinally associated with the glucose-insulin axis in obese pregnant women. Subjects/methods In this secondary analysis of the DALI (vitamin D And Lifestyle Intervention for gestational diabetes mellitus prevention) study, pregnant women, <20 weeks gestation, with a pre-pregnancy body mass index (BMI) ≥ 29 kg/m2, without GDM on entry were included. Time spent in moderate-to-vigorous PA (MVPA) and ST were measured objectively with accelerometers at <20 weeks, 24–28 weeks and 35–37 weeks of gestation. Fasting glucose (mmol/l) and insulin (mU/l), insulin resistance (HOMA-IR) and first-phase and second-phase insulin release (Stumvoll first and second phase) were assessed at the same time. Linear mixed regression models were used to calculate between-participant differences and within-participant changes over time. Analyses were adjusted for gestational age, randomisation, pre-pregnancy BMI, education and age. MVPA, Insulin, HOMA-IR and Stumvoll first and second phase were log-transformed for analyses due to skewness. Results 232 women were included in the analysis. Concerning differences between participants, more ST was associated with higher fasting glucose (Estimate: 0.008; 95% CI: 0.002, 0.014), fasting insulin (0.011; 0.002, 0.019), HOMA-IR (0.012; 0.004, 0.021) and Stumvoll first and second phase (0.008; 0.001, 0.014 and 0.007; 0.001, 0.014). Participants with more MVPA had lower Stumvoll first and second phase (−0.137; −0.210, −0.064 and −0.133; −0.202, −0.063). Concerning changes over time, an increase in ST during gestation was associated with elevated Stumvoll first and second phase (0.006; 0.000, 0.011). Conclusions As the glucose-insulin axis is more strongly associated with ST than MVPA in our obese population, pregnant women could be advised to reduce ST in addition to increasing MVPA. Moreover, our findings suggest that behaviour change interventions aiming at GDM risk reduction should start in early or pre-pregnancy.
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Affiliation(s)
- Anna M Dieberger
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria.
| | - Gernot Desoye
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Erwin Stolz
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
| | - David J Hill
- Recherche en Santé Lawson SA, Bronschhofen, Switzerland.,Lawson Health Research Institute, London, ON, N6C 2R5, Canada
| | - Rosa Corcoy
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain.,CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Madrid, Spain
| | - David Simmons
- Macarthur Clinical School, Western Sydney University, Sydney, Australia
| | - Jürgen Harreiter
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Fidelma Dunne
- Galway Diabetes Research Centre and College of Medicine Nursing and Health Sciences, National University of Ireland, Galway, Ireland
| | - Roland Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium
| | | | - Agnieszka Zawiejska
- Division of Reproduction, Poznan University of Medical Sciences, Poznan, Poland
| | | | | | | | - Sander Galjaard
- Department of Obstetrics and Gynaecology, Division of Obstetrics and Prenatal Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Juan M Adelantado
- Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Dorte Møller Jensen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.,Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Lise-Lotte Andersen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.,Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Mette Tanvig
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.,Department of Gynaecology and Obstetrics, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth Reinhardt Mathiesen
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Frank J Snoek
- Department of Medical Psychology, Amsterdam University Medical Centres, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - Judith G M Jelsma
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Weng SS, Lee YH, Chien LY. Physical activity, sitting time and sleep duration before and during pregnancy and pregnancy outcomes: A prospective panel study. J Clin Nurs 2020; 29:3494-3505. [PMID: 32567140 DOI: 10.1111/jocn.15388] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 04/25/2020] [Accepted: 06/05/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To examine how changes in physical activity, sitting time and sleep duration through pre-, mid- and late pregnancy are in association with Caesarean section, medically indicated Caesarean section and small for gestational age. BACKGROUND While circadian activities could change throughout pregnancy, studies exploring the effect of change in those activities on pregnancy outcomes remain limited. DESIGN This study applied a prospective panel design. METHODS A self-reported questionnaire was used to assess the three activities before and during pregnancy and was administered three times from August 2015-July 2017. Multiple logistic regression models were used. The analysis included 488, 477 and 455 participants in the models for Caesarean section, medically indicated Caesarean section and small for gestational age, respectively. This study followed the STROBE guidelines. RESULTS The mean age of participants was 32.18 years, and more than half (54.90%) were primiparous. Sleep duration of >8 hr/day before pregnancy and experiencing a decrease in mid-pregnancy was a risk factor for Caesarean section and medically indicated Caesarean section. Sitting ≥8 hr/weekday in pre-, mid- and late pregnancy had a protective effect for Caesarean section and medically indicated Caesarean section. Sitting <8 hr in mid-pregnancy and experiencing a decrease in late pregnancy was a risk factor for small-for-gestational-age infants. Physical activity was not significantly related to pregnancy outcomes. CONCLUSION Sleep duration of 7-8 hr and sitting time of more than 8 hr/day seem beneficial for women both before and during pregnancy. RELEVANCE TO CLINICAL PRACTICE Health professionals could assess pregnant women or those intending to become pregnant regarding their sleep and sitting behaviour and provide relevant interventions.
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Affiliation(s)
- Shiue-Shan Weng
- School of Nursing, Institute of Community Health Care, National Yang-Ming University, Taipei, Taiwan.,Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Yu-Hsiang Lee
- Department of Obstetrics and Gynecology, Taipei Tzu Chi Hospital, Taipei, Taiwan
| | - Li-Yin Chien
- School of Nursing, Institute of Community Health Care, National Yang-Ming University, Taipei, Taiwan
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Validity of self-reported and objectively measured sedentary behavior in pregnancy. BMC Pregnancy Childbirth 2020; 20:99. [PMID: 32046663 PMCID: PMC7014698 DOI: 10.1186/s12884-020-2771-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 01/27/2020] [Indexed: 11/15/2022] Open
Abstract
Background Sedentary behavior (SED) is a potential risk factor for poor pregnancy outcomes. We evaluated the validity of several common and one new method to assess SED across three trimesters of pregnancy. Methods This cohort study of pregnant women measured objective and self-reported SED each trimester via thigh-worn activPAL3 micro (criterion), waist-worn Actigraph GT3X, and self-report from the Pregnancy Physical Activity Questionnaire (PPAQ) and the de novo Sedentary Behavior Two Domain Questionnaire (SB2D). SED (hours per day) and percent time in SED (SED%) from activPAL were compared to GT3X, SB2D, and PPAQ using Pearson’s r, ICC, Bland-Altman analysis, and comparison of criterion SED and SED% across tertiles of alternative methods. Results Fifty-eight women (mean age 31.5 ± 4.8 years; pre-pregnancy BMI 25.1 ± 5.6 kg/m2; 76% white) provided three trimesters of valid activPAL data. Compared to activPAL, GT3X had agreement ranging from r = 0.54–0.66 and ICC = 0.52–0.65. Bland-Altman plots revealed small mean differences and unpatterned errors, but wide limits of agreement (greater than ±2 h and ± 15%). The SB2D and PPAQ had r < 0.5 and ICC < 0.3 vs. activPAL SED, with lower agreement during the 2nd and 3rd trimesters, and performed poorly in Bland-Altman analyses. SED% from the modified SB2D performed best of the self-reported instruments with modest mean differences, r ranging from 0.55 to 0.60, and ICCs from 0.31–0.33; though, limits of agreement were greater than ±35%. Significant trends in activPAL SED were observed across increasing tertiles of SB2D SED in the 1st and 3rd trimesters (both p ≤ 0.001), but not the 2nd trimester (p = 0.425); and for PPAQ SED in the 1st and 2nd trimesters (both p < 0.05), but not the 3rd trimester (p = 0.158). AcitvPAL SED and SED% increased significantly across tertiles of GT3X SED and SED% as well as SB2D SED% (all p-for-trend ≤ 0.001). Conclusions Compared to activPAL, waist-worn GT3X produced moderate agreement, though similar mean estimates of SED across pregnancy. Self-report questionnaires had large absolute error and wide limits of agreement for SED hr./day; SB2D measurement of SED% was the best self-report method. These data suggest activPAL be used to measure SED when possible, followed by GT3X, and – when necessary – SB2D assessing SED% in pregnancy. Trial registration www.clinicaltrials.govNCT03084302 on 3/20/2017.
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Sinclair I, St-Pierre M, Elgbeili G, Bernard P, Vaillancourt C, Gagnon S, Dancause KN. Psychosocial Stress, Sedentary Behavior, and Physical Activity during Pregnancy among Canadian Women: Relationships in a Diverse Cohort and a Nationwide Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E5150. [PMID: 31861085 PMCID: PMC6950602 DOI: 10.3390/ijerph16245150] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/06/2019] [Accepted: 12/13/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Past research shows that psychosocial stress and distress predict sedentary behavior and physical activity, but few studies focus on pregnant women. Our objective was to analyze relationships between psychosocial stress and distress with sedentary behavior and physical activity among pregnant women in Canada. METHODS We analyzed objectively-measured sedentary behavior and physical activity at 16-18, 24-26, and 32-24 weeks pregnancy in a sociodemographically diverse cohort of 70 women in Montreal, Canada. Participants completed the Perceived Stress Questionnaire and wore an accelerometer for 3 days that quantified sitting time and steps per day. We used univariate general linear models to analyze relationships between perceived stress with sedentary behavior and physical activity at each evaluation. To assess generalizability, we analyzed relationships between psychological distress with self-reported leisure-time sedentary behavior and daily energy expenditure in transportation and leisure physical activities among a sample representative of 166,095 women in the Canadian Community Health Survey. RESULTS In the Montreal cohort, we observed a positive association between perceived stress and sitting time, with small to moderate effect sizes (partial η2 = 0.08-0.16). We observed negative relationships between perceived stress and steps per day at the first two evaluations only, with small to moderate effect sizes (partial η2 = 0.08-0.11). Relationships for sedentary behavior were similar in the nationwide sample, but with smaller effect sizes (partial η2 = 0.02). There were no relationships between distress and physical activity in the nationwide sample. CONCLUSION Psychosocial stress represents one risk factor for sedentarity, with relationships evident throughout pregnancy and at the population level. Relationships with physical activity are less consistent, but stress might represent a risk factor for low physical activity in early to mid-pregnancy. Results might guide the development of more comprehensive interventions targeting stress, sedentarity, and physical activity. In particular, integrating psychosocial health into interventions to reduce sedentarity, and including concrete guidelines on sedentary behavior in psychosocial health interventions, might be prioritized.
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Affiliation(s)
- Isabelle Sinclair
- Département des sciences de l’activité physique, Université du Québec à Montréal (UQAM), Montreal, QC H2X 1Y4, Canada (P.B.)
- Réseau intersectoriel de recherche en santé de l’Université du Québec (RISUQ), Laval, QC H7V 1B7, Canada;
| | - Myriane St-Pierre
- Département des sciences de l’activité physique, Université du Québec à Montréal (UQAM), Montreal, QC H2X 1Y4, Canada (P.B.)
| | - Guillaume Elgbeili
- Douglas Hospital Research Center, Psychosocial Research Division, Montreal, QC H4H 1R3, Canada;
| | - Paquito Bernard
- Département des sciences de l’activité physique, Université du Québec à Montréal (UQAM), Montreal, QC H2X 1Y4, Canada (P.B.)
- Research Center, University Institute of Mental Health at Montreal, Montreal, QC H1N 3V2, Canada
| | - Cathy Vaillancourt
- Réseau intersectoriel de recherche en santé de l’Université du Québec (RISUQ), Laval, QC H7V 1B7, Canada;
- INRS Centre Armand-Frappier Santé Biotechnologie, Laval, QC H7V 1B7, Canada
| | - Sonia Gagnon
- Département d’obstétrique-gynécologie, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, QC H4J 1C5, Canada;
| | - Kelsey Needham Dancause
- Département des sciences de l’activité physique, Université du Québec à Montréal (UQAM), Montreal, QC H2X 1Y4, Canada (P.B.)
- Réseau intersectoriel de recherche en santé de l’Université du Québec (RISUQ), Laval, QC H7V 1B7, Canada;
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REYES LAURAM, FAROOQ SAULEHAM, SKOW RACHELJ, BUSCH STEPHENA, PYKE KYRAE, KHURANA RSHMI, CHARI RADHAS, STICKLAND MICHAELK, DEVOLIN MAUREEN, DAVIDGE SANDRAT, SOBIERAJSKI FRANCES, LUGG ANNA, STEINBACK CRAIGD, DAVENPORT MARGIEH. Physical Activity in Pregnancy Is Associated with Increased Flow-mediated Dilation. Med Sci Sports Exerc 2019; 52:801-809. [DOI: 10.1249/mss.0000000000002201] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Oviedo-Caro MÁ, Bueno-Antequera J, Munguía-Izquierdo D. Associations of 24-hours activity composition with adiposity and cardiorespiratory fitness: The PregnActive project. Scand J Med Sci Sports 2019; 30:295-302. [PMID: 31593623 DOI: 10.1111/sms.13566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 09/17/2019] [Accepted: 09/30/2019] [Indexed: 01/20/2023]
Abstract
AIM This study examined the associations of activity behaviors composition (sleep, sedentary time, light and moderate-to-vigorous physical activity) with adiposity and cardiorespiratory fitness, and how isotemporal reallocations of time between activity behaviors are associated with differences in adiposity and cardiorespiratory fitness. METHODS A cross-sectional study was conducted in 130 women during midpregnancy. Activity behaviors, conceptualized as a 24-hours composition, were objectively assessed by multi-sensor monitors. Skinfold thickness, fat mass index, and body mass index were calculated as indicators of adiposity. Cardiorespiratory fitness was assessed using a 6-minute walk test. Log-ratio multiple linear regression models and compositional isotemporal substitutions were used to analyze the associations and estimated differences in outcomes. RESULTS The activity composition was significantly associated with adiposity indicators (all P < .001) and cardiorespiratory fitness (P values from .025 to <.001) during midpregnancy. The isotemporal substitutions were asymmetrical, showing the highest estimated differences in adiposity (8.7%, 0.80 kg/m2 , for fat mass index; 6.0%, 2.65 mm, for the sum of skinfold thickness; and 3.8%, 1.02 kg/m2 , for body mass index) and cardiorespiratory fitness (3.0%, 1.00 mL/kg min) when 30 minutes of moderate-to-vigorous physical activity was reallocated by sedentary time. CONCLUSION The activity composition was associated with adiposity and the cardiorespiratory fitness levels during midpregnancy, with moderate-to-vigorous physical activity being the leading activity behavior. The most unfavorable differences in adiposity and cardiorespiratory fitness were found when moderate-to-vigorous physical activity was replaced by another behavior, mainly sedentary time, reinforcing the importance of at least maintaining moderate-to-vigorous physical activity during pregnancy.
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Affiliation(s)
- Miguel Ángel Oviedo-Caro
- Department of Sports and Computer Science, Faculty of Sports Sciences, Physical Performance & Sports Research Center, Section of Physical Education and Sports, University Pablo de Olavide, Seville, Spain.,Research Group in Development MovimientoHumano, Universidad de Zaragoza, Seville, Spain
| | - Javier Bueno-Antequera
- Department of Sports and Computer Science, Faculty of Sports Sciences, Physical Performance & Sports Research Center, Section of Physical Education and Sports, University Pablo de Olavide, Seville, Spain.,Research Group in Development MovimientoHumano, Universidad de Zaragoza, Seville, Spain
| | - Diego Munguía-Izquierdo
- Department of Sports and Computer Science, Faculty of Sports Sciences, Physical Performance & Sports Research Center, Section of Physical Education and Sports, University Pablo de Olavide, Seville, Spain.,Research Group in Development MovimientoHumano, Universidad de Zaragoza, Seville, Spain.,Biomedical Research Networking Center on Frailty and Healthy Aging, Madrid, Spain
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Most J, Dervis S, Haman F, Adamo KB, Redman LM. Energy Intake Requirements in Pregnancy. Nutrients 2019; 11:nu11081812. [PMID: 31390778 PMCID: PMC6723706 DOI: 10.3390/nu11081812] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/02/2019] [Accepted: 04/08/2019] [Indexed: 12/21/2022] Open
Abstract
Energy intake requirements in pregnancy match the demands of resting metabolism, physical activity, and tissue growth. Energy balance in pregnancy is, therefore, defined as energy intake equal to energy expenditure plus energy storage. A detailed understanding of these components and their changes throughout gestation can inform energy intake recommendations for minimizing the risk of poor pregnancy outcomes. Energy expenditure is the sum of resting and physical activity-related expenditure. Resting metabolic rate increases during pregnancy as a result of increased body mass, pregnancy-associated physiological changes, i.e., cardiac output, and the growing fetus. Physical activity is extremely variable between women and may change over the course of pregnancy. The requirement for energy storage depends on maternal pregravid body size. For optimal pregnancy outcomes, women with low body weight require more fat mass accumulation than women with obesity, who do not require to accumulate fat mass at all. Given the high energy density of fat mass, these differences affect energy intake requirements for a healthy pregnancy greatly. In contrast, the energy stored in fetal and placental tissues is comparable between all women and have small impact on energy requirements. Different prediction equations have been developed to quantify energy intake requirements and we provide a brief review of the strengths and weaknesses and discuss their application for healthy management of weight gain in pregnant women.
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Affiliation(s)
- Jasper Most
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Sheila Dervis
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Francois Haman
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Kristi B Adamo
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Leanne M Redman
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA.
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van der Waerden J, Nakamura A, Pryor L, Charles MA, El-Khoury F, Dargent-Molina P. Domain-specific physical activity and sedentary behavior during pregnancy and postpartum depression risk in the French EDEN and ELFE cohorts. Prev Med 2019; 121:33-39. [PMID: 30763624 DOI: 10.1016/j.ypmed.2019.02.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 01/05/2019] [Accepted: 02/08/2019] [Indexed: 11/19/2022]
Abstract
The potential beneficial effects of physical activity during pregnancy on postpartum depressive symptoms (PPD) remain inconclusive. Using data from two prospective French birth cohorts, we aimed to examine the relationship between domain-specific physical activity (including leisure-time sedentary behavior) in pregnancy and the occurrence of PPD. Participants of the ELFE cohort (n = 15,538) completed the Pregnancy Physical Activity Questionnaire (PPAQ), which assesses the following physical activity/sedentary behavior domains: household/caregiving, occupational, sports/exercise, transportation and leisure-time sedentary behavior during the third pregnancy trimester. In the EDEN cohort (n = 1745) women completed the Baecke Questionnaire (BQ) measuring occupational, sports/exercise, and leisure-time activity during the first trimester of pregnancy. Depressive symptoms in the first postpartum year were measured using the Edinburgh Postnatal Depression Scale in both cohorts. Associations of physical activity/sedentary behavior with PPD symptoms were determined by logistic regression analysis, with adjustment on potential confounding factors. In the adjusted models, higher levels of household/caregiving activities (OR = 1.10 (95% CI 1.01-1.19)) and leisure-time sedentary behavior (OR = 1.16 (95% CI 1.06-1.23)), in the third pregnancy trimester were associated with an increased odds of PPD. No significant associations were found for physical activity domains during the first pregnancy trimester. Higher levels of household and caregiving activities and leisure-time sedentary behavior in the last trimester of pregnancy appear to increase the likelihood of postpartum depression. Purpose and context should be taken into account when encouraging physical activity as a strategy to help prevent postpartum mental health problems from pregnancy onwards. Reducing sedentary behavior could be a complementary strategy.
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Affiliation(s)
- Judith van der Waerden
- INSERM, Sorbonne Université, Institut Pierre Louis d'épidémiologie et de Santé Publique, IPLESP UMR-S1136, F75012 Paris, France.
| | - Aurelie Nakamura
- INSERM, Sorbonne Université, Institut Pierre Louis d'épidémiologie et de Santé Publique, IPLESP UMR-S1136, F75012 Paris, France
| | - Laura Pryor
- INSERM, Sorbonne Université, Institut Pierre Louis d'épidémiologie et de Santé Publique, IPLESP UMR-S1136, F75012 Paris, France; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Marie-Aline Charles
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Developmental Origins of Health and disease (ORCHAD) Team, Villejuif F-94807, France; Paris Descartes University, France; INED-INSERM-EFS joint unit Elfe, France
| | - Fabienne El-Khoury
- INSERM, Sorbonne Université, Institut Pierre Louis d'épidémiologie et de Santé Publique, IPLESP UMR-S1136, F75012 Paris, France
| | - Patricia Dargent-Molina
- INSERM, UMR1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Developmental Origins of Health and disease (ORCHAD) Team, Villejuif F-94807, France; Paris Descartes University, France
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31
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Buckingham-Schutt LM, Ellingson LD, Vazou S, Campbell CG. The Behavioral Wellness in Pregnancy study: a randomized controlled trial of a multi-component intervention to promote appropriate weight gain. Am J Clin Nutr 2019; 109:1071-1079. [PMID: 30949691 DOI: 10.1093/ajcn/nqy359] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 11/20/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adequate weight gain during pregnancy is important to both maternal and fetal outcomes. To date, randomized controlled trials have not been effective at increasing the proportion of women meeting gestational weight-gain guidelines. OBJECTIVES The aim of this study was to determine whether a multi-component behavioral intervention with a Registered Dietitian Nutritionist significantly improves the proportion of women who adhere to the 2009 Institute of Medicine weight-gain guidelines. METHODS Participants were randomly assigned to usual care (UC; n = 24) or intervention (n = 23) between 8 and 14 weeks of gestation. The intervention included a minimum of 6 one-on-one counseling sessions over ∼30 wk focusing on healthy diet and physical activity (PA) goals. In addition to the face-to-face visits, weekly communication via email supported healthy eating, PA, and appropriate weight gain. Gestational weight gain, PA, and diet were assessed at 8-14, 26-28, and 34-36 weeks of gestation; weight retention was measured 2 mo postpartum. RESULTS The proportion of women meeting the guidelines was significantly greater in those receiving the intervention than UC (60.8% compared with 25.0%, OR: 4.7; 95% CI: 1.3, 16.2; P = 0.019). Furthermore, 36.4% of the intervention women were at or below their prepregnancy weight at 2 mo postpartum compared with 12.5% in the UC group (P = 0.05). CONCLUSIONS A multi-component behavioral intervention improved adherence to the 2009 Institute of Medicine weight-gain guidelines. This trial was registered with clinicaltrials.gov as NCT02168647.
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Oviedo-Caro MÁ, Bueno-Antequera J, Munguía-Izquierdo D. Measuring Sedentary Behavior During Pregnancy: Comparison Between Self-reported and Objective Measures. Matern Child Health J 2019; 22:968-977. [PMID: 29427017 DOI: 10.1007/s10995-018-2473-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objectives To quantify and compare the sedentary time estimated by the Sedentary Behavior Questionnaire (SBQ) and the sedentary time objectively measured by a multi-sensor monitor (SWA) in pregnant women. Methods One hundred eighty-six participants answered the SBQ and wore the SWA at least 7 valid days. The concordance, correlation, agreement and relative activity levels between both measures of sedentary time were examined. Differences of sedentary time between weekday and weekend and between groups stratified by sociodemographic and clinical characteristic were evaluated by one-way analysis of variance. Results Pregnant women were sedentary the 64% of their waking hours. Television viewing is the most prevalent sedentary behavior. The concordance, correlation, and agreement between SBQ and SWA were weak, yet a significant correlation in weekday and average day sedentary time (r = 0.23 and 0.20, P = 0.001 and 0.008, respectively) was observed. A significant linear trend was found for increasing sedentary time between both methods using a relative activity levels analysis. Conclusions for Practice Pregnant women experience high amount of sedentary time, for approximately half of the day. The SBQ shows a low validity and agreement, but strong ability to rank individuals compared with SWA in pregnant women.
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Affiliation(s)
- Miguel Ángel Oviedo-Caro
- Section of Physical Education and Sports, Department of Sports and Computer Science, University Pablo de Olavide, 41013, Seville, Spain
| | - Javier Bueno-Antequera
- Section of Physical Education and Sports, Department of Sports and Computer Science, University Pablo de Olavide, 41013, Seville, Spain
| | - Diego Munguía-Izquierdo
- Section of Physical Education and Sports, Department of Sports and Computer Science, University Pablo de Olavide, 41013, Seville, Spain.
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Di Biase N, Balducci S, Lencioni C, Bertolotto A, Tumminia A, Dodesini AR, Pintaudi B, Marcone T, Vitacolonna E, Napoli A. Review of general suggestions on physical activity to prevent and treat gestational and pre-existing diabetes during pregnancy and in postpartum. Nutr Metab Cardiovasc Dis 2019; 29:115-126. [PMID: 30642790 DOI: 10.1016/j.numecd.2018.10.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 10/21/2018] [Accepted: 10/27/2018] [Indexed: 12/16/2022]
Abstract
The aim of this review is to provide general suggestions on physical activity (PA) in pre-gestational and gestational diabetes mellitus (GDM) and encourage women to take part in safe and effective activities throughout pregnancy, in the absence of other contraindications. PA before and during pregnancy and in postpartum has many positive effects on the mother, as it could reduce the risk of GDM, excessive weight gain and lower back pain and also prevents, in the postpartum, diabetes mellitus. It may also reduce the duration of labour and complications at childbirth, fatigue, stress, anxiety and depression, thereby leading to an improved sense of wellbeing. Clinically, it is thought to help prevent preeclampsia and premature birth even though RCTs provide conflicting evidence with regard to the prevention of GDM. The main reason for this rests on the fact that the majority of clinical trials have not been able to replicate the preventive effect of PA on the onset of GDM, such as the different adherence of the patient to PA. Herein, we survey the literature regarding exercise and PA on GDM prevention and treatment as well as on clinical outcomes in pre-GDM in pregnancy. On the basis of the current literature, we also present a series of general recommendations and suggestions on PA and exercise training in pregnancy among both diabetic patients and those at risk for GDM.
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Affiliation(s)
| | - S Balducci
- Metabolic Fitness Association, Monterotondo, Rome, Italy; Department of Clinical and Molecular Medicine, "La Sapienza" University, Rome, Italy
| | - C Lencioni
- Diabetes Unit, USL Toscana Nord Ovest, Lucca, Italy
| | - A Bertolotto
- Diabetes and Metabolic Disease Section, Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - A Tumminia
- Department of Clinical and Experimental Medicine, Endocrinology Section, University of Catania, Garibaldi-Nesima Hospital, Catania, Italy
| | - A R Dodesini
- U.S.C. Malattie endocrine, Diabetologia ASST Papa Giovanni XXIII, Bergamo, Italy
| | - B Pintaudi
- Diabetes Unit, ASST Niguarda Ca Granda Hospital, Milan, Italy
| | - T Marcone
- SSD Diabetology, University Hospital OORR Foggia, Foggia, Italy
| | - E Vitacolonna
- Department of Medicine and Aging, School of Medicine and Health Sciences, "G. D'Annunzio" University, Chieti-Pescara, Chieti, Italy
| | - A Napoli
- Department of Clinical and Molecular Medicine, "La Sapienza" University, Rome, Italy
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34
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Watson ED, Brage S, White T, Westgate K, Norris SA, Van Poppel MNM, Micklesfield LK. The Influence of Objectively Measured Physical Activity During Pregnancy on Maternal and Birth Outcomes in Urban Black South African Women. Matern Child Health J 2019. [PMID: 29516229 PMCID: PMC6060755 DOI: 10.1007/s10995-018-2504-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objectives Research indicates the beneficial effects of physical activity during pregnancy on maternal health, although controversy still exists regarding its influence on birth outcomes. Little research has been done to objectively measure physical activity during pregnancy in black African women from low-to-middle income countries. The purpose of this study was to examine the association between physical activity and maternal and birth outcomes in this unique population. Methods This observational, longitudinal study assessed total physical activity using a hip-mounted triaxial accelerometer at 14–18 weeks (second trimester, n = 120) and 29–33 weeks (third trimester, n = 90) gestation. Physical activity is expressed as gravity-based acceleration units (mg). Maternal outcomes included both weight and weight gain at 29–33 weeks gestation. Birth outcomes included gestational age, birth weight, ponderal index and Apgar score, measured within 48 h of delivery. Results There was a significant decline in physical activity from the second to the third trimester (12.8 ± 4.1 mg vs. 9.7 ± 3.6 mg, p ≤ 0.01). Physical activity at 29–33 weeks as well as a change in PA was inversely associated with weight change at 29–33 weeks (β = − 0.24; 95% CI − 0.49; − 0.00; p = 0.05 and β = − 0.36; 95% CI − 0.62; − 0.10; p = 0.01, respectively). No significant associations were found between physical activity and birth outcomes. Conclusions for Practice Physical activity during pregnancy may be an effective method to control gestational weight gain, whilst presenting no adverse risk for fetal development, in women from a low-income urban setting.
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Affiliation(s)
- Estelle D Watson
- Centre for Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Physical Education Building, WITS Education Campus, 27 St Andrews Rd, Parktown, Johannesburg, 2194, South Africa. .,MRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Private Bag X3, Wits, Johannesburg, 2050, South Africa.
| | - Søren Brage
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Box 285, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Tom White
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Box 285, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Kate Westgate
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Box 285, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Shane A Norris
- MRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Private Bag X3, Wits, Johannesburg, 2050, South Africa
| | - Mireille N M Van Poppel
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria.,Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Lisa K Micklesfield
- MRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Private Bag X3, Wits, Johannesburg, 2050, South Africa
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Brekke I, Richardsen KR, Jenum AK. Sickness absence in pregnancy and sedentary behavior: a population-based cohort study from Norway. BMC Public Health 2019; 19:71. [PMID: 30651106 PMCID: PMC6334424 DOI: 10.1186/s12889-018-6379-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 12/27/2018] [Indexed: 11/21/2022] Open
Abstract
Background Sickness absence in pregnancy accounts for a large part of sickness-related absenteeism among women. Exercise in pregnancy is associated with a lower level of sickness absence, however little is known about how sedentary behaviour is related to sickness absence in pregnancy. In the current study, we hypothesize a positive association between sedentary hours/day and the risk of long-term sickness absence. Methods Population-based cohort study of pregnant women attending three Child Health Clinics in Groruddalen, Oslo, 823 Women (74% of those eligible) were included between 2008 and 2010. Questionnaire data were collected at gestational weeks 10–20 (visit 1) and 28 (visit 2). Sedentary time and physical activity were objectively recorded at visit 1 with the multi-sensor SenseWear™ Pro3 Armband (SWA). Long-term sickness absence was self-reported at visit 2. We explored the association between sedentary time and long-term sickness absence in pregnancy using multiple logistic regression analysis. Results The odds of long-term sickness absence was significantly increased per one-hour increase in daily sedentary time (odds ratio 1.45 [95% confidence interval 1.13–1.84]), providing support for our hypothesis that sedentary time is positively associated with long-term sickness absence. Conclusions Pregnant women with a sedentary lifestyle have a higher risk of long-term sickness absence from work. Reducing sedentary time in pregnancy may improve health, and may, in turn reduce sickness absence in pregnancy.
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Affiliation(s)
- Idunn Brekke
- Centre for Welfare and Labour Research - Norwegian Social Research, OsloMet - Oslo Metropolitan University, Post box 4 St. Olavs plass, N-0130, Oslo, Norway. .,Faculty of Health Sciences - Department of Nursing and Health promotion, OsloMet - Oslo Metropolitan University, Post box 4 St. Olavs plass, N-0130, Oslo, Norway.
| | - Kåre Rønn Richardsen
- Faculty of Health Sciences - Department of Physiotherapy, OsloMet - Oslo Metropolitan University, Post box 4 St. Olavs plass, N-0130, Oslo, Norway
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, University of Oslo, Institute of Health and Society, Post Box 1130 Blindern, 0318, Oslo, Norway
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Badon SE, Littman AJ, Chan KCG, Williams MA, Enquobahrie DA. Maternal sedentary behavior during pre-pregnancy and early pregnancy and mean offspring birth size: a cohort study. BMC Pregnancy Childbirth 2018; 18:267. [PMID: 29945548 PMCID: PMC6020429 DOI: 10.1186/s12884-018-1902-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 06/18/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Sedentary behavior is associated with adverse health outcomes in the general population. Whether sedentary behavior during pregnancy is associated with newborn outcomes, such as birth size, is not established, and previous studies have been inconsistent. While previous research suggests that male and female fetuses respond differently to maternal behaviors, such as physical activity, the role of infant sex in sedentary behavior-birth size associations has not been examined. METHODS Participants in the Omega study, a cohort in Washington State (1996-2008), reported leisure time sedentary behavior (non-work time spent sitting), light intensity physical activity, and moderate/vigorous leisure time physical activity duration in the year before pregnancy (N = 1373) and in early pregnancy (N = 1535, mean 15 weeks). Offspring birth size was abstracted from delivery records. Non-parametric calibration weighting was used to assign adjustment weight (matching the distribution of sociodemographic and medical characteristics of the full cohort (N = 4128)) to participants with available sedentary behavior data. Weighted linear regression models were used to estimate mean differences in offspring birthweight, head circumference, and ponderal index (birthweight/length3) associated with leisure time sedentary behavior. Regression models were run overall and stratified by offspring sex. Isotemporal substitution modeling was used to determine mean differences in birthweight associated with replacing sedentary behavior with light or moderate/vigorous physical activity. RESULTS On average, women spent 2.3 and 2.6 h/day in leisure time sedentary behavior during pre- and early pregnancy, respectively. There were no associations of pre-pregnancy leisure time sedentary behavior with mean birthweight, head circumference, or ponderal index (adjusted β = - 12, 95% CI: -28, 4.1; β = 0.0, 95% CI: -0.04, 0.1; and β = 0.1, 95% CI: -0.2, 0.4, respectively). Early pregnancy sedentary behavior was not associated with mean birth size. Associations of sedentary behavior with mean birth size did not differ by offspring sex. Replacing sedentary time with light or moderate/vigorous physical activity was not associated with mean birthweight. CONCLUSIONS We did not observe associations of maternal sedentary behavior during pre- or early pregnancy with mean offspring birth size. Pre-pregnancy and early pregnancy sedentary behavior may have important adverse effects on maternal health, but our results do not support associations with mean offspring birth size.
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Affiliation(s)
- Sylvia E. Badon
- Department of Epidemiology, University of Washington, Box 357236, Health Sciences Building, 1959 NE Pacific Street, Seattle, WA 98195-7236 USA
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 USA
| | - Alyson J. Littman
- Department of Epidemiology, University of Washington, Box 357236, Health Sciences Building, 1959 NE Pacific Street, Seattle, WA 98195-7236 USA
- Seattle Epidemiologic Research and Information Center, Box 358280, VA Puget Sound, 1660 S Columbian Way, Seattle, WA 98108 USA
| | - K. C. Gary Chan
- Department of Biostatistics, University of Washington, Box 357232, Health Sciences Building, 1705 NE Pacific Street, Seattle, WA 98195-7232 USA
| | - Michelle A. Williams
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Kresge Building, 677 Huntington Avenue, Boston, MA 02115 USA
| | - Daniel A. Enquobahrie
- Department of Epidemiology, University of Washington, Box 357236, Health Sciences Building, 1959 NE Pacific Street, Seattle, WA 98195-7236 USA
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Leisure-Time Physical Activity in Pregnancy and Maternal-Child Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Cohort Studies. Sports Med 2018; 47:295-317. [PMID: 27282925 DOI: 10.1007/s40279-016-0565-2] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Evidence suggests that leisure-time physical activity (LTPA) during pregnancy is associated with a reduced risk of preeclampsia, gestational diabetes mellitus (GDM), and preterm birth. However, these results are inconsistent when comparing cohort studies and randomized controlled trials (RCTs). OBJECTIVE The purpose of our study was to compare the associations between LTPA in pregnancy and maternal (GDM, preeclampsia, and weight gain during pregnancy) and child health outcomes (preterm birth, birthweight, and fetal growth) between RCTs and cohort studies. METHODS We performed a systematic search in PubMed, Web of Science, and EBSCO up to 31 August 2015. Inclusion criteria for experimental studies required randomized trials with a control group and exposure to a physical activity structured program. The inclusion criteria for cohort studies required information on LTPA during pregnancy as an exposure and at least one maternal-child health outcome. We assessed the methodological quality of all studies and performed a meta-analysis to produce summary estimates of the effects using random models. RESULTS We included 30 RCTs and 51 cohort studies. The meta-analysis of RCTs indicated that participation in LTPA was associated with lower weight gain during pregnancy, lower likelihood of GDM, and lower likelihood of delivering a large-for-gestational-age infant. Cohort studies indicated that participation in LTPA was associated with lower weight gain during pregnancy, lower likelihood of GDM, and lower risk of preterm delivery. CONCLUSIONS Our findings support the promotion of LTPA in pregnancy as a strategy to improve maternal and child health.
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Reasons, Motivational Factors, and Perceived Personal Barriers to Engagement in Physical Activity During Pregnancy Vary Within the BMI Classes: The Prenatal Prevention Project Germany. J Phys Act Health 2017; 15:204-211. [PMID: 28872388 DOI: 10.1123/jpah.2016-0563] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND International data indicate that approximately only 20.0% of pregnant women reach physical activity recommendations (≥150 min/wk). To find ways for increasing physical activity, the reasons for exercising, motivational factors, and barriers need to be determined. The aim of this pilot study was to identify these factors in respect to body mass index classification in German pregnant women. METHODS A total of 61 women [age: 32.7 (4.8) y; 13.3 (3.4) wk of gestation] participated in this study. Before pregnancy, 10.0% of women were underweight, 58.3% were normal weight, 18.3% were overweight, and 13.4% were obese. Standardized questionnaires were used to evaluate the abovementioned factors. RESULTS "Fun" was one of the main reasons for being active in underweight/normal weight compared with overweight/obese women (53.7% vs 10.5%; P = .002), whereas "burning fat" was more important in overweight/obese women (9.8% vs 36.8%; P = .027). According to motivational factors, differences occurred in "calorie burning" (7.3% underweight/normal weight vs 31.6% overweight/obese; P = .025) and "fat burning" (7.3% underweight/normal weight vs 47.4% overweight/obese; P = .001). Regarding barriers for being active, "tiredness" was more often a barrier in overweight/obese (63.2%) compared with normal weight/underweight women (31.7%; P = .022). CONCLUSION Pregnant women should be given tailored advice/motivation according to prepregnancy body mass index. However, larger studies are necessary to evaluate these factors on pregnant women's physical activity level.
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Abstract
Physicians should discuss decreasing sedentary time and behavior with their pregnant patients to assist sedentary women to become more active using light activities. Medical screening before engaging or continuing in a moderate aerobic exercise program is vital to ensure a low-risk pregnancy. The FITT principle is important to use in prescription that suggests: Frequency (3 to 4 times per week), Intensity (appropriate target heart rate zone, rating of perceived exertion scale, or the talk test), Time (start at 15 min progressing to 30 min), and Type (moving large muscles groups such as walking, swimming, and cycling) of physical activity.
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40
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Smith KM, Ziel E. Special Populations: Training the Pregnant Client. Strength Cond J 2017. [DOI: 10.1519/ssc.0000000000000316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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41
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Edwardson CL, Winkler EA, Bodicoat DH, Yates T, Davies MJ, Dunstan DW, Healy GN. Considerations when using the activPAL monitor in field-based research with adult populations. JOURNAL OF SPORT AND HEALTH SCIENCE 2017; 6:162-178. [PMID: 30356601 PMCID: PMC6188993 DOI: 10.1016/j.jshs.2016.02.002] [Citation(s) in RCA: 275] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 10/26/2015] [Accepted: 12/04/2015] [Indexed: 05/28/2023]
Abstract
Research indicates that high levels of sedentary behavior (sitting or lying with low energy expenditure) are adversely associated with health. A key factor in improving our understanding of the impact of sedentary behavior (and patterns of sedentary time accumulation) on health is the use of objective measurement tools that collect date and time-stamped activity information. One such tool is the activPAL monitor. This thigh-worn device uses accelerometer-derived information about thigh position to determine the start and end of each period spent sitting/lying, standing, and stepping, as well as stepping speed, step counts, and postural transitions. The activPAL is increasingly being used within field-based research for its ability to measure sitting/lying via posture. We summarise key issues to consider when using the activPAL in physical activity and sedentary behavior field-based research with adult populations. It is intended that the findings and discussion points be informative for researchers who are currently using activPAL monitors or are intending to use them. Pre-data collection decisions, monitor preparation and distribution, data collection considerations, and manual and automated data processing possibilities are presented using examples from current literature and experiences from 2 research groups from the UK and Australia.
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Affiliation(s)
- Charlotte L. Edwardson
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester LE5 4PW, UK
- NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester LE5 4PW, UK
| | - Elisabeth A.H. Winkler
- School of Population Health, The University of Queensland, Brisbane, QLD 4006, Australia
| | - Danielle H. Bodicoat
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester LE5 4PW, UK
- NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester LE5 4PW, UK
| | - Tom Yates
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester LE5 4PW, UK
- NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester LE5 4PW, UK
| | - Melanie J. Davies
- Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester LE5 4PW, UK
- NIHR Leicester-Loughborough Diet, Lifestyle, and Physical Activity Biomedical Research Unit, Leicester LE5 4PW, UK
| | - David W. Dunstan
- School of Population Health, The University of Queensland, Brisbane, QLD 4006, Australia
- Baker IDI Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
- School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC 3125, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, WA 6009, Australia
- Central Clinical School, Monash University, Melbourne, VIC 3800, Australia
| | - Genevieve N. Healy
- School of Population Health, The University of Queensland, Brisbane, QLD 4006, Australia
- Baker IDI Heart and Diabetes Institute, Melbourne, VIC 3004, Australia
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA 6102, Australia
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Fazzi C, Saunders DH, Linton K, Norman JE, Reynolds RM. Sedentary behaviours during pregnancy: a systematic review. Int J Behav Nutr Phys Act 2017; 14:32. [PMID: 28298219 PMCID: PMC5353895 DOI: 10.1186/s12966-017-0485-z] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 03/01/2017] [Indexed: 12/22/2022] Open
Abstract
Background In the general population, at least 50% of time awake is spent in sedentary behaviours. Sedentary behaviours are activities that expend less energy than 1.5 metabolic equivalents, such as sitting. The amount of time spent in sedentary behaviours is a risk factor for diseases such as type 2 diabetes, cardiovascular disease, and death from all causes. Even individuals meeting physical activity guidelines are at a higher risk of premature death and adverse metabolic outcomes if they sit for extended intervals. The associations between sedentary behaviour with type 2 diabetes and with impaired glucose tolerance are stronger for women than for men. It is not known whether sedentary behaviour in pregnancy influences pregnancy outcomes, but if those negative outcomes observed in general adult population also occur in pregnancy, this could have implications for adverse outcomes for mothers and offspring. We aimed to determine the proportion of time spent in sedentary behaviours among pregnant women, and the association of sedentary behaviour with pregnancy outcomes in mothers and offspring. Methods Two researchers independently performed the literature search using 5 different electronic bibliographic databases. Studies were included if sedentary behaviours were assessed during pregnancy. Two reviewers independently assessed the articles for quality and bias, and extracted the relevant information. Results We identified 26 studies meeting the inclusion criteria. Pregnant women spent more than 50% of their time in sedentary behaviours. Increased time in sedentary behaviour was significantly associated with higher levels of C Reactive Protein and LDL Cholesterol, and a larger newborn abdominal circumference. Sedentary behaviours were significantly higher among women who delivered macrosomic infants. Discrepancies were found in associations of sedentary behaviour with gestational weight gain, hypertensive disorders, and birth weight. No consistent associations were found between sedentary behaviour and other variables such as gestational diabetes. There was considerable variability in study design and methods of assessing sedentary behaviour. Conclusions Our review highlights the significant time spent in sedentary behaviour during pregnancy, and that sedentary behaviour may impact on pregnancy outcomes for both mother and child. The considerable heterogeneity in the literature suggests future studies should use robust methodology for quantifying sedentary behaviour. Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0485-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Caterina Fazzi
- Tommy's Centre for Maternal and Fetal Health, MRC/University of Edinburgh, Centre for Reproductive Health, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ, United Kingdom.,Department of Physical Education, Sports and Recreation, Metropolitan University of Educational Sciences, Santiago, Chile
| | - David H Saunders
- Physical Activity for Health Research Centre (PAHRC), Institute for Sport, Physical Education and Health Sciences, University of Edinburgh, Holyrood Road, Edinburgh, EH8 8AQ, United Kingdom
| | - Kathryn Linton
- Metabolic Unit Western General Hospital, Crewe Road South, Edinburgh, EH4 2XE, United Kingdom.,University BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Jane E Norman
- Tommy's Centre for Maternal and Fetal Health, MRC/University of Edinburgh, Centre for Reproductive Health, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ, United Kingdom
| | - Rebecca M Reynolds
- Tommy's Centre for Maternal and Fetal Health, MRC/University of Edinburgh, Centre for Reproductive Health, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ, United Kingdom. .,University BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.
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Coll CDVN, Domingues MR, Hallal PC, da Silva ICM, Bassani DG, Matijasevich A, Barros A, Santos IS, Bertoldi AD. Changes in leisure-time physical activity among Brazilian pregnant women: comparison between two birth cohort studies (2004 - 2015). BMC Public Health 2017; 17:119. [PMID: 28122524 PMCID: PMC5267459 DOI: 10.1186/s12889-017-4036-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 01/13/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Low levels of leisure-time physical activity (LTPA) during pregnancy have been shown in studies conducted worldwide. Surveillance is extremely important to monitor the progress of physical activity patterns over time and set goals for effective interventions to decrease inactivity among pregnant women. The aim of this study was to evaluate time changes in LTPA among Brazilian pregnant women in an 11-year period (2004-2015) by comparing data from two birth cohort studies. METHODS Two population-based birth cohort studies were carried out in the city of Pelotas, southern Brazil, in 2004 and 2015. A total of 4244 and 4271 mothers were interviewed after delivery. Weekly frequency and duration of each session of LTPA in a typical week were reported for the pre-pregnancy period and for each trimester of pregnancy. Trends in both recommended LTPA (≥150 min/week) and any LTPA (regardless of weekly amount) were analysed overtime. Changes were also calculated separately for subgroups of maternal age, schooling, family income, parity, pre-pregnancy body mass index and pre-pregnancy LTPA. RESULTS The proportion of women engaged in recommended levels of LTPA pre-pregnancy increased from 11.2% (95%CI 10.0-12.2) in 2004 to 15.8% (95%CI 14.6-16.9) in 2015. During pregnancy, no changes were observed over the period for the first (10.6 to 10.9%) and second (8.7 to 7.9%) trimesters, whereas there was a decrease from 3.4% (95%CI 2.9-4.0) to 2.4% (95%CI 1.9-2.8) in the last trimester. Major decreases in LTPA in the last trimester were observed among women who were younger, with intermediate to high income, high schooling, primiparous, pre-pregnancy obese and, engaged in LTPA before pregnancy. Changes in any LTPA practice followed the same patterns described for recommended LTPA. CONCLUSIONS Despite the increase in the proportion of women engaged in LTPA before pregnancy between 2004 and 2005, LTPA levels remained stable during the first and second trimesters of pregnancy and declined during the third gestational trimester over the period. Interventions to encourage the maintenance of LTPA practice throughout pregnancy are urgently needed.
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Affiliation(s)
| | | | - Pedro Curi Hallal
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Inácio Crochemore Mohnsam da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Diego Garcia Bassani
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
- Department of Paediatrics and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Alicia Matijasevich
- Department of Preventive Medicine, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Aluísio Barros
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Iná S. Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Craike M, Hill B, Gaskin CJ, Skouteris H. Interventions to improve physical activity during pregnancy: a systematic review on issues of internal and external validity using the RE-AIM framework. BJOG 2016; 124:573-583. [PMID: 27571933 DOI: 10.1111/1471-0528.14276] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2016] [Indexed: 01/28/2023]
Abstract
BACKGROUND Physical activity (PA) during pregnancy has significant health benefits for the mother and her child; however, many women reduce their activity levels during pregnancy and most are not sufficiently active. Given the important health benefits of PA during pregnancy, evidence that supports research translation is vital. OBJECTIVES To determine the extent to which physical activity interventions for pregnant women report on internal and external validity factors using the RE-AIM framework (reach, efficacy/effectiveness, adoption, implementation, and maintenance). SEARCH STRATEGY Ten databases were searched up to 1 June 2015. Eligible published papers and unpublished/grey literature were identified using relevant search terms. SELECTION CRITERIA Studies had to report on physical activity interventions during pregnancy, including measures of physical activity during pregnancy at baseline and at least one point post-intervention. Randomised controlled trials and quasi-experimental studies that had a comparator group were included. DATA COLLECTION AND ANALYSIS Reporting of RE-AIM dimensions were summarised and synthesised across studies. MAIN RESULTS The reach (72.1%) and efficacy/effectiveness (71.8%) dimensions were commonly reported; however, the implementation (28.9%) and adoption (23.2%) dimensions were less commonly reported and no studies reported on maintenance. CONCLUSIONS This review highlights the under-reporting of issues of contextual factors in studies of physical activity during pregnancy. The translation of physical activity interventions during pregnancy could be improved through reporting of representativeness of participants, clearer reporting of outcomes, more detail on the setting and staff who deliver interventions, costing of interventions and the inclusion of process evaluations and qualitative data. TWEETABLE ABSTRACT The systematic review highlights the under-reporting of contextual factors in studies of physical activity during pregnancy.
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Affiliation(s)
- M Craike
- Institute of Sport, Exercise and Active Living (ISEAL), College of Sport and Exercise Science, Victoria University, Melbourne, Vic., Australia.,Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Geelong, Australia
| | - B Hill
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Geelong, Australia
| | - C J Gaskin
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Geelong, Australia
| | - H Skouteris
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Geelong, Australia
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Richardsen KR, Falk RS, Jenum AK, Mørkrid K, Martinsen EW, Ommundsen Y, Berntsen S. Predicting who fails to meet the physical activity guideline in pregnancy: a prospective study of objectively recorded physical activity in a population-based multi-ethnic cohort. BMC Pregnancy Childbirth 2016; 16:186. [PMID: 27460363 PMCID: PMC4962490 DOI: 10.1186/s12884-016-0985-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 07/22/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND A low physical activity (PA) level in pregnancy is associated with several adverse health outcomes. Early identification of pregnant women at risk of physical inactivity could inform strategies to promote PA, but no studies so far have presented attempts to develop prognostic models for low PA in pregnancy. Based on moderate-to-vigorous intensity PA (MVPA) objectively recorded in mid/late pregnancy, our objectives were to describe MVPA levels and compliance with the PA guideline (≥150 MVPA minutes/week), and to develop a prognostic model for non-compliance with the PA guideline. METHODS From a multi-ethnic population-based cohort, we analysed data from 555 women with MVPA recorded in gestational week (GW) 28 with the monitor SenseWear™ Pro3 Armband. Predictor variables were collected in early pregnancy (GW 15). We organized the predictors within the domains health, culture, socioeconomic position, pregnancy, lifestyle, psychosocial factors, perceived preventive effect of PA and physical neighbourhood. The development of the prognostic model followed several steps, including univariate and multiple logistic regression analyses. RESULTS Overall, 25 % complied with the PA guideline, but the proportion was lower in South Asians (14 %) and Middle Easterners (16 %) compared with Westerners (35 %). Among South Asians and Middle Easterners, 35 and 28 %, respectively, did not accumulate any MVPA minutes/week compared with 18 % among Westerners. The predictors retained in the prognostic model for PA guideline non-compliance were ethnic minority background, multiparity, high body fat percentage, and perception of few physically active friends. The prognostic model provided fair discrimination between women who did vs. did not comply with the PA guideline. CONCLUSION Overall, the proportion who complied with the PA guideline in GW 28 was low, and women with ethnic minority background, multiparity, high body fat percentage and few physically active friends had increased probability of non-compliance. The prognostic model showed fair performance in discriminating between women who did comply and those who did not comply with the PA guideline.
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Affiliation(s)
- Kåre Rønn Richardsen
- Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Oslo, Norway. .,Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway. .,Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
| | - Ragnhild Sørum Falk
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Anne Karen Jenum
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kjersti Mørkrid
- Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Egil Wilhelm Martinsen
- Clinic Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Yngvar Ommundsen
- Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway.,Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Sveinung Berntsen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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46
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Anjana RM, Sudha V, Lakshmipriya N, Anitha C, Unnikrishnan R, Bhavadharini B, Mahalakshmi MM, Maheswari K, Kayal A, Ram U, Ranjani H, Ninov L, Deepa M, Pradeepa R, Pastakia SD, Malanda B, Belton A, Mohan V. Physical activity patterns and gestational diabetes outcomes - The wings project. Diabetes Res Clin Pract 2016; 116:253-62. [PMID: 27321343 DOI: 10.1016/j.diabres.2016.04.041] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 04/15/2016] [Accepted: 04/21/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To compare physical activity (PA) patterns in pregnant woman with and without gestational diabetes (GDM) and to assess the effects of an exercise intervention on change in PA patterns, blood glucose levels and pregnancy outcomes in GDM women. METHODS For the first objective, PA patterns were studied in 795 pregnant women with and without GDM. For the second objective, the Women in India with Gestational Diabetes Strategy-Model of Care (WINGS-MOC) intervention were evaluated in 151 women out of 189 with GDM. PA was assessed using a validated questionnaire and a pedometer. Changes in PA patterns, glycemic parameters and neonatal outcomes were evaluated. RESULTS Overall, only 10% of pregnant women performed recommended levels of PA. Women with GDM were significantly more sedentary compared to those without GDM (86.2 vs. 61.2%, p<0.001). After the MOC was implemented in women with GDM, there was a significant improvement in PA and a decrease in sedentary behaviour amongst women (before MOC, moderate activity: 15.2%, sedentary: 84.8% vs. after MOC-moderate: 26.5%, sedentary: 73.5%; p<0.001), and an increase in their daily step count from 2206/day to 2476/day (p<0.001). Fasting 1 and 2-h postprandial glucose values significantly decreased (p<0.001 for all). Sedentary behaviour was associated with a fourfold higher risk (p=0.02), and recreational walking with 70% decreased risk, of adverse neonatal outcomes (p=0.04) after adjusting for potential confounders. CONCLUSIONS PA levels are inadequate amongst this group of pregnant women studied i.e. those with and without GDM. However, a low-cost, culturally appropriate MOC can bring about significant improvements in PA in women with GDM. These changes are associated with improved glycemic control and reduction in adverse neonatal outcomes.
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Affiliation(s)
- Ranjit Mohan Anjana
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India.
| | - Vasudevan Sudha
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Nagarajan Lakshmipriya
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Chandrasekaran Anitha
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Ranjit Unnikrishnan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Balaji Bhavadharini
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Manni Mohanraj Mahalakshmi
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Kumar Maheswari
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Arivudainambi Kayal
- Department of Policy and Programme, International Diabetes Federation, Brussels, Belgium
| | - Uma Ram
- SeethapathyClinic and Hospital, Chennai, India
| | - Harish Ranjani
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Lyudmil Ninov
- Department of Policy and Programme, International Diabetes Federation, Brussels, Belgium
| | - Mohan Deepa
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Rajendra Pradeepa
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
| | - Sonak D Pastakia
- Department of Pharmacy Practice Personnel, Colleges of Pharmacy, Purdue University, West Lafayette, Indiana, USA
| | - Belma Malanda
- Department of Policy and Programme, International Diabetes Federation, Brussels, Belgium
| | - Anne Belton
- Department of Policy and Programme, International Diabetes Federation, Brussels, Belgium
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, WHO Collaborating Centre for Non-Communicable Diseases, Gopalapuram, Chennai, India
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Huberty JL, Buman MP, Leiferman JA, Bushar J, Adams MA. Trajectories of objectively-measured physical activity and sedentary time over the course of pregnancy in women self-identified as inactive. Prev Med Rep 2016; 3:353-60. [PMID: 27419036 PMCID: PMC4929212 DOI: 10.1016/j.pmedr.2016.04.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 04/15/2016] [Accepted: 04/20/2016] [Indexed: 12/16/2022] Open
Abstract
There is a need for investigations that document the daily course of pregnancy-related changes in PA and sedentary behavior. The purpose of this study was to describe the trajectory of PA and sedentary behavior and whether they differ among weight status in pregnant women self-identified as inactive. Eighty inactive pregnant women (8-16 weeks) were recruited from a nationwide text-message intervention. PA was measured using a Fitbit. Chi-square analyses and t-tests were used to analyze univariate demographic and PA variables. Mixed model-repeated measures ANOVA was used to analyze trajectory changes in daily PA and sedentary behavior. Light activity (beta [SE] = 2.79 [0.30], p < .001), active time (b [SE] = 1.62 [0.16], p < .001), and steps (b [SE] = 112.21 [10.66], p < .001) increased during the second trimester followed by a precipitous decline during the third trimester. Sedentary behavior followed an opposite pattern (b = - 9.88 [1.07], p < .001). Overweight and obese women took significantly fewer steps/day (b [SE] = - 742.37 [362.57], p < .05 and - 855.94 [381.25], p < .05, respectively) than normal weight women, and obese women had less "active" minutes/day (~> 3.0 metabolic equivalents; b [SE] = - 12.99 [5.89], p < .05) than normal weight women (P's < 0.05). Women who self-identify as inactive, become more sedentary and less physically active as pregnancy progresses. This study was among the first to describe the trajectory of daily PA and sedentary behavior throughout pregnancy. This study may help inform health care provider and patient communication related to PA, sedentary behavior, and the time in which to communicate about these behaviors.
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Affiliation(s)
- Jennifer L. Huberty
- Arizona State University, Exercise Science and Health Promotion, 500 North 3rd Street, Phoenix, AZ 85004, United States
| | - Matthew P. Buman
- Arizona State University, Exercise Science and Health Promotion, 500 North 3rd Street, Phoenix, AZ 85004, United States
| | - Jenn A. Leiferman
- University of Colorado Denver, Department of Community and Behavioral Health, 1201 Larimer Street, Denver, CO 80204, United States
| | - Jessica Bushar
- Text4baby, ZERO TO THREE, 1255 23rd Street, NW, Suite 350, Washington, DC 20037, United States
| | - Marc A. Adams
- Arizona State University, Exercise Science and Health Promotion, 500 North 3rd Street, Phoenix, AZ 85004, United States
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48
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Newham JJ, Allan C, Leahy-Warren P, Carrick-Sen D, Alderdice F. Intentions Toward Physical Activity and Resting Behavior in Pregnant Women: Using the Theory of Planned Behavior Framework in a Cross-Sectional Study. Birth 2016; 43:49-57. [PMID: 26660944 DOI: 10.1111/birt.12211] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/30/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pregnant women are recommended to 1) perform daily moderate-intensity physical activity and 2) limit the amount of sedentary time. Many women do not meet these recommendations. Reduced physical activity and increased sedentary behavior may result from women actively intending to rest during pregnancy. The Theory of Planned Behavior (TPB) has been used to assess attitudes (e.g., positive/negative beliefs), subjective norms (e.g., perception of others' views), perceived behavioral control (PBC) (e.g., self-efficacy), and intention toward exercising while pregnant but has not been applied to aspects pertaining to resting during pregnancy. METHODS Pregnant women (n = 345) completed a cross-sectional questionnaire that included two TPB Questionnaires where the target behaviors were 1) being physically active and 2) resting. Bootstrapped paired t tests, ANOVA, and linear hierarchal regression analyses were performed to identify predictors of intentions and whether intentions toward the two behaviors varied at different stages of pregnancy. RESULTS As women progressed in their pregnancy, their attitude, PBC, and intention toward being physically active all significantly declined. A positive attitude, subjective norms, and intention toward resting all significantly increased with the advancing trimester. Self-reported health conditions predicted lower intention for physical activity but not for resting. DISCUSSION The significantly inverse relationship between physical activity and resting across time suggests that women feel they should focus on one behavior at the expense of the other. Finding that women generally do not perceive these behaviors as mutually compatible has implications in strategizing as to how to encourage women to be active during pregnancy.
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Affiliation(s)
- James J Newham
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | | | | | | | - Fiona Alderdice
- School of Nursing and Midwifery Queen's University Belfast, UK
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