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Evenson KR, Brown WJ, Brinson AK, Budzynski-Seymour E, Hayman M. A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:472-483. [PMID: 38158180 DOI: 10.1016/j.jshs.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The period following pregnancy is a critical time window when future habits with respect to physical activity (PA) and sedentary behavior (SB) are established; therefore, it warrants guidance. The purpose of this scoping review was to summarize public health-oriented country-specific postpartum PA and SB guidelines worldwide. METHODS To identify guidelines published since 2010, we performed a (a) systematic search of 4 databases (CINAHL, Global Health, PubMed, and SPORTDiscus), (b) structured repeatable web-based search separately for 194 countries, and (c) separate web-based search. Only the most recent guideline was included for each country. RESULTS We identified 22 countries with public health-oriented postpartum guidelines for PA and 11 countries with SB guidelines. The continents with guidelines included Europe (n = 12), Asia (n = 5), Oceania (n = 2), Africa (n = 1), North America (n = 1), and South America (n = 1). The most common benefits recorded for PA included weight control/management (n = 10), reducing the risk of postpartum depression or depressive symptoms (n = 9), and improving mood/well-being (n = 8). Postpartum guidelines specified exercises to engage in, including pelvic floor exercises (n = 17); muscle strengthening, weight training, or resistance exercises (n = 13); aerobics/general aerobic activity (n = 13); walking (n = 11); cycling (n = 9); and swimming (n = 9). Eleven guidelines remarked on the interaction between PA and breastfeeding; several guidelines stated that PA did not impact breast milk quantity (n = 7), breast milk quality (n = 6), or infant growth (n = 3). For SB, suggestions included limiting long-term sitting and interrupting sitting with PA. CONCLUSION Country-specific postpartum guidelines for PA and SB can help promote healthy behaviors using a culturally appropriate context while providing specific guidance to public health practitioners.
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Affiliation(s)
- Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8050, USA.
| | - Wendy J Brown
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Alison K Brinson
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3115, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8120, USA
| | | | - Melanie Hayman
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
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Dennis AT, Traer E, Ismail H, Riedel B. Hemodynamic, ventilatory and gas exchange responses to exercise using a cycle ergometer and the incremental shuttle walk test in pregnant women. Am Heart J 2024; 272:56-68. [PMID: 38493884 DOI: 10.1016/j.ahj.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 03/04/2024] [Accepted: 03/13/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Cardiovascular disease, including hypertension, in pregnant women is a leading cause of morbidity and mortality globally. The development of reference intervals for cardiovascular responses using exercising testing to measure oxygen utilisation (V̇O2) with cardiopulmonary exercise testing (CPET), and distances walked using the incremental shuttle walk test (ISWT), may be promising methods to assess and stratify pregnant women regarding their risk of adverse pregnancy outcomes, to encourage exercise during pregnancy, and to improve exercise prescriptions during pregnancy. We aimed to determine the reference intervals for V̇O2 at rest, anaerobic threshold (AT), and submaximal exercise using CPET, and the reference interval for the ISWT, to develop a correlation equitation that predicts submaximal V̇O2 from the distance walked in the ISWT, and to explore the relationship between hemoglobin (Hb) and ferritin concentration and V̇O2 at AT in women in second trimester. METHODS After prospective IRB approval (HREC 15/23) and clinical trials registration (ANZCTR ACTRN12615000964516), and informed written consent, we conducted CPET and the ISWT according to international guidelines in a university associated tertiary referral obstetric and adult medicine hospital, in healthy pregnant women in second trimester (14 to 27 gestational weeks). Hemoglobin and ferritin concentrations were recorded from pathology results in the participants' medical records at the time of exercise testing. Adverse events were recorded. RESULTS About 90 participants undertook CPET, 28 of which also completed the ISWT. The mean ± SD age and body mass index (BMI) were 32 ± 3.2 years, and 25 ± 2.7 kg/m2. Median (IQR) gestation was 23 (22-24) weeks. One in 4 women were 24 weeks or greater gestation. The reference intervals for V̇O2 at rest, AT, and submaximal exercise were 2.9 to 5.3, 8.1 to 20.7, and 14.1 to 30.5 mL/kg/min respectively. The reference interval for the ISWT was 218 to 1058 meters. The correlation equation to predict submaximal V̇O2 from the distance walked in the ISWT was submaximal V̇O2 (mL/kg/min) = 0.012*distance walked in ISWT (m) + 14.7 (95%CI slope 0.005-0.070, Pearson r = 0.5426 95%CI 0.2126-0.7615, P = .0029). Hemoglobin concentration was positively correlated with V̇O2 at AT (AT V̇O2 (mL/kg/min) = 0.08*Hb (g/L) + 4.9 (95%CI slope 0.0791-0.143, Pearson r = 0.2538 95%CI 0.049-0.438, P = .016). There was no linear association between ferritin and submaximal V̇O2 (Pearson r = 0.431 P = .697). There were no maternal or fetal complications. CONCLUSIONS CPET and ISWT are safe and feasible in women in second trimester including those at or beyond 24 weeks gestation. We have established the reference interval for V̇O2 at rest, AT, and submaximal exercise by CPET, the reference interval for the distance walked for the ISWT, and a correlation equation to predict submaximal V̇O2 for use in clinical practice and research. Hemoglobin rather than ferritin is likely correlated with exercise capacity in pregnancy suggesting vigilance to correct lower hemoglobin levels may positively impact maternal health. CLINICAL TRIALS REGISTRY The study was prospectively registered with the Australian and New Zealand Clinical Date of registration - 15/9/2015; Date of initial participant enrolment - 4/11/2015; Clinical trial identification number; ACTRN12615000964516; URL of the registration site - https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369216.
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Affiliation(s)
- Alicia Therese Dennis
- Division of Obstetric Anesthesia, Department of Anesthesiology, Perioperative medicine and Pain Medicine, Brigham and Women's Hospital, Boston, MA; Department of Anaesthesia, The Royal Women's Hospital, Parkville, Australia; Department of Anaesthesia and Perioperative Medicine, Western Health, Sunshine, Australia; School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Victoria, Australia; Departments of Critical Care, Obstetrics and Gynaecology, and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia; Honorary researcher, Peter MacCallum Cancer Centre, Victoria, Australia.
| | - Emily Traer
- Division of Obstetric Anesthesia, Department of Anesthesiology, Perioperative medicine and Pain Medicine, Brigham and Women's Hospital, Boston, MA; Department of Anaesthesia Peter MacCallum Cancer Centre, Victoria, Australia
| | - Hilmy Ismail
- Department of Anaesthesia Peter MacCallum Cancer Centre, Victoria, Australia
| | - Bernhard Riedel
- Department of Anaesthesia and Perioperative Medicine, Western Health, Sunshine, Australia; Department of Anaesthesia Peter MacCallum Cancer Centre, Victoria, Australia
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Chen L, Deng YF, Fan MQ, Yuan HB, Meng LR, Gao LL. Assisted reproductive technology and physical activity among Chinese pregnant women at high risk for gestational diabetes mellitus in early pregnancy: A cross-sectional study. Res Nurs Health 2024; 47:324-334. [PMID: 38229213 DOI: 10.1002/nur.22369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 12/10/2023] [Accepted: 12/29/2023] [Indexed: 01/18/2024]
Abstract
Currently, the number of pregnant women at high risk for gestational diabetes mellitus (GDM) and using assisted reproductive technology (ART) is increasing. The present study aims to explore the relationship between ART and physical activity in Chinese pregnant women at high risk for GDM in early pregnancy. A cross-sectional study was conducted in a regional teaching hospital in Guangzhou, China, between July 2022 and March 2023. Three hundred fifty-five pregnant women at high risk for GDM in early pregnancy completed the Chinese version of the Pregnant Physical Activity Questionnaire (PPAQ), the Pregnancy Physical Activity Knowledge Scale, the Pregnancy Physical Activity Self-Efficacy Scale, the Pregnancy Physical Activity Social Support Scale, and a sociodemographic and obstetric characteristics data sheet. Compared to women who conceived naturally, women who used ART were more likely to be 35 years or older, unemployed, primigravidae, and to have intentionally planned their pregnancies. Women who used ART had significantly lower levels of physical activity and self-efficacy compared to their counterparts who conceived naturally. Over half (55.6%) of women who used ART reported being physically inactive, and those with lower self-efficacy, as well as the unemployed, were significantly more likely to be inactive. Physical inactivity is a critical clinical issue among women who use ART, especially in the context of GDM risk. Future research should develop and test physical activity programs, including enhancing physical activity self-efficacy for women who use ART. Patient or public contribution: In this study, survey questionnaires were completed by participants among Chinese pregnant women at high risk for GDM in early pregnancy.
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Affiliation(s)
- Lu Chen
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Yong-Fang Deng
- Department of Obstetrics and Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Mei-Qiong Fan
- Department of Obstetrics and Gynecology, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Hao Bin Yuan
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Rua de Luis Gonzaga Gomes, Macao, China
| | - Li-Rong Meng
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Rua de Luis Gonzaga Gomes, Macao, China
| | - Ling-Ling Gao
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Kracht CL, Drews KL, Flanagan EW, Keadle SK, Gallagher D, Van Horn L, Haire-Joshu D, Phelan S, Pomeroy J, Redman LM. Maternal 24-h movement patterns across pregnancy and postpartum: The LIFE-Moms consortium. Prev Med Rep 2024; 42:102740. [PMID: 38707249 PMCID: PMC11068928 DOI: 10.1016/j.pmedr.2024.102740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/18/2024] [Accepted: 04/21/2024] [Indexed: 05/07/2024] Open
Abstract
Objective Time spent among the 24-h movement behaviors (physical activity [PA], sleep, sedentary behavior [SB]) in the perinatal period is important for maternal and child health. We described changes to 24-h movement behaviors and behavior guideline attainment during pregnancy and postpartum and identified correlates of behavior changes. Methods This secondary data analysis included the standard of care group (n = 439) from the U.S.-based Lifestyle Interventions For Expectant Moms (LIFE-Moms) consortium, including persons with overweight and obesity. Wrist-worn accelerometry was used to measure movement behaviors early (9-15 weeks) and late (35-36 weeks) pregnancy, and ∼ 1-year postpartum. Sleep and moderate-to-vigorous PA (MVPA) were compared to adult and pregnancy-specific guidelines, respectively. SB was classified into quartiles. PA and SB context were quantified using questionnaires. Mixed models were used to examine changes in behaviors and guidelines and identify correlates. Results Participants were 31.3 ± 3.5 years, 53.5 % were Black or Hispanic, and 45.1 % had overweight. Sleep duration decreased across time, but participants consistently met the guideline (range: 85.0-93.6 %). SB increased during pregnancy and decreased postpartum, while light PA and MVPA followed the inverse pattern. Participants met slightly fewer guidelines late pregnancy (1.2 ± 0.7 guidelines) but more postpartum (1.7 ± 0.8 guidelines) than early pregnancy (1.4 ± 0.8 guidelines). Black or Hispanic race/ethnicity, higher pregravid body mass index, and non-day work-shift (e.g., night-shift) were identified correlates of lower guideline adherence and varying PA and SB context. Conclusion Perinatal interventions should consider strategies to prevent SB increase and sustain MVPA to promote guideline adherence.
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Affiliation(s)
- Chelsea L. Kracht
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
- University of Kansas Medical Center, Kansas City, KS 66160, USA
| | | | | | - Sarah K. Keadle
- California Polytechnic State University, San Luis Obispo, CA, USA
| | | | | | | | - Suzanne Phelan
- California Polytechnic State University, San Luis Obispo, CA, USA
| | - Jeremy Pomeroy
- Marshfield Clinic Research Institute, Marshfield, WI, USA
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Bueno SV, Nielsen RO, Kallestrup P, Ryom K, Morgan K, Elsborg P, Petersen CB, Jacobsen JS. Parous women perform less moderate to vigorous physical activity than their nulliparous peers: a population-based study in Denmark. Public Health 2024; 231:47-54. [PMID: 38626671 DOI: 10.1016/j.puhe.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 04/18/2024]
Abstract
OBJECTIVES The World Health Organization (WHO) highlights parous women as a key population for monitoring trends of physical activity (PA). We aimed to estimate the proportion of Danish women non-adhering to WHO PA guidelines in parous women compared with nulliparous women and to describe leisure-time PA intensity in each of these groups. STUDY DESIGN Cross-sectional study. METHODS This population-based study builds on a sample of 27,668 women aged 16-40 years from the Danish National Health Survey 2021. These data were linked with childbirth data from the Danish National Birth Registry. The primary outcome was self-reported weekly hours of moderate to vigorous leisure-time PA (MVPA) dichotomized into: (i) adhering to WHO guidelines for MVPA or (ii) not adhering to WHO guidelines for MVPA. Binomial regression analysis was used to calculate prevalence proportions (PP) and prevalence proportion ratios (PPR). RESULTS Of the 27,668 women, a total of 20,022 were included; 9338 (46.6%) parous women and 10,684 (53.4%) nulliparous women. The PP of women non-adhering to WHO PA guidelines was 63.8% (95% CI 62.9-64.8) for parous and 51.3% (95% CI 50.4-52.3) for nulliparous women, corresponding to a PPR of 1.24 (95% CI 1.21; 1.27). CONCLUSIONS The proportion of parous women who did not adhere to WHO PA guidelines for MVPA was 24% higher than that of nulliparous women. This highlights parous women as a subgroup of the adult population at increased risk of non-adherence to WHO PA guidelines. These findings call for future research to inform new strategies aiming to promote PA in parous women.
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Affiliation(s)
- S V Bueno
- Research Unit for General Practice, Bartholins Allé 2, Aarhus C 8000, Denmark; Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark.
| | - R O Nielsen
- Research Unit for General Practice, Bartholins Allé 2, Aarhus C 8000, Denmark; Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark
| | - P Kallestrup
- Research Unit for General Practice, Bartholins Allé 2, Aarhus C 8000, Denmark; Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark
| | - K Ryom
- Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark
| | - K Morgan
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Spark, Maindy Road, Cardiff CF24 4HQ, United Kingdom
| | - P Elsborg
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Capital Region of Denmark, Copenhagen, Denmark
| | - C B Petersen
- National Institute of Public Health, Faculty of Health Science, University of Southern Denmark, Copenhagen, Denmark
| | - J S Jacobsen
- Research Unit for General Practice, Bartholins Allé 2, Aarhus C 8000, Denmark; Research Centre for Health and Welfare Technology, VIA University College, Aarhus, Denmark
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Agarwala A, Dixon DL, Gianos E, Kirkpatrick CF, Michos ED, Satish P, Birtcher KK, Braun LT, Pillai P, Watson K, Wild R, Mehta LS. Dyslipidemia management in women of reproductive potential: An expert clinical consensus from the national lipid association. J Clin Lipidol 2024:S1933-2874(24)00188-0. [PMID: 38824114 DOI: 10.1016/j.jacl.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 05/20/2024] [Indexed: 06/03/2024]
Abstract
Cardiovascular disease (CVD) is the leading cause of death among women and its incidence has been increasing recently, particularly among younger women. Across major professional society guidelines, dyslipidemia management remains a central tenet for atherosclerotic CVD prevention for both women and men. Despite this, women, particularly young women, who are candidates for statin therapy are less likely to be treated and less likely to achieve their recommended therapeutic objectives for low-density lipoprotein cholesterol (LDL-C) levels. Elevated LDL-C and triglycerides are the two most common dyslipidemias that should be addressed during pregnancy due to the increased risk for adverse pregnancy outcomes, such as preeclampsia, gestational diabetes mellitus, and pre-term delivery, as well as pancreatitis in the presence of severe hypertriglyceridemia. In this National Lipid Association Expert Clinical Consensus, we review the roles of nutrition, physical activity, and pharmacotherapy as strategies to address elevated levels of LDL-C and/or triglycerides among women of reproductive age. We include a special focus on points to consider during the shared decision-making discussion regarding pharmacotherapy for dyslipidemia during preconception planning, pregnancy, and lactation.
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Affiliation(s)
- Anandita Agarwala
- Center for Cardiovascular Disease Prevention Cardiovascular Division, Baylor Scott and White Health Heart Hospital Baylor Plano, Plano, TX, USA (Dr Agarwala).
| | - Dave L Dixon
- Department of Pharmacotherapy & Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USA (Dr Dixon); Center for Pharmacy Practice Innovation, Virginia Commonwealth University, Richmond, Virginia, USA (Dr Dixon)
| | - Eugenia Gianos
- Department of Cardiology, Northwell Health, New Hyde Park, Cardiovascular Institute, Lenox Hill Hospital Northwell, New York, NY, USA (Dr Gianos)
| | - Carol F Kirkpatrick
- Midwest Biomedical Research, Addison, IL, USA (Dr Kirkpatrick); Kasiska Division of Health Sciences, Idaho State University, Pocatello, ID, USA (Dr Kirkpatrick)
| | - Erin D Michos
- Division of Cardiology, Department of Medicine Johns Hopkins University School of Medicine Baltimore, MD, USA (Dr Michos)
| | - Priyanka Satish
- The University of Texas at Austin Dell School of Medicine, Ascension Texas Cardiovascular, Austin, TX, USA (Dr Satish)
| | - Kim K Birtcher
- University of Houston College of Pharmacy, Houston, TX, USA (Dr Birtcher)
| | - Lynne T Braun
- Rush University College of Nursing, Rush Heart Center for Women, Chicago, IL, USA (Dr Braun)
| | - Priyamvada Pillai
- Baylor Scott and White Health Heart Hospital Baylor Plano, Plano, TX, USA (Dr Pillai)
| | - Karol Watson
- Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA (Dr Watson)
| | - Robert Wild
- Oklahoma University Health Sciences Center, Oklahoma City, OK, USA (Dr Wild)
| | - Laxmi S Mehta
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA (Dr Mehta)
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He P, Deng Y, Dong S, Li H, Liu C, Ma Y, Tang C, Zhang M. Association of different domains of physical activity with diabetic kidney disease: a population-based study. Front Endocrinol (Lausanne) 2024; 15:1364028. [PMID: 38863925 PMCID: PMC11165133 DOI: 10.3389/fendo.2024.1364028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/13/2024] [Indexed: 06/13/2024] Open
Abstract
Background The aim of this cross-sectional study was to elucidate the associations between various domains of physical activity, such as occupation-related (OPA), transportation-related (TPA), leisure-time (LTPA) and overall physical activity (PA), and diabetic kidney disease. Methods Our study encompassed 2,633 participants, drawn from the cross-sectional surveys of the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2018, and employed survey-weighted logistic regression, generalized linear regression, and restricted cubic spline (RCS) analyses to ascertain the relationship between different domains of physical activity and diabetic kidney disease. Results After controlling for all confounders, multivariate logistic regression analyses revealed a lack of correlation between the various domains of physical activity and the prevalence of diabetic kidney disease. Multiple generalized linear regression analyses showed that durations of PA (β = 0.05, 95% CI, 0.01-0.09, P = 0.012) and TPA (β = 0.32, 95% CI, 0.10-0.55, P = 0.006) were positively associated with eGFR levels; and LTPA durations were inversely associated with UACR levels (β = -5.97, 95% CI, -10.50 - -1.44, P = 0.011). The RCS curves demonstrated a nonlinear relationship between PA, OPA, and eGFR, as well as a nonlinear correlation between PA and ACR. Subgroup and sensitivity analyses largely aligned with the outcomes of the multivariate generalized linear regression, underscoring the robustness of our findings. Conclusion Our population-based study explored the association between different domains of physical activity and diabetic kidney disease. Contrary to our expectations, we found no significant association between the duration of physical activity across all domains and the prevalence of diabetic nephropathy. Nonetheless, renal function markers, including eGFR and UACR, exhibited significant correlations with the duration of total physical activity (TPA) and leisure-time physical activity (LTPA), respectively, among diabetic patients. Interestingly, our findings suggest that diabetic patients engage in physical activity to preserve renal function, ensuring moderate exercise durations not exceeding 35 hours per week.
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Affiliation(s)
- Pengfei He
- Department of Nuphrology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yuanyuan Deng
- Department of Nephrology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Shaoning Dong
- Department of Nephrology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Hongdian Li
- Department of Nuphrology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Cong Liu
- Department of Nuphrology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yu Ma
- Department of Nuphrology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Cheng Tang
- Department of Endocrinology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Mianzhi Zhang
- Department of Nuphrology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
- Department of Nephrology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
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Wan CS, Teede H, Nankervis A, Aroni R. Ethnic differences in physical activity participation when managing gestational diabetes mellitus: a mixed-methods study comparing ethnic Chinese migrants and Australian women. ETHNICITY & HEALTH 2024:1-20. [PMID: 38805266 DOI: 10.1080/13557858.2024.2359379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/20/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Physical activity is a key component in gestational diabetes mellitus management to optimise glycaemic control and reduce adverse pregnancy outcomes. However, inadequate physical activity during pregnancy is common. Underpinned by a woman-centred pregnancy care model, appropriate strategies targeting patients' cultural needs may facilitate physical activity participation. Ethnic Chinese migrants have a four-fold higher risk of gestational diabetes mellitus than the Australian Caucasian host population. To identify potentially effective disease management strategies to improve physical activity participation, understanding and comparing ethnic Chinese migrants' and Caucasian women's views will provide insights into developing an end-user-informed intervention. AIMS This study aimed to compare perceptions and practices around physical activity participation during pregnancy between 44 ethnic Chinese migrants and 39 Australian-born Caucasian women with gestational diabetes mellitus. METHODS This mixed-methods study used in-depth, semi-structured audio-recorded interviews, validated pregnancy physical activity questionnaires and pedometers. Qualitative data were thematically analysed and compared between ethnicities. SPSS (SPSS Inc) was used in quantitative data analysis. Data triangulation was made to identify patterns in participant characteristics, physical activity beliefs and participation. RESULTS Despite both ethnic groups doing less physical activity than recommended, Chinese participants were less physically active than Caucasian participants. Chinese participants expressed greater safety concerns about physical activity and opted for a more sedentary lifestyle. Data triangulation indicated that non-Australian-born Chinese participants whose husbands were Asian were overcautious about miscarriage risk related to physical activity, which promoted a sedentary lifestyle. Chinese participants suggested individualised, specific physical activity advice on safe physical activity during pregnancy would mitigate their concerns. Caucasian participants reported that digital step measurement technologies motivated their participation in physical activity. CONCLUSION Different strategies are suggested by Chinese and Caucasian participants to improve physical activity participation to manage gestational diabetes mellitus among ethnic Chinese and Caucasian populations, which will be evaluated in future interventions.
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Affiliation(s)
- Ching Shan Wan
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Endocrinology and Diabetes, Monash Health, Clayton, Australia
| | - Alison Nankervis
- Departments of Diabetes and Endocrinology, The Royal Melbourne and Royal Women's Hospitals, Parkville, Australia
- Department of Medicine, The University of Melbourne, Parkville, Australia
| | - Rosalie Aroni
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- ANU Medical School, College of Health and Medicine, Australian National University, Canberra, Australia
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Lesser I, Wurz A, Bean C, Hatfield G. Exploring the Feasibility, Acceptability, and Potential Benefits of the Mom Movement Intervention (MOMmi). Nurs Womens Health 2024:S1751-4851(24)00085-0. [PMID: 38782044 DOI: 10.1016/j.nwh.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/18/2024] [Accepted: 04/09/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE To explore the feasibility, acceptability, and potential benefits associated with a mind-body intervention and varied delivery styles among women during the postpartum period. DESIGN Mixed-methods feasibility study. SETTING Fraser Valley, British Columbia, Canada. PARTICIPANTS Forty-three women (93% White), with an average age of 32.1 (SD = 2.9) years, who had given birth within the last 6 months. METHODS Participants were randomized to three physical activity groups. Validated questionnaires were administered before and after the 12-week intervention. Attendance and feasibility metrics and qualitative semistructured interviews were conducted to assess the intervention. RESULTS The intervention and trial were partially feasible, and retention to the intervention was high; however, adherence as assessed by attendance was lower than expected. There was high acceptability among those in the group-based, in-person intervention. There was moderate acceptability among those in the individual, home-based asynchronous program. CONCLUSION Findings highlight the necessity of better understanding what is desired by this population or simply providing more options to participants so that we can tailor physical activity to their needs and provide the necessary support.
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Brites-Lagos C, Maranhão C, Szumilewicz A, Santos-Rocha R. Development and validation of the physical exercise program "Active Mums" for postpartum recovery: application of the CReDECI-2 guidelines. BMC Pregnancy Childbirth 2024; 24:378. [PMID: 38769520 PMCID: PMC11103992 DOI: 10.1186/s12884-024-06387-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/02/2024] [Indexed: 05/22/2024] Open
Abstract
Postpartum physical activity is a public health issue. Reporting on the quality of exercise interventions designs must be ensured in view of the reproducibility and successful implementation of such studies. The objective was to develop and preliminary validate a physical exercise program for postpartum recovery, aiming to promote physical fitness and health of the new mothers. The study was carried out through the three stages of development, piloting, and evaluation. The Consensus on Exercise Reporting Template (CERT) was used to describe the postpartum exercise program. The Criteria for Reporting the Development and Evaluation of Complex Interventions in Healthcare (CReDECI2) was followed to develop and preliminary validate the program. A tailored postpartum exercise program was developed based on evidence-based international recommendations to be implemented by qualified exercise professionals. A pilot intervention of 16 weeks was carried out, engaging a group of postpartum women. The viability of the program was subsequently evaluated by all participants. The present work provided guidance to develop a study protocol with a larger sample in order to prove the effectiveness of a supervised postpartum exercise program on selected parameters of health.
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Affiliation(s)
- Carla Brites-Lagos
- ESDRM Sport Sciences School of Rio Maior - Santarem Polytechnic University, Rio Maior, Portugal
| | - Cristiana Maranhão
- ESDRM Sport Sciences School of Rio Maior - Santarem Polytechnic University, Rio Maior, Portugal
| | - Anna Szumilewicz
- Gdansk University of Physical Education and Sport, Gdansk, Poland
| | - Rita Santos-Rocha
- ESDRM Sport Sciences School of Rio Maior - Santarem Polytechnic University, Rio Maior, Portugal.
- SPRINT - Sport Physical Activity and Health Research and Innovation Center - Santarem Polytechnic University, Rio Maior, Portugal.
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Zafaranieh S, Siwetz M, Leopold-Posch B, Kummer D, Huppertz B, Desoye G, van Poppel M. Placental structural adaptation to maternal physical activity and sedentary behavior: findings of the DALI lifestyle study. Hum Reprod 2024:deae090. [PMID: 38733100 DOI: 10.1093/humrep/deae090] [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: 01/30/2024] [Revised: 04/09/2024] [Indexed: 05/13/2024] Open
Abstract
STUDY QUESTION Are maternal levels of moderate-to-vigorous physical activity (MVPA) and sedentary time (ST) in obese pregnant women associated with placental structural adaptations for facilitating oxygen delivery to the fetus? SUMMARY ANSWER Higher maternal MVPA and ST are associated with a higher density of villi, a proxy measure of placental surface area for oxygen delivery to the fetus, without further added placental vessels. WHAT IS KNOWN ALREADY Physical activity during pregnancy intermittently reduces uterine blood flow, potentially limiting placental and fetal oxygen supply. The placenta can mount several adaptive responses, including enlargement of the surface area of villi and/or feto-placental vessels to accommodate fetal needs. Early research on the morphology and growth of the placenta with exercise interventions has shown inconsistencies and is lacking, particularly in non-lean pregnant women. STUDY DESIGN, SIZE, DURATION This study is a secondary longitudinal analysis of the vitamin D and lifestyle intervention for gestational diabetes prevention (DALI) randomized controlled trial. The prospective study was conducted between 2012 and 2015 in nine European countries at 11 different sites. In this analysis, 92 pregnant women with a BMI ≥ 29 kg/m2 were combined into one cohort. PARTICIPANTS/MATERIALS, SETTING, METHODS MVPA and percentage of time spent sedentary (% ST) were measured with accelerometers during gestation. Placental sections were immunostained for endothelial cell-specific CD34. Artificial intelligence (AI)-based stereology assessed villous density, number, and cross-sectional area of vessels on whole-slide images and in selected regions comprising peripheral villi only, where the majority of vascular adaptations occur. Expression of pro- and anti-angiogenic factors was quantified using molecular counting analysis. MAIN RESULTS AND THE ROLE OF CHANCE In multivariable regression, higher levels of maternal MVPA (min/day) were associated with a higher density of villi in both whole-slide images (beta 0.12; 95% CI 0.05, 0.2) and selected regions (0.17; CI 0.07, 0.26). Unexpectedly, ST was also positively associated with density of villi (0.23; CI 0.04, 0.43). MVPA and ST were not associated with vessel count/mm2 villous area, vessel area, or pro- and anti-angiogenic factor mRNA expression. All estimates and statistical significance of the sensitivity analyses excluding smokers, women who developed gestational diabetes or pre-eclampsia and/or pregnancy-induced hypertension were similar in the main analysis. LIMITATIONS, REASONS FOR CAUTION The placenta is a complex organ undergoing dynamic changes. While various adjustments were made to account for different maternal contributing factors, in addition to the outcome measures, various other factors could impact oxygen delivery to the fetus. WIDER IMPLICATIONS OF THE FINDINGS For the first time, we evaluated the association between placental structures quantified using an AI-based approach with objectively measured physical activity and ST at multiple time points in pregnant women with obesity. The observed adaptations contribute to the advancement of our understanding of the hemodynamics and adaptations of the placental unit in response to MVPA and ST. However, our results might not be generalizable to lean pregnant women. STUDY FUNDING/COMPETING INTEREST(S) The DALI project has received funding from the European Community's 7th Framework Program (FP7/2007-2013) under grant agreement no. 242187. The funders had no role in study design, collection of data, analyses, writing of the article, or the decision to submit it for publication. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER ISRCTN70595832.
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Affiliation(s)
- Saghi Zafaranieh
- Department of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Monika Siwetz
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | | | - Daniel Kummer
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Berthold Huppertz
- Division of Cell Biology, Histology and Embryology, Gottfried Schatz Research Center, Medical University of Graz, Graz, Austria
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria
| | - Mireille van Poppel
- Department of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
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12
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Yang X, Han R, Song Y, Zhang J, Huang H, Zhang J, Wang Y, Gao L. The Mediating Role of Physical Activity Self-Efficacy in Predicting Moderate-Intensity Physical Activity in Pregnant People at High Risk for Gestational Diabetes. J Midwifery Womens Health 2024; 69:403-413. [PMID: 38069454 DOI: 10.1111/jmwh.13589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/09/2023] [Indexed: 06/05/2024]
Abstract
INTRODUCTION Gestational diabetes mellitus (GDM) is a common medical complication in pregnancy. Moderate-intensity physical activity during pregnancy can lower the risk of GDM. However, the relationship between moderate-intensity physical activity and correlated factors among pregnant people at high risk for GDM remains unknown. METHODS A cross-sectional study was conducted in China. Two hundred fifty-two participants completed the Pregnancy Physical Activity Questionnaire, Pregnancy Physical Activity Self-Efficacy Scale, Physical Activity Knowledge Questionnaire, Physical Activity Social Support Scale, 7-item Generalized Anxiety Disorder Scale, Edinburgh Postnatal Depression Scale, and a sociodemographic data sheet. Structural equation modeling was used to explore the direct and indirect associations between the study variables. RESULTS A total of 51.6% of the participants did not meet the current physical activity guidelines. Only physical activity self-efficacy was significantly correlated with moderate-intensity physical activity. Physical activity self-efficacy mediated the relationship between moderate-intensity physical activity and knowledge of physical activity, social support for physical activity, and anxiety symptoms. Furthermore, knowledge of physical activity was also associated with improved moderate-intensity physical activity mediated by reduced anxiety symptoms and increased physical activity self-efficacy. CONCLUSION Our study revealed a high prevalence of not meeting current physical activity guidelines among pregnant people at high risk for GDM. Physical activity self-efficacy played an important mediating role in predicting moderate-intensity physical activity. Future studies should focus on enhancing self-efficacy to improve moderate-intensity physical activity for pregnant people at high risk for GDM.
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Affiliation(s)
- Xiao Yang
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Rongrong Han
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
| | - Yingli Song
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, China
| | - Ji Zhang
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, China
| | - Hui Huang
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, China
| | - Jing Zhang
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, China
| | - Yan Wang
- Zhengzhou Maternal and Child Health Hospital, Zhengzhou, China
| | - Lingling Gao
- School of Nursing, Sun Yat-Sen University, Guangzhou, China
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Radwan H, Naja F, Abbas N, Kharma JA, Obaid RS, Al Ghazal H, Abdelrahim DN, Saqan R, Alameddine M, Al Hilali M, Hasan H, Hashim M. Influence of maternal characteristics and infant feeding patterns on infant growth from birth till 18 months: The MISC study. Pediatr Obes 2024; 19:e13106. [PMID: 38383983 DOI: 10.1111/ijpo.13106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/06/2023] [Accepted: 12/15/2023] [Indexed: 02/23/2024]
Abstract
BACKGROUND The growth and development of infants during the first 1000 days of life are crucial for their health. OBJECTIVES This study aims to assess the impact of maternal characteristics and infant feeding patterns on infant growth from birth to 18 months. METHODS Data were derived from the 2-year perspective Mother Infant Study Cohort (MISC) study which included six visits from the third trimester of pregnancy until 18 months postpartum. A convenient sample of 256 pregnant women aged 19-40 years was recruited from Sharjah, Dubai and Ajman in the United Arab Emirates. RESULTS Amongst mothers' characteristics, Arab nationality, pre-pregnancy overweight/obesity, higher gestational weight gain and lower physical activity were found to increase the likelihood of infants being overweight at 6, 12 and 18 months. Exclusive breastfeeding was positively correlated with reduced odds of the infant being overweight at 18 months (aOR = 0.31, 95% CI: 0.12-0.81). Breastfeeding for up to 6 months and the introduction of solid foods after 6 months was associated with reduced odds of the infant being overweight at 12 months old (aOR = 4, 95% CI: 1.1-14.6; aOR = 2.97, 95% CI: 1.09-8.08, respectively). CONCLUSION The findings spotlight the influence of maternal characteristics and infant feeding on infant growth. This asserts the need for evidence-based programmes targeting mothers to promote optimal feeding practices and foster healthy child growth.
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Affiliation(s)
- Hadia Radwan
- College of Health Sciences, Department of Clinical Nutrition and Dietetics, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Farah Naja
- College of Health Sciences, Department of Clinical Nutrition and Dietetics, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Nada Abbas
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Joelle Abi Kharma
- Nutrition Program, Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
| | - Reyad Shaker Obaid
- College of Health Sciences, Department of Clinical Nutrition and Dietetics, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Hessa Al Ghazal
- Sharjah Child-Friendly Office-Sharjah Health Authority, Sharjah, United Arab Emirates
| | - Dana N Abdelrahim
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Roba Saqan
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Marwa Al Hilali
- Clinical Nutrition Department, Al Qassimi Hospital, Emirates Health Services, Sharjah, United Arab Emirates
| | - Hayder Hasan
- College of Health Sciences, Department of Clinical Nutrition and Dietetics, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Mona Hashim
- College of Health Sciences, Department of Clinical Nutrition and Dietetics, Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Sylvetsky AC, Hughes SA, Kuttamperoor JT, Moore HR, Murphy J, Sacheck J, Smith ER. Mothers' Experiences During the 2022 Infant Formula Shortage in Washington D.C. Matern Child Health J 2024; 28:873-886. [PMID: 38147276 PMCID: PMC11001681 DOI: 10.1007/s10995-023-03860-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 12/27/2023]
Abstract
INTRODUCTION An unprecedented shortage of infant formula occurred in the United States (U.S.) in 2022 and posed widespread challenges to infant feeding nationwide. The purpose of this study is to investigate mothers' experiences during the 2022 infant formula shortage and its perceived impacts on infants' diet and health. METHODS Mothers (n = 45) of infants under 8 months old from Washington D.C. were invited to participate in a virtual study meeting during the summer of 2022. Mothers completed surveys regarding their demographics, infants' anthropometrics, infant feeding practices, information they have received about infant feeding, and knowledge about infant feeding practices. They then participated in a qualitative interview about their experiences during the infant formula shortage. RESULTS Overarching themes were: the shortage (1) had adverse impacts on mothers' mental and emotional health; (2) had significant financial and intangible costs; (3) led to changes in infant feeding practices; (4) social and family networks were helpful in navigating the shortage; and (5) mothers felt fortunate to have resources to breastfeed and/or obtain formula. DISCUSSION The infant formula shortage adversely impacted mothers' mental and emotional health, and was costly, in terms of financial and intangible costs. Findings demonstrate the need to develop clinical and policy approaches to support mothers in feeding their infants and provide education about safe infant feeding practices.
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Affiliation(s)
- Allison C Sylvetsky
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, D.C., 20052, USA.
| | - Sarah A Hughes
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, D.C., 20052, USA
| | - Janae T Kuttamperoor
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, D.C., 20052, USA
| | - Hailey R Moore
- Division of Psychology, Children's National Hospital, 111 Michigan Ave NW, Washington, D.C., 20010, USA
| | - Jeanne Murphy
- School of Nursing, The George Washington University, 1919 Pennsylvania Ave. NW, Washington, D.C., 20006, USA
| | - Jennifer Sacheck
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, D.C., 20052, USA
| | - Emily R Smith
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, D.C., 20052, USA
- Department of Global Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, D.C., 20052, USA
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15
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Kim HS, Chung MY. A Motivational Technology Perspective on the Use of Smart Wrist-Worn Wearables for Postpartum Exercise and Weight Management. HEALTH COMMUNICATION 2024:1-15. [PMID: 38644619 DOI: 10.1080/10410236.2024.2343472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Exercise and weight management is crucial in preventing postpartum depression and long-term obesity that carries the risk of chronic illness among postpartum women. Although communication devices, such as a smart wrist-worn wearable (SWW), can help users be more physically active, the extent to which postpartum women might benefit from this technology is unknown. We examined how SWWs promoted exercise and helped postpartum women return to pre-pregnancy weight. We tested a model based on the premise that a motivational device that prompts users to engage with it can establish healthy daily routines. An online survey of 309 postpartum women who were living in the United States and were current users of SWWs revealed that the device encouraged them to spend time completing workout goals. Technological affordances (i.e. customization, navigability, and interactivity) and subsequent user engagement with the device positively predicted total workout hours among postpartum women. We present practical implications for postpartum care programs and smart wearable developers.
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Gibbs BB, Kozai AC, McAdoo SN, Davis KD, Savidge MB, Paley JL, Hauspurg A, Catov JM. The sedentary behavior reduction in pregnancy intervention (SPRING) pilot and feasibility randomized trial. BMC Pregnancy Childbirth 2024; 24:261. [PMID: 38605328 PMCID: PMC11007988 DOI: 10.1186/s12884-024-06474-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/31/2024] [Indexed: 04/13/2024] Open
Abstract
Pregnant individuals rarely achieve moderate-to-vigorous intensity physical activity recommendations.Purpose The sedentary behavior reduction in pregnancy intervention (SPRING) pilot and feasibility randomized trial aimed to demonstrate feasibility, acceptability, and initial efficacy of a lower intensity intervention targeting reduced sedentary behavior and increased standing and steps.Methods First trimester pregnant individuals at risk for high sedentary behavior and adverse pregnancy outcomes (APO) were randomized 2:1 to a multi-component sedentary behavior reduction intervention or no-contact control. Intervention components included biweekly remote health coaching, wearable activity monitor, height-adjustable workstation, and a private Facebook group. Evidence-based behavioral targets included sedentary time < 9 h/day, increasing standing by 2-3 h/day, and ≥ 7500 steps/day. Participants completed all-remote assessments (baseline, second trimester, third trimester) of sedentary behavior and activity (thigh-worn activPAL) along with exploratory pregnancy health outcomes abstracted from medical records. Intervention effects vs. control were evaluated using generalized mixed models and an intention-to-treat approach. Intervention participants also provided feedback on perceived benefits and acceptability.Results Participants (34 intervention; 17 control) had mean age 32 years, were 83% White, with mean pre-pregnancy BMI 28 kg/m2. Retention was high (90% and 83% at second and third trimester follow-up visits). Intervention participants decreased sedentary time (-0.84 h/day, p = 0.019) and increased standing (+0.77 h/day, p = 0.003), but did not increase steps/day (+710, p = 0.257) compared to controls. Intervention participants reported many perceived benefits and identified the wearable, height-adjustable workstation, and behavioral lessons as most useful.Conclusion For pregnant individuals at risk for high sedentary behavior and APOs, a sedentary behavior reduction intervention is feasible, acceptable, and may offer a viable alternative to more intense physical activity recommendations during pregnancy. Further testing in a fully powered clinical trial is warranted.Trial registration NCT05093842 on clinicaltrials.gov.
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Affiliation(s)
- Bethany Barone Gibbs
- Department of Epidemiology and Biostatistics, West Virginia University School of Public Health, PO Box 9190, 64 Medical Center Drive, Morgantown, WV, 26506, USA.
| | - Andrea C Kozai
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA
| | - Shannon N McAdoo
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA
| | - Kelliann D Davis
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA
| | - Meghan B Savidge
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Joshua L Paley
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alisse Hauspurg
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, and Magee Women's Research Institute, Pittsburgh, PA, USA
| | - Janet M Catov
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, and Magee Women's Research Institute, Pittsburgh, PA, USA
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Gallo-Galán LM, Gallo-Vallejo MA, Gallo-Vallejo JL. [Medical recommendations from primary care on physical exercise in the postpartum]. Semergen 2024; 50:102148. [PMID: 38064768 DOI: 10.1016/j.semerg.2023.102148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/05/2023] [Accepted: 11/08/2023] [Indexed: 04/01/2024]
Abstract
There is evidence that demonstrates the benefits of practicing physical activity/exercise for the mother after childbirth. However, this postpartum period (PP) is often a missed opportunity in a lifetime for women to start or resume physical exercise and get the great benefits that it can bring them. The objective of this article was to analyze the benefits of physical exercise during PP; the prescription of physical exercise; recommendations on when to resume your practice; barriers and facilitators; physical exercise during breastfeeding; as well as its role in the most frequent illnesses and discomforts in this period, always keeping in mind that the work of the primary care doctor is essential to motivate and encourage women to perform physical exercise in the PP.
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Affiliation(s)
- L M Gallo-Galán
- Servicio de Obstetricia y Ginecología, Hospital Universitario Sanitas La Moraleja, Madrid, España
| | - M A Gallo-Vallejo
- Centro de Medicina Deportiva, Concejalía de Deportes del Ayuntamiento de Granada, Granada, España
| | - J L Gallo-Vallejo
- Servicio de Obstetricia y Ginecología, Hospital Universitario Virgen de las Nieves, Granada, España; Departamento de Obstetricia y Ginecología de la Universidad de Granada, Granada, España.
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Wang J, Carru C, Sedda S, Fiori PL, Li Z, Chen Z. Comparative impact of exercise-based interventions for postpartum depression: A Bayesian network meta-analysis. Int J Gynaecol Obstet 2024; 165:67-75. [PMID: 37688384 DOI: 10.1002/ijgo.15091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/02/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVE The current study aimed to address and rank which exercise-based interventions are preferable to standard care/no therapy or another exercise intervention for postpartum depression (PPD) management and provide estimates for future definitive evidence. METHODS The authors systematically searched PubMed, Embase, the Web of Science, PsycInfo, and ClinicalTrails.gov for randomized controlled trials (RCTs) on exercise-based interventions for PPD from their inception to May 9, 2023. Included were RCTs of exercise-based interventions for PPD with at least 4 weeks' duration. The pooled effects of intervention comparisons were generated by the Bayesian random-effects model, and the quality of evidence was evaluated by the Grading of Recommendations, Assessment, Development, and Evaluations framework. RESULTS Twelve RCTs (1260 women; mean age, 20-35 years) comparing exercise-based interventions with usual care/no therapy were included. Exercise effectively treats depressive symptoms (standard mean difference [SMD], -0.81 [95% confidence interval (CI), -1.20 to -0.42], P < 0.001). Pram walking was significantly associated with a reduction of depressive symptoms during the postpartum period (SMD, -1.00 [95% CI, -2.60 to -0.10], P = 0.020), as well as yoga (SMD, -0.73 [95% CI, -1.84 to -0.43], P < 0.001) and supervised mixed exercise (SMD, -0.77 [95% CI, -1.67 to -0.01], P = 0.041) compared with usual care/no therapy. In indirect comparisons, pram walking (surface under the cumulative ranking curve, 58.9%) was better than yoga (SMD, -0.28 [95% CI, -1.86 to 1.22], P = 0.322) and supervised mixed exercise (SMD, -0.23 [95% CI, -1.59 to 1.12], P = 0.358). However, the difference was not statistically significant. The confidence in evidence was very low to moderate. CONCLUSION In women with PPD, all commonly prescribed physical exercises were effective alternative or complementary treatments. However, pram walking may perform better in improving the symptoms of PPD.
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Affiliation(s)
- Jing Wang
- Department of Obstetrics and Gynecology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Stefania Sedda
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Pier Luigi Fiori
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Zhi Li
- Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Zhichao Chen
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
- Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China
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Davis JW, Serna ADL, Carey C, Ally F, Giurgescu C. Pilot Study of the FitMoms2B Physical Activity Promotion Program Among Black Women With High-Risk Pregnancies. J Obstet Gynecol Neonatal Nurs 2024:S0884-2175(24)00038-8. [PMID: 38552675 DOI: 10.1016/j.jogn.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 05/14/2024] Open
Abstract
OBJECTIVE To explore the feasibility of recruitment, adherence, and retention and the acceptability of the FitMoms2B physical activity promotion program and study measures among non-Hispanic Black women with high-risk pregnancies. DESIGN One-arm pilot feasibility study. SETTING A large regional high-risk prenatal clinic in the southeastern United States. PARTICIPANTS Non-Hispanic Black women who had singleton, high-risk pregnancies at 16 to 23 weeks gestation with no contraindications to physical activity (N = 13). METHOD We evaluated the feasibility and acceptability of a multicomponent intervention, which included physical activity coaching, support from a workout partner, and an activity tracker. We also assessed the feasibility of study measures for future trials of the program. RESULTS Of 179 patients screened, 20 were eligible, and 13 consented and enrolled (65%). Of the 13 participants, 9 completed data collection at Time Point (T) 1 (16-23 weeks gestation) and T2 (24-30 weeks), and 8 completed data collection at T3 (31 or more weeks). Adherence met expectations for coaching (63%), exercise with a workout partner (100%), and use of the activity tracker (92%). Acceptability was high (100%). CONCLUSION We found that recruitment, retention, and adherence are feasible for the FitMoms2B physical activity promotion program. The program and study measures were acceptable to participants in our sample. We provide preliminary support for a randomized controlled trial to study physical activity promotion with virtual coaching, workout partner support, and activity tracking among Black pregnant women with high-risk pregnancies without contraindications to physical activity.
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Grau González A, Sánchez Del Pino A, Amezcua-Prieto C, Møller Luef B, Anne Vinter C, Stener Jorgensen J, García-Valdés L. An umbrella review of systematic reviews on interventions of physical activity before pregnancy, during pregnancy, and postpartum to control and/or reduce weight gain. Int J Gynaecol Obstet 2024. [PMID: 38466033 DOI: 10.1002/ijgo.15453] [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: 11/21/2023] [Revised: 02/13/2024] [Accepted: 02/18/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND The increasing prevalence of overweight and obesity worldwide represents a (chronic) complex public health problem. This is also seen among women of childbearing age despite increased efforts to promote physical activity (PA) interventions. Excessive gestational weight gain (GWG) is associated with negative health outcomes for both mothers and offspring. OBJECTIVES To summarize current systematic reviews (SRs) on PA interventions during pregnancy and postpartum to prevent excessive GWG and identify the most effective approaches. SEARCH STRATEGY A literature search was conducted on major electronic databases (MEDLINE/Pubmed, Cochrane, Web of Science, Epistemonikos) from inception to March 2023. SELECTION CRITERIA This study included SRs and meta-analyses of studies involving women aged 18 years or older from diverse ethnic backgrounds, who were either in the preconception period, pregnant, or within 1 year postpartum and who had no contraindications for exercise. Women with chronic diseases, such as pre-existing diabetes (type 1 or type 2) were excluded. DATA COLLECTION AND ANALYSIS Two reviewers extracted data from selected studies assessing the impact of PA in preconception, pregnancy, and postpartum. Methodologic quality was assessed with the AMSTAR-2 tool. A narrative summary of results addresses relationships between PA and weight before, during, and after pregnancy, informing future research priorities for preventing excessive weight gain. This study is registered on PROSPERO (CRD420233946666). MAIN RESULTS Out of 892 identified articles, 25 studies were included after removing duplicates, unrelated titles, and screening titles and abstracts for eligibility. The results demonstrate that PA can help prevent excessive GWG and postpartum weight retention. Structured and supervised moderate-intensity exercise, at least twice a week, and each session lasting a minimum of 35 min seems to provide the greatest benefits. CONCLUSIONS Women who comply with the PA program and recommendations are more likely to achieve adequate GWG and return to their pre-pregnancy body mass index after delivery. Further research is warranted to explore how preconception PA influences pregnancy and postpartum outcomes given the absence of identified preconception-focused interventions.
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Affiliation(s)
- Andrea Grau González
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
| | - Ana Sánchez Del Pino
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
| | - Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
- CIBER of Epidemiology and Public Health, Carlos III Health Institute, Madrid, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
| | - Birgitte Møller Luef
- University of Southern Denmark, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Christina Anne Vinter
- University of Southern Denmark, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | - Jan Stener Jorgensen
- University of Southern Denmark, Odense, Denmark
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Luz García-Valdés
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Granada, Spain
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Paudel S, Mishra GD, Veitch J, Mielke GI, Hesketh KD. Examination of Physical Activity, Organized Sport, and Sitting Time Among Women and Mothers From Culturally and Linguistically Diverse Backgrounds. J Phys Act Health 2024; 21:229-237. [PMID: 38086350 DOI: 10.1123/jpah.2023-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 10/29/2023] [Accepted: 11/14/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND Little evidence is available from culturally and linguistically diverse (CALD) communities on the association between motherhood and physical activity (PA). This study aimed to examine independent and joint associations of cultural background and motherhood with meeting PA guidelines, participation in organized sports, and high sitting time (>8 h/d). METHODS We used self-reported cross-sectional data from survey 8 of the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health. PA was measured using the Active Australia Survey while organized sport and sitting time were measured using single items. CALD was defined as being born in a non-English speaking country or primarily speaking a non-English language at home. Multivariable-adjusted logistic regression analyses were used to examine independent and joint associations. RESULTS Data from 5967 women (mean age 42.4 [SD 1.5] y, 6.9% CALD, 81.2% mothers) were analyzed. Women of CALD background had lower odds of meeting PA guidelines (odds ratio; 95% confidence interval: 0.80; 0.64-0.98) and participation in organized sports (0.68; 0.54-0.86), but no statistically significant association with sitting time (0.90; 0.72-1.14). Mothers had lower odds of meeting PA guidelines (0.75; 0.64-0.87) and high sitting time (0.42; 0.36-0.49). Compared with non-CALD women without children, mothers (irrespective of cultural background) were less likely to meet PA guidelines and have high sitting time. The association of "cultural background and motherhood" with organized sports participation was only significant for CALD mothers. CONCLUSIONS Increased efforts and investments are needed to ensure that sports and other PA promotion interventions are culturally sensitive and engaging for CALD women and those with children.
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Affiliation(s)
- Susan Paudel
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Gita D Mishra
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Jenny Veitch
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Gregore I Mielke
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
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Howie EK, Nelson A, McVeigh JA, Andres A. Relationships between physical behaviour phenotypes of mothers in pregnancy and their offspring with child body composition. Acta Paediatr 2024; 113:486-494. [PMID: 38174743 DOI: 10.1111/apa.17089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/15/2023] [Accepted: 12/22/2023] [Indexed: 01/05/2024]
Abstract
AIM The aim of this study was to identify physical behaviour phenotypes in mothers in the first trimester and in their offspring at 24 months of age. The secondary aim was to examine relationships between mother and child behaviours with child body composition at age 24 months. METHODS Longitudinal secondary analysis of the Glowing cohort collected between 1 February 2011 and 22 August 2017 in Little Rock, Arkansas. Behaviours were measured using ankle-worn accelerometers in mothers during the first trimester and offspring at 24 months of age, including total activity, sleep, sedentary time and a novel variable of daily variation, patternicity. Child body fat was measured using quantitative nuclear magnetic resonance. RESULTS Three phenotypes were identified for mothers and children (n = 159 complete dyads). There were no relationships between mother and child phenotypes, but higher maternal patternicity was associated with higher child patternicity (0.2, 95% CI 0.1, 0.3, p = 0.001). There were no associations between mother or child phenotypes with child body composition, however higher child activity was associated with lower body fat (-0.01, 95% CI: -0.02, -0.001, p = 0.031). CONCLUSION Limited associations were found between mothers' pregnancy physical behaviours with child behaviours or child body composition at 24 months of age. Factors such as child diet or current parental physical activity may be better predictors of early childhood outcomes.
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Affiliation(s)
- Erin K Howie
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, Arkansas, USA
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Alexander Nelson
- Department of Computer Science and Computer Engineering, University of Arkansas, Fayetteville, Arkansas, USA
| | - Joanne A McVeigh
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
| | - Aline Andres
- Arkansas Children's Nutrition Center & Arkansas Children's Research Institute, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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23
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Tawfeeq F, Alkhaldi M, AlAwainati Z, Mansoor F, AlShomeli H, Makarem B, AlAsomi H. Factors Influencing Women's Attendance to Postnatal Clinics in the Primary Healthcare Centers in the Kingdom of Bahrain, 2023. Cureus 2024; 16:e55834. [PMID: 38590500 PMCID: PMC11000530 DOI: 10.7759/cureus.55834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Despite the significance of postnatal care for maternal health, the attendance rate of mothers at postnatal clinics (PNCs) in primary healthcare (PHC) centers in Bahrain is low. This study aims to identify factors influencing women's attendance at PNC in PHC centers in the Kingdom of Bahrain and to propose strategies for service improvement. METHODS In January 2023, we conducted a cross-sectional study. We selected mothers who gave birth between six and 12 months before the survey and met inclusion criteria using systematic simple random sampling and obtained consent (n = 319). Data collection utilized an electronic, structured, interviewer-administered questionnaire, and analysis was carried out using SPSS version 28 (IBM Corp., Armonk, NY). RESULTS Out of the 319 participants, 31% were unaware of the existence of PNC, 42% were aware but did not attend, and 27% were aware and had attended the clinic. Mother and child department clerks, doctors, health education boards, and midwives served as the primary sources of information about the PNC for only 34%, 16%, 16%, and 11% of participants, respectively. Understanding the importance of PNC, the services offered by a healthcare worker, the booking process, having a vaginal delivery, and prior experience with a PNC visit were significantly associated with PNC attendance (p = 0.0046, p = 0.027, p < 0.001, p = 0.028, and p < 0.001, respectively). The attendance of 81 mothers, representing 94% of the total women who attended the clinic, was driven by their acknowledgment of the service's importance. Childcare responsibilities, perception of the visit as unimportant, and reluctance to undergo a pelvic examination were the top reasons for not attending the clinic, despite 41%, 38%, and 37% of participants being aware of it. CONCLUSION Postnatal care attendance remains suboptimal for mothers in Bahrain. Awareness of the clinic's presence, counseling by healthcare providers, and prior experience with PNC visits were found to be significant determinants of attendance.
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Affiliation(s)
- Fatema Tawfeeq
- Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Maryam Alkhaldi
- Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Zahra AlAwainati
- Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Fatema Mansoor
- Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Hajer AlShomeli
- Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Basheer Makarem
- Department of Family and Community Medicine, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, BHR
| | - Hala AlAsomi
- Department of Mother and Child Services, Primary Health Care Center, Ministry of Health, Manama, BHR
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24
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Aktaş Reyhan F. Determination of exercise attitudes of women of reproductive age in pregnancy. Eur J Obstet Gynecol Reprod Biol X 2024; 21:100294. [PMID: 38495928 PMCID: PMC10940935 DOI: 10.1016/j.eurox.2024.100294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/16/2024] [Accepted: 02/28/2024] [Indexed: 03/19/2024] Open
Abstract
Objective This study was conducted to evaluate the exercise attitudes of women of reproductive age during pregnancy. Method The descriptive study was conducted with 326 women who applied to the gynecology outpatient clinics of a state hospital between September and November 2023. Data were collected with the "Personal Information Form" and "Exercise Attitudes in Pregnant Women Scale". Statistical analyses were analyzed at p < .05 significance level with the independent samples t test method. Results Most of the participants (85.6%) stated that they did not know the benefits of exercise during pregnancy and did not exercise during pregnancy (89.6%). The mean exercise attitude scale score of the participants was 135.42 ± 25.90. A significant difference was found between the participants' education level, exercising outside pregnancy, attending a pregnancy school, knowing the benefits of exercise during pregnancy and exercising during pregnancy and all sub-dimension scores (p < .05). Conclusion In the study, it was observed that the participants had positive attitudes towards exercise during pregnancy, although their knowledge and behaviors were insufficient. Women's attitudes towards exercise should be determined by health professionals and women's positive attitudes, knowledge and behaviors should be improved by organizing trainings and exercise programs starting from pre-pregnancy.
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25
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Laudańska-Krzemińska I, Krzysztoszek J. Physical activity promotion among pregnancy - the role of physician from the women's perspective. Front Public Health 2024; 12:1335983. [PMID: 38487188 PMCID: PMC10937457 DOI: 10.3389/fpubh.2024.1335983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Abstract
Objective The clear benefits of planned and supervised physical activity (PA) during pregnancy make it imperative that women are encouraged and educated about this activity. This study aimed to investigate how effectively physician promote physical activity and exercise among pregnant women. It also examines pro-health changes in selected health behaviours during pregnancy. Methods This cross-sectional study recruited a total of 353 pregnant women in Wielkopolskie Voivodship in Poland. An anonymous survey (on-line or in-paper) was used to assess physical activity before and during pregnancy (with Pregnancy Physical Activity Questionnaire), physical activity self-efficacy, well-being (WHO-5 Well-Being Index), and guidance received from physicians on physical activity during pregnancy. Results Only 41% of women surveyed followed WHO recommendations for PA before pregnancy, and they were much more likely to discuss safety and the need to change the intensity or type of PA with their doctor or gynaecologist. Only 23% of women were asked about their PA before pregnancy and less than 40% were encouraged to be active during pregnancy. We observed a higher probability of poor well-being among pregnant women who were inactive before pregnancy (OR = 1.873, 95%CI 1.026 to 3.421, p = 0.041). Conclusion Health professionals infrequently educate and motivate women to be physically active during pregnancy. Physician advice, as it is currently perceived by women, seems to be insufficient to help pregnant women meet the recommendations for PA during pregnancy.
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Affiliation(s)
- Ida Laudańska-Krzemińska
- Department of Physical Activity and Health Promotion Science, Poznan University of Physical Education, Poznan, Poland
| | - Jana Krzysztoszek
- Department of Didactics of Physical Activity, Poznan University of Physical Education, Poznan, Poland
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Pereira-Payo D, Mendoza-Muñoz M, Denche-Zamorano A, Rubio-de la Osa A, Moreno-Quintanilla M, Pastor-Cisneros R. Physical Activity Is Associated with the Incidence of Depression in United States Adults from the NHANES 2013-18: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:552. [PMID: 38470663 PMCID: PMC10931288 DOI: 10.3390/healthcare12050552] [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: 01/10/2024] [Revised: 02/05/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
The number of depression sufferers is rising globally. In the United States, 8% of adults over 20 years of age suffer from it, making it the most prevalent mental disorder in the country. Some lifestyle habits have been shown to favor or prevent the onset of depression; for instance, physical inactivity is associated with an increased likelihood of suffering depression, whilst multiple benefits have been attributed to performing physical activity (PA). This study aims to test whether there is a dependence between the prevalence of depression and PA, age, gender and educational level. The secondary objective was to identify the differentiating variables for depression and non-depression. This cross-sectional study is based on data from the NHANES 2013-2014, 2015-2016 and 2017-2018 editions. Some of the items in this survey were taken from preexisting questionnaires: the Patient Health Questionnaire-9 for depression screening and the Global Physical Activity Questionnaire (GPAQ) for the PA groups. The final sample was formed of 15,574 United States residents over 18 years old. After testing the data normality (p < 0.001), a descriptive analysis and the non-parametric chi-square test was conducted, as well as discriminant analysis. The results showed that there was an association between depression prevalence and PA (p < 0.001) in the general population and for both genders. Inactive participants had the highest prevalence of major depression and other depressive disorders. The discriminant analysis identified PA group (0.527), education level (0.761) and gender (-0.505) as significant variables that differentiate between participants with and without depression. The results of this research confirmed that a dependency relationship between PA group according to the GPAQ and depression prevalence according to the PHQ-9 existed in the United States adult population, and that PA group is a relevant variable to differentiate between depression sufferers and non-sufferers.
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Affiliation(s)
- Damián Pereira-Payo
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (D.P.-P.); (M.M.-Q.)
| | - María Mendoza-Muñoz
- Physical and Health Literacy and Health-Related Quality of Life (PHYQoL), Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7000-645 Évora, Portugal
| | - Angel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (A.D.-Z.); (R.P.-C.)
| | | | - Miranda Moreno-Quintanilla
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (D.P.-P.); (M.M.-Q.)
| | - Raquel Pastor-Cisneros
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain; (A.D.-Z.); (R.P.-C.)
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Nasri NM, Gan WY, Mohd Shukri NH. Mother-infant postnatal experience and its association with maternal emotion and coping during the COVID-19 pandemic. J Reprod Infant Psychol 2024:1-17. [PMID: 38407161 DOI: 10.1080/02646838.2024.2314187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/30/2024] [Indexed: 02/27/2024]
Abstract
INTRODUCTION The COVID-19 pandemic resulted in a partial lockdown in Malaysia known as Movement-Controlled-Order (MCO), which has affected primary care management and social life norms. Thus, psychological health is a concern for mothers, particularly during the postpartum period. This study aimed to determine factors associated with maternal emotional experiences and coping during the pandemic. METHODOLOGY Mothers of infants aged < 18 months (n = 1449) in Malaysia completed an online survey during MCO (July 2020 to February 2021). The survey comprised questions on sociodemographics, pandemic livelihood impact, maternal experiences, and emotions. RESULTS More than one-third of mothers expressed feeling worried (54.7%), annoyed (48.1%), and tired (42.2%) to some or a high extent. Mothers who were younger (p = .001), more educated (p = .001), faced difficulty paying rent (p = .002), and whose husbands were unemployed (p < .001) expressed higher negative emotions. In contrast, mothers who received enough support for health (p = .001) and breastfeeding (p = .008), had infants sleep less (p = .042) and had more time to focus on health (p < .001) expressed better emotions. Higher coping was expressed among mothers with a higher household income (p = .004), had more time to focus on their health (p = .010), received additional breastfeeding support (p = 0.039), and practised traditional postpartum care (p < .001). In contrast, difficulty paying for essentials (p = .023) was associated with negative coping. CONCLUSION Maternal emotional experiences were significantly associated with sociodemographic characteristics, livelihood impact, postnatal experiences, and infant behaviours. Postpartum mental health screening is recommended to prevent severe distress, especially in first-time mothers. Coping interventions for mothers at risk may include comprehensive support and maternity care.
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Affiliation(s)
- Nuruljannah Mohamad Nasri
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Wan Ying Gan
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nurul Husna Mohd Shukri
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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Paley JL, Jones MA, Catov JM, Whitaker KM, Kozai AC, Barone Gibbs B. Associations of Physical Activity and Sedentary Behaviors with Depressive Symptoms and Mood Disturbance Throughout Pregnancy. J Womens Health (Larchmt) 2024. [PMID: 38324012 DOI: 10.1089/jwh.2023.0419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Purpose: Mental health is critical for a healthy pregnancy, yet few studies have evaluated its associations with best practice, objectively measured moderate- to vigorous-intensity physical activity (MVPA) or sedentary behavior (SED). This study evaluated associations of MVPA and SED with mental health across pregnancy. Materials and Methods: Two cohort studies (total n = 125, mean [standard deviation] 31 [5] years, and 14.4% Black) measured MVPA (waist-worn ActiGraph GT3X) and SED (thigh-mounted activPAL) as well as self-reported depressive symptoms and mood disturbance in each trimester. Associations of group-based trajectories of MVPA and SED with depressive symptoms and mood disturbance were analyzed using regression analyses, both overall and by trimester. Results: Overall, the medium versus low trajectory of MVPA was associated with lower levels of depressive symptoms (B = -1.82, 95% confidence interval [CI] -2.97 to -0.68). In the second trimester, women in either the medium or high MVPA trajectories had lower levels of depressive symptoms compared with women in the low MVPA trajectory (B = -8.73, 95% CI -15.74 to -1.71; and B = -2.18, 95% CI -3.80 to -0.56). SED trajectories were not associated with depressive symptoms. Higher trajectories of MVPA and lower trajectories of SED were associated with lower total mood disturbance, with significant associations in the second trimester for MVPA and the first and second trimesters for SED. Higher MVPA trajectories were associated with higher tension, fatigue, and confusion subscales, while higher SED trajectories were associated with higher anger and fatigue and lower esteem and vigor subscales. Conclusions: MVPA and SED levels appear to affect mental health during pregnancy, although larger prospective studies are warranted. Clinical Trail Registration Number: NCT03084302.
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Affiliation(s)
- Joshua L Paley
- Department of Health and Human Development, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Melissa A Jones
- Department of Human Movement Science, Oakland University, Rochester, Michigan, USA
| | - Janet M Catov
- Department of Ob/Gyn and Reproductive Sciences, Magee-Womens Research Institute and Clinical and Translational Sciences Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kara M Whitaker
- Department of Human Movement Science, Oakland University, Rochester, Michigan, USA
- Department of Epidemiology, The University of Iowa, Iowa City, Iowa, USA
| | - Andrea C Kozai
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Bethany Barone Gibbs
- Department of Epidemiology and Biostatistics, West Virginia University School of Public Health, Morgantown, WV, USA
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Darroch FE, Varcoe C, Montaner GG, Webb J, Paquette M. Taking Practical Steps: A Feminist Participatory Approach to Cocreating a Trauma- and Violence-Informed Physical Activity Program for Women. Violence Against Women 2024; 30:598-621. [PMID: 36357357 PMCID: PMC10775643 DOI: 10.1177/10778012221134821] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Trauma- and violence-informed physical activity (TVIPA) is a feasible approach to improve access/engagement in physical activity for pregnant/parenting women with experiences of trauma. Through feminist participatory action research, 56 semistructured interviews were completed to understand TVIPA. Four themes were identified: (1) "I have to be on edge": Trauma and violence pervade women's lives, (2) "It should be mandatory that you feel safe": Emotional safety is essential, (3) "The opportunity to step up and be decision-makers and leaders": Choice, collaboration, and connection create safety, and (4) "It's a good start for healing," strengths-based and capacity building foster individual and community growth.
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Affiliation(s)
| | | | | | - Jessica Webb
- Community Partner Organization, Vancouver, BC, Canada
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Bennetter KE, Waage CW, Jenum AK, Vøllestad NK, Robinson HS, Richardsen KR. Cross-Cultural Contact and Norwegian Language Skills Among Ethnic Minority Women in Norway, and Relationship with Physical Activity in Pregnancy and Postpartum: The STORK-Groruddalen Cohort Study. J Immigr Minor Health 2024; 26:63-71. [PMID: 37639042 PMCID: PMC10771598 DOI: 10.1007/s10903-023-01535-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 08/29/2023]
Abstract
There are few studies of the migration context factors and physical activity (PA) level among minority ethnic women in Europe. We investigated the association between migration context factors and moderate to vigorous physical activity (MVPA) among minority ethnic women. Objectively recorded MVPA were obtained from 487 minority ethnic women included in the STORK-Groruddalen Cohort Study at three time points in pregnancy/postpartum. We investigated the associations between (a) contact with ethnic Norwegians and (b) Norwegian language skills and. No associations were observed in pregnancy. Postpartum, women who reported contact with ethnic Norwegians accumulated 17 MVPA min/day (95% CI: -.60, 34.54) more than women with no contact. In complete case analyses, this difference was significant (27 MVPA min/day (95% CI: 8.60, 44.54)). In early postpartum women with contact with ethnic Norwegians seems to be more physically active than women without contact. No associations were observed in pregnancy.
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Affiliation(s)
- Karin Elisabeth Bennetter
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Box 1130, 0318, Blindern, Oslo, Norway.
| | - Christin Wiegels Waage
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Box 1130, 0318, Blindern, Oslo, Norway
- Institute of Physiotherapy, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
| | - Anne Karen Jenum
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Box 1130, 0318, Blindern, Oslo, Norway
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nina Køpke Vøllestad
- Institute of Health and Society, Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
| | - Hilde Stendal Robinson
- Institute of Health and Society, Department of Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
| | - Kåre Rønn Richardsen
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Box 1130, 0318, Blindern, Oslo, Norway
- Institute of Physiotherapy, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
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Yan S, Jiang H, Yang Z, Tang X, Chen Z, Chen Z, Liu H, Zhang F. Physical activity trajectory during pregnancy and associations with maternal fatigue using a growth mixture modeling approach. Sci Rep 2024; 14:1020. [PMID: 38200232 PMCID: PMC10781982 DOI: 10.1038/s41598-024-51648-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/08/2024] [Indexed: 01/12/2024] Open
Abstract
The purpose of this study was to investigate the associations of physical activity trajectories with maternal fatigue. Pregnant women provided objectively assessed physical activity data by Pregnancy Physical Activity Questionnaire four times. Fatigue scale-14 was used to assess fatigue during pregnancy. Growth mixture modelling characterized physical activity trajectories across pregnancy. The generalized estimating equations was used to analyze the relationship between different physical activity profiles and fatigue in pregnant women. A total of 626 pregnant women were included in analysis in a teaching hospital in Nantong city. Fatigue (total, mental and physical) was not different between two groups based on total energy expenditure of PA (constantly high vs. constantly low). The pregnant women in "constantly high household PA" group had the higher fatigue compared to "constantly low household PA" (P < 0.05) and "constantly medium household PA" (P < 0.05). The pregnant women in "constantly high sport PA" group had lower fatigue compared to "constantly low sport PA" (P < 0.05). Household PA and sport PA were still an independent influencing factor for fatigue after controlling for confounding variables. Specifically, we observed that higher household PA and lower sport PA were associated with higher fatigue during pregnancy.
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Affiliation(s)
- Shuhan Yan
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China
- Health School attached to Shanghai University of Medicine & Health Sciences, 200237, Shanghai, China
| | - Hui Jiang
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China
- Affiliated hospital of Nantong university, Nantong, China
| | - Ziyi Yang
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China
| | - Xinyan Tang
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China
| | - Zihang Chen
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China
| | - Zhifang Chen
- Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong City, Jiangsu Province, China
| | - Huahua Liu
- Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong City, Jiangsu Province, China
| | - Feng Zhang
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China.
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Knudsen SDP, Roland CB, Alomairah SA, Jessen AD, Maindal HT, Bendix JM, Clausen TD, Løkkegaard E, Stallknecht B, Molsted S. The effect of exercise training and motivational counselling on physical activity behaviour and psychosocial factors in pregnant women: secondary analyses of the FitMum randomised controlled trial investigating prenatal physical activity. BMC Public Health 2024; 24:92. [PMID: 38178045 PMCID: PMC10768443 DOI: 10.1186/s12889-023-17525-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND A physically active lifestyle is beneficial during pregnancy. However, little is known about physical activity (PA) behaviour and psychosocial factors in women during and after pregnancy. This study examined exercise behavioural regulation, exercise self-efficacy, health-related quality of life, sickness absence and musculoskeletal pain in pregnant women offered either structured supervised exercise training, motivational counselling on PA, or standard prenatal care in the FitMum randomised controlled trial. METHODS Two hundred and eighteen healthy inactive pregnant women were randomised to structured supervised exercise training (n = 87), motivational counselling on PA (n = 86) or standard prenatal care (n = 45). The women answered the Behavioural Regulation in Exercise Questionnaire-2 (BREQ-2), the Pregnancy Exercise Self-Efficacy Scale (P-ESES-DK) and the Short Form 36 Health Survey Questionnaire (SF-36) at baseline (gestational age (GA) of max 15 weeks), GA 28 and 34 weeks, and one year after delivery. Sickness absence and low back and/or pelvic girdle pain were likewise reported in questionnaires at baseline and GA 28 weeks. RESULTS Participants offered structured supervised exercise training or motivational counselling on PA had higher autonomous motivation for exercise during pregnancy compared with participants receiving standard prenatal care (e.g., difference in intrinsic regulation at GA 28 weeks, structured supervised exercise training vs. standard prenatal care: mean difference in score 0.39 [0.16; 0.64], p < 0.001). Participants offered structured supervised exercise training also had higher exercise self-efficacy during pregnancy (e.g., GA 28 weeks, structured supervised exercise training vs. standard prenatal care: mean difference in score 6.97 [2.05; 12.02], p = 0.005). All participants reported high exercise self-efficacy at baseline and medium exercise self-efficacy during pregnancy and one year after delivery. No differences were found between groups in health-related quality of life, sickness absence or low back and/or pelvic girdle pain during pregnancy. No group differences were found one year after delivery. CONCLUSION Structured supervised exercise training and motivational counselling on PA had important effects on autonomous exercise motivation during pregnancy. Exercise self-efficacy was also increased with structured supervised exercise training compared to standard prenatal care. No group differences in health-related quality of life, sickness absence, or pain were found during and after pregnancy. No effects were found one year post-delivery after intervention cessation. TRIAL REGISTRATION The study was approved by the Danish National Committee on Health Research Ethics (#H-18011067) and the Danish Data Protection Agency (#P-2019-512). The study adheres to the principles of the Helsinki declaration. Written informed consent was obtained at inclusion.
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Affiliation(s)
- Signe de Place Knudsen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark.
| | - Caroline Borup Roland
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
| | - Saud Abdulaziz Alomairah
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Public Health Department, Saudi Electronic University, College of Health Sciences, Riyadh, Saudi Arabia
| | - Anne Dsane Jessen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
| | - Helle Terkildsen Maindal
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Jane M Bendix
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
- Department of Clinical Research, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
| | - Tine D Clausen
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Ellen Løkkegaard
- Department of Gynaecology and Obstetrics, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Bente Stallknecht
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Stig Molsted
- Department of Clinical Research, Copenhagen University Hospital - North Zealand, Hillerod, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Veisy A, Mohammad-Alizadeh-Charandabi S, Abbas-Alizadeh S, Mirghafourvand M, Ghaderi F, Haghighi M. Monitored home-based with or without face-to-face exercise for maternal mental health during the COVID-19 pandemic. J Reprod Infant Psychol 2024; 42:110-125. [PMID: 35416742 DOI: 10.1080/02646838.2022.2063267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 03/31/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Despite the known beneficial effects of exercise, most pregnant women do not exercise regularly. Most studies on exercise have been conducted on supervised exercise and there is limited evidence regarding the adherence and effect of other exercise programs on pregnancy outcomes. Therefore, we aimed to investigate adherence to a face-to-face plus monitored home exercise program versus a monitored home-based exercise program on its own during pregnancy. In addition, effects of these two exercise programs on women's mental health during pregnancy and postpartum (primary outcomes) and on some other maternal and neonatal outcomes (secondary outcomes) will be assessed. METHODS In this superiority trial with three parallel arms, 150 women at 12-18 weeks of gestation will be randomised equally into three groups (face-to-face plus monitored home exercise, only monitored home-based exercise, and control). The exercise programs will be performed up to the 38th week of gestation during which participants will be assessed at specific intervals during the pregnancy, and post-partum and followed up until six months after childbirth. The exercise diary will be used to assess the adherence. The Edinburgh Depression Scale and the Positive and Negative Affect Schedule will be used to assess prenatal and postnatal depression and affect, respectively. DISCUSSION This study reflects the feasibility and acceptance of two exercise programs for pregnant women and their effects on important outcomes. If these programs are followed properly and effectively, pregnant women's health can be improved using these methods at a lower cost compared to the conventional supervised exercise program.
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Affiliation(s)
- Afsaneh Veisy
- Student Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sakineh Mohammad-Alizadeh-Charandabi
- Social Determinants of Health Research Center, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shamci Abbas-Alizadeh
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center (Sdhrc), Department of Family Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Fariba Ghaderi
- Department of Physiotherapy, Faculty of Rehabilitation, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahmonir Haghighi
- Department of Psychiatry, Urmia University of Medical Sciences, Urmia, Iran
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Evenson KR, Mowla S, Olshan AF, Shaw GM, Ailes EC, Reefhuis J, Joshi N, Desrosiers TA. Maternal physical activity, sitting, and risk of non-cardiac birth defects. Pediatr Res 2024; 95:334-341. [PMID: 37543708 PMCID: PMC10875984 DOI: 10.1038/s41390-023-02768-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND The relationship between maternal physical activity (PA)/sitting and birth defects is largely unexplored. We examined whether pre-pregnancy PA/sitting were associated with having a pregnancy affected by a birth defect. METHODS We used data from two United States population-based case-control studies: 2008-2011 deliveries from the National Birth Defects Prevention Study (NBDPS; 9 states) and 2014-2018 deliveries from the Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS; 7 states). Cases with one of 12 non-cardiac birth defects (n = 3798) were identified through population-based registries. Controls (n = 2682) were live-born infants without major birth defects randomly sampled using vital/hospital records. Mothers self-reported pre-pregnancy PA/sitting. Unconditional logistic regression models estimated associations between PA/sitting categories and the 12 birth defects. RESULTS Mothers engaging in pre-pregnancy PA was associated with a reduced odds of five (spina bifida, cleft palate, anorectal atresia, hypospadias, transverse limb deficiency) and a higher odds of two (anencephaly, gastroschisis) birth defects. Mothers spending less time sitting in pre-pregnancy was associated with a reduced odds of two (anorectal atresia, hypospadias) and a higher odds of one (cleft lip with or without cleft palate) birth defect. CONCLUSIONS Reasonable next steps include replication of these findings, improved exposure assessment, and elucidation of biologic mechanisms. IMPACT Using data from two population-based case-control studies, we found that mothers engaging in different types of physical activity in the 3 months before pregnancy had an infant with a reduced odds of five and a higher odds of two birth defects. Mothers spending less time sitting in the 3 months before pregnancy had an infant with a reduced odds of two and a higher odds of one birth defect. Clarification and confirmation from additional studies are needed using more precise exposure measures, distinguishing occupational from leisure-time physical activity, and elucidation of mechanisms supporting these associations.
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Affiliation(s)
- Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA.
| | - Sanjida Mowla
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - Gary M Shaw
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Elizabeth C Ailes
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jennita Reefhuis
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Neha Joshi
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - Tania A Desrosiers
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
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Lackovic M, Jankovic M, Mihajlovic S, Milovanovic Z, Nikolic D. Exploring the Connection between Migraines and Pregnancy: The Impact of Physical Activity on Symptom Management. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:49. [PMID: 38256310 PMCID: PMC10820455 DOI: 10.3390/medicina60010049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024]
Abstract
Migraine is a prevalent neurological disorder that significantly impacts the quality of life for affected individuals. The pathogenesis behind migraines is not yet fully understood, but hormonal changes, especially fluctuations in, estrogen and progesterone levels, have a significant role in the susceptibility of women to migraines. Pregnancy introduces a unique set of challenges for women who experience migraines, as they must navigate the complexities of managing their condition while safeguarding the health of both them and their unborn child. Pharmacological options for treating migraines during pregnancy are limited, and, therefore, there is a growing interest in exploring alternative approaches to migraine symptom relief and management. Physical activity during pregnancy provides a range of benefits, and it has gained attention as a potentially valuable tool for alleviating migraine symptoms in pregnant patients. This review explores the intricate relationship between migraines and pregnancy, emphasizing how physical activity and other alternative approaches may influence the frequency, severity, and overall experience of migraines during pregnancy. Through collaboration with healthcare providers and the adoption of personalized management strategies, women can strike a balance that supports both their own well-being and the healthy development of their unborn child. By examining existing research and emerging insights, we aim to provide a comprehensive understanding of the potential benefits and considerations of incorporating physical activity and other treatment options into migraine management strategies for pregnant women. Further research is needed to elucidate the specific mechanisms linking migraines, pregnancy, and physical activity, enabling the development of more targeted interventions and guidelines.
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Affiliation(s)
- Milan Lackovic
- Department of Obstetrics and Gynecology, University Hospital “Dragisa Misovic”, Milana Tepica 1, 11000 Belgrade, Serbia; (M.L.); (S.M.)
| | - Milena Jankovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.J.); (Z.M.)
- Neurology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Sladjana Mihajlovic
- Department of Obstetrics and Gynecology, University Hospital “Dragisa Misovic”, Milana Tepica 1, 11000 Belgrade, Serbia; (M.L.); (S.M.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.J.); (Z.M.)
| | - Zagorka Milovanovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.J.); (Z.M.)
- Clinic for Gynecology and Obstetrics “Narodni Front”, 11000 Belgrade, Serbia
| | - Dejan Nikolic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.J.); (Z.M.)
- Department of Physical Medicine and Rehabilitation, University Children’s Hospital, 11000 Belgrade, Serbia
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Barakat R, Silva-Jose C, Zhang D, Sánchez-Polán M, Refoyo I, Montejo R. Influence of Physical Activity during Pregnancy on Maternal Hypertensive Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Pers Med 2023; 14:10. [PMID: 38276226 PMCID: PMC10817323 DOI: 10.3390/jpm14010010] [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: 11/18/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Gestational hypertension is a notable concern with ramifications for maternal and fetal health. Preemptive measures, including physical activity (PA), are crucial. There is a pressing need for comprehensive investigations into the impact of various forms of PA on hypertensive disorders. A systematic review and meta-analysis (CRD42022372468) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed. Our review exclusively considered randomized clinical trials (RCTs) between 2010 and 2023, using the following databases: EBSCO, including Academic Search Premier, Education Resources Information Center, PubMed/MEDLINE, SPORTDiscus, and OpenDissertations; Clinicaltrials.gov; Web of Science; Scopus; the Cochrane Database of Systematic Reviews; and the Physiotherapy Evidence Database (PEDro). The primary outcome was hypertensive disorders occurring during pregnancy (14 studies). Diagnosed preeclampsia (15 studies) and blood pressure levels were also examined (17 studies). PA during pregnancy was significantly associated with a reduced risk of hypertensive disorders (RR = 0.44, 95% CI = 0.30, 0.66). The data also indicate a positive correlation between PA during pregnancy and both systolic (MD = -2.64, 95% CI = -4.79, -0.49) and diastolic (MD = -1.99, 95% CI = -3.68, -0.29) blood pressure levels. The relationship between PA and the incidence of diagnosed preeclampsia did not demonstrate a statistically significant association (RR = 0.81, 95% CI = 0.59, 1.11; p = 0.20). Random effects were used for all analyses. PA during pregnancy promises to improve maternal health by reducing the risk of gestational hypertension and positively affecting systolic and diastolic blood pressure.
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Affiliation(s)
- Rubén Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.S.-J.); (D.Z.); (M.S.-P.)
| | - Cristina Silva-Jose
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.S.-J.); (D.Z.); (M.S.-P.)
| | - Dingfeng Zhang
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.S.-J.); (D.Z.); (M.S.-P.)
| | - Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.S.-J.); (D.Z.); (M.S.-P.)
| | - Ignacio Refoyo
- Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Rocío Montejo
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 41346 Gothenburg, Sweden;
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, 41346 Gothenburg, Sweden
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Whooten RC, Kotelchuck M, Gonzalez AVC, Johnson N, Kwete G, Luo M, Muir HF, Barth EA, Smith N, Taveras EM. Expectant fathers' health behaviors, infant care intentions, and social-emotional wellbeing in the perinatal period: A latent class analysis and comparison to mothers. Prev Med Rep 2023; 36:102375. [PMID: 37719794 PMCID: PMC10500477 DOI: 10.1016/j.pmedr.2023.102375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/18/2023] [Accepted: 08/19/2023] [Indexed: 09/19/2023] Open
Abstract
While parental behaviors during the 'first thousand days' are critical for child health, little is known about fathers during this time. We examined prenatal patterns of health behaviors, social-emotional wellbeing, and infant care intentions among expectant fathers, both overall and compared to expectant mothers. Among 227 mother-father dyads enrolling in a randomized controlled trial of a perinatal obesity prevention program in Boston, Massachusetts (July 2020-July 2022), participants independently completed baseline surveys addressing (1) health behaviors, (2) social emotional wellbeing, and (3) infant care intentions. We compared paternal and maternal responses to survey items within each of these domains. Further, we conducted a latent class analysis of paternal responses and examined their associations with sociodemographic characteristics. Compared to expectant mothers, fathers were more likely to report increased body mass index, less fruit intake, decreased sleep, increased physical activity, and no recent primary care visit. Latent class analysis revealed four distinct groups of paternal health behaviors and infant care intentions: (1) more health behaviors with less infant care; (2) less health behaviors with less infant care; (3) less health behaviors with more infant care; and (4) more health behaviors with more infant care. Fathers with increased health behaviors were more likely to have higher education and income. Fathers with decreased health behaviors were more likely to endorse food insecurity, housing insecurity, and social isolation. Our findings identify potential areas for targeting expectant fathers in health promotion initiatives and suggest that social needs may impact the capacity to adopt healthy lifestyle behaviors.
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Affiliation(s)
- Rachel C. Whooten
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
| | - Milton Kotelchuck
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
| | - Ariadne V. Caballero Gonzalez
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
| | - Nafissa Johnson
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
| | - Gracia Kwete
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
| | - Man Luo
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
| | - Haley Farrar Muir
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
| | - Elizabeth A. Barth
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
| | - Nicole Smith
- Department of Obstetrics, Brigham and Women’s Hospital, Boston, MA, United States
| | - Elsie M. Taveras
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, MA, United States
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Lesser IA, Nienhuis CP, Hatfield GL. Moms on the move: A qualitative exploration of a postpartum group exercise program on physical activity behaviour at three distinct time points. Int J Qual Stud Health Well-being 2023; 18:2172793. [PMID: 36710424 PMCID: PMC9888496 DOI: 10.1080/17482631.2023.2172793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
PURPOSE Physical activity (PA) after the birth of a child is associated with improved physical and mental health benefits. The aim of the study was to explore new mothers' experiences of PA before and after participation in a group-based PA program for new mothers. The study has three research questions: how new mothers felt; 1) about PA after the birth of their child 2) about engaging in a group-based PA program and 3) after the program ended about ongoing PA engagement. METHODS We conducted an 8-week bi-weekly PA program for postpartum women. To understand the experience of postpartum women engaging in a group-based PA program we conducted one-on-one semi-structured interviews before, after, and at 6-month follow-up. RESULTS Of the n = 21 participants in the Moms on the Move study; n = 17 completed pre interviews.s. One primary theme emerged from pre-program interviews where mothers shared how they were lost as to where to start PA. Post-program interviews produced two primary themes; engaging in PA helped mothers, and mothers learned to rethink PA. CONCLUSIONS Postpartum women who participated in this group-based PA program had positive benefits to their mental and physical health and were able to alter their PA behaviour.
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Affiliation(s)
- Iris A. Lesser
- School of Kinesiology, University of the Fraser Valley, Chilliwack, BC, Canada
| | - Carl P. Nienhuis
- School of Kinesiology, University of the Fraser Valley, Chilliwack, BC, Canada,CONTACT Carl P. Nienhuis School of Kinesiology, University of the Fraser Valley, ChilliwackV2R0N3, Canada
| | - Gillian L. Hatfield
- School of Kinesiology, University of the Fraser Valley, Chilliwack, BC, Canada
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Xu H, Liu R, Wang X, Yang J. Effectiveness of aerobic exercise in the prevention and treatment of postpartum depression: Meta-analysis and network meta-analysis. PLoS One 2023; 18:e0287650. [PMID: 38019729 PMCID: PMC10686497 DOI: 10.1371/journal.pone.0287650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Aerobic exercise is widely recognized for improving mental health and reducing negative emotions, including anxiety. However, research on its role in preventing and treating postpartum depression (PPD) has yielded inconsistent results. Some studies show positive effects on PPD symptoms, while others find limited impact, suggesting various factors at play, such as exercise type, intensity, and individual differences. To address this gap, our study aims to comprehensively gather evidence on the preventive and therapeutic effects of aerobic exercise for PPD. We'll focus on differences in exercise program design and implementation, exploring how these factors impact intervention outcomes. By identifying effective exercise approaches, we aim to provide more comprehensive exercise prescription recommendations for this vulnerable population. METHODS We conducted a quantitative systematic review of the study in 5 representative databases for the effect of aerobic exercise on PPD. Meta-analysis and network meta-analysis were performed with Review-Manager.5.4 and Stata.16.0 software, respectively. This study has been registered on the official Prospero website, and the registration code is CRD42023398221. RESULTS Twenty-six studies with 2,867 participants were eventually included and the efficacy of aerobic exercise in preventing and treating postpartum depression is significant compared to standard care. (MD = -1.90; 95%CL: -2.58 to -1.21; I2 = 86%). Subgroup analysis suggests that the intervention objective (prevention vs. treatment) of exercise could potentially be a source of heterogeneity in this study, as the "Test for subgroup difference" revealed the presence of significant distinctions (p = 0.02<0.05). The "Test for subgroup difference" yielded non-significant results for both the supervised vs. unsupervised subgroup comparison (p = 0.55 > 0.05) and the individual vs. team subgroup comparison (p = 0.78 > 0.05). Nonetheless, when assessing their effect sizes [Subtotal (95%CL)], the supervised exercise group [-1.66 (-2.48, -0.85)] exhibited a slightly better performance than the unsupervised exercise group [-1.37 (-1.86, -0.88)], while the team exercise group [-1.43 (-1.94, -0.93)] slightly outperformed the individual exercise group [-1.28 (-2.23, -0.33)]. Network meta-analysis indicated that moderate intensity (35~45 min) group demonstrated a more pronounced intervention effect compared to low intensity (50~60 min) group [-2.63 (-4.05, -1.21)] and high intensity (20~30 min) group [-2.96 (-4.51, -1.41)], while the 3~4 times/week group had a more significant intervention effect compared to 1~2 times/week groups [-2.91 (-3.99, -1.83)] and 5~6 times/week groups [-3.28 (-4.75, -1.81)]. No significant differences were observed in pairwise comparisons of intervention effects among the five common types of aerobic exercises. (95%CL including 0). The Surface Under the Cumulative Ranking curve (SUCRA) results align with the findings mentioned above and will not be reiterated here. CONCLUSION The efficacy of aerobic exercise in preventing and treating postpartum depression is significant compared to standard care, with a greater emphasis on prevention. The optimal prescribed exercise volume for intervention comprises a frequency of 3~4 exercise sessions per week, moderate intensity (35~45 minutes). Currently, several uncharted internal factors influence the optimal intervention effect of aerobic exercise, such as the potential enhancement brought by team-based and supervised exercise. Given the absence of significant differences in certain results and the limitations of the study, it is essential to exercise caution when interpreting the outcomes. Further research is needed in the future to provide a more comprehensive understanding.
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Affiliation(s)
- Hao Xu
- School of Physical Education, China University of Geosciences (Wuhan), Wuhan, China
| | - Renyi Liu
- School of Physical Education, China University of Geosciences (Wuhan), Wuhan, China
| | - Xiubing Wang
- School of Physical Education, China University of Geosciences (Wuhan), Wuhan, China
| | - Jiahui Yang
- School of Physical Education, China University of Geosciences (Wuhan), Wuhan, China
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Shang X, Ye L, Gu X, Zhou A, Xu Y, Zhang Y, Liao Y, Li L. Attitudes and Barriers to Physical Activity and Exercise Self-Efficacy Among Chinese Pregnant Women: A Cross-Sectional Study. J Multidiscip Healthc 2023; 16:3561-3573. [PMID: 38024132 PMCID: PMC10676646 DOI: 10.2147/jmdh.s441210] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/15/2023] [Indexed: 12/01/2023] Open
Abstract
Background Most pregnant women do not reach the recommendation for physical activity (PA). As a subcategory of PA, exercise is also essential. Evidence on pregnant women's attitudes and barriers to PA and exercise self-efficacy in China is scarce. Aim To explore the levels and influencing factors of attitudes and barriers to PA and exercise self-efficacy among pregnant women. Methods A cross-sectional study of 311 pregnant women was conducted from August to December 2022. Individual characteristics, pregnant women's attitudes toward exercise, barriers to prenatal PA and exercise, and exercise self-efficacy were measured using the self-designed demographic questionnaire, pregnant women's attitudes toward exercise questionnaire, barriers to prenatal PA and exercise questionnaire, and the pregnancy exercise self-efficacy scale, respectively. Results More than 90% of pregnant women believed exercise benefits themselves and their babies, and 40.8% of pregnant women did not know how to exercise. Women encounter different types of barriers to PA and exercise. Intrapersonal barriers included the proportion of feelings of tiredness (56.6%), low energy (54.7%), lack of interest or motivation (49.2%), feelings of illness and morning sickness (46.6%), and large body weight (43.7%). Interpersonal barriers included pregnant women being advised to avoid PA and exercise (49.2%), lack of clear advice about the intensity and dose of exercise (41.8%), no one to exercise with (38.9%), and lack of advice from healthcare professionals (38.6%). Weather conditions were the most significant environmental barriers (41.2%). The total score of pregnancy exercise self-efficacy was (38.50±7.33). Education level, parity, and attitudes toward exercise independently predict pregnant women's attitudes toward exercise, barriers to prenatal PA and exercise, and exercise self-efficacy, respectively. Conclusion Pregnant women have a favorable attitude toward exercise and relatively good exercise self-efficacy but lack knowledge of exercise. They face numerous barriers. Medical professionals should encourage pregnant women with lower levels of education to exercise and assist multipara in overcoming obstacles.
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Affiliation(s)
- Xingchen Shang
- School of Nursing, Yangzhou University, Yangzhou, People’s Republic of China
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, People’s Republic of China
| | - Linfei Ye
- School of Nursing, Yangzhou University, Yangzhou, People’s Republic of China
| | - Xiaohua Gu
- Delivery Room, Yangzhou Maternal and Child Care Service Centre, Yangzhou, People’s Republic of China
| | - Aihua Zhou
- Delivery Room, Taizhou Second People’s Hospital, Taizhou, People’s Republic of China
| | - Yunmei Xu
- Obstetrics and Gynecology Department, Baoying People’s Hospital, Yangzhou, People’s Republic of China
| | - Yiran Zhang
- School of Nursing, Yangzhou University, Yangzhou, People’s Republic of China
| | - Yuexia Liao
- School of Nursing, Yangzhou University, Yangzhou, People’s Republic of China
| | - Lin Li
- Department of Nursing, The Affiliated Hospital of Yangzhou University, Yangzhou, People’s Republic of China
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Brites-Lagos C, Ramos L, Szumilewicz A, Santos-Rocha R. Feasibility of a Supervised Postpartum Exercise Program and Effects on Maternal Health and Fitness Parameters-Pilot Study. Healthcare (Basel) 2023; 11:2801. [PMID: 37893875 PMCID: PMC10606677 DOI: 10.3390/healthcare11202801] [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: 09/05/2023] [Revised: 09/27/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
The postpartum period is marked by profound changes in women at physical, psychological, and physiological levels. Many of these changes persist after four to six weeks postpartum, and most women do not resume their levels of physical activity, which increases the risk of remaining inactive for many years. It is crucial to implement effective programs that promote exercise during the postpartum period. The objective of this study was to test the feasibility and analyze the effects of a structured and supervised postpartum exercise program on maternal health and fitness parameters. To analyze the potential effects of the intervention, the level of physical activity, quality of life, pelvic girdle and low back pain, fatigue, depression, and the level of functional and physical fitness were assessed at baseline, after 8 weeks, and after 16 weeks of intervention. Feedback on the exercise program was collected after the final assessment. The results showed that a structured and supervised postpartum exercise program was feasible and safe and produced positive effects on selected maternal health and fitness parameters. These results will encourage a study protocol with a larger sample in order to prove its effectiveness, improve the guidelines for postpartum exercise, and incorporate this program into a routine healthcare setting.
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Affiliation(s)
- Carla Brites-Lagos
- ESDRM, Department of Physical Activity and Health, Sport Sciences School of Rio Maior, Polytechnic Institute of Santarem, 2040-413 Rio Maior, Portugal; (C.B.-L.); (L.R.)
| | - Liliana Ramos
- ESDRM, Department of Physical Activity and Health, Sport Sciences School of Rio Maior, Polytechnic Institute of Santarem, 2040-413 Rio Maior, Portugal; (C.B.-L.); (L.R.)
- CIEQV, Life Quality Research Center, Polytechnic Institute of Santarem, 2040-413 Rio Maior, Portugal
| | - Anna Szumilewicz
- Department of Fitness, Faculty of Physical Culture, Gdansk University of Physical Education and Sport, 80-336 Gdansk, Poland;
| | - Rita Santos-Rocha
- ESDRM, Department of Physical Activity and Health, Sport Sciences School of Rio Maior, Polytechnic Institute of Santarem, 2040-413 Rio Maior, Portugal; (C.B.-L.); (L.R.)
- CIPER, Interdisciplinary Centre for the Study of Human Performance, Faculty of Human Kinetics, University of Lisbon, 1499-002 Cruz Quebrada, Portugal
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Chasan-Taber L, Park S, Marcotte RT, Staudenmayer J, Strath S, Freedson P. Update and Novel Validation of a Pregnancy Physical Activity Questionnaire. Am J Epidemiol 2023; 192:1743-1753. [PMID: 37289205 DOI: 10.1093/aje/kwad130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 05/12/2023] [Accepted: 05/26/2023] [Indexed: 06/09/2023] Open
Abstract
The aim of this study was to update and validate the Pregnancy Physical Activity Questionnaire (PPAQ), using novel and innovative accelerometer and wearable camera measures in a free-living setting, to improve the measurement performance of this method for self-reporting physical activity. A prospective cohort of 50 eligible pregnant women were enrolled in early pregnancy (mean = 14.9 weeks' gestation). In early, middle, and late pregnancy, participants completed the updated PPAQ and, for 7 days, wore an accelerometer (GT3X-BT; ActiGraph, Pensacola, Florida) on the nondominant wrist and a wearable camera (Autographer; OMG Life (defunct)). At the end of the 7-day period, participants repeated the PPAQ. Spearman correlations between the PPAQ and accelerometer data ranged from 0.37 to 0.44 for total activity, 0.17 to 0.53 for moderate- to vigorous-intensity activity, 0.19 to 0.42 for light-intensity activity, and 0.23 to 0.45 for sedentary behavior. Spearman correlations between the PPAQ and wearable camera data ranged from 0.52 to 0.70 for sports/exercise and from 0.26 to 0.30 for transportation activity. Reproducibility scores ranged from 0.70 to 0.92 for moderate- to vigorous-intensity activity and from 0.79 to 0.91 for sports/exercise, and were comparable across other domains of physical activity. The PPAQ is a reliable instrument and a valid measure of a broad range of physical activities during pregnancy.
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Morales-Suárez-Varela M, Marcos Puig B, Peraita-Costa I, Llopis-Morales J, Hernandez-Segura N, Llopis-González A. [Sedentary lifestyle in pregnancy: Effects on the mother and the newborn]. Semergen 2023; 49:102025. [PMID: 37348252 DOI: 10.1016/j.semerg.2023.102025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 06/24/2023]
Abstract
OBJECTIVE Identify the state of sedentary lifestyle during pregnancy and the factors associated with this behavior, the possible factors of your health situation and that of the newborn. MATERIAL AND METHODS This two-phase, cross-sectional observational study was developed at the La Fe University and Polytechnic Hospital and 228 pregnant women participated. Maternal sociodemographic characteristics were obtained using structured questionnaire and health information from the electronic medical records, as well as perinatal results of the newborn. To assess sedentary lifestyle, exercise in free time and exercise during working hours were assessed, categorizing them based on intensity (sedentary lifestyle, light activity, moderate and intense activity). RESULTS In total, the prevalence of physical inactivity was 31.14%. The profile of this group has a lower level of education and unemployment (P<.05), presenting a higher prevalence of problems during childbirth, which required a caesarean section, as well as problems after birth in the newborn (P<.05). CONCLUSIONS Physical inactivity is highly prevalent among pregnant women. Due to the benefits (or non-harm) attributed to exercise during pregnancy. Further efforts should be taken to overcome the barriers to promote activities among pregnant women who are younger, less well educated, and unemployed and those with multiple children and a lower income are less likely to engage in an adequate amount of physical activity, aware of the importance of doing it, resolving doubts and allaying fears that may arise from a poor understanding of the mechanism of its benefit.
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Affiliation(s)
- M Morales-Suárez-Varela
- Grupo de investigación en Epidemiología Social y Nutricional, Farmacoepidemiología y Salud Pública. Departamento de Medicina Preventiva y Salud Pública, Ciencias de la Alimentación, Toxicología y Medicina Legal. Facultad de Farmacia. Universitat de València, Burjassot, Valencia, España; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, España.
| | - B Marcos Puig
- Departamento de Ginecología y Obstetricia, Hospital Universitario y Politécnico de La Fe, Valencia, España
| | - I Peraita-Costa
- Grupo de investigación en Epidemiología Social y Nutricional, Farmacoepidemiología y Salud Pública. Departamento de Medicina Preventiva y Salud Pública, Ciencias de la Alimentación, Toxicología y Medicina Legal. Facultad de Farmacia. Universitat de València, Burjassot, Valencia, España; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, España
| | - J Llopis-Morales
- Grupo de investigación en Epidemiología Social y Nutricional, Farmacoepidemiología y Salud Pública. Departamento de Medicina Preventiva y Salud Pública, Ciencias de la Alimentación, Toxicología y Medicina Legal. Facultad de Farmacia. Universitat de València, Burjassot, Valencia, España
| | - N Hernandez-Segura
- Grupo de Investigación Gen-Ambiente y Salud (GIIGAS), Instituto de Biomedicina (IBIOMED), Universidad de León, León, España
| | - A Llopis-González
- Grupo de investigación en Epidemiología Social y Nutricional, Farmacoepidemiología y Salud Pública. Departamento de Medicina Preventiva y Salud Pública, Ciencias de la Alimentación, Toxicología y Medicina Legal. Facultad de Farmacia. Universitat de València, Burjassot, Valencia, España; CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, España
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Al-Dahshan A, Kehyayan V, Al-Kubaisi N, Selim N. Utilization of the internet for physical activity and diet information and its influence on pregnant women's lifestyle habits in Qatar. Front Public Health 2023; 11:1272109. [PMID: 37829092 PMCID: PMC10564989 DOI: 10.3389/fpubh.2023.1272109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 09/11/2023] [Indexed: 10/14/2023] Open
Abstract
Background Maintaining a healthy lifestyle during pregnancy is essential. With the increasing availability of the internet, pregnant women have access to a wealth of information related to physical activity (PA) and healthy diets. Objectives The study aims to investigate the extent of internet usage by pregnant women attending antenatal clinics in Qatar to obtain information about PA and healthy diets, identify associated factors, and evaluate the impact of this information on their lifestyle habits. Methods A cross-sectional study was conducted in six randomly selected public antenatal clinics in Qatar. Pregnant women aged ≥18 years in any trimester were recruited using a probability sampling technique. Data were collected through self-administered questionnaires. Descriptive and analytic statistics were employed for data analysis. Results A total of 327 pregnant women (mean age of 29.5 years ± 4.0) completed and returned the questionnaire (response rate: 87.5%). Among the participants, 54.5% used the internet to obtain information about PA, while 72% sought online diet-related information. Factors such as age (26-35 years), tertiary education, employment status, and being primigravidae were associated with a higher likelihood of using the internet for healthy lifestyles information. Participants who reported using the internet for PA information a great deal were more likely to increase their PA during pregnancy compared to those who used it somewhat or very little (57.6, 26.8, and 5.0%, p < 0.001; respectively). Similarly, those who used the internet for diet information a great deal were more likely to increase their fruit and vegetable consumption compared to those who used it somewhat, or very little (84.2, 68.5, and 63.6%, p = 0.038; respectively). Also, participants who used the internet for diet information a great deal were more likely to decrease the amount of sugary and fatty foods they ate compared to women who used the internet somewhat or very little (61.4, 45.2, and 18.2%, p < 0.001; respectively) and (50.9, 30.4, and 18.2%, p = 0.001; respectively). Conclusion Many pregnant women use the internet to access information about PA and diet, and greater use is associated with more positive lifestyle changes. This study provides useful information to consider when designing intervention programs for pregnant women about adopting and maintaining healthy lifestyles.
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Affiliation(s)
- Ayman Al-Dahshan
- Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
| | - Vahe Kehyayan
- University of Doha for Science and Technology, Doha, Qatar
| | - Noora Al-Kubaisi
- Department of Clinical Affairs, Primary Health Care Corporation, Doha, Qatar
| | - Nagah Selim
- Department of Public Health and Preventive Medicine, Faculty of Medicine Cairo University, Cairo, Egypt
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Kishman EE, Castleberry LA, Wang X. Physical Activity Participation of Black and White Women during the First Year Postpartum: Results and Study Recruitment Strategies. Healthcare (Basel) 2023; 11:2625. [PMID: 37830662 PMCID: PMC10573046 DOI: 10.3390/healthcare11192625] [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: 08/16/2023] [Revised: 09/08/2023] [Accepted: 09/23/2023] [Indexed: 10/14/2023] Open
Abstract
Background: Little is known about how physical activity participation changes throughout the first year postpartum. This may be due to the difficulty in recruiting this population. The aims of this study were first to describe the recruitment methods and second to examine physical activity in the first year postpartum. Methods: Black and White women who gave birth to a singleton infant at ≥37 weeks gestation were recruited by a variety of strategies. At 6-8 weeks (baseline) and 4, 6, 9, and 12 months postpartum, women were instructed to wear an accelerometer for 7 days. Results: Active recruitment with interactions between staff and potential participants was more successful than non-active strategies for enrolling women. Throughout the first year postpartum, physical activity counts and light and moderate-to-vigorous physical activity increased from baseline (165.2 and 21.5 min, respectively) to 12 months (185.0 and 27.6 min, respectively). Sedentary time decreased from 775.3 min at baseline to 749.4 min per day at 12 months. In this sample, Black participants had lower physical activity (counts per minute per day) and greater sedentary time than White participants. Conclusions: Active strategies were more successful in recruiting women into the study. Of those who enrolled, physical activity levels increased over time. Identifying barriers to physical activity that may change over the postpartum period will help develop more targeted interventions to increase physical activity.
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Affiliation(s)
- Erin E. Kishman
- Department of Exercise Science, School of Public Health, University of South Carolina, 921 Assembly St., PHRC 301, Columbia, SC 29208, USA
| | - Lauren A. Castleberry
- Department of Obstetrics and Gynecology, Lexington Medical Center, West Columbia, SC 29169, USA
| | - Xuewen Wang
- Department of Exercise Science, School of Public Health, University of South Carolina, 921 Assembly St., PHRC 301, Columbia, SC 29208, USA
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Prémusz V, Makai A, Ács P, Derkács E, Laczkó T. Association of Outdoor Physical Activity and Sports with Life Satisfaction among Women of Reproductive Age According to a European Representative Sample-A Longitudinal Analysis. Eur J Investig Health Psychol Educ 2023; 13:1859-1879. [PMID: 37754474 PMCID: PMC10528805 DOI: 10.3390/ejihpe13090135] [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: 08/10/2023] [Revised: 09/01/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023] Open
Abstract
(1) Background: Low life satisfaction (LS) is associated with impaired mental and physical health. Outdoor physical activity (PA) has diverse somatic and psychological benefits. This study aimed to analyse the associations between sports settings and LS in women of reproductive age. (2) Methods: Special Eurobarometer on Sport and Physical Activity (2022, 2018, 2013) data on regularity and settings of sports/PA, LS and sociodemographic variables were analysed. The representative sample consisted of 18,489 women (34.60 ± 9.36 years). Pearson χ2 test and multivariate logistic regression analysis were conducted, using IBM SPSS version 28.0 according to the STROBE guidelines. The significance level was set at p < 0.05. (3) There was a significant difference in LS based on sports settings (χ2 = 409.696, p < 0.001). In the outdoor group, a 21.4% higher probability of being "very satisfied" compared to the non-outdoor, 30.0% higher compared to the inactive group, was found (R2N = 0.151). Dividing the sample by age, a significant effect remained in middle adulthood (35-44 years p = 0.002 and 45-49 years p = 0.033). (4) Conclusions: Our results underline the importance of the promotion of outdoor, green exercise and the development of special interventions to maintain or improve the psychological well-being of women in reproductive age.
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Affiliation(s)
- Viktória Prémusz
- Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (A.M.); (P.Á.); (E.D.); (T.L.)
- Physical Activity Research Group, Szentágothai Research Centre, 7624 Pécs, Hungary
- MTA-PTE Human Reproduction Scientific Research Group, University of Pécs, 7624 Pécs, Hungary
- National Laboratory on Human Reproduction, University of Pécs, 7624 Pécs, Hungary
| | - Alexandra Makai
- Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (A.M.); (P.Á.); (E.D.); (T.L.)
- Physical Activity Research Group, Szentágothai Research Centre, 7624 Pécs, Hungary
| | - Pongrác Ács
- Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (A.M.); (P.Á.); (E.D.); (T.L.)
- Physical Activity Research Group, Szentágothai Research Centre, 7624 Pécs, Hungary
| | - Evelin Derkács
- Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (A.M.); (P.Á.); (E.D.); (T.L.)
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
| | - Tamás Laczkó
- Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary; (A.M.); (P.Á.); (E.D.); (T.L.)
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Chu AHY, Padmapriya N, Tan SL, Goh CMJL, Chong YS, Shek LP, Tan KH, Gluckman PD, Yap FKP, Lee YS, Loy SL, Chan JKY, Godfrey KM, Eriksson JG, Chan SY, Bernard JY, Müller-Riemenschneider F. Longitudinal Analysis of Patterns and Correlates of Physical Activity and Sedentary Behavior in Women From Preconception to Postpartum: The Singapore Preconception Study of Long-Term Maternal and Child Outcomes Cohort. J Phys Act Health 2023; 20:850-859. [PMID: 37146982 DOI: 10.1123/jpah.2022-0642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/24/2023] [Accepted: 03/20/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVE Longitudinal changes in physical activity (PA) and sedentary behavior patterns from preconception to postpartum are not fully characterized. We examined changes and baseline sociodemographic/clinical correlates of PA and sedentary behavior in women from preconception to postpartum. METHODS The Singapore Preconception Study of Long-Term Maternal and Child Outcomes cohort recruited 1032 women planning pregnancy. Participants completed questionnaires at preconception, 34 to 36 weeks gestation, and 12 months postpartum. Repeated-measures linear regression models were used to analyze changes in walking, moderate to vigorous PA (MVPA), screen time, and total sedentary time, and to identify sociodemographic/clinical correlates associated with these changes. RESULTS Of the 373 women who delivered singleton live births, 281 provided questionnaires for all time points. Walking time increased from preconception to late pregnancy but decreased postpartum (adjusted means [95% CI]: 454 [333-575], 542 [433-651], and 434 [320-547] min/wk, respectively). Vigorous-intensity PA and MVPA decreased from preconception to late pregnancy but increased postpartum (vigorous-intensity PA: 44 [11-76], 1 [-3-5], and 11 [4-19] min/wk, MVPA: 273 [174-372], 165 [95-234], and 226 [126-325] min/wk, respectively). Screen time and total sedentary time remained consistent from preconception to pregnancy but decreased postpartum (screen: 238 [199-277], 244 [211-277], and 162 [136-189] min/d, total: 552 [506-598], 555 [514-596], and 454 [410-498] min/d, respectively). Individual characteristics of ethnicity, body mass index, employment, parity, and self-rated general health significantly influenced women's activity patterns. CONCLUSION During late pregnancy, walking time increased, while MVPA declined significantly, and partially returned to preconception levels postpartum. Sedentary time remained stable during pregnancy but decreased postpartum. The identified set of sociodemographic/clinical correlates underscores need for targeted strategies.
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Affiliation(s)
- Anne H Y Chu
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,Singapore
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Singapore
| | - Natarajan Padmapriya
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore
| | - Shuen Lin Tan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Singapore
| | - Claire Marie J L Goh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore
| | - Lynette P Shek
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore,Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Singapore
- Liggins Institute, University of Auckland, Auckland,New Zealand
| | - Fabian K P Yap
- Duke-NUS Medical School, Singapore,Singapore
- Department of Pediatrics, KK Women's and Children's Hospital, Singapore,Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore,Singapore
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Singapore
- Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore
| | - See Ling Loy
- Duke-NUS Medical School, Singapore,Singapore
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore,Singapore
| | - Jerry K Y Chan
- Duke-NUS Medical School, Singapore,Singapore
- Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore,Singapore
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Centre and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton,UK
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki,Finland
- Folkhälsan Research Center, Helsinki,Finland
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), Singapore,Singapore
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore,Singapore
| | - Jonathan Y Bernard
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and Statistics, Paris,France
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,Singapore
- Berlin Institute of Health, Charite University Medical Centre, Berlin,Germany
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48
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Zhang W, Zhang L, Wang X, Xu P, Guo P, Mao M, Zhao R, Feng S. Prevalence of Chinese pregnant women meeting physical activity recommendation and its influencing factors: a protocol for systematic review and meta-analysis. BMJ Open 2023; 13:e072700. [PMID: 37648391 PMCID: PMC10471849 DOI: 10.1136/bmjopen-2023-072700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023] Open
Abstract
INTRODUCTION Regular physical activity during pregnancy is effective in preventing diseases and promoting the health outcomes of mothers and babies. However, the level of physical activity among them is not ideal. Especially in China, the proportion of pregnant women who meet the recommendation of physical activity in the guidelines is even lower. Thus, we aim to evaluate the prevalence of meeting physical activity recommendation and its influencing factors during pregnancy in China. METHODS AND ANALYSIS This protocol is developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. PubMed, Web of Science, Scopus, CINAHL, MEDLINE, PsycINFO, EMBASE, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (Weipu) and WanFang Data will be comprehensively searched by two reviewers. Studies that report the prevalence of Chinese pregnant women meeting physical activity recommendation will be included. Two reviewers will independently assess eligibility, extract data and evaluate methodological quality. Data including authors, publication years, language, geographical region, tools, trimesters, prevalence and influence factors will be extracted. Data will be analysed by Stata V.11 statistical software. ETHICS AND DISSEMINATION No formal ethics approval is required for this protocol and no primary data are to be collected. Findings from this review may be useful to develop interventions for the physical activity of pregnant women in China. The results will be disseminated through peer-reviewed journals, conference presentations and public events. PROSPERO REGISTRATION NUMBER CRD42022372722.
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Affiliation(s)
- Wei Zhang
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Le Zhang
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaojuan Wang
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Ping Xu
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Pingping Guo
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Minna Mao
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Rujia Zhao
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Suwen Feng
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
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Currie S, Eadie A, O'Carroll RE. Qualitatively exploring the application of the necessity concerns framework to antenatal physical activity. BMC Pregnancy Childbirth 2023; 23:609. [PMID: 37620798 PMCID: PMC10463828 DOI: 10.1186/s12884-023-05918-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 08/12/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Adherence to physical activity (PA) recommendations during pregnancy is low. A common reason for low adherence is concern of harm to mother and/or baby. The Necessity-Concerns Framework (NCF), is a well-established framework in medicine adherence, however it has not been used to explore adherence to antenatal PA. This study aims to explore (1) what influences pregnant women's PA in the context of the NCF; and (2) if the NCF is an appropriate framework to understand antenatal PA engagement. METHODS Semi-structured interviews were conducted with 18 pregnant women in the UK and Ireland (mean gestation 27 weeks). Interviews explored beliefs, experiences, perceived necessities and concerns about PA. Interviews were transcribed verbatim and analysed using thematic framework analysis. RESULTS Five themes were identified as influential to antenatal PA: (1) Perceived benefits and necessity of PA, (2) Concerns regarding antenatal PA, (3) Balancing the necessity and concern, (4) Barriers to antenatal PA, (5) Facilitators of antenatal PA. Women described a number of perceived necessities and concerns regarding antenatal PA. These necessities and concerns were described as being consciously balanced, supporting the NCF. However, a number of additional influences (for example, feelings of nausea and lack of advice and knowledge) seemed to impact antenatal PA engagement before women could consider their perceived necessities and concerns around antenatal PA. CONCLUSIONS The Necessity Concerns Framework is a useful framework to help explain how and why women engage with antenatal PA, more specifically why women do and do not engage in antenatal PA at different times during their pregnancy. However, there are a number of other interpersonal and intrapersonal influences on antenatal PA (e.g. physical symptoms, motivation and time), suggesting the NCF alone may be too simplistic to understand and influence complex behaviour such as antenatal PA.
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Affiliation(s)
- Sinéad Currie
- Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, Scotland.
| | - Alison Eadie
- Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, Scotland
| | - Ronan E O'Carroll
- Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, Scotland
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50
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Do NC, Vestgaard M, Nørgaard SK, Damm P, Mathiesen ER, Ringholm L. Prediction and prevention of preeclampsia in women with preexisting diabetes: the role of home blood pressure, physical activity, and aspirin. Front Endocrinol (Lausanne) 2023; 14:1166884. [PMID: 37614711 PMCID: PMC10443220 DOI: 10.3389/fendo.2023.1166884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/13/2023] [Indexed: 08/25/2023] Open
Abstract
Women with type 1 or type 2 (preexisting) diabetes are four times more likely to develop preeclampsia compared with women without diabetes. Preeclampsia affects 9%-20% of pregnant women with type 1 diabetes and 7%-14% of pregnant women with type 2 diabetes. The aim of this narrative review is to investigate the role of blood pressure (BP) monitoring, physical activity, and prophylactic aspirin to reduce the prevalence of preeclampsia and to improve pregnancy outcome in women with preexisting diabetes. Home BP and office BP in early pregnancy are positively associated with development of preeclampsia, and home BP and office BP are comparable for the prediction of preeclampsia in women with preexisting diabetes. However, home BP is lower than office BP, and the difference is greater with increasing office BP. Daily physical activity is recommended during pregnancy, and limiting sedentary behavior may be beneficial to prevent preeclampsia. White coat hypertension in early pregnancy is not a clinically benign condition but is associated with an elevated risk of developing preeclampsia. This renders the current strategy of leaving white coat hypertension untreated debatable. A beneficial preventive effect of initiating low-dose aspirin (150 mg/day) for all in early pregnancy has not been demonstrated in women with preexisting diabetes.
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Affiliation(s)
- Nicoline Callesen Do
- Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark
- Department of Endocrinology and Metabolism, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Marianne Vestgaard
- Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark
- Department of Endocrinology and Metabolism, Rigshospitalet, Copenhagen, Denmark
| | - Sidse Kjærhus Nørgaard
- Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark
- Department of Endocrinology and Metabolism, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark
| | - Elisabeth R. Mathiesen
- Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark
- Department of Endocrinology and Metabolism, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lene Ringholm
- Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark
- Department of Endocrinology and Metabolism, Rigshospitalet, Copenhagen, Denmark
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