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Versele V, Dieberger A, van Poppel M, Van De Maele K, Deliens T, Aerenhouts D, Clarys P, Devlieger R, Bogaerts A. The influence of parental body composition and lifestyle on offspring growth trajectories. Pediatr Obes 2022; 17:e12929. [PMID: 35578741 DOI: 10.1111/ijpo.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/18/2022] [Accepted: 04/13/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Parental body composition, physical activity (PA) and sedentary time (ST) have been linked with offspring body weight and health. However, independent contributions of body composition, PA and ST of both parents on growth trajectories of their offspring, taking into account sex differences, has not been investigated. METHODS A total of 114 mother-father-child triads were included for analyses. Parental weight, height, PA and ST were objectively measured at 12 weeks of gestation. Gestational weight gain (GWG) and birthweight and -length were obtained from medical records. Offspring weight and length were measured repeatedly until 1 year of age. Longitudinal linear mixed models, stratified by offspring sex, were used to analyse the association between parental characteristics and offspring growth. RESULTS GWG (positive association), maternal moderate-to-vigorous PA (negative association) and paternal ST (positive association) were associated with weight trajectories in girls but not in boys. Parental characteristics were not associated with offspring length trajectories. CONCLUSIONS This study highlights the contribution of parental lifestyle characteristics on weight trajectories of their daughters during the first year of life. The paternal impact stresses the need to further investigate health behaviours of expecting fathers in relation to offspring health. Family-based interventions are needed with a focus on increasing PA and limiting ST in both parents.
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Affiliation(s)
- Vickà Versele
- Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium.,Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Anna Dieberger
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Mireille van Poppel
- Institute of Human Movement Science, Sport and Health, University of Graz, Austria
| | | | - Tom Deliens
- Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Dirk Aerenhouts
- Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Peter Clarys
- Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Roland Devlieger
- Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Obstetrics and Gynaecology, University Hospital, KU Leuven, Leuven, Belgium.,Department of Obstetrics, Gynaecology and Fertility, Wilrijk, Belgium
| | - Annick Bogaerts
- Department of Development and Regeneration, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Antwerp, Belgium.,Faculty of Health, University of Plymouth, Plymouth, UK
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Miranda LA, de Moura ACR, Kasawara KT, Surita FG, Moreira MA, do Nascimento SL. Exercise and Physical Activity Levels and Associated Factors Among High-Risk Pregnant Women. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:360-368. [PMID: 35276747 PMCID: PMC10032053 DOI: 10.1055/s-0042-1743099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To assess the levels of physical activity and exercise practice, and examine the associated maternal characteristics; as well as the anxiety levels of high-risk pregnant women. METHODS A cross-sectional study conducted with pregnant women at a High-risk Prenatal Clinic (HRPC) in a tertiary maternity. Pregnant women of 18 to 40-years-old, with a single fetus, and with gestational age up to 38 weeks were included. The level of physical activity and exercise practice of the study's participants were investigated using the Pregnancy Physical Activity Questionnaire (PPAQ). Maternal sociodemographic, anthropometric, and medical data were investigated using a specific form. For anxiety levels, the short version of the State-Trait Anxiety Inventory (STAI) was applied. We used the Student t-test, chi-square test, odds ratio (OR) with 95% confidence interval (95% CI) and multiple logistic regression. The significance level was 5%. RESULTS Among the 109 pregnant women included, 82 (75.2%) were classified as sedentary/little active. The higher energy expenditure were for domestic activities (133.81 ± 81.84 METs), followed by work-related activities (40.77 ± 84.71 METs). Only 19.3% women exercised during pregnancy (4.76 ± 12.47 METs), with slow walking being the most reported exercise. A higher level of education was the most important factor associated with women being moderately or vigorously active (OR = 29.8; 95% CI 4.9-117.8). Nulliparity (OR = 3.1; 95% CI 1.0-9.1), low levels of anxiety (OR = 3.6; 95% CI 1.2-10.7), and unemployment (OR = 4.8; 95% CI 1.1-19.6) were associated with the practice of exercise during pregnancy. CONCLUSION Most women with high-risk pregnancies exhibited a sedentary pattern, with low prevalence of physical exercise practice. Recognizing factors that hinder the adoption of a more physically active lifestyle is essential for an individualized guidance regarding exercise during pregnancy.
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Relationship between Physical Activity and Physical and Mental Health Status in Pregnant Women: A Prospective Cohort Study of the Japan Environment and Children's Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111373. [PMID: 34769889 PMCID: PMC8583492 DOI: 10.3390/ijerph182111373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 10/24/2021] [Accepted: 10/27/2021] [Indexed: 12/16/2022]
Abstract
To discuss appropriate physical activity (PA) levels during pregnancy, this prospective cohort study examined the relationships between PA levels before and during pregnancy and physical and mental health status. Fixed data for 104,102 pregnant women were used from the Japan Environment and Children’s Study, of which data for 82,919 women were analyzed after excluding women with multiple birth and pregnancy complications. PA levels were measured using the International Physical Activity Questionnaire-Short Form. The 8-Item Short Form Health Survey was used to measure outcomes. Logistic regression with multiple imputations showed that moderate PA for over 720 min/wk and vigorous PA before pregnancy were associated with poorer mental health in the first trimester (adjusted odds ratio (AOR): 1.087–1.376. Walking in the second and third trimesters was associated with better physical and mental health (AOR: 0.855–0.932). Moderate PA over 1080 min/wk and vigorous PA in the second and third trimesters were associated with poorer mental health (AOR: 1.223–1.873). Increases over 4135.4 MET–min/wk and decreases in PA levels were associated with poorer mental and physical health (AOR: 1.070–1.333). Namely, pregnant women receiving health benefits prefer continuous walking in addition to avoiding vigorous PA and excessive changes in PA levels during pregnancy.
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Wen J, Xun P, Chen C, Quan M, Wang R, Liu Y, He K. Non-occupational physical activity during pregnancy and the risk of preterm birth: a meta-analysis of observational and interventional studies. Sci Rep 2017; 7:44842. [PMID: 28327589 PMCID: PMC5361095 DOI: 10.1038/srep44842] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 02/14/2017] [Indexed: 12/16/2022] Open
Abstract
A meta-analysis was conducted to evaluate the association between non-occupational physical activity (PA) during pregnancy and the risk of preterm birth (PTB). By searching PubMed and EMBASE from inception to August 20, 2016, 25 observational studies (18 cohorts and 7 case-controls) and 12 interventional studies were identified. Comparing the highest to the lowest category of leisure-time PA during pregnancy, the pooled relative risk (RR) of PTB was 0.83 [95% confidence interval (CI) = 0.74-0.93] for cohort studies and 0.60 (95% CI = 0.43-0.84) for case-control studies. No overall significant association was found between domestic or commuting PA and the risk of PTB. In addition, PA intervention did not indicate significant beneficial effect on the risk of PTB. Evidence from the observational studies suggested that leisure-time, but not domestic or commuting, PA during pregnancy was inversely associated with the risk of PTB. The findings were not supported by small-scale and short-term interventional studies. Further research with objective measurement on leisure-time PA is warranted.
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Affiliation(s)
- Ju Wen
- Key Laboratory of Exercise and Health Sciences of the Ministry of Education, Shanghai University of Sport, Shanghai, China
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Pengcheng Xun
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Cheng Chen
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
| | - Minghui Quan
- Key Laboratory of Exercise and Health Sciences of the Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Ru Wang
- Key Laboratory of Exercise and Health Sciences of the Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Yu Liu
- Key Laboratory of Exercise and Health Sciences of the Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Ka He
- Department of Epidemiology and Biostatistics, School of Public Health-Bloomington, Indiana University, Bloomington, IN, USA
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5
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Bø K, Artal R, Barakat R, Brown W, Dooley M, Evenson KR, Haakstad LAH, Larsen K, Kayser B, Kinnunen TI, Mottola MF, Nygaard I, van Poppel M, Stuge B, Davies GAL. Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 2-the effect of exercise on the fetus, labour and birth. Br J Sports Med 2016; 50:1297-1305. [PMID: 27733352 DOI: 10.1136/bjsports-2016-096810] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2016] [Indexed: 11/03/2022]
Abstract
This is Part 2 of 5 in the series of evidence statements from the IOC expert committee on exercise and pregnancy in recreational and elite athletes. Part 1 focused on the effects of training during pregnancy and on the management of common pregnancy-related symptoms experienced by athletes. In Part 2, we focus on maternal and fetal perinatal outcomes.
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Affiliation(s)
- Kari Bø
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Raul Artal
- Department of Obstetrics/Gynecology and Women's Health, Saint Louis University, St Louis, Missouri, USA
| | - Ruben Barakat
- Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Wendy Brown
- Centre for Research on Exercise Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - Michael Dooley
- The Poundbury Clinic, King Edward VII Hospital London, Dorchester, UK
| | - Kelly R Evenson
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Lene A H Haakstad
- Department of Sport Sciences, Norwegian School of Sport Sciences, Oslo, Norway
| | - Karin Larsen
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Bengt Kayser
- Faculty of Biology and Medicine, Institute of Sport Science, University of Lausanne, Lausanne, Switzerland
| | - Tarja I Kinnunen
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Michelle F Mottola
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Lab, The University of Western Ontario, London, Ontario, Canada
| | - Ingrid Nygaard
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA
| | | | - Britt Stuge
- Division of Orthopaedic Surgery, Oslo University Hospital, Ullevål, Oslo, Norway
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Malta MB, Carvalhaes MADBL, Takito MY, Tonete VLP, Barros AJD, Parada CMGDL, Benício MHD. Educational intervention regarding diet and physical activity for pregnant women: changes in knowledge and practices among health professionals. BMC Pregnancy Childbirth 2016; 16:175. [PMID: 27439974 PMCID: PMC4955265 DOI: 10.1186/s12884-016-0957-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 07/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The knowledge and practices of health professionals have a recognized role in behaviors related to the health of their patients. During pregnancy, this influence can be even stronger because there is frequent contact between women and doctors/nurses at periodic antenatal visits. When trained, supported and motivated, these professionals can act as health promoters. This study aimed to evaluate the effect of a focused educational intervention on improving the knowledge and practices of health professionals concerning diet and physical activity during pregnancy. METHODS A controlled, non-randomized study was performed to assess the effects of an educational intervention on the knowledge and practices of nurses and doctors who provide primary care to pregnant women. The intervention group, doctors and nurses (n = 22) from the family health units in a medium-sized city of São Paulo State, Brazil, received 16 h of training comprising an introductory course and three workshops, whereas the control group, doctors and nurses (n = 20) from traditional basic health units in Botucatu, did not. The professionals' knowledge was assessed at two time points, 1 month prior to and 1 year after the beginning of the intervention, using an ad hoc self-report questionnaire. The increases in the knowledge scores for walking and healthy eating of the intervention and control groups were calculated and compared using Student's t-test. To analyze the professionals' practice, women in the second trimester of pregnancy were asked whether they received guidance on healthy eating and leisure-time walking; 140 of these women were cared for by professionals in the intervention group, and 141 were cared for by professionals in the control group. The percentage of pregnant women in each group that received guidance was compared using the chi-square test and the Prevalence Ratio (PR), and the corresponding 95 % confidence intervals (CI) were calculated. RESULTS The intervention improved the professionals' knowledge regarding leisure-time walking (92 % increase in the score, p < 0.001). The women who were cared for by the intervention group were more likely to receive guidance regarding leisure-time walking (PR = 2.65; 95 % CI = 1.82-3.83) and healthy eating (PR = 1.76; 95 % CI = 1.34-2.31) when compared to the control group. CONCLUSION It is possible to improve the knowledge and practices of health professionals through the proposed intervention aimed at primary health care teams providing antenatal care.
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Affiliation(s)
- Maíra Barreto Malta
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo - USP, Av. Dr. Arnaldo, 715, São Paulo, São Paulo, 01246-904, Brazil. .,, Rua Egidio Martins, 160 ap 315 Ponta da Praia, Santos, São Paulo, 11030160, Brazil.
| | | | - Monica Yuri Takito
- Departamento de Pedagogia do Movimento do Corpo Humano, Escola de Educação Física e Esporte, Universidade de São Paulo - USP, Av. Prof. Mello Moraes, 65, 05508-030, São Paulo, São Paulo, Brazil
| | - Vera Lucia Pamplona Tonete
- Departamento de Enfermagem, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP, Av. Professor Montenegro, 18618970, Botucatu, São Paulo, Brazil
| | - Aluísio J D Barros
- Departamento de Medicina Social, Faculdade de Medicina, Universidade Federal de Pelotas, Rua Mal. Deodoro, 1160, 3ºpiso, Pelotas, 96020220, Rio Grande do Sul, Brazil
| | - Cristina Maria Garcia de Lima Parada
- Departamento de Enfermagem, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP, Av. Professor Montenegro, 18618970, Botucatu, São Paulo, Brazil
| | - Maria Helena D'Aquino Benício
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo - USP, Av. Dr. Arnaldo, 715, São Paulo, São Paulo, 01246-904, Brazil
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Physical activity during pregnancy: predictors of change, perceived support and barriers among women at increased risk of gestational diabetes. Matern Child Health J 2015; 18:2158-66. [PMID: 24615354 DOI: 10.1007/s10995-014-1464-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The aim of this study was to examine the predictors of change in intensity-specific leisure-time physical activity (LTPA) during pregnancy, and the perceived support and barriers of LTPA in Finnish pregnant women at increased risk of gestational diabetes. The study population consisted of 399 pregnant women who participated in a randomized controlled trial aiming to prevent gestational diabetes. Evaluation of LTPA was based on a self-report at baseline, 26-28, and 36-37 weeks' gestation. Data on predictors of change, perceived support and barriers were collected with questionnaires and from the maternity cards. Multinomial logistic regression was used to assess associations between the variables. The average weekly minutes of light-intensity LTPA were 179 at baseline, 161 at 26-28 weeks' gestation, and 179 at 36-37 weeks' gestation. The corresponding minutes of moderate-to-vigorous-intensity LTPA were 187, 133 and 99. At 26-28 weeks' gestation, the strongest predictors for light-intensity LTPA were meeting the PA recommendations prior to pregnancy, having polytechnic education and working part-time, while having a physically active spouse prior to pregnancy was the strongest predictor for moderate-to-vigorous-intensity LTPA. The people and/or factors that encouraged women to LTPA the most were the spouse, a child, other family members and weather, whereas tiredness, nausea, perceived health, work and lack of time restricted their LTPA the most. The strongest predictors for maintaining LTPA during pregnancy were pre-pregnancy LTPA, education, working part-time and a spouse's LTPA. Most common barriers were perceived health, work and lack of time.
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Physically demanding work and preterm delivery: a systematic review and meta-analysis. Int Arch Occup Environ Health 2014; 87:809-34. [PMID: 24390632 DOI: 10.1007/s00420-013-0924-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 12/12/2013] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Physically demanding work may increase the risk of preterm delivery (PTD), defined as delivery before 37 weeks. We assessed the available evidence. METHODS A systematic search in Medline, Embase and Nioshtic for the period 1990 to June 2012 for observational and intervention studies on physically demanding work (prolonged standing, heavy lifting, physical exertion, occupational fatigue and demanding posture) and PTD. Selected studies were assessed for their risk of bias and pooled using a random effects model. Results of case-control and cohort studies were reported separately in subgroups. RESULTS We found 10 studies with low risk of bias and seven studies with moderate risk of bias. Standing and walking at work during pregnancy for more than 3 h per day was associated with an increased risk for PTD [OR 1.3 (95% CI 1.1-1.6)], just as lifting and carrying >5 kg [OR 1.3 (95% CI 1.05-1.6)] or lifting and carrying in the third trimester of the pregnancy [OR 1.3 (95% CI 1.01-1.8)]. Jobs that required physical effort or physical exertion were associated with an increased risk of PTD [OR 1.4 (95% CI 1.19-1.66)]. Working during pregnancy in jobs with a combination of two or more physical tasks, physical effort or occupational fatigue was also associated with an increased risk of PTD [OR 1.5 (95% CI 1.1-2.0)]. CONCLUSIONS Physically demanding work during pregnancy is associated with an increased risk of PTD, especially in jobs with a combination of tasks with physical effort. In general, only small to moderate elevations of risks were found.
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Wu J, Jiang C, Jaimes G, Bartell S, Dang A, Baker D, Delfino RJ. Travel patterns during pregnancy: comparison between Global Positioning System (GPS) tracking and questionnaire data. Environ Health 2013; 12:86. [PMID: 24107241 PMCID: PMC3907015 DOI: 10.1186/1476-069x-12-86] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Accepted: 09/30/2013] [Indexed: 05/06/2023]
Abstract
BACKGROUND Maternal exposures to traffic-related air pollution have been associated with adverse pregnancy outcomes. Exposures to traffic-related air pollutants are strongly influenced by time spent near traffic. However, little is known about women's travel activities during pregnancy and whether questionnaire-based data can provide reliable information on travel patterns during pregnancy. OBJECTIVES Examine women's in-vehicle travel behavior during pregnancy and examine the difference in travel data collected by questionnaire and global positioning system (GPS) and their potential for exposure error. METHODS We measured work-related travel patterns in 56 pregnant women using a questionnaire and one-week GPS tracking three times during pregnancy (<20 weeks, 20-30 weeks, and >30 weeks of gestation). We compared self-reported activities with GPS-derived trip distance and duration, and examined potentially influential factors that may contribute to differences. We also described in-vehicle travel behavior by pregnancy periods and influences of demographic and personal factors on daily travel times. Finally, we estimated personal exposure to particle-bound polycyclic aromatic hydrocarbon (PB-PAH) and examined the magnitude of exposure misclassification using self-reported vs. GPS travel data. RESULTS Subjects overestimated both trip duration and trip distance compared to the GPS data. We observed moderately high correlations between self-reported and GPS-recorded travel distance (home to work trips: r = 0.88; work to home trips: r = 0.80). Better agreement was observed between the GPS and the self-reported travel time for home to work trips (r = 0.77) than work to home trips (r = 0.64). The subjects on average spent 69 and 93 minutes traveling in vehicles daily based on the GPS and self-reported data, respectively. Longer daily travel time was observed among participants in early pregnancy, and during certain pregnancy periods in women with higher education attainment, higher income, and no children. When comparing self-reported vs. GPS data, we found that estimated personal exposure to PB-PAH did not differ remarkably at the population level, but the difference was large at an individual level. CONCLUSION Self-reported home-to-work data overestimated both trip duration and trip distance compared to GPS data. Significant differences in PAH exposure estimates were observed at individual level using self-reported vs. GPS data, which has important implications in air pollution epidemiological studies.
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Affiliation(s)
- Jun Wu
- Program in Public Health, College of Health Sciences, University of California, Irvine, CA, USA
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA
| | - Chengsheng Jiang
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Guillermo Jaimes
- Department of Environmental Science, Policy, & Management, University of California, Berkeley, CA, USA
| | - Scott Bartell
- Program in Public Health, College of Health Sciences, University of California, Irvine, CA, USA
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA
| | - Andy Dang
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA
| | - Dean Baker
- Center for Occupational & Environmental Health, University of California, Irvine, CA, USA
| | - Ralph J Delfino
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA
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Evenson KR, Barakat R, Brown WJ, Dargent-Molina P, Haruna M, Mikkelsen EM, Mottola MF, Owe KM, Rousham EK, Yeo S. Guidelines for Physical Activity during Pregnancy: Comparisons From Around the World. Am J Lifestyle Med 2013; 8:102-121. [PMID: 25346651 DOI: 10.1177/1559827613498204] [Citation(s) in RCA: 176] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Women attain numerous benefits from physical activity during pregnancy. However, due to physical changes that occur during pregnancy, special precautions are also needed. This review summarizes current guidelines for physical activity among pregnant women worldwide. METHODS We searched PubMed (MedLINE) for country-specific governmental and clinical guidelines on physical activity during pregnancy through the year 2012. We cross-referenced with articles referring to guidelines, with only the most recent included. An abstraction form was used to extract key details and summarize. RESULTS In total, 11 guidelines were identified from nine countries (Australia, Canada, Denmark, France, Japan, Norway, Spain, United Kingdom, United States). Most guidelines supported moderate intensity physical activity during pregnancy (10/11) and indicated specific frequency (9/11) and duration/time (9/11) recommendations. Most guidelines provided advice on initiating an exercise program during pregnancy (10/11). Six guidelines included absolute and relative contraindications to exercise. All guidelines generally ruled-out sports with risks of falls, trauma, or collisions. Six guidelines included indications for stopping exercise during pregnancy. CONCLUSION This review contrasted pregnancy-related physical activity guidelines from around the world, and can help to inform new guidelines as they are created or updated, and facilitate the development of a worldwide guideline.
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Affiliation(s)
- Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, 137 East Franklin Street Suite 306, Chapel Hill, North Carolina 27514, United States
| | - Ruben Barakat
- Faculty of Physical Activity and Sports Sciences_INEF. Technical University of Madrid. Martin Fierro 7. 28040, Madrid, Spain
| | - Wendy J Brown
- School of Human Movement Studies, University of Queensland, Blair Drive, St Lucia, QLD, 4072, Australia
| | - Patricia Dargent-Molina
- Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Epidemiology of Diabetes, Obesity and Chronic Kidney Disease Over the Lifecourse, F-94807, Villejuif, France, Univ Paris-Sud, UMRS 1018, F-94807, Villejuif, France
| | - Megumi Haruna
- Department of Midwifery and Women's Health, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan, Phone &
| | - Ellen M Mikkelsen
- Department of Clinical Epidemiology, Aarhus University Hospital, Olof Palmes Allé 43-45, Aarhus, 8200 N, Denmark
| | - Michelle F Mottola
- R. Samuel McLaughlin Foundation-Exercise & Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine, Children's Health Research Institute, University of Western Ontario, London, Canada N6A 3K7, , extension 85480
| | - Katrine M Owe
- Department of Social Statistics, Statistics Norway, Oslo, Norway
| | - Emily K Rousham
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - SeonAe Yeo
- School of Nursing, University of North Carolina - Chapel Hill, Chapel Hill, North Carolina, United States
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11
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Kasawara KT, Burgos CSG, do Nascimento SL, Ferreira NO, Surita FG, Pinto e Silva JL. Maternal and Perinatal Outcomes of Exercise in Pregnant Women with Chronic Hypertension and/or Previous Preeclampsia: A Randomized Controlled Trial. ISRN OBSTETRICS AND GYNECOLOGY 2013; 2013:857047. [PMID: 23997960 PMCID: PMC3753734 DOI: 10.1155/2013/857047] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 06/23/2013] [Indexed: 12/17/2022]
Abstract
Objectives. To evaluate the association between physical exercise supervised in pregnant women with chronic hypertension and/or previous preeclampsia and maternal and neonatal outcomes. Method. Randomized controlled trial, which included 116 pregnant women with chronic hypertension and/or previous preeclampsia, considered risk of preeclampsia development. They were divided into two groups: study group that performed physical exercise with a stationary bicycle once a week, for 30 minutes; the intensity was controlled (heart rate 20% above resting values), under professional supervision and a control group that was not engaged in any physical exercise. The data was retrieved from medical charts. Significance level assumed was 5%. Results. Women from study group performed 9.24 ± 7.03 of physical exercise sessions. There were no differences between groups comparing type of delivery and maternal outcomes, including maternal morbidity and hospitalization in intensive unit care, and neonatal outcomes, including birth weight, adequacy of weight to gestational age, prematurity, Apgar scale at first and fifth minutes, hospitalization in intensive unit care, and neonatal morbidity. Conclusions. Physical exercise using a stationary bicycle in pregnant women with chronic hypertension and/or previous preeclampsia, once a week, under professional supervision, did not interfere in the delivery method and did not produce maternal and neonatal risks of the occurrence of morbidity. This trial is registered with ClinicalTrials.gov NCT01395342.
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Affiliation(s)
- Karina Tamy Kasawara
- 101 Alexander Fleming Avenue, Cidade Universitária Zeferino Vaz, 13083-881 Campinas, SP, Brazil
| | | | | | | | | | - João Luiz Pinto e Silva
- 101 Alexander Fleming Avenue, Cidade Universitária Zeferino Vaz, 13083-881 Campinas, SP, Brazil
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Ficks CA, Lahey BB, Waldman ID. Does low birth weight share common genetic or environmental risk with childhood disruptive disorders? JOURNAL OF ABNORMAL PSYCHOLOGY 2013; 122:842-53. [PMID: 23834065 DOI: 10.1037/a0033079] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although advances in neonatal care over the past century have resulted in increased rates of survival among at-risk births, including infants with low birth weight, we have much to learn about psychological outcomes in this population. In particular, despite growing evidence that low birth weight may be associated with an increased risk for Attention-Deficit/Hyperactive Disorder (ADHD) symptoms in childhood, few studies have examined birth weight as a risk factor for disruptive disorders that commonly co-occur with ADHD. In addition, the etiology of the relation between birth weight and these disorders is unknown. The current investigation aimed to better understand these associations in the context of potentially confounding genetic and environmental influences by examining phenotypic associations between birth weight and disruptive disorder symptoms both between families and within families in two independent twin samples (Sample 1: N = 1,676 individuals; Sample 2: N = 4,038 individuals). We found negative associations between birth weight and inattentive, hyperactive-impulsive, and broad externalizing symptoms in both samples. Nonetheless, the overall magnitude of these associations was very small, contributing to less than 1% of the variance in these symptom dimensions. Within-family associations between birth weight and disruptive disorder symptoms did not differ for monozygotic and dizygotic twin pairs, suggesting that nonshared environmental influences rather than common genetic influences are responsible for these associations. Overall, the consistent albeit weak associations between birth weight and disruptive disorder symptoms suggest that low birth weight may not represent a major risk factor in the development of these symptoms.
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Lacerda RA, Egry EY, da Fonseca RMGS, Lopes NA, Nunes BK, Batista ADO, Graziano KU, Angelo M, Januário MML, Merighi MAB, Castilho V. [Evidence-based practices published in Brazil: identification and analysis studies about human health prevention]. Rev Esc Enferm USP 2013; 46:1237-47. [PMID: 23223743 DOI: 10.1590/s0080-62342012000500028] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Accepted: 02/27/2012] [Indexed: 11/22/2022] Open
Abstract
Integrative review of Brazilian studies about evidence-based practices (EBP) about prevention in human health, published in Web of Science/JCR journals, between October 2010 and April 2011. The aim was to identify the specialties that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 84 studies were selected, mainly published in public health journals, focusing on primary care and also addressing clinical issues and different specialties. Prevention foci and methodological approaches also varied, with a predominance of systematic reviews without meta-analysis. The results indicate that there is no single way to conceptualize and practice EBP in the field of prevention, and that its application may not only serve to obtain indisputable evidence to equip intervention actions. This endless knowledge area is under construction, with a view to the analysis and further understanding of health phenomena.
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Prepregnancy physical activity in relation to offspring birth weight: a prospective population-based study in Norway-The HUNT Study. J Pregnancy 2013; 2013:780180. [PMID: 23431451 PMCID: PMC3569934 DOI: 10.1155/2013/780180] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 12/07/2012] [Accepted: 01/10/2013] [Indexed: 12/03/2022] Open
Abstract
Background. The objective was to examine the association between prepregnancy physical exercise and offspring birth weight and to assess the combined association of pre-pregnancy body mass index (BMI) and physical exercise on birth weight. Methods. The study included 2,026 women aged 20–39 years participating in the Norwegian HUNT study and linked with the Medical Birth Registry. We calculated mean differences in birth weight and odds ratios (ORs) for a macrosomic infant (i.e., birth weight >4000 g) using linear and logistic regression analysis. Results. There was no clear association between leisure time physical exercise and mean birth weight. Women who reported no exercise had reduced risk of a macrosomic infant (OR, 0.6; 95% confidence interval (CI), 0.4–0.9) compared to women with a high exercise level. Overweight (BMI ≥ 25.0 kg/m2) was associated with an OR of 1.9 (95% CI, 1.2–2.9) for a macrosomic infant among women who reported low exercise levels, whereas the OR was 1.2 (95% CI, 0.8–1.8) among women with higher exercise levels. Conclusion. There was some evidence that women who reported no exercise before pregnancy had lower risk for a macrosomic infant than women who exercised. Pre-pregnancy BMI was positively associated with birth weight and risk of macrosomia but only among the least active women.
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Flak AL, Yun Tark J, Tinker SC, Correa A, Cogswell ME. Major, non-chromosomal, birth defects and maternal physical activity: a systematic review. ACTA ACUST UNITED AC 2012; 94:521-31. [PMID: 22628185 DOI: 10.1002/bdra.23017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 03/08/2012] [Accepted: 03/11/2012] [Indexed: 11/07/2022]
Abstract
BACKGROUND We reviewed the published literature to assess the association between maternal periconceptional physical activity and the risk for major, non-chromosomal, birth defects and whether this varies by pre-pregnancy obesity. METHODS We conducted a systematic literature search of MEDLINE, EMBASE, and CINAHL databases. Data were abstracted from all articles that met our inclusion criteria and included information on physical activity intensity (mild, moderate, and vigorous) and modality (i.e., standing, lifting, other). We assessed occupational and recreational physical activity separately. The quality of included articles was assessed using the Newcastle-Ottawa Scale. RESULTS Of 3316 screened articles, 11 were included in this review. Of the four studies that assessed prolonged standing, two reported a positive association with risk for some birth defects; null associations were observed in the other two studies. Associations between heavy lifting or other occupational physical activity exposures and risk for birth defects were inconsistent. A protective association between leisure-time physical activity (i.e., active sports, swimming) and some birth defects (e.g., neural tube defects), was suggested by the results of two studies. Only one study reported assessment of possible effect modification by maternal body mass index (BMI). DISCUSSION Our review suggests that there may be some associations between occupational and leisure-time physical activities and some, major non-chromosomal, birth defects, but relatively limited published research exists on these associations. Further research in this area should include differentiation of birth defects phenotypes, valid assessments of all domains of physical activity, including household and transportation activity, and account for the potential influence of pre-pregnancy BMI.
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Affiliation(s)
- Audrey L Flak
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Lacerda RA, Nunes BK, Batista ADO, Egry EY, Graziano KU, Angelo M, Merighi MAB, Lopes NA, Fonseca RMGSD, Castilho V. [Evidence-based practices published in Brazil: identification and analysis of their types and methodological approches]. Rev Esc Enferm USP 2011; 45:777-86. [PMID: 21710089 DOI: 10.1590/s0080-62342011000300033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Accepted: 01/17/2010] [Indexed: 11/22/2022] Open
Abstract
This is an integrative review of Brazilian studies on evidence-based practices (EBP) in health, published in ISI/JCR journals in the last 10 years. The aim was to identify the specialty areas that most accomplished these studies, their foci and methodological approaches. Based on inclusion criteria, 144 studies were selected. The results indicate that most EBP studies addressed childhood and adolescence, infectious diseases, psychiatrics/mental health and surgery. The predominant foci were prevention, treatment/rehabilitation, diagnosis and assessment. The most used methods were systematic review with or without meta-analysis, protocol review or synthesis of available evidence studies, and integrative review. A strong multiprofessional expansion of EBP is found in Brazil, contributing to the search for more selective practices by collecting, recognizing and critically analyzing the produced knowledge. The study also contributes to the analysis itself of ways to do research and new research possibilities.
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