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Hu Y, Kong Y, Fei J, Zhang H, Mei S. Pathways to depressive symptoms in Chinese pregnant women and their influence on delivery approach: a qualitative comparative analysis. J Psychosom Obstet Gynaecol 2024; 45:2404011. [PMID: 39352101 DOI: 10.1080/0167482x.2024.2404011] [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: 03/22/2024] [Revised: 09/02/2024] [Accepted: 09/05/2024] [Indexed: 10/03/2024] Open
Abstract
The aim of this study was to apply complexity theory to explain and understand how risk factors combined in complex ways, eventually leading to a high prevalence of depressive symptoms among pregnant women. We also aimed to evaluate whether depressive symptoms affected delivery approach. The study had a longitudinal design and was conducted between May and September 2017. A total of 481 pregnant women were recruited to participate and completed closed-end surveys at two distinct times: during prenatal care at the hospital after 26 weeks of pregnancy and 1 to 4 weeks after delivery. This study identified eleven different pathways that led to an increase in depressive symptoms. Each pathway differentiated the effects of different influencing factors. Among the 481 pregnant women, 128 (26.6%) had cesarean deliveries without medical indications. Although depressive symptoms could affect delivery approach, it was not the most important factor. Surprisingly, the first production emerged as the key factor determining delivery mode. This study was innovative in that it examined which factors and which combinations of factors were necessary for the development of depressive symptoms. Additionally, this study provided a better understanding of the mechanisms underlying the choice of cesarean section without medical indications.
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Affiliation(s)
- Yueyang Hu
- Department of Epidemiology, School of Public Health, Baotou Medical College, Baotou, China
| | - Yixi Kong
- Changchun Obstetrics-Gynecology Hospital, Early Childhood Development Center, Changchun, China
| | - Junsong Fei
- Department of Social Medicine and Health Management, School of Public Health of Jilin University, Changchun, China
| | - Han Zhang
- Department of Applied Psychology, School of Education, Linyi University, Linyi, Shandong Province, China
| | - Songli Mei
- Department of Social Medicine and Health Management, School of Public Health of Jilin University, Changchun, China
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van Poppel MNM, Kruse A, Carter AM. Maternal physical activity in healthy pregnancy: Effect on fetal oxygen supply. Acta Physiol (Oxf) 2024; 240:e14229. [PMID: 39262271 DOI: 10.1111/apha.14229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 08/27/2024] [Accepted: 08/28/2024] [Indexed: 09/13/2024]
Abstract
AIM We review evidence for effects of physical activity before and during gestation on the course of pregnancy and ask if there are circumstances where physical activity can stress the fetus due to competition for oxygen and energy substrates. RESULTS We first summarize physiological responses to exercise in nonpregnant people and known physiological adaptations to pregnancy. Comparing the two, we conclude that physical activity prior to and continuing during gestation is beneficial to pregnancy outcome. The effect of starting an exercise regimen during pregnancy is less easy to assess as few studies have been undertaken. Results from animal models suggest that the effects of maternal exercise on the fetus are transient; the fetus can readily compensate for a short-term reduction in oxygen supply. CONCLUSION In general, we conclude that physical activity before and during pregnancy is beneficial, and exercise started during pregnancy is unlikely to affect fetal development. We caution, however, that there are circumstances where this may not apply. They include the intensive exercise regimens of elite athletes and pregnancies at high altitudes where hypoxia occurs even in the resting state.
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Affiliation(s)
| | - Annika Kruse
- Department of Human Movement Science, Sport and Health, University of Graz, Graz, Austria
| | - Anthony M Carter
- Cardiovascular and Renal Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
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Garfield L, Watson-Singleton NN, Mathews HL, Witek Janusek L. Protocol for a pilot study assessing a virtual mindfulness intervention for postpartum African American women. BRAIN BEHAVIOR AND IMMUNITY INTEGRATIVE 2024; 6:100060. [PMID: 39036323 PMCID: PMC11258811 DOI: 10.1016/j.bbii.2024.100060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/23/2024]
Abstract
Elevated perinatal depressive symptoms are more common among disadvantaged African American women, and they are almost four times as likely to have postpartum posttraumatic stress compared to white women. For new mothers, depressive symptoms and posttraumatic stress can lead to negative parenting, poor mother-infant bonding, and delayed infant development. For African American women, a culturally adapted mindfulness-based intervention offers great potential as an acceptable approach to reduce psycho-behavioral symptoms and improve mother-infant interactions (i.e., bonding). Additionally, it is critical that mindfulness interventions consider time constraints of new mothers, provide accessible intervention delivery, address parenting, and consider the challenges of caring for an infant. Given these considerations, we describe a pilot research protocol in which we evaluate a culturally adapted mindfulness program: Mindfulness for African Americans Postpartum (MAAP). The intervention is based upon Kabat-Zinn's Mindfulness Based Stress Reduction program, but is adapted to include culturally relevant concepts of spirituality, inter-dependence, self-empowerment, and storytelling, which are salient to African American culture. To accommodate the needs of new mothers, a certified mindfulness interventionist delivers each session virtually using Zoom. The investigation uses a randomized controlled design in which African American women within 12 months of giving birth are randomized either to the MAAP intervention or to an Education Program. The primary aim is to determine the extent to which the MAAP intervention decreases maternal psycho-behavioral symptoms (perceived stress, depressive symptoms, anxiety, poor sleep, posttraumatic stress, and fatigue) and improves mother-infant bonding. A secondary aim is to explore the effects of MAAP on proinflammatory cytokines and oxytocin. Culturally adapted mindfulness interventions delivered virtually will make mindfulness more accessible and meaningful to populations, like African American new mothers, who are at higher risk for postpartum mood disorders and poor infant outcomes.
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Affiliation(s)
- Lindsey Garfield
- Marcella Niehoff School of Nursing, 2160 S. First Ave, Maywood, IL 60153, United States
| | - Natalie N. Watson-Singleton
- Spelman College, Department of Psychology, 350 Spelman Lane, Box 1657 Giles Hall 317, Atlanta, GA 30314, United States
| | - Herbert L. Mathews
- Stritch School of Medicine, Department of Microbiology and Immunology, Loyola University Chicago, United States
| | - Linda Witek Janusek
- Marcella Niehoff School of Nursing, Loyola University Chicago, United States
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Karim S, Liu J, Wilcox S, Cai B, Merchant AT. Association Between Physical Activity During Pregnancy and Perinatal Depressive Symptoms in Pregnant Individuals With Overweight and Obesity. Womens Health Issues 2024; 34:72-79. [PMID: 37940507 PMCID: PMC10843526 DOI: 10.1016/j.whi.2023.09.002] [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: 01/25/2023] [Revised: 09/01/2023] [Accepted: 09/21/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION Current research on the association between physical activity and perinatal depression is inconclusive. This study examined the association between objectively measured physical activity during pregnancy and perinatal depressive symptoms among individuals with overweight and obesity. METHODS Data came from the Health in Pregnancy and Postpartum study (N = 205). Physical activity was measured using the SenseWear Armband at 16 weeks' or fewer and 32 weeks' gestation and categorized into 1) never meeting 2018 physical activity guidelines, 2) meeting the guidelines at one time point, or 3) meeting the guidelines at both time points. Antenatal depressive symptoms were assessed at 32 weeks' gestation, and postpartum depressive symptoms were assessed at 6 and 12 months postpartum using the Edinburgh Postnatal Depression Scale. A score of 10 or higher was defined as probable at least minor depression (hereafter, probable depression). RESULTS Nearly one-half of the participants (45.4%) met physical activity guidelines both in early and late pregnancy. Pregnant individuals who met physical activity guidelines at one (adjusted odds ratio, 0.07; 95% confidence interval, 0.01-0.76) or both time points (adjusted odds ratio, 0.08; 95% confidence interval, 0.01-0.69) during pregnancy had lower odds of probable depression at 6 months postpartum than individuals who never met physical activity guidelines during pregnancy. No significant associations were found between prenatal physical activity and probable antenatal or postpartum depression at 12 months. CONCLUSIONS Antenatal physical activity was associated with lower odds of probable depression at 6 months after childbirth. Physicians should use evidence-based strategies to encourage pregnant people, especially those who are at risk for postpartum depression, to meet physical activity guidelines.
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Affiliation(s)
- Sabrina Karim
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina; Institute for Families in Society, College of Social Work, University of South Carolina, Columbia, South Carolina
| | - Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
| | - Sara Wilcox
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Bo Cai
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
| | - Anwar T Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina
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Sánchez-Polán M, Nagpal TS, Zhang D, Silva-Jose C, Montejo R, Barakat R. The Influence of Physical Activity during Pregnancy on Maternal Pain and Discomfort: A Meta-Analysis. J Pers Med 2023; 14:44. [PMID: 38248744 PMCID: PMC10817295 DOI: 10.3390/jpm14010044] [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: 11/18/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
Pregnant women may experience pain and discomfort during pregnancy, especially in areas such as the lower back and pelvic girdle. Pain in pregnancy is associated with poor quality of life, and because it is a common occurrence, pregnant women may be offered several resources to prevent discomforts throughout pregnancy, such as engaging in physical activity. This study was a meta-analysis of randomised controlled trials (prospectively registered in Prospero, registration number: CRD42023451320) aimed to assess the effects of physical activity during pregnancy on maternal pain and discomfort. We analysed 16 randomised clinical trials. The results of these analyses indicate that women who performed physical activity had significantly less intensity of pain (z = <2.69, p = <0.007; SMD = -0.66, 95% CI = -1.13, -0.18, I2 = <91%, Pheterogeneity = <0.001) and a reduction observed in the disability questionnaire (z = <2.37, p = <0.02; SMD = -0.80, 95% CI = -1.47, -0.14, I2 = <91%, Pheterogeneity = <0.001), and overall reduced general pain (z = <3.87, p = <0.001; SMD = -0.56, 95% CI = -0.84, -0.27, I2 = <86%, Pheterogeneity = <0.001) than women who did not practice physical activity during pregnancy. In conclusion, physical activity during pregnancy could effectively help to diminish pain intensity, reduce disability due to pain, and generally reduce pain.
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Affiliation(s)
- Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (M.S.-P.); (D.Z.); (C.S.-J.)
| | - Taniya S. Nagpal
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Dingfeng Zhang
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (M.S.-P.); (D.Z.); (C.S.-J.)
| | - Cristina Silva-Jose
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (M.S.-P.); (D.Z.); (C.S.-J.)
| | - Rocío Montejo
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 405 30 Gothenburg, Sweden;
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, 413 46 Gothenburg, Sweden
| | - Rubén Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (M.S.-P.); (D.Z.); (C.S.-J.)
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Bahrami‐Samani S, Omidvar S, Mohsenzadeh‐Ledari F, Azizi A, Ashrafpour M, Kordbagheri M. The relationship between perceived stress and pregnancy distress with self-care of pregnant women: The mediating role of social support-A cross-sectional study. Health Sci Rep 2023; 6:e1730. [PMID: 38028701 PMCID: PMC10663433 DOI: 10.1002/hsr2.1730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/19/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Aims Pregnancy is a stressful experience, which can affect different aspects of a woman's life. Yet, women with a supportive network of friends and family may experience lower stress and improved self-care behavior. The study aimed to investigate the relationship between perceived stress and pregnancy distress with the self-care of pregnant women, as well as the mediating role of social support. Methods This cross-sectional study was conducted from February to May 2022 in Babol, Iran. A total of 157 pregnant women participated in the study. The participants completed five questionnaires, including a demographic and obstetric questionnaire, a Self-care questionnaire, Perceived Social support (PSS), Perceived Stress Inventory (PSI), and Pregnancy Specific Distress. Structural equation modeling was used to test the hypothesis relationships among the variables. Results We found that Perceived stress (β = -0.221, p = 0.012β) and pregnancy distress (β = -0.203, p = 0.002β) had a negative and significant effect on the self-care of pregnant women. Also, perceived stress (β = -0.429, p < 0.001β) and pregnancy distress (β = -0.381, p < 0.001β) had a negative and significant effect on the social support of pregnant women. The results exhibited a significant specific indirect effect between pregnancy distress, perceived stress, and pregnancy self-care, with social support as the mediator: standardized indirect effect = -0.068, -0.076, respectively. Conclusion According to the findings, social support plays a direct and mediating role in improving self-care behaviors among pregnant women. Therefore, providing strategies and measures to improve perceived social support by maternal health professionals may be expected to reduce the impact of stress on pregnant women's self-care. The implementation of policies and social interventions to improve the social support of pregnant women can be one of the applications of the findings.
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Affiliation(s)
| | - Shabnam Omidvar
- Social Determinants of Health Research Center, Health Research InstituteBabol University of Medical SciencesBabolI.R. Iran
| | - Farideh Mohsenzadeh‐Ledari
- Social Determinants of Health Research Center, Health Research InstituteBabol University of Medical SciencesBabolI.R. Iran
| | - Alireza Azizi
- Social Determinants of Health Research Center, Health Research InstituteBabol University of Medical SciencesBabolI.R. Iran
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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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Altaş ZM, Lüleci NE, Hıdıroğlu S. Evaluation of Physical Activity Level and Related Factors in Pregnancy During the COVID-19 Period. Int J Public Health 2023; 68:1605800. [PMID: 37215648 PMCID: PMC10196054 DOI: 10.3389/ijph.2023.1605800] [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: 01/21/2023] [Accepted: 04/26/2023] [Indexed: 05/24/2023] Open
Abstract
Objectives: It was aimed to determine the level of physical activity and related factors in pregnant women. Methods: The study is a mixed methods study. The participants are women applied to the pregnancy outpatient clinic of a hospital. The level of physical activity was assessed with the Pregnancy Physical Activity Questionnaire. Sociodemographic questions and seven questions of the International Physical Activity Environment Module were asked. Besides, in-depth interviews were conducted with 14 women. Results: The study was conducted with 304 women. The median age was 29.0 (18.0-40.0) years. The mean total activity and sedentary activity scores were 195.8 ± 107.9 and 37.22 ± 31.08 MET-hours/week, respectively. Pregnant women were mostly involved in light-intensity and housework/caregiving activities. Most of the participants mentioned that they were less active than pre-pregnancy period. The most common reasons for being less active were weakness, fatigue, lack of time and complaints such as low back pain and nausea. Conclusion: More than half of the pregnant women mentioned that they were less active during pregnancy. Thus, interventions should be planned to increase physical activity level of pregnant women.
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Stefaniak M, Dmoch-Gajzlerska E, Jankowska K, Rogowski A, Kajdy A, Maksym RB. Progesterone and Its Metabolites Play a Beneficial Role in Affect Regulation in the Female Brain. Pharmaceuticals (Basel) 2023; 16:ph16040520. [PMID: 37111278 PMCID: PMC10143192 DOI: 10.3390/ph16040520] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/25/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023] Open
Abstract
Premenstrual dysphoric disorder is a female affective disorder that is defined by mood symptoms. The condition is linked to unstable progesterone concentrations. Progestin supplementation is given in cases of threatened or recurrent miscarriage and for luteal phase support. Progesterone is essential for implantation, immune tolerance, and modulation of uterine contractility. For a long time, the administration of progestins was associated with an unfavorable impact on mood, leading to negative affect, and, therefore, was contraindicated in existing mood disorders. Establishing the role of the natural progesterone derivative allopregnanolone in advances in the treatment of postpartum depression has shed new light on the general pathophysiology of mood disorders. Allopregnanolone directly interacts with gamma-aminobutyric acid type A (GABA-A) receptors even at nanomolar concentrations and induces significant anti-depressant, anti-stress, sedative, and anxiolytic effects. Postpartum depression is caused by a rapid drop in hormones and can be instantly reversed by the administration of allopregnanolone. Premenstrual dysphoric disorder can also be considered to result from insufficient neuroactive steroid action due to low progesterone derivative concentration, unstable hormone levels, or decreased receptor sensitivity. The decrease in progesterone levels in perimenopause is also associated with affective symptoms and an exacerbation of some psychosomatic syndromes. Bioidentical progesterone supplementation encounters several obstacles, including limited absorption, first-pass effect, and rapid metabolism. Hence, non-bioidentical progestins with better bioavailability were widely applied. The paradoxical, unfavorable effect of progestins on mood can be explained by the fact that progestins suppress ovulation and disturb the endocrine function of the ovary in the luteal phase. Moreover, their distinct chemical structure prevents their metabolism to neuroactive, mood-improving derivatives. A new understanding of progesterone-related mood disorders can translate the study results from case series and observational studies to cohort studies, clinical trials, and novel, effective treatment protocols being developed.
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Affiliation(s)
- Małgorzata Stefaniak
- Department of Obstetrics and Gynecology Didactics, Medical University of Warsaw, ul. Litewska 14/16, 00-575 Warsaw, Poland
| | - Ewa Dmoch-Gajzlerska
- Department of Obstetrics and Gynecology Didactics, Medical University of Warsaw, ul. Litewska 14/16, 00-575 Warsaw, Poland
| | - Katarzyna Jankowska
- Department of Endocrinology, Centre of Postgraduate Medical Education, ul. Cegłowska 80, 01-809 Warsaw, Poland
| | - Artur Rogowski
- Department of Minimally Invasive and Endoscopic Gynecology, Military Institute of Medicine, ul. Zegrzyńska 8, 05-119 Legionowo, Poland
| | - Anna Kajdy
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, ul. Żelazna 90, 02-004 Warszawa, Poland
| | - Radosław B. Maksym
- 1st Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, ul. Żelazna 90, 02-004 Warszawa, Poland
- Correspondence:
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Chen X, Kemperman A, Timmermans H. Socio-demographics, neighborhood characteristics, time use, and leisure-time physical activity engagement patterns over the life course. SSM Popul Health 2022; 19:101244. [PMID: 36203469 PMCID: PMC9529596 DOI: 10.1016/j.ssmph.2022.101244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 09/20/2022] [Accepted: 09/27/2022] [Indexed: 12/02/2022] Open
Abstract
Physical inactivity remains a major public health challenge today. Understanding the determinants of changes in habitual leisure-time physical activity patterns by type across the life course is important for developing targeted interventions. This study presents a multiple discrete-continuous extreme value model to examine the determinants of habitual participation in and time allocation to multiple leisure-time physical activities over the life course. A comprehensive set of socio-demographics, life transitions, neighborhood characteristics, and time-related factors are considered as determinants of each activity type, including sports, recreational walking, cycling, outdoor playing, and dog walking. Results estimated on retrospective survey data collected in the Netherlands show significant differences in the determinants of the different types of leisure-time physical activity. Social-demographic factors have a strong influence on sports participation, followed by recreational walking, cycling, outdoor playing, and then dog walking. Life transitions have different effects. A change in marital status appears to be the most important life event for sports participation while changing jobs is the most important event for the other two activities. Neighborhood characteristics primarily affect participation in recreational walking, cycling, outdoor playing, and dog walking. As for time-related factors, they mainly impact sports engagement. The findings of this study could help develop effective interventions to promote leisure-time physical activity participation during life transitions and encourage healthy living. The determinants of different types of leisure-time physical activity differ significantly. Social-demographic factors have a strong impact on sports participation, followed by recreational-WCP, and then dog walking. Changes in marital status and work seem to be important events for joining sports and the other two activities, respectively. Neighborhood characteristics primarily affect participation in recreational-WCP and dog walking. Study-related physical activity time and work-related physical activity time mainly impact sports participation.
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A Cross-Sectional Study Examining the Association between Physical Activity and Perinatal Depression. Medicina (B Aires) 2022; 58:medicina58091174. [PMID: 36143851 PMCID: PMC9504270 DOI: 10.3390/medicina58091174] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: International organisations recommend that women without illness should have regular moderate-intensity physical exercise throughout their pregnancy and postpartum period as a measure to prevent possible pathologies in both the mother and the newborn. Physical activity during pregnancy reduces the likelihood of depression during pregnancy and after childbirth, benefiting both the pregnant woman and the foetus. However, most pregnant women are known to be inactive. The Pregnancy Physical Activity Questionnaire (PPAQ) analyses the level of physical activity of pregnant women. These data are correlated with the variable depression, for which the Edinburgh Postnatal Depression Scale (EPDS) during pregnancy was used. Materials and Methods: The research employed a cross sectional study design on ninety-nine pregnant women. Results: The data on physical activity in relation to depression in those pregnant women who had not previously suffered from depression were 719.29 METS min/wk compared with 624.62 METS min/wk in those who had. And for pregnant women who suffered from depression at the time of the study, their physical activity was 698.25 METS min/wk, while those who did not suffer from depression reached 826.57 METS. Conclusions: Pregnant women without depression are much more active. A favourable employment situation or a high level of education is directly related to higher physical activity. Physical activity and higher energy expenditure occur at home, as opposed to activity carried out as transport, exercise or at work.
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The Association between Physical Exercise during Pregnancy and Maternal and Neonatal Health Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:3462392. [PMID: 36045949 PMCID: PMC9420626 DOI: 10.1155/2022/3462392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 12/01/2022]
Abstract
Objective To explore the effect of exercise during pregnancy on the maternal and neonatal health outcomes. Methods Eligible papers were systematically retrieved from PubMed, Embase, OVID, and ScienceDirect. Two researchers independently extracted the primary endpoints from the included literature. Random-effect model or fixed-effect model were utilized to generate and compute relative risk and mean difference, as appropriate. Publication bias was quantified and assessed using the funnel plot with Egger's test. Results This study included 13 literatures with a total of 3047 pregnant women with gestational weeks more than 10 weeks. The incidence of vaginal delivery was significantly higher in the intervention group than that in the control group (28.7% vs 23.3%, P < 0.001). The differences of duration of the first stage and second stage of labor between the interventional group and control group were both statistically insignificant (mean difference: 27.92, 95% CI: − 70.60, 14.7, P = 0.20; mean difference: 0.63, 95% CI: − 4.47, 5.74, P = 0.81). In addition, there were no significant differences with regard to gestational age at delivery (mean difference = −0.23, 95% CI: − 1.29, 0.83, P = 0.67), Apgar score (mean difference = 0.06, 95% CI: − 0.13, 0.26, P = 0.53), and birth weight (mean difference = −23.78, 95% CI: − 60.66, 13.11, P = 0.21) between the 2 groups. Women in the intervention group were more likely to experience vaginal delivery than the control group (RR = 1.27, 95% CI: 1.04, 1.55, P = 0.01). Conclusions Physical exercise during pregnancy could improve the incidence of natural labor.
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Nguyen LD, Nguyen LH, Ninh LT, Nguyen HTT, Nguyen AD, Vu LG, Nguyen HSA, Nguyen SH, Doan LP, Vu TMT, Tran BX, Latkin CA, Ho CSH, Ho RCM. Women's holistic self-care behaviors during pregnancy and associations with psychological well-being: implications for maternal care facilities. BMC Pregnancy Childbirth 2022; 22:631. [PMID: 35945522 PMCID: PMC9364562 DOI: 10.1186/s12884-022-04961-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 07/20/2022] [Indexed: 12/12/2022] Open
Abstract
Background Self-care behaviors during pregnancy significantly impacts mother and children's health. This study aimed to explore the self-care behaviors and the associations of these behaviors with the psychological well-being of women during pregnancy, as well as the mediating effects of different social support with these associations. Methods A cross-sectional data of 562 pregnant women at Hanoi Obstetrics & Gynecology Hospital and Ca Mau Obstetrics & Pediatrics in Vietnam were analyzed. Questions about self-care behaviors, pregnancy characteristics, social support, and psychological well-being were asked. Multivariate regression models were performed. Structural Equation Modeling (SEM) was employed to test the mediating effects of different social support with the association between self-care behaviors and psychological well-being. Findings Only 13% of pregnant women often or always did physical exercise at least three times a week, and 40% consumed enough fiber and five servings of vegetables a day. Only 78.7% always avoided alcohol drinking, and 53.9% of pregnant women avoided being exposed to second-hand smoking and 71,7% avoided using traditional medicine without physicians’ prescriptions. Around 66% of pregnant women always or often had prenatal care checkups as scheduled. Information sources, social support and childbirth expectation were major drivers for self-care practices. SEM model showed that social support mediated the relationship between maternal health behaviors and mental well-being. Conclusion This study highlighted the remarkable gaps in self-care practices among our pregnant women, which were significantly associated with their mental well-being. Social support-oriented consultancy and interventions should be warranted for improving behaviors and the mental well-being of pregnant women in Vietnam.
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Affiliation(s)
- Lam Duc Nguyen
- Department of Anaesthesiology, Hanoi Medical University, Hanoi, Vietnam
| | - Long Hoang Nguyen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ly Thi Ninh
- Social Affair Department, Ca Mau Obstetrics & Pediatrics Hospital, Ca Mau, Vietnam
| | | | - Anh Duy Nguyen
- Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam
| | - Linh Gia Vu
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.,Faculty of Nursing, Duy Tan University, Da Nang, 550000, Vietnam
| | | | - Son Hoang Nguyen
- Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Linh Phuong Doan
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam. .,Faculty of Nursing, Duy Tan University, Da Nang, 550000, Vietnam.
| | | | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
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14
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Silva-Jose C, Sánchez-Polán M, Barakat R, Gil-Ares J, Refoyo I. Level of Physical Activity in Pregnant Populations from Different Geographic Regions: A Systematic Review. J Clin Med 2022; 11:jcm11154638. [PMID: 35956253 PMCID: PMC9369818 DOI: 10.3390/jcm11154638] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/23/2022] [Accepted: 08/05/2022] [Indexed: 12/05/2022] Open
Abstract
The aim of this study was to examine the level of physical activity during pregnancy in different populations worldwide. An intensive search was carried out from February until May 2021. The inclusion criteria were original studies of healthy pregnant women, and the main study variable was the assessment of physical activity. A total of 110 out of 1451 studies were assessed for inclusion, using the Newcastle–Ottawa Scale for quality, and for the risk of bias. The 44 analyzed articles were divided into 5 tables according to the characteristics of the intervention and the validated instrument used to measure physical activity (PA). A total of 59.09% of the studies indicated that participants had a low level of physical activity during pregnancy. In addition, the median quality score of the studies was 7.12, and 77.27% of the studies were cataloged as having a high-quality score. Although international guidelines recommend that women without a contraindication engage in prenatal physical activity, the results of the present study show that the level of PA is too low for women to achieve scientifically proven maternal-fetal benefits. Failure to achieve the recommended levels of weekly physical activity could pose significant risks to maternal well-being.
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Affiliation(s)
- Cristina Silva-Jose
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-913364120
| | - Rubén Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Javier Gil-Ares
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Ignacio Refoyo
- Sports Department, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
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15
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Uludağ E, Göral Türkcü S. Ramadan Fasting as a Religious Obligation: A Qualitative Study on Opinions and Experiences of Muslim Pregnant Women about Fasting in Turkey. JOURNAL OF RELIGION AND HEALTH 2022; 61:2960-2974. [PMID: 35612646 DOI: 10.1007/s10943-022-01588-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
The aim of this study was to examine opinions and experiences of Muslim pregnant women about Ramadan fasting in Turkey. The study had a descriptive, phenomenological design and included 17 Muslim pregnant women living in Turkey. Content analysis and word cloud analysis were performed. The content analysis revealed two themes. The most frequent words in the word cloud analysis were fasting, pregnancy, Ramadan, fast, religious duty, health, observing a missed fast, relief, concern, baby, thirsty and hungry. The findings of the study showed that religious beliefs, experiences, family and society pressured the pregnant women to keep Ramadan fasts. However, due to feeling worried about their own physical and psychological health and their infants, some of the women did not go on a fast. It can be recommended that pregnant women wanting to keep their fasts should be offered information about possible risks of fasting.
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Affiliation(s)
- Elif Uludağ
- Faculty of Health Science, Pamukkale University, Denizli, Turkey.
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16
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How Do Health Schemas Inform Healthy Behaviours During Pregnancy? Qualitative Findings from the Be Healthy in Pregnancy (BHIP) Study. Matern Child Health J 2022; 26:1861-1870. [PMID: 35217935 DOI: 10.1007/s10995-022-03385-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Excess gestational weight gain (GWG) is associated with adverse long and short-term outcomes for both woman and child, yet evidence demonstrates pregnant women are frequently not engaging in healthy behaviours linked to appropriate weight gain. The purpose of the current study was to explore women's values and beliefs related to weight, nutrition and physical activity during pregnancy and to describe how these beliefs influence their behaviours. METHODS As part of a larger randomized controlled trial, we conducted 20 focus groups with 66 pregnant women between 16 and 24-weeks gestation using a semi-structured interview guide. Focus groups were recorded and transcribed verbatim and analyzed using a grounded theory approach. RESULTS Three personal health schemas emerged from the findings which illustrated women's diverging beliefs about their health behaviours in pregnancy. 'Interconnected health' described beliefs regarding the impact their health had on that of their growing baby and awareness of risks associated with inappropriate weight gain. 'Gestational weight gain as an indicator of health' illustrated perceptions regarding how GWG impacted health and the utility of guidelines. Finally, 'Control in pregnancy' described the sense of agency over one's body and health. CONCLUSIONS FOR PRACTICE Our results showed that health-related behaviours in pregnancy are driven by personal health schemas which are often discordant with clinical evidence. Interventions and health care provider advice aimed at behaviour modification would benefit from first understanding and addressing these schemas. Tackling the conflict between beliefs and behaviour may improve health outcomes associated with appropriate weight gain in pregnancy.
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17
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Morres ID, Tzouma NA, Hatzigeorgiadis A, Krommidas C, Kotronis KV, Dafopoulos K, Theodorakis Y, Comoutos N. Exercise for perinatal depressive symptoms: A systematic review and meta-analysis of randomized controlled trials in perinatal health services. J Affect Disord 2022; 298:26-42. [PMID: 34728280 DOI: 10.1016/j.jad.2021.10.124] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 09/14/2021] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Exercise improves perinatal depressive (PD) symptoms, but reports call for more robust evidence. This systematic review and meta-analysis aimed at synthesizing evidence exclusively from randomized controlled trials (RCTs) examining the effects of exercise on PD symptoms in women recruited through perinatal health services. METHODS Nine e-databases and fifteen systematic reviews were searched for relevant RCTs. Exercise-specific tools extracted/coded data. A meta-analysis using a random effects model (Standardized Mean Difference [SMD]) investigated the effects of exercise on PD scores post-intervention. RESULTS From 285 records, 14 RCTs (2.025 participants) were considered eligible including two RCTs with clinically diagnosed PD women. Exercise showed a statistically significant, small, overall antidepressant effect (SMD = -0.21, 95% CI = -0.31, -0.11, p = 0.0001) with low/non-significant heterogeneity (Q = 17.82, I 2 = 16%, p = 0.27). Only the fail-safe criterion recorded marginally significant publication bias, but trim-fill analysis added no study. Sensitivity analyses increased the overall effect in RCTs showing lower risk of bias or delivering ≥150 min/week moderate intensity aerobic exercise. Subgroup analyses revealed significant antidepressant effects for exercise across various settings, delivery formats, depressive symptoms severities and outcome measures used. Heterogeneity was low/non-significant in all analyses (I 2 ≤ 50%). Hedges' g corrections did not influence the results. LIMITATIONS Study limitations include the small number of available trials and clinically diagnosed PD samples and the variety of exercise modalities. CONCLUSIONS Exercise improved PD symptoms, especially in RCTs with lower risk of bias or with ≥150 min/day moderate intensity aerobic exercise interventions. Findings are clinically useful but more RCTs for clinically diagnosed PD women are needed for firmer conclusions.
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Affiliation(s)
- Ioannis D Morres
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece.
| | - Natalia-Antigoni Tzouma
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece
| | - Antonis Hatzigeorgiadis
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece
| | - Charalampos Krommidas
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece
| | | | - Konstantinos Dafopoulos
- Department of Obstetrics and Gynecology, School of Health Sciences, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Yannis Theodorakis
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece
| | - Nikolaos Comoutos
- Department of Physical Education and Sport Science, School of Physical Education, Sport & Dietetics, University of Thessaly, Trikala, Greece
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18
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Ribeiro MM, Andrade A, Nunes I. Physical exercise in pregnancy: benefits, risks and prescription. J Perinat Med 2022; 50:4-17. [PMID: 34478617 DOI: 10.1515/jpm-2021-0315] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 07/08/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this article is to provide a comprehensive literature review, gathering the strongest evidence about the risks and benefits and the prescription of physical exercise during pregnancy. CONTENT Regular physical exercise during pregnancy is associated with numerous benefits. In general women are not adequately advised on this matter. Along with their concerns regarding the potential associated risks, it contributes to the abandonment or refusal to start exercising during pregnancy. A systematic review was conducted in MEDLINE including articles considered to have the highest level of scientific evidence. Fifty-seven articles, including 32 meta-analysis, 9 systematic reviews and 16 randomized controlled trials were included in the final literature review. SUMMARY Exercise can help preventing relevant pregnancy related disorders, such as gestational diabetes, excessive gestational weight gain, hypertensive disorders, urinary incontinence, fetal macrosomia, lumbopelvic pain, anxiety and prenatal depression. Exercise is not related with an increased risk of maternal or perinatal adverse outcomes. Compliance with current guidelines is sufficient to achieve the main benefits, and exercise type and intensity should be based on woman's previous fitness level. OUTLOOK Exercise in pregnancy is safe for both mother and fetus, contributing to prevent pregnancy related disorders. Exercise type and intensity should be adapted to woman's previous fitness level, medical history and characteristics of the ongoing pregnancy.
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Affiliation(s)
| | - Ana Andrade
- Department of Women and Reproductive Medicine, Centro Hospitalar Universitário do Porto EPE Centro Materno-Infantil do Norte Dr Albino Aroso, Porto, Portugal
| | - Inês Nunes
- Department of Women and Reproductive Medicine, Centro Hospitalar Universitário do Porto EPE Centro Materno-Infantil do Norte Dr Albino Aroso, Porto, Portugal
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19
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Prospective associations between prepartum physical activity, birth experience, and maternal depressive symptoms in the postpartum period: Insights from the population-based DREAM cohort study. J Affect Disord 2022; 297:366-374. [PMID: 34715172 DOI: 10.1016/j.jad.2021.10.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 09/09/2021] [Accepted: 10/23/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND This study aims to examine whether physical activity (PA) before and during pregnancy and birth experience predict incident postpartum depressive (PPD) symptoms. Because PA may increase endurance and feelings of physical control, it may contribute to a positive birth experience and birth experience may mediate the association between PA before and during pregnancy and PPD symptoms. METHODS The study is part of the prospective-longitudinal cohort study "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Participants were n = 1,254 (expectant) mothers. PA was assessed during pregnancy, birth experience and PPD symptoms 8 weeks postpartum. Multiple regression analyses were performed, including potential confounders. RESULTS A negative birth experience was linked to PPD symptoms, when controlling for relevant confounders. There was no evidence for a link between PA before and during pregnancy and birth experience or between PA during pregnancy and PPD symptoms. PA at low and at vigorous intensity before pregnancy was associated with PPD symptoms, but not when controlling for confounders. Because PA was not associated with birth experience, no mediation analysis was performed. LIMITATIONS The current sample was relatively homogenous (i.e., mostly German native speakers, primiparous, highly educated). Birth experience was assessed retrospectively at 8 weeks following birth. CONCLUSIONS Our results highlight the importance of the birth experience in the development of PPD symptoms. Promoting a positive birth experience represents a promising approach to prevent PPD symptoms. Further research on the association between PA and PPD symptoms is warranted.
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20
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Abdullahi A, Bala AS, Danazumi SM, Abubakar SM, Adamu RI, Truijen S, Zakari MK, Akosile CO, Saeys W, Lawal IU, Etoom M, Nuhu JM, Oyeniran MA, Mayana KI, Useh U. Determination of hand grip strength and its correlates during pregnancy: a cross-sectional study. BMC Pregnancy Childbirth 2021; 21:540. [PMID: 34348682 PMCID: PMC8340369 DOI: 10.1186/s12884-021-04003-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 07/12/2021] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Pregnancy results in many changes, including reduced hand grip strength (HGS). However, good HGS is required for physical functions such as carrying and breastfeeding the baby after birth. The aim of this study was to determine the factors that may predict HGS during pregnancy. METHODS The study was a cross-sectional study approved by the Research Ethics Committees of Kano State Ministry of Health and Aminu Kano Teaching Hospital in Kano, north-west, Nigeria. Pregnant women at the designated hospitals were included in the study if they had no serious comorbidities or any known neurological condition that affects the hands and the neck. Demographic characteristics and independent (predictor) variables (age, weight, height, BMI, maternity leave status, number of full-term deliveries, number of preterm deliveries, number of live births, number of abortuses, gravidity, trimester, systolic blood pressure, diastolic blood pressure, inter arm systolic BP difference [IASBP], inter arm diastolic BP difference [IADBP], and heart rate) of each of the participants were recorded by experienced therapists. The data were analysed using descriptive statistics, t-test, Pearson correlation coefficient and standard multiple regression. RESULT One hundred and sixty-one pregnant women with mean age, 25.04 ± 4.83 years participated in the study. In the dominant hand, 120 participants (74.5%) had weak grip strength. In the non-dominant hand, 135 participants (83.9%) had weak grip strength. For the dominant hand, the total variance explained by the whole model was significant, 28.5%, F(11, 161) = 1.187, R2 = 0.081, p = 0.300 . In the final model, none of the variables significantly predicted HGS. However, systolic blood pressure contributed to the model more than any other variable (Beta = -0.155). For the non-dominant hand, the total variance explained by the whole model was not significant, 33.1%, F(11, 161) = 1.675, R2 = 0.111, p = 0.089 . In the final model, only systolic blood pressure (Beta = -0.254, p = 0.023) significantly predicted hand grip strength. CONCLUSION Cardiovascular events or changes during pregnancy (such as change in systolic blood pressure) may be related to HGS in pregnant women. It is therefore, important for clinicians to pay attention to this, in planning rehabilitation strategies for pregnant women.
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Affiliation(s)
- Auwal Abdullahi
- Department of Physiotherapy, Bayero University, Kano, Nigeria.
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Movant, Wilrijk, Belgium.
| | | | - Sani Musa Danazumi
- Department of Physiotherapy, Federal Medical Center, Nguru, Yobe State, Nigeria
| | | | - Rislanu Isyaku Adamu
- Department of Physiotherapy, University of Maiduguri Teaching Hospital, Maiduguri, Nigeria
| | - Steven Truijen
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Movant, Wilrijk, Belgium
| | | | | | - Wim Saeys
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Movant, Wilrijk, Belgium
| | - Isa Usman Lawal
- Department of Physiotherapy, Bayero University, Kano, Nigeria
| | - Mohammed Etoom
- Department of Physiotherapy, Aqba University of Technology, Aqaba, Jordan
| | | | - Mukadas Akindele Oyeniran
- Department of Physiotherapy, Bayero University, Kano, Nigeria
- Lifestyle Diseases Research Entity, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Kabir Isah Mayana
- Department of Physiotherapy, Bayero University, Kano, Nigeria
- Faculty of Health Sciences, University of Salford, Salford, UK
| | - Ushotanefe Useh
- Lifestyle Diseases Research Entity, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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21
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Ullah F, Iqbal A, Iqbal S, Kwak D, Anwar H, Khan A, Ullah R, Siddique H, Kwak KS. A Framework for Maternal Physical Activities and Health Monitoring Using Wearable Sensors. SENSORS 2021; 21:s21154949. [PMID: 34372186 PMCID: PMC8348787 DOI: 10.3390/s21154949] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/28/2021] [Accepted: 07/03/2021] [Indexed: 12/03/2022]
Abstract
We propose a physical activity recognition and monitoring framework based on wearable sensors during maternity. A physical activity can either create or prevent health issues during a given stage of pregnancy depending on its intensity. Thus, it becomes very important to provide continuous feedback by recognizing a physical activity and its intensity. However, such continuous monitoring is very challenging during the whole period of maternity. In addition, maintaining a record of each physical activity, and the time for which it was performed, is also a non-trivial task. We aim at such problems by first recognizing a physical activity via the data of wearable sensors that are put on various parts of body. We avoid the use of smartphones for such task due to the inconvenience caused by wearing it for activities such as “eating”. In our proposed framework, a module worn on body consists of three sensors: a 3-axis accelerometer, 3-axis gyroscope, and temperature sensor. The time-series data from these sensors are sent to a Raspberry-PI via Bluetooth Low Energy (BLE). Various statistical measures (features) of this data are then calculated and represented in features vectors. These feature vectors are then used to train a supervised machine learning algorithm called classifier for the recognition of physical activity from the sensors data. Based on such recognition, the proposed framework sends a message to the care-taker in case of unfavorable situation. We evaluated a number of well-known classifiers on various features developed from overlapped and non-overlapped window size of time-series data. Our novel dataset consists of 10 physical activities performed by 61 subjects at various stages of maternity. On the current dataset, we achieve the highest recognition rate of 89% which is encouraging for a monitoring and feedback system.
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Affiliation(s)
- Farman Ullah
- Department of Electrical & Computer Engineering, COMSATS University Islamabad-Attock Campus, Punjab 43600, Pakistan; (S.I.); (H.A.); (A.K.); (H.S.)
- Correspondence: (F.U.); (K.-S.K.)
| | - Asif Iqbal
- Department of Information and Communication Engineering, Inha University, Incheon 22212, Korea;
| | - Sumbul Iqbal
- Department of Electrical & Computer Engineering, COMSATS University Islamabad-Attock Campus, Punjab 43600, Pakistan; (S.I.); (H.A.); (A.K.); (H.S.)
| | - Daehan Kwak
- Department of Computer Science, Kean University, Union, NJ 07083, USA;
| | - Hafeez Anwar
- Department of Electrical & Computer Engineering, COMSATS University Islamabad-Attock Campus, Punjab 43600, Pakistan; (S.I.); (H.A.); (A.K.); (H.S.)
| | - Ajmal Khan
- Department of Electrical & Computer Engineering, COMSATS University Islamabad-Attock Campus, Punjab 43600, Pakistan; (S.I.); (H.A.); (A.K.); (H.S.)
| | - Rehmat Ullah
- Department of Computer Systems Engineering, University of Engineering & Technology, Peshawar 25000, Pakistan;
| | - Huma Siddique
- Department of Electrical & Computer Engineering, COMSATS University Islamabad-Attock Campus, Punjab 43600, Pakistan; (S.I.); (H.A.); (A.K.); (H.S.)
| | - Kyung-Sup Kwak
- Department of Information and Communication Engineering, Inha University, Incheon 22212, Korea;
- Correspondence: (F.U.); (K.-S.K.)
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22
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Ekelöf K, Andersson O, Holmén A, Thomas K, Almquist Tangen G. Depressive symptoms postpartum is associated with physical activity level the year prior to giving birth - A retrospective observational study. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 29:100645. [PMID: 34274857 DOI: 10.1016/j.srhc.2021.100645] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 06/22/2021] [Accepted: 07/05/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To examine physical activity level prior to pregnancy, during pregnancy and postpartum and investigate the association with depressive symptoms postpartum among women in Sweden. STUDY DESIGN Retrospective observational study including 532 women on self-assessment of physical activity level before pregnancy, during pregnancy and postpartum, depressive symptoms postpartum as well as stressful life events in the past two years. MAIN OUTCOME MEASURES Level and change of physical activity before pregnancy, during pregnancy and postpartum and depressive symptoms postpartum. RESULTS Almost two-thirds of the women in the study reported that they were inactive or performed light physical activity (62.9%; n = 331) in the year prior to giving birth. Women with a sedentary lifestyle or performing light physical activity level reported depressive symptoms postpartum to a greater extent than active women. CONCLUSIONS A higher level of physical activity during pregnancy was associated with a lower level of depressive symptoms postpartum. Physical activity is a contributing factor to promote a healthier lifestyle and can contribute to improve mental health for pregnant women, newly become mothers and their children.
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Affiliation(s)
- Katarina Ekelöf
- Department of Research and Development, Region Halland, Halmstad, Sweden; Department of Medical and Health Sciences, Linköping University, Sweden.
| | - Ola Andersson
- Department of Clinical Sciences Lund, Pediatrics, Lund University, Lund, Sweden; Department of Neonatology, Skåne University Hospital, Malmö/Lund, Sweden
| | - Anders Holmén
- Department of Research and Development, Region Halland, Halmstad, Sweden
| | - Kristin Thomas
- Department of Medical and Health Sciences, Linköping University, Sweden
| | - Gerd Almquist Tangen
- Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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23
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Falskog F, Landsem AM, Meland E, Bjorvatn B, Hjelle OP, Mildestvedt T. Patients want their doctors' help to increase physical activity: a cross sectional study in general practice. Scand J Prim Health Care 2021; 39:131-138. [PMID: 33871303 PMCID: PMC8293971 DOI: 10.1080/02813432.2021.1910670] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 01/24/2021] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Inactivity is prevalent in patients presenting in general practice, and the health benefits of increased physical activity (PA) are well known. Few studies have explored whether patients want their general practitioner's (GPs) contribution in facilitating a lifestyle change. OBJECTIVE To identify the characteristics of patients who expect help from their doctor in increasing levels of PA. DESIGN We collected data via questionnaires for this cross-sectional study from general practices. SETTING General practices in Norway, during Spring 2019. SUBJECTS A total of 2104 consecutive patients (response rate 75%) participated. MAIN OUTCOME MEASURES The questionnaire included questions about self-rated health, level of physical activity, the desire to become more physically active, and questions about the role of the GP in increasing the level of physical activity in their patients. We analysed our data using Pearson chi-square and binary logistic regression. RESULTS Female patients were less active, but their motivation to increase activity and their expectations of receiving help from their doctor were similar to males. Younger patients were more motivated for increased activity, and to manage without help from their doctors. Impaired self-rated health (SRH) was associated with inactivity and, at the same time, with the motivation to become more active with help from general practitioners. CONCLUSION Most patients in the GPs' office are physically inactive. This study revealed an important message for GPs: in clinical work, emphasise physical activity for health gains, especially for patients with impaired SRH.Key PointsFour out of five patients attending Norwegian general practice are inactiveMore than 85% of these patients want to increase their physical activity levelMore than 50% would like help from their GP to achieve this goal.
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Affiliation(s)
- Frida Falskog
- Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Ane M. Landsem
- Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Eivind Meland
- Department of Global Public Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Ole P. Hjelle
- Faculty of Health and Social Sciences, Department of Nursing and Health Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Thomas Mildestvedt
- Department of Global Public Health and Primary Health Care, University of Bergen, Bergen, Norway
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Dieberger AM, van Poppel MNM, Watson ED. Baby Steps: Using Intervention Mapping to Develop a Sustainable Perinatal Physical Activity Healthcare Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5869. [PMID: 34070723 PMCID: PMC8198094 DOI: 10.3390/ijerph18115869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 05/25/2021] [Accepted: 05/27/2021] [Indexed: 12/16/2022]
Abstract
While the benefits of physical activity (PA) during and after pregnancy have been established, many women do not reach the recommended PA levels during this time. A major barrier found in the literature is a lack of counselling by healthcare providers (HCPs), which is partly caused by the limited knowledge on the topic. The aim of this study was to develop an intervention to improve the promotion of PA by HCPs. We used Intervention Mapping (IM), a theory-based framework to develop an intervention, called "Baby steps", in a high-income (Austria) and a low-to-middle-income country (South Africa). We applied the following IM steps: (1) A needs assessment to determine the barriers and enablers of PA promotion by HCPs, including a scoping literature review and community needs assessments (qualitative interviews, questionnaires, and focus groups with midwives, obstetricians, and community health workers) to determine the desired outcomes of the intervention. (2) Performance and change objectives were formulated, describing the behaviors that need to change for the intervention to succeed. (3) Based on these objectives, theory-based behavior change techniques were selected, and practical applications were developed. (4) The applications were combined into two evidence-based interventions tailored to each country's needs. Step (5) and (6) consist of an implementation and evaluation plan, respectively. The intervention is aimed at HCPs, such as midwives and community health workers, consisting of a two-day training course, including practical resources. Combining didactic and interactive education, it addresses both PA knowledge and the skills needed to transfer knowledge and facilitate behavior change. In the future, the intervention's effect on women's activity levels during and after pregnancy needs to be studied.
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Affiliation(s)
- Anna M. Dieberger
- Department of Obstetrics and Gynaecology, Medical University of Graz, Auenbruggerplatz 14, 8036 Graz, Austria
| | - Mireille N. M. van Poppel
- Institute of Human Movement Science, Sport and Health, University of Graz, Mozartgasse 14, 8010 Graz, Austria;
| | - Estelle D. Watson
- Centre for Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 27 St. Andrews Road, Parktown, Johannesburg 2193, South Africa;
- Department of Exercise Sciences, Faculty of Science, The University of Auckland, Building 907, Suiter Street, Newmarket, Auckland 1142, New Zealand
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Rodriguez-Ayllon M, Acosta-Manzano P, Coll-Risco I, Romero-Gallardo L, Borges-Cosic M, Estévez-López F, Aparicio VA. Associations of physical activity, sedentary time, and physical fitness with mental health during pregnancy: The GESTAFIT project. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:379-386. [PMID: 34024352 PMCID: PMC8167327 DOI: 10.1016/j.jshs.2019.04.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/13/2019] [Accepted: 03/11/2019] [Indexed: 05/21/2023]
Abstract
PURPOSE This study was aimed to analyze the associations of objectively measured physical activity (PA), sedentary time, and physical fitness with mental health in the early second trimester (16 ± 2 gestational weeks) of pregnancy. METHODS From 229 women initially contacted, 124 pregnant women participated in the present cross-sectional study. Data were collected between November 2015 and March 2017. The participants wore Actigraph GT3X+ Triaxial accelerometers for 9 consecutive days to objectively measure their PA levels and sedentary time. A performance-based test battery was used to measure physical fitness. Self-report questionnaires assessed psychological ill-being (i.e., negative affect, anxiety, and depression), and psychological well-being (i.e., emotional intelligence, resilience, and positive affect). Linear regression analyses were adjusted for age, educational level, accelerometer wear time, miscarriages, and low back pain. RESULTS Moderate-to-vigorous PA was negatively associated with depression (β = -0.222, adjusted R2 = 0.050, p = 0.041). Higher levels of sedentary time were negatively associated with positive affect (β = -0.260, adjusted R2 = 0.085, p = 0.017). Greater upper-body flexibility was positively associated with better emotional regulation (β = 0.195, adjusted R2= 0.030, p = 0.047). The remaining associations were not significant (all p > 0.05). CONCLUSION An active lifestyle characterized by higher levels of moderate-to-vigorous PA and lower levels of sedentary time during pregnancy might modestly improve the mental health of pregnant women. Although previous research has focused on the benefits of cardiorespiratory exercise, the present study shows that only upper-body flexibility is related to emotional regulation in early pregnant women. If the present findings are corroborated in further experimental research, physical exercise programs should focus on enhancing flexibility to promote improvements in emotional regulation during early second-trimester of pregnancy.
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Affiliation(s)
- María Rodriguez-Ayllon
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain.
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain; Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18007, Spain
| | - Irene Coll-Risco
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain; Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18007, Spain
| | - Lidia Romero-Gallardo
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain; Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18007, Spain
| | - Milkana Borges-Cosic
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain; Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18007, Spain
| | - Fernando Estévez-López
- Department of Psychology, Faculty of Social and Behavioral Sciences, Utrecht University, CS Utrecht 3584, the Netherlands
| | - Virginia A Aparicio
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18007, Spain; Department of Physiology, Faculty of Pharmacy and Institute of Nutrition and Food Technology, University of Granada, Granada 18011, Spain
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Kogutt BK, Szymanski LM. Diabesity and Pregnancy: How Do We Get Our Patients Moving? Clin Obstet Gynecol 2021; 64:185-195. [PMID: 33284141 DOI: 10.1097/grf.0000000000000588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Obesity and diabetes are 2 commonly encountered complications in pregnancy that adversely affect pregnancy outcomes, maternal health, and the health of the offspring, both short-term and long-term. It is well established that physical activity provides numerous health benefits, both during and outside of pregnancy. By participating in physical activity, many of the negative consequences of both obesity and diabetes may be mitigated. Physical activity guidelines recommend that all adults, including pregnant women, perform at least 150 minutes of moderate-intensity exercise weekly in order to obtain health benefits. More physical activity may be needed to achieve weight management goals.
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Affiliation(s)
- Benjamin K Kogutt
- Obstetrix Medical Group of Texas & Baylor Medical Center, Fort Worth, Texas
| | - Linda M Szymanski
- Division of Maternal-Fetal Medicine, Mayo Clinic, Rochester, Minnesota
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Wehner C, Scheppingen MAV, Bleidorn W. Stability and change in major life goals during the transition to parenthood. EUROPEAN JOURNAL OF PERSONALITY 2021. [DOI: 10.1177/0890207021996894] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The transition to parenthood introduces changes in various life domains. In this paper, we examined whether and to what degree the transition to parenthood is related to changes in the importance of major life goals. To do this, we examined the rank-order stability, ipsative stability, and mean-level change in six life goal domains ( achievement, power, variation, affiliation, altruism, and intimacy) in a sample of 248 parents and 294 individuals in a romantic relationship without children across two time points. Overall, we found high rank-order (variable-oriented) and ipsative (person-oriented) stability, and little evidence for mean-level changes in the importance of life goals across the transition to parenthood. However, we found several selection effects suggesting that women without children tended to endorse agentic life goals ( variation and achievement) more than mothers did. Generally, our findings underline the overall stability of life goals and their role as guiding principles in life.
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Al-Ziyadi S, Almashyakhi S, AlEssa H, Turkistani O, Al-Harthi R. Barriers to physical activity during pregnancy among Saudi population on the Western region. SAUDI JOURNAL FOR HEALTH SCIENCES 2021. [DOI: 10.4103/sjhs.sjhs_66_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lee KJ, Moon H, Yun HR, Park EL, Park AR, Choi H, Hong K, Lee J. Greenness, civil environment, and pregnancy outcomes: perspectives with a systematic review and meta-analysis. Environ Health 2020; 19:91. [PMID: 32854706 PMCID: PMC7457282 DOI: 10.1186/s12940-020-00649-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 08/21/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND Various maternal conditions, especially in utero conditions and prenatal exposure to environments with air pollution and greenness, have been reviewed to address the enhancement and prevention of susceptibility to health risks, including low birthweight, preterm delivery, and preeclampsia. This study aimed to qualitatively and quantitatively investigate the associations between pregnancy outcomes and the characteristics of surrounding living environment, including greenness, air pollution, and civilization. METHODS A secondary search of the MEDLINE, EMBASE, Cochrane Library, K-eArticles, and CINAHL databases was conducted without language restrictions to identify the relevant publications from the time of inception of the databases to April 2019. RESULTS A total of 89 studies were identified, and 10 were included in the quantitative synthesis. The greenness of the environment within 100-, 250- and 500-m buffers, after adjusting for the air quality and civilization factors, was weakly but positively associated with birthweight. The pooled regression slope was 0.00134 (95% confidence interval [CI], 0.000, 0.0020). The greenness of the environment was also associated with a significant decrease in the incidence of poor pregnancy outcomes, namely, low birthweight, small for gestational age (odds ratio [OR] 0.94; 95% CI, 0.92, 0.97), and preterm delivery (OR 0.98; 95% CI, 0.97, 0.99). CONCLUSIONS The greenness of the environment had a positive effect on the pregnancy outcomes, despite poor air quality and civilization. Following urbanization, planning for greenness management, environmental medicine, and public health is important and thus should be proposed as preventive methods as way of increasing birthweight and life expectancy.
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Affiliation(s)
- Kyung Ju Lee
- Department of Obstetrics and Gynecology, Korea University Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea.
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea.
- Department of Public Health, Korea University Graduate School, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea.
| | - Hyemi Moon
- Department of Biostatistics, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, South Korea
| | - Hyo Ri Yun
- Department of Biostatistics, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, South Korea
| | - Eun Lyeong Park
- Department of Biostatistics, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, South Korea
| | - Ae Ran Park
- Department of Biostatistics, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, South Korea
| | - Hijeong Choi
- Graduate School of Integrative Medicine, Cha University, Pocheon-si, Gyeonggi-do, South Korea
| | - Kwan Hong
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
- Department of Public Health, Korea University Graduate School, 73, Goryeodae-ro, Seongbuk-gu, Seoul, 02841, South Korea
| | - Juneyoung Lee
- Department of Biostatistics, Korea University College of Medicine, 73, Goryeodae-ro, Seongbuk-gu, Seoul, South Korea.
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Grenier LN, Atkinson SA, Mottola MF, Wahoush O, Thabane L, Xie F, Vickers-Manzin J, Moore C, Hutton EK, Murray-Davis B. Be Healthy in Pregnancy: Exploring factors that impact pregnant women's nutrition and exercise behaviours. MATERNAL AND CHILD NUTRITION 2020; 17:e13068. [PMID: 32705811 PMCID: PMC7729656 DOI: 10.1111/mcn.13068] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 06/23/2020] [Accepted: 07/06/2020] [Indexed: 11/30/2022]
Abstract
Excess gestational weight gain is associated with short‐ and long‐term pregnancy complications. Although a healthy diet and physical activity during pregnancy are recommended and shown to reduce the risk of complications and improve outcomes, adherence to these recommendations is low. The aims of this study were to explore women's view of nutrition and physical activity during pregnancy and to describe barriers and facilitators experienced in implementing physical activity and nutrition recommendations. In a substudy of the Be Healthy in Pregnancy randomized trial, 20 semistructured focus groups were conducted with 66 women randomized to the control group when they were between 16 and 24 weeks gestation. Focus groups were recorded, transcribed verbatim, coded and thematically analysed. The results indicate that women felt motivated to be healthy for their baby, but competing priorities may take precedence. Participants described limited knowledge and access to information on safe physical activity in pregnancy and lacked the skills needed to operationalize both physical activity and dietary recommendations. Women's behaviours regarding diet and physical activity in pregnancy were highly influenced by their own and their peers' beliefs and values regarding how weight gain impacted their health during pregnancy. Pregnancy symptoms beyond women's control such as fatigue and nausea made physical activity and healthy eating more challenging. Counselling from care providers about nutrition and physical activity was perceived as minimal and ineffective. Future interventions should address improving counselling strategies and address individual's beliefs around nutrition and activity in pregnancy.
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Affiliation(s)
- Lindsay N Grenier
- McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | | | - Michelle F Mottola
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Lab, School of Kinesiology, The University of Western Ontario, London, Ontario, Canada
| | - Olive Wahoush
- Global Health, McMaster University, Hamilton, Ontario, Canada.,School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.,Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Feng Xie
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Vickers-Manzin
- Public Health Services-Healthy Families, Healthy & Safe Communities, Hamilton, Ontario, Canada
| | - Caroline Moore
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Eileen K Hutton
- McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Beth Murray-Davis
- McMaster Midwifery Research Center, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
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31
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Flannery C, Fredrix M, Olander EK, McAuliffe FM, Byrne M, Kearney PM. Effectiveness of physical activity interventions for overweight and obesity during pregnancy: a systematic review of the content of behaviour change interventions. Int J Behav Nutr Phys Act 2019; 16:97. [PMID: 31675954 PMCID: PMC6825353 DOI: 10.1186/s12966-019-0859-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/10/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Behaviour change techniques (BCTs) employed within PA intervention for pregnant women with a healthy body mass index (BMI) have been previously identified, however, these BCTS may differ for other weight profiles during pregnancy. The aim of this current review was to identify and summarise the evidence for effectiveness of PA interventions on PA levels for pregnant women with overweight and obesity, with an emphasis on the BCTs employed. METHODS A systematic review and meta-analysis of PA intervention studies using the PRISMA statement was conducted. Searches were conducted of eight databases in January 2019. Strict inclusion/exclusion criteria were employed. The validity of each included study was assessed using the Cochrane Collaboration's tool for assessing risk of bias. The primary outcome measure was change in PA levels, subjectively or objectively measured, with physical fitness as a secondary outcome. All intervention descriptions were double coded by two authors using Michie's et al's BCT taxonomy V1. Meta-analyses using random effect models assessed the intervention effects on PA. Other PA outcomes were summarised in a narrative synthesis. RESULTS From 8389 studies, 19 met the inclusion criteria 13 of which were suitable for inclusion in a meta-analysis. The remaining 6 studies were described narratively due to insufficient data and different outcome measures reported. In the meta-analysis, comparing interventions to a control group, significant increases were found in the intervention group for metabolic equivalent (SMD 0.39 [0.14, 0.64], Z = 3.08 P = 0.002) and physical fitness (VO2 max) (SMD 0.55 [0.34, 0.75], Z = 5.20 P = < 0.001). Of the other six, five studies reported an increase in PA for the intervention group versus the control with the other study reporting a significant decrease for women in their 3rd trimester (p = 0.002). 'Self-monitoring of behaviour' was the most frequently used BCTs (76.5%), with 'social support' being newly identified for this pregnant population with overweight or obesity. CONCLUSIONS This review identified a slight increase in PA for pregnant women with overweight and obesity participating in interventions. However, due to the high risk of bias of the included studies, the results should be interpreted with caution. PA measures should be carefully selected so that studies can be meaningfully compared and standardised taxonomies should be used so that BCTs can be accurately assessed.
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Affiliation(s)
- Caragh Flannery
- School of Public Health, University College Cork, Cork, Ireland.
| | - Milou Fredrix
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
| | - Ellinor K Olander
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, United Kingdom
| | - Fionnuala M McAuliffe
- Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - Molly Byrne
- Health Behaviour Change Research Group, School of Psychology, National University of Ireland, Galway, Ireland
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Sjögren Forss K, Stjernberg L. Physical Activity Patterns Among Women and Men During Pregnancy and 8 Months Postpartum Compared to Pre-pregnancy: A Longitudinal Study. Front Public Health 2019; 7:294. [PMID: 31750283 PMCID: PMC6843064 DOI: 10.3389/fpubh.2019.00294] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/01/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Realizing the essential prerequisite of regular physical activity (PA) it is essential to have knowledge about how different life change events may influence individual's participation. Many studies have documented that pregnancy and the transition to parenthood are life change events associated with decreased PA among women however, the examination of changes of PA in the male parent during this major life change event has been largely neglected in scientific literature and a significant research gap can be found. In the light of this, this longitudinal study aimed to follow changing PA patterns among women and men during pregnancy and 8 months postpartum compared to pre-pregnancy. Methods: In this study, 123 women and 112 men (partners of the women) that lived in the municipality of Karlskrona, Sweden, were included. Data were collected between 2008 and 2010. The self-reported amount of PA performed outdoors and indoors before pregnancy throughout the entire pregnancy, and 8 months postpartum, were measured. Results: We found similar changes in PA patterns among both women and men during pregnancy and 8 months postpartum when compared to pre-pregnancy. In almost all the activities studied except for walking/strolling, a significant decline was found. Conclusions: Our findings contribute new knowledge about changes in men's PA patterns from pre-pregnancy to pregnancy and postpartum. As couples seem to change activity patterns similarly, it is important to promote family-based PA initiatives and encourage couples to be active together during pregnancy and postpartum.
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Affiliation(s)
- Katarina Sjögren Forss
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Louise Stjernberg
- Department of Health Sciences, The Swedish Red Cross University College, Huddinge, Sweden
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Uterine Artery Doppler Velocimetry During Individually Prescribed Exercise in Pregnancy. Obstet Gynecol 2019; 132:1026-1032. [PMID: 30130345 DOI: 10.1097/aog.0000000000002779] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate uterine artery blood flow in response to typical exercise sessions performed in pregnancy in accordance with the current recommendations from the American College of Obstetricians and Gynecologists and the U.S. Department of Health and Human Services. METHODS This prospective cross-sectional study measured uterine artery Doppler velocimetry in healthy pregnant women after individually prescribed exercise, including 1) moderate-intensity exercise (40-59% of heart rate reserve) in both nonexercisers and regular exercisers and 2) vigorous-intensity exercise (60-84% of heart rate reserve) in women who regularly engage in exercise. Resting uterine artery Doppler measures were obtained after a 20-minute fetal heart tracing; then the exercise session was performed. Immediately after the exercise session ended, the participants returned to the semirecumbent, leftward tilt position for ultrasound examination. Uterine artery measures were obtained 3.4±0.9 minutes (mean±SD) postexercise. RESULTS Forty-five healthy pregnant women participated in the study: 30 regular exercisers and 15 nonexercisers. For the moderate-intensity session, mean gestational age was 31.1 and 31.7 weeks for the exercisers and nonexercisers, respectively. Mean uterine artery Doppler indices (pulsatility index, resistance index, systolic/diastolic ratio) did not significantly change with exercise. For the vigorous-intensity session, the average gestational age was 31.5 weeks. After vigorous activity, all mean uterine artery Doppler indices showed reductions postexercise, for example, pulsatility index decreased from 0.63±0.12 to 0.58±0.12 (P=.04). CONCLUSION Individually prescribed exercise according to guidelines for pregnant women does not adversely alter uterine artery Doppler values, suggesting that uterine blood flow is not reduced as a result of exercise.
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Kołomańska-Bogucka D, Mazur-Bialy AI. Physical Activity and the Occurrence of Postnatal Depression-A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E560. [PMID: 31480778 PMCID: PMC6780177 DOI: 10.3390/medicina55090560] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 08/12/2019] [Accepted: 08/29/2019] [Indexed: 12/20/2022]
Abstract
Background and Objectives: During pregnancy and the postnatal period many changes occur in a woman's body, both in mental and physical spheres. The birth of a child and a new role-of a mother-can sometimes be associated with numerous negative emotions, uncertainty, fear, anxiety, disgust, depression, or sadness. In the puerperium period, the development of baby blues or postpartum depression may occur. Postpartum depression develops within one month of childbirth and may last up to one year. Depressive disorders that may develop in a young mother affect both her and the newborn's health. That is why it is so important to try to search for factors that could significantly reduce the likelihood of developing depression in this period. The study aims at assessing the relationship between physical activity during pregnancy and puerperium or in the postpartum and the development of postnatal depression. Materials and Methods: A review of the literature was carried out in the Medline-PubMed database. The search terms were "pregnancy" AND "physical activity AND postpartum depression". The study included only English-language publications published in the period 2000-2018. Results: A total of 216 references were found. After establishing the inclusion and exclusion criteria based on the analysis of titles and abstracts, 173 articles were excluded from the review. A total of 43 publications were read in full. Finally, 16 articles were included in the review. It was shown that regular physical activity during pregnancy, pregnancy, and puerperium, or in the postnatal period itself as compared to inactivity, reduces the risk of developing depression in pregnant women and after the birth of a child. Conclusions: Physical activity can be an essential factor in the prevention of depressive disorders of women in the postnatal period.
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Affiliation(s)
- Daria Kołomańska-Bogucka
- Department of Ergonomics and Exercise Physiology, Faculty of Health Science, Jagiellonian University Medical College, Grzegorzecka 20, 31-531 Krakow, Poland
| | - Agnieszka Irena Mazur-Bialy
- Department of Ergonomics and Exercise Physiology, Faculty of Health Science, Jagiellonian University Medical College, Grzegorzecka 20, 31-531 Krakow, Poland.
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Kawajiri M, Nakamura Y, Takeishi Y, Ito N, Atogami F, Yoshizawa T. Longitudinal study of physical activity using an accelerometer in Japanese pregnant women. Jpn J Nurs Sci 2019; 17:e12294. [PMID: 31465152 DOI: 10.1111/jjns.12294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 04/26/2019] [Accepted: 07/12/2019] [Indexed: 11/28/2022]
Abstract
AIM To describe the characteristics of objectively measured physical activity (PA) during the 2nd and 3rd trimesters of pregnancy using a accelerometer. METHODS This was a longitudinal observational study wherein PA in pregnant women in the 2nd and 3rd trimesters was measured for seven consecutive days using a accelerometer (Silmee W10, TDK, Japan). RESULTS A total of 34 primiparous women were examined. There was no statistically significant difference in the amount of PA during the 2nd and 3rd trimesters of pregnancy. Sub-group analysis demonstrated that PA in the full-time housewife group increased significantly from the 2nd to the 3rd trimester, while total PA and moderate and vigorous PA of the stopped-working group, decreased significantly over that time. There was no difference in the PA of the currently working group between trimesters. In the full-time housewife group, the amount of PA for each hour significantly increased at 12:00, 18:00, and 22:00 hr. In the currently working group, the amount of PA for each hour significantly increased at 9:00, 10:00, and 16:00 hr. In the stopped-working group, the amount of PA for each hour significantly decreased at 7:00, 8:00, and 18:00 hr. CONCLUSION Objective measurements using an accelerometer did not identify any significant changes in PA during the different trimesters of pregnancy. Sub-group analysis revealed clear patterns in PA change correlating with different lifestyles during pregnancy. Future research may enable the development of personalized health guidance by identifying the relationship between PA and pregnancy outcomes.
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Affiliation(s)
| | | | | | - Naoko Ito
- Tohoku University Hospital, Sendai, Japan
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da Silva SG, Evenson KR, Ekelund U, da Silva ICM, Domingues MR, da Silva BGC, Mendes MDA, Cruz GIN, Hallal PC. How many days are needed to estimate wrist-worn accelerometry-assessed physical activity during the second trimester in pregnancy? PLoS One 2019; 14:e0211442. [PMID: 31246953 PMCID: PMC6597041 DOI: 10.1371/journal.pone.0211442] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 06/15/2019] [Indexed: 11/28/2022] Open
Abstract
Background Objective methods to measure physical activity (PA) can lead to better cross-cultural comparisons, monitoring temporal PA trends, and measuring the effect of interventions. However, when applying this technology in field-work, the accelerometer data processing is prone to methodological issues. One of the most challenging issues relates to standardizing total wear time to provide reliable data across participants. It is generally accepted that at least 4 complete days of accelerometer wear represent a week for adults. It is not known if this same assumption holds true for pregnant women. Aim We assessed the optimal number of days needed to obtain reliable estimates of overall PA and moderate-to-vigorous physical activity (MVPA) during the 2nd trimester in pregnancy using a raw triaxial wrist-worn accelerometer. Methods Cross-sectional analyses were carried out in the antenatal wave of the 2015 Pelotas (Brazil) Birth Cohort Study. Participants wore the wrist ActiGraph wGT3X-BT accelerometer for seven consecutive days. The daily average acceleration, which indicated overall PA, was measured as milli-g (mg), and time spent in MVPA (minutes/day) was analyzed in 5-minute bouts. ANOVA and Kruskal-Wallis tests were used to compare variability across days of the week. Bland-Altman plots and the Spearman-Brown Prophecy Formula were applied to determine the reliability coefficient associated with one to seven days of measurement. Results Among 2,082 pregnant women who wore the accelerometer for seven complete days, overall and MVPA were lower on Sundays compared to other days of the week. Reliability of > = 0.80 to evaluate overall PA was reached with at least three monitoring days, whereas seven days were needed to estimate reliable measures of MVPA. Conclusions Our findings indicate that obtaining one week of accelerometry in adults is appropriate for pregnant women, particularly to obtain differences on weekend days and reliably estimate overall PA and MVPA.
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Affiliation(s)
- Shana Ginar da Silva
- PostGraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Medical School, Federal University of Fronteira Sul–Passo Fundo, Passo Fundo, RS, Brazil
- * E-mail:
| | - Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Ulf Ekelund
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Inácio Crochemore Mohsam da Silva
- PostGraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- PostGraduate Program in Physical Education, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | | | | | | | - Pedro Curi Hallal
- PostGraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
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Martin-Fairey CA, Zhao P, Wan L, Roenneberg T, Fay J, Ma X, McCarthy R, Jungheim ES, England SK, Herzog ED. Pregnancy Induces an Earlier Chronotype in Both Mice and Women. J Biol Rhythms 2019; 34:323-331. [PMID: 31018734 PMCID: PMC7408307 DOI: 10.1177/0748730419844650] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Daily rhythms generated by endogenous circadian mechanisms and synchronized to the light-dark cycle have been implicated in the timing of birth in a wide variety of species. Although chronodisruption (e.g., shift work or clock gene mutations) is associated with poor reproductive outcomes, little is known about circadian timing during pregnancy. This study tested whether daily rhythms change during full-term pregnancies in mice and women. We compared running wheel activity continuously in both nonpregnant ( n = 14) and pregnant ( n = 13) 12- to 24-week-old C57BL/6NJ mice. We also monitored wrist actigraphy in women ( N = 39) for 2 weeks before conception and then throughout pregnancy and measured daily times of sleep onset. We found that on the third day of pregnancy, mice shift their activity to an earlier time compared with nonpregnant dams. Their time of daily activity onset was maximally advanced by almost 4 h around day 7 of pregnancy and then shifted back to the nonpregnant state approximately 1 week before delivery. Mice also showed reduced levels of locomotor activity during their last week of pregnancy. Similarly, in women, the timing of sleep onset was earlier during the first and second trimesters (gestational weeks 4-13 and 14-27) than before pregnancy and returned to the prepregnant state during the third trimester (weeks 28 until delivery). Women also showed reduced levels of locomotor activity throughout pregnancy. These results indicate that pregnancy induces changes in daily rhythms, altering both time of onset and amount of activity. These changes are conserved between mice and women.
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Affiliation(s)
- Carmel A Martin-Fairey
- Department of Biology, Washington University, St. Louis, MO, USA
- Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, USA
| | - Peinan Zhao
- Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, USA
| | - Leping Wan
- Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, USA
| | - Till Roenneberg
- Institute for Medical Psychology, Department of Human Chronobiology, Ludwig-Maximilians-University, Munich, Germany
| | - Justin Fay
- Department of Biology, University of Rochester, Rochester, NY, USA
| | - Xiaofeng Ma
- Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, USA
| | - Ronald McCarthy
- Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, USA
| | - Emily S Jungheim
- Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, USA
| | - Sarah K England
- Department of Obstetrics and Gynecology, Washington University, St. Louis, MO, USA
| | - Erik D Herzog
- Department of Biology, Washington University, St. Louis, MO, USA
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Kołomańska D, Zarawski M, Mazur-Bialy A. Physical Activity and Depressive Disorders in Pregnant Women-A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E212. [PMID: 31130705 PMCID: PMC6572339 DOI: 10.3390/medicina55050212] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/05/2019] [Accepted: 05/21/2019] [Indexed: 12/12/2022]
Abstract
Background and Objectives: Pregnancy is a unique period in the life of every woman. The lifestyle of a pregnant woman has a significant impact on her and her child's health. Regular physical activity is one of the elements that help maintain normal mental and physical well-being. In pregnant women who regularly have moderate physical activity, there is a lower risk of developing obesity and overweight. Physical exercises have an impact on maintaining proper muscular tonus, reduce pain and prepare for the exertion during labour. Based on the available literature, the aim of this study was to present the impact of physical activity on depressive disorders in pregnant women. Materials and Methods: A review of the literature was carried out in the Medline PubMed database. The basic search terms were: "pregnancy" AND "physical activity AND depression". The work included only English-language publications published in the years 2000-2018. Results: A total of 408 references were found. On the basis of an analysis of titles, abstracts and the language of publication (other than English), 354 articles were rejected, and 54 articles were fully read, of which five were rejected due to lack of access to the full version. Finally, 17 references were included in the review. Conclusions: Physical activity, at least once a week, significantly reduces the symptoms of depression in pregnant women and may be an important factor in the prevention of depression in this period.
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Affiliation(s)
- Daria Kołomańska
- Department of Ergonomics and Exercise Physiology, Faculty of Health Science, Jagiellonian University Medical College, Grzegorzecka 20, 31-531 Krakow, Poland.
| | - Marcin Zarawski
- Department of Gynecology and Obstetrics with Gynecologic Oncology, Rydygier Hospital, Złotej Jesieni 1, 31-826 Krakow, Poland.
| | - Agnieszka Mazur-Bialy
- Department of Ergonomics and Exercise Physiology, Faculty of Health Science, Jagiellonian University Medical College, Grzegorzecka 20, 31-531 Krakow, Poland.
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Eichler J, Schmidt R, Hiemisch A, Kiess W, Hilbert A. Gestational weight gain, physical activity, sleep problems, substance use, and food intake as proximal risk factors of stress and depressive symptoms during pregnancy. BMC Pregnancy Childbirth 2019; 19:175. [PMID: 31101019 PMCID: PMC6525385 DOI: 10.1186/s12884-019-2328-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 05/03/2019] [Indexed: 12/23/2022] Open
Abstract
Background Because maternal depressive symptoms and stress during pregnancy are strongly associated with poor health of the mother and the developing child, understanding the predictors of women’s mental health problems is important to prevent complications in the perinatal period. Therefore, this study sought to examine the association between six risk factors – gestational weight gain (GWG), low physical activity, sleep problems, alcohol use, cigarette smoking and snack food intake – and mental health problems during pregnancy. We hypothesized that risk factors would predict mental health problems while adjusting for socio-demographic characteristics and pregnancy intention, both cross-sectionally and longitudinally. Methods Hierarchical linear regression analyses were conducted in a population-based sample of N = 463 pregnant women during their 2nd trimester (gestational age: 23 to 28 weeks) of whom n = 349 were reassessed during their 3rd trimester (gestational age: 33 to 38 weeks). Women had a mean age of 29.8 ± 4.2 years and a mean pregravid body mass index of 23.5 ± 4.3 kg/m2. Data were collected by the ‘Leipzig Research Center for Civilization Diseases’ via the Patient Health Questionnaire, Pittsburgh Sleep Quality Index, Food Frequency Questionnaire, self-report items on physical activity and substance use, and objectively measured anthropometrics. Results Cross-sectionally, while a higher snack food intake and sleep problems predicted depressive symptoms and stress during the 2nd trimester, gestational weight gain predicted stress only. Longitudinally, sleep problems positively predicted depressive symptoms during the 3rd trimester. All results remained significant after controlling for age, pregravid body mass index, and pregnancy intention. GWG and significant longitudinal effects became insignificant when controlling for gestational age or baseline depressive symptoms and stress, respectively. Conclusions The results showed that sleep problems were associated with maternal mental health problems during pregnancy. Longitudinal studies using standardized measures, particularly diagnostic interviews and physiological or biochemical markers, are warranted to confirm patterns of risk factors, their association with depressive symptoms and stress during the course of pregnancy, and their effects on mother’s and child’s health. Electronic supplementary material The online version of this article (10.1186/s12884-019-2328-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Janina Eichler
- Integrated Research and Treatment Center AdiposityDiseases, Medical Psychology and Medical Sociology, Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.
| | - Ricarda Schmidt
- Integrated Research and Treatment Center AdiposityDiseases, Medical Psychology and Medical Sociology, Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
| | - Andreas Hiemisch
- LIFE Child Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.,Department of Women and Child Health, Hospital for Children and Adolescents and Centre for Paediatric Research (CPL), University of Leipzig, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Wieland Kiess
- LIFE Child Leipzig Research Center for Civilization Diseases, University of Leipzig, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.,Department of Women and Child Health, Hospital for Children and Adolescents and Centre for Paediatric Research (CPL), University of Leipzig, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Anja Hilbert
- Integrated Research and Treatment Center AdiposityDiseases, Medical Psychology and Medical Sociology, Psychosomatic Medicine and Psychotherapy, Leipzig University Medical Center, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
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Sattler MC, Jaunig J, Watson ED, van Poppel MNM, Mokkink LB, Terwee CB, Dietz P. Physical Activity Questionnaires for Pregnancy: A Systematic Review of Measurement Properties. Sports Med 2019; 48:2317-2346. [PMID: 30094797 PMCID: PMC6132497 DOI: 10.1007/s40279-018-0961-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background In order to assess physical activity (PA) during pregnancy, it is important to choose the instrument with the best measurement properties. Objectives To systematically summarize, appraise, and compare the measurement properties of all self-administered questionnaires assessing PA in pregnancy. Methods We searched PubMed, Embase, and SPORTDiscus with the following inclusion criteria: (i) the study reported at least one measurement property (reliability, criterion validity, construct validity, responsiveness) of a self-administered questionnaire; (ii) the questionnaire intended to measure PA; (iii) the questionnaire was evaluated in healthy pregnant women; and (iv) the study was published in English. We evaluated results, quality of individual studies, and quality of evidence using a standardized checklist (Quality Assessment of Physical Activity Questionnaires [QAPAQ]) and the GRADE (Grading of Recommendation, Assessment, Development, and Evaluation) approach. Results Seventeen articles, reporting 18 studies of 11 different PA questionnaires (17 versions), were included. Most questionnaire versions showed insufficient measurement properties. Only the French and Turkish versions of the Pregnancy Physical Activity Questionnaire (PPAQ) showed both sufficient reliability and construct validity. However, all versions of the PPAQ pooled together showed insufficient construct validity. The quality of individual studies was usually high for reliability but varied considerably for construct validity. Overall, the quality of evidence was very low to moderate. Conclusions We recommend the PPAQ to assess PA in pregnancy, although the pooled results revealed insufficient construct validity. The lack of appropriate standards in data collection and processing criteria for objective devices in measuring PA during pregnancy attenuates the quality of evidence. Therefore, research on the validity of comparison instruments in pregnancy followed by consensus on validation reference criteria and standards of PA measurement is needed. Electronic supplementary material The online version of this article (10.1007/s40279-018-0961-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Johannes Jaunig
- Institute of Sport Science, University of Graz, Graz, Austria
| | - Estelle D Watson
- Centre for Exercise Science and Sports Medicine, Faculty of Health Sciences, School of Therapeutic Sciences, University of Witwatersrand, Private Bag 3, Johannesburg, 2050, South Africa.,MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of Witwatersrand, Private Bag 3, Johannesburg, 2050, South Africa
| | - Mireille N M van Poppel
- Institute of Sport Science, University of Graz, Graz, Austria.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Lidwine B Mokkink
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Caroline B Terwee
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Pavel Dietz
- Institute of Sport Science, University of Graz, Graz, Austria.,Institute of Occupational, Social and Environmental Medicine, University Medical Centre, University of Mainz, Mainz, Germany
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Watson ED, Brage S, White T, Westgate K, Norris SA, Van Poppel MNM, Micklesfield LK. The Influence of Objectively Measured Physical Activity During Pregnancy on Maternal and Birth Outcomes in Urban Black South African Women. Matern Child Health J 2019. [PMID: 29516229 PMCID: PMC6060755 DOI: 10.1007/s10995-018-2504-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objectives Research indicates the beneficial effects of physical activity during pregnancy on maternal health, although controversy still exists regarding its influence on birth outcomes. Little research has been done to objectively measure physical activity during pregnancy in black African women from low-to-middle income countries. The purpose of this study was to examine the association between physical activity and maternal and birth outcomes in this unique population. Methods This observational, longitudinal study assessed total physical activity using a hip-mounted triaxial accelerometer at 14–18 weeks (second trimester, n = 120) and 29–33 weeks (third trimester, n = 90) gestation. Physical activity is expressed as gravity-based acceleration units (mg). Maternal outcomes included both weight and weight gain at 29–33 weeks gestation. Birth outcomes included gestational age, birth weight, ponderal index and Apgar score, measured within 48 h of delivery. Results There was a significant decline in physical activity from the second to the third trimester (12.8 ± 4.1 mg vs. 9.7 ± 3.6 mg, p ≤ 0.01). Physical activity at 29–33 weeks as well as a change in PA was inversely associated with weight change at 29–33 weeks (β = − 0.24; 95% CI − 0.49; − 0.00; p = 0.05 and β = − 0.36; 95% CI − 0.62; − 0.10; p = 0.01, respectively). No significant associations were found between physical activity and birth outcomes. Conclusions for Practice Physical activity during pregnancy may be an effective method to control gestational weight gain, whilst presenting no adverse risk for fetal development, in women from a low-income urban setting.
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Affiliation(s)
- Estelle D Watson
- Centre for Exercise Science and Sports Medicine, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Physical Education Building, WITS Education Campus, 27 St Andrews Rd, Parktown, Johannesburg, 2194, South Africa. .,MRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Private Bag X3, Wits, Johannesburg, 2050, South Africa.
| | - Søren Brage
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Box 285, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Tom White
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Box 285, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Kate Westgate
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Box 285, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK
| | - Shane A Norris
- MRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Private Bag X3, Wits, Johannesburg, 2050, South Africa
| | - Mireille N M Van Poppel
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria.,Department of Public and Occupational Health, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Lisa K Micklesfield
- MRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Private Bag X3, Wits, Johannesburg, 2050, South Africa
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Krzepota J, Sadowska D, Biernat E. Relationships between Physical Activity and Quality of Life in Pregnant Women in the Second and Third Trimester. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15122745. [PMID: 30563083 PMCID: PMC6313753 DOI: 10.3390/ijerph15122745] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/01/2018] [Accepted: 12/03/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND The problem of an inadequate level of physical activity (PA) is important in the context of its relationship with the quality of life (QoL) of pregnant women. The aim of this study was to analyze the relationships between PA and QoL among pregnant women. METHODS The study analyzed 346 questionnaires filled in by pregnant women (157 in the second trimester and 189 in the third). The tool used for assessment of PA was the Pregnancy Physical Activity Questionnaire-Polish version (PPAQ-PL). The quality of life (QoL) was assessed by the World Health Organization Quality of Life Questionnaire-short form (WHOQoL-Bref). The results obtained from the PPAQ-PL and WHOQoL-Bref questionnaires for women in the second and third trimesters of pregnancy and intergroup differences were analyzed. RESULTS There was a significant correlation in the group of women in the second trimester of pregnancy between quality of life in the physical health domain and the intensity and type of physical activity. The women who rated their quality of life higher in this domain declared higher energy expenditures (EE) associated with vigorous activity (R = 0.159, p ≤ 0.05), as well as with occupational activity (R = 0.166; p ≤ 0.05) and sport/exercise activity (R = 0.187; p ≤ 0.05). In women in the third trimester, higher EE related to sport/exercise activity coincided with higher assessments of the overall quality of life (R = 0.149, p ≤ 0.05) and general health (R = 0.170, p ≤ 0.05). In the case of the psychological domain (R = 0.161, p ≤ 0.05) and social relationship domain (R = 0.188; p ≤ 0.05) of QoL, positive correlations occurred with EE related to vigorous activity. In contrast, high assessment of physical health domain coincided with higher EE related to occupational activity (R = 0.174; p ≤ 0.05). CONCLUSIONS Our study makes an important contribution to knowledge concerning the correlations between PA and QoL in pregnancy. The results suggest the need for improvement in prenatal care and promotion of PA programs for pregnant women.
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Affiliation(s)
- Justyna Krzepota
- Department of Physical Culture and Health Promotion, University of Szczecin, al. Piastów 40b, blok 6, 71-065 Szczecin, Poland.
| | - Dorota Sadowska
- Department of Physiology, Institute of Sport-National Research Institute, ul. Trylogii 2/16, 01-982 Warsaw, Poland.
| | - Elżbieta Biernat
- Department of Tourism, Collegium of World Economy, Warsaw School of Economics, al. Niepodległości 162, 02-554 Warsaw, Poland.
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Sytsma TT, Zimmerman KP, Manning JB, Jenkins SM, Nelson NC, Clark MM, Boldt K, Borowski KS. Perceived Barriers to Exercise in the First Trimester of Pregnancy. J Perinat Educ 2018; 27:198-206. [PMID: 31073266 PMCID: PMC6491162 DOI: 10.1891/1058-1243.27.4.198] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Regular physical activity has been shown to improve pregnancy outcomes. We sought to identify barriers to exercise during the first trimester of pregnancy. Five hundred forty-nine pregnant women in their first trimester rated barriers to exercise on a scale of 1 (not a barrier) to 5 (a huge barrier) and recorded physical activity (minutes/week). Women were placed into one of three classifications, nonexercisers (zero exercise), infrequent exercisers (<150 minutes/week), or exercisers (≥150 minutes/week). The greatest barriers (mean) were nausea/fatigue (3.0) and lack of time (2.6). Exercisers reported significantly lower barrier levels. Nausea/fatigue was a greater barrier for nonexercisers compared to exercisers (3.6 vs 2.8, p < .001). Focusing education and interventions on these barriers may help pregnant women achieve healthy exercise levels.
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Abstract
Purpose This paper concerns participation of Poles aged 15+ years in leisure time and transport-related physical activity (PA) with a special focus on the life stages. The purpose of the paper was to analyze types of exercises, current and future behavior concerning PA, availability of sport and recreation facilities, and factors having the strongest relation with undertaking PA at a sufficient level according to pro-health recommendations of World Health Organization (WHO). Patients and methods A survey was carried out on the representative sample (n=2,000). Respondents were classified in accordance to their life stages with a two-step cluster analysis. Relationships between meeting the dose of PA required for health recommendations and a membership in groups of life stages were evaluated using log-linear analysis. The strength of this relationship was expressed by the odds ratio. In order to capture relationships between meeting WHO recommendations and a set of explanatory variables, a predictive model was built. Results Life stages and various related events have a significant relation with a decrease of PA. Among groups of a particular risk, there are professionally active and unemployed people aged 50–64 years without children as well as retirees aged 65+ years who do not meet WHO recommendations (45.3; 50.4% and 47.6%). The unemployed and retirees more frequently (p<0.0001) do not or cannot practice sport and do not think that a change of their situation is expected soon. However, 35% of professionally active people aged 50–64 years without children and 18.2% of unemployed people declare that they are currently not active but if they had the possibility, they would start practicing sport. Conclusion Campaigns promoting PA should be targeted at groups of a particular risk. Any attempts of increasing PA or changing tendencies of its decrease should consider life conditions of these persons, as well as their needs, motivations, and barriers.
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Affiliation(s)
- Elżbieta Biernat
- Department of Tourism, Collegium of World Economy, Warsaw School of Economics, Warsaw, Poland,
| | - Monika Piątkowska
- Department of Organization and History of Sport, Faculty of Physical Education, Józef Pilsudski University of Physical Education in Warsaw, Warsaw, Poland
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Vargas-Terrones M, Barakat R, Santacruz B, Fernandez-Buhigas I, Mottola MF. Physical exercise programme during pregnancy decreases perinatal depression risk: a randomised controlled trial. Br J Sports Med 2018; 53:348-353. [DOI: 10.1136/bjsports-2017-098926] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2018] [Indexed: 12/16/2022]
Abstract
IntroductionThe incidence of depression is high during the perinatal period. This mood disorder can have a significant impact on the mother, the child and the family.ObjectiveTo examine the effect of an exercise programme during pregnancy on the risk of perinatal depression.MethodsHealthy women who were <16 weeks pregnant were randomly assigned to two different groups. Women in the intervention group participated in a 60 min exercise programme throughout pregnancy, 3 days per week, which was conducted from October 2014 to December 2016. The Center for Epidemiological Studies-Depression Scale was used to measure the risk of depression at the beginning of the study (12–16 weeks), at gestational week 38 and at 6 weeks postpartum.ResultsOne hundred and twenty-four pregnant women were allocated to either the intervention (IG=70) or the control (CG=54) group. No differences were found in the percentage of depressed women at baseline (20% vs 18.5%) (χ2=0.043; p=0.836). A smaller percentage of depressed women were identified in the IG compared with the CG at 38 gestational weeks (18.6% vs 35.6%) (χ2=4.190; p=0.041) and at 6 weeks postpartum (14.5% vs 29.8%) (χ2=3.985; p=0.046) using the per-protocol analysis. No significant differences were found using the intention-to-treat analyses, except in the multiple imputation analysis at week 38 (18.6% vs 34.4%) (χ2=4.085; p=0.049).ConclusionAn exercise programme performed during pregnancy may reduce the prevalence of depression in late pregnancy and postpartum.Trial registration numberNCT02420288; Results.
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Stress Regulation, Physical Activity, and Perseverance in Spanish Teenagers with Perfectionist Trends. SUSTAINABILITY 2018. [DOI: 10.3390/su10051489] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Effects of Resistance Training on Fatigue-Related Domains of Quality of Life and Mood During Pregnancy: A Randomized Trial in Pregnant Women With Increased Risk of Back Pain. Psychosom Med 2018; 80:327-332. [PMID: 29394188 PMCID: PMC5878127 DOI: 10.1097/psy.0000000000000559] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The aim of the study was to test whether the adoption of twice weekly, low-to-moderate intensity resistance training during weeks 22 to 34 of pregnancy can improve quality of life and mood. METHODS A parallel-group trial was conducted. Women in their second trimester (N = 134) were randomly assigned to 12 weeks of wait list, bimonthly pregnancy education classes, or twice weekly low-to-moderate intensity resistance training. Resistance training involved one abdominal exercise with no external load and five exercises (leg extension, leg press, arm lat pull, leg curl, and lumbar extension) with an external load that gradually progressed, and the total active exercise time during each exercise session was approximately 17 minutes. Quality of life and mood were measured before and after the interventions using the 36-item Short Form Health Survey and Profile of Mood States. Intent-to-treat mixed-model analyses of variance (3 groups by 2 times, pre- and postintervention) tested the hypothesis that outcomes would worsen for the controls and not change or improve for the resistance training group. RESULTS The group by time interaction (F(2,131) = 3.144, η = .046, p = .046) for 36-item Short Form Health Survey vitality and subsequent simple main effects showed that scores were unchanged across time after resistance training (-1.8 (14.8)) but significantly decreased for the education (-6.44 (12.69), t = 3.408, df = 44, p = .001) and wait list (-9.11 (14.78), t = 4.135, df = 44, p < .001) groups, whereas posttest vitality scores for the pregnancy group (45.9 (16.9)) were significantly higher than the wait list (40.1 (16.3), t = 1.989, df = 87, p = .05) but not the education group (42.1 (15.4), p = .27). Profile of mood states fatigue scores showed a similar pattern. CONCLUSIONS Adverse changes in symptoms of energy and fatigue during pregnancy are attenuated by adopting low-to-moderate intensity resistance training. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov, NCT02557893.
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Leiferman J, Gutilla MJ, Nicklas JM, Paulson J. Effect of Online Training on Antenatal Physical Activity Counseling. Am J Lifestyle Med 2018; 12:166-174. [PMID: 30202389 PMCID: PMC6124996 DOI: 10.1177/1559827616639023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 01/26/2016] [Accepted: 02/24/2016] [Indexed: 12/16/2022] Open
Abstract
Objective: The objective of this study was to test the effect of an online education intervention on providers' attitudes, beliefs, knowledge, and practices pertaining to antenatal physical activity. Study design: A sample of 181 providers (ie, obstetricians, family medicine physicians, and certified nurse-midwives) was directed to view an online training on antenatal physical activity guidelines, counseling methods, and resources. Providers completed surveys before and 12 weeks after viewing the educational website material. Repeated-measures analyses were conducted to examine the effects of the online education. Results: A total of 164 providers (87.2%) completed baseline and follow-up surveys. After viewing the online training, participants more strongly agreed that it was their responsibility to encourage engagement in antenatal physical activity (P = .02) and believed that women would follow their advice about beginning antenatal physical activity (P = .01). Viewing the website material facilitated an increased confidence in ability to effectively talk with overweight and obese women about physical activity (P = .04) and more frequent advising to begin a moderate-intensity physical activity program for sedentary women (P = .02). Knowledge on antenatal physical activity guidelines also improved. Conclusion: Findings suggest that online educational interventions may be an effective tool in altering providers' knowledge and practices pertaining to antenatal physical activity.
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Affiliation(s)
- Jenn Leiferman
- Jenn Leiferman, PhD, MS, Department of Community and Behavioral Health, Colorado School of Public Health, 13001 E 17th Pl, Building 500, 3rd Fl, Mailstop B119, Aurora, CO 80045;
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Álvarez-Bueno C, Cavero-Redondo I, Sánchez-López M, Garrido-Miguel M, Martínez-Hortelano JA, Martínez-Vizcaíno V. Pregnancy leisure physical activity and children's neurodevelopment: a narrative review. BJOG 2018; 125:1235-1242. [DOI: 10.1111/1471-0528.15108] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2017] [Indexed: 12/17/2022]
Affiliation(s)
- C Álvarez-Bueno
- Health and Social Research Center; Universidad de Castilla-La Mancha; Cuenca Spain
| | - I Cavero-Redondo
- Health and Social Research Center; Universidad de Castilla-La Mancha; Cuenca Spain
| | - M Sánchez-López
- Health and Social Research Center; Universidad de Castilla-La Mancha; Cuenca Spain
- School of Education; Universidad de Castilla-La Mancha; Ciudad Real Spain
| | - M Garrido-Miguel
- Health and Social Research Center; Universidad de Castilla-La Mancha; Cuenca Spain
| | | | - V Martínez-Vizcaíno
- Health and Social Research Center; Universidad de Castilla-La Mancha; Cuenca Spain
- Facultad de Ciencias de la Salud; Universidad Autónoma de Chile; Talca Chile
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Sattler MC, Jelsma JGM, Bogaerts A, Simmons D, Desoye G, Corcoy R, Adelantado JM, Kautzky-Willer A, Harreiter J, van Assche FA, Devlieger R, Jans G, Galjaard S, Hill D, Damm P, Mathiesen ER, Wender-Ozegowska E, Zawiejska A, Blumska K, Lapolla A, Dalfrà MG, Bertolotto A, Dunne F, Jensen DM, Andersen LLT, Snoek FJ, van Poppel MNM. Correlates of poor mental health in early pregnancy in obese European women. BMC Pregnancy Childbirth 2017; 17:404. [PMID: 29202779 PMCID: PMC5715612 DOI: 10.1186/s12884-017-1595-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 11/24/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Depression during pregnancy is associated with higher maternal morbidity and mortality, and subsequent possible adverse effects on the cognitive, emotional and behavioral development of the child. The aim of the study was to identify maternal characteristics associated with poor mental health, in a group of overweight/obese pregnant women in nine European countries, and thus, to contribute to better recognition and intervention for maternal depression. METHODS In this cross-sectional observational study, baseline data from early pregnancy (< 20 weeks) of the DALI (Vitamin D and Lifestyle Intervention for gestational diabetes mellitus prevention) study were analyzed. Maternal mental health was assessed with the World Health Organization Well-Being Index (WHO-5). Women were classified as having a low (WHO-5 ≤ 50) or high wellbeing. RESULTS A total of 735 pregnant women were included. The prevalence of having a low wellbeing was 27.2%, 95% CI [24.0, 30.4]. Multivariate analysis showed independent associations between low wellbeing and European ethnicity, OR = .44, 95% CI [.25, .77], shift work, OR = 1.81, 95% CI [1.11, 2.93], insufficient sleep, OR = 3.30, 95% CI [1.96, 5.55], self-efficacy, OR = .95, 95% CI [.92, .98], social support, OR = .94, 95% CI [.90, .99], and pregnancy-related worries (socioeconomic: OR = 1.08, 95% CI [1.02, 1.15]; health: OR = 1.06, 95% CI [1.01, 1.11]; relationship: OR = 1.17, 95% CI [1.05, 1.31]). CONCLUSIONS Mental health problems are common in European overweight/obese pregnant women. The identified correlates might help in early recognition and subsequent treatment of poor mental health problems during pregnancy. This is important to reduce the unfavorable effects of poor mental health on pregnancy outcomes. TRIAL REGISTRATION ISRCTN70595832 , 02.12.2011.
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Affiliation(s)
- Matteo C. Sattler
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria
| | - Judith G. M. Jelsma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, the Netherlands
| | - Annick Bogaerts
- Department of Development and Regeneration KULeuven, University of Leuven, Leuven, Belgium and Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, Belgium and Faculty of Health and Social Work, research unit Healthy Living, UC Leuven-Limburg, Leuven, Belgium
| | - David Simmons
- Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, England and Macarthur Clinical School, Western Sydney University, Sydney, Australia
| | - Gernot Desoye
- Department of Obstetrics and Gynecology, Medizinische Universität Graz, Graz, Austria
| | - Rosa Corcoy
- Institut de Recerca de L’Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Zaragaza, Spain
| | - Juan M. Adelantado
- Institut de Recerca de L’Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Alexandra Kautzky-Willer
- Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Jürgen Harreiter
- Division of Endocrinology and Metabolism, Department of Medicine III, Medical University of Vienna, Vienna, Austria
| | - Frans A. van Assche
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals, Leuven, Belgium
| | - Roland Devlieger
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals, Leuven, Belgium
| | - Goele Jans
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals, Leuven, Belgium
| | - Sander Galjaard
- KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals, Leuven, Belgium
- Department of Obstetrics and Gynaecology Division of Obstetrics and Prenatal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - David Hill
- Recherche en Santé Lawson SA, Bronschhofen, Switzerland
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Elisabeth R. Mathiesen
- Center for Pregnant Women with Diabetes, Departments of Endocrinology and Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Agnieszka Zawiejska
- Division of Reproduction, Poznan University of Medical Sciences, Poznan, Poland
| | - Kinga Blumska
- Division of Reproduction, Poznan University of Medical Sciences, Poznan, Poland
| | | | | | | | | | | | | | - Frank J. Snoek
- Department of Medical Psychology, VU University Medical Centre, Amsterdam, the Netherlands
- Department of Medical Psychology, Academic Medical Centre, Amsterdam, the Netherlands
| | - Mireille N. M. van Poppel
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010, Graz, Austria
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre, Amsterdam, the Netherlands
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