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Pongpanit K, Dayan N, Janaudis-Ferreira T, Roig M, Spahija J, Bertagnolli M. Exercise effects on maternal vascular health and blood pressure during pregnancy and postpartum: a systematic review and meta-analysis. Eur J Prev Cardiol 2024; 31:1606-1620. [PMID: 38711399 DOI: 10.1093/eurjpc/zwae165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/27/2024] [Accepted: 05/02/2024] [Indexed: 05/08/2024]
Abstract
AIMS This systematic review aimed to assess the effects of exercise training during pregnancy and the postpartum period on maternal vascular health and blood pressure (BP). METHODS AND RESULTS The outcome of interest was pulse wave velocity (PWV), flow-mediated dilation (FMD), and BP from pregnancy to 1-year postpartum. Five databases, including Ovid MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane Library, were systematically searched from inception to August 2023. Studies of randomized controlled trials (RCTs) comparing the effects of prenatal or postpartum exercise to a non-exercise control group were included. The risk of bias and the certainty of evidence were assessed. Random-effects meta-analyses and sensitivity analyses were conducted. In total, 20 RCTs involving 1221 women were included. Exercise training, initiated from Week 8 during gestation or between 6 and 14 weeks after delivery, with the programme lasting for a minimum of 4 weeks up to 6 months, showed no significant impact on PWV and FMD. However, it resulted in a significant reduction in systolic BP (SBP) [mean difference (MD): -4.37 mmHg; 95% confidence interval (CI): -7.48 to -1.26; P = 0.006] and diastolic BP (DBP) (MD: -2.94 mmHg; 95% CI: -5.17 to -0.71; P = 0.01) with very low certainty. Subgroup analyses revealed consistent trends across different gestational stages, types of exercise, weekly exercise times, and training periods. CONCLUSION Exercise training during pregnancy and the postpartum period demonstrates a favourable effect on reducing maternal BP. However, further investigations with rigorous methodologies and larger sample sizes are needed to strengthen these conclusions.
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Affiliation(s)
- Karan Pongpanit
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3630 prom. Sir-William-Osler, Montreal, Quebec H3G 1Y5, Canada
- Department of Physical Therapy, Faculty of Allied Health Sciences, Thasmmasat University, Khlong Nueng, Khlong Luang District, Pathum Thani 12120, Thailand
- Hospital Sacré-Cœur Research Center, CIUSSS Nord-de-l'Île-de-Montréal, 5400 Boul Gouin Ouest, Montreal, Quebec H4J 1C5, Canada
| | - Natalie Dayan
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Cardiovascular Health Across the Lifespan Program, Research Institute of the McGill University Health Centre, 1001 Decarie Boulevard, Montreal, Quebec H4A 3J1, Canada
| | - Tania Janaudis-Ferreira
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3630 prom. Sir-William-Osler, Montreal, Quebec H3G 1Y5, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Marc Roig
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3630 prom. Sir-William-Osler, Montreal, Quebec H3G 1Y5, Canada
| | - Jadranka Spahija
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3630 prom. Sir-William-Osler, Montreal, Quebec H3G 1Y5, Canada
- Hospital Sacré-Cœur Research Center, CIUSSS Nord-de-l'Île-de-Montréal, 5400 Boul Gouin Ouest, Montreal, Quebec H4J 1C5, Canada
| | - Mariane Bertagnolli
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, 3630 prom. Sir-William-Osler, Montreal, Quebec H3G 1Y5, Canada
- Hospital Sacré-Cœur Research Center, CIUSSS Nord-de-l'Île-de-Montréal, 5400 Boul Gouin Ouest, Montreal, Quebec H4J 1C5, Canada
- Cardiovascular Health Across the Lifespan Program, Research Institute of the McGill University Health Centre, 1001 Decarie Boulevard, Montreal, Quebec H4A 3J1, Canada
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Hwang DJ, Cho JY, Hyun AH. Contactless exercise intervention in prenatal and postnatal period during COVID-19 lowers the risk of postpartum depression. Sci Rep 2024; 14:9780. [PMID: 38684812 PMCID: PMC11058814 DOI: 10.1038/s41598-024-60658-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 04/25/2024] [Indexed: 05/02/2024] Open
Abstract
The COVID-19 pandemic has had a substantial adverse impact on the physical and mental health of pregnant and postpartum women, thereby increasing the risk of postpartum depression (PPD). This study aimed to evaluate the effectiveness of a continuous contactless exercise intervention in reducing the risk of depression during the prenatal and postnatal periods. The study utilized an interactive contactless exercise program consisting of Pilates movement over a 16-week period, with 8 weeks during pregnancy and 8 weeks after childbirth. Metabolic and psychological factors related to postpartum depression, including pain, stress, and stress-response markers, were analyzed. The results showed that the exercise intervention significantly alleviated postpartum depression by improving pain (Oswestry Disability Index: Non-exercise, 11.4 ± 14.8 versus Exercise, - 63.1 ± 18.4, p < .001) and stress factors (Edinburgh Postnatal Depression Scale: Non-exercise, 8.8 ± 8.72 versus Exercise, - 37.6 ± 9.13, p < .001; Perceived Stress Scale: Non-exercise, 9.21 ± 9.35 versus Exercise, - 20.7 ± 14.4, p < .001) caused by physical/structural imbalances in postpartum women. Additionally, the intervention improved the metabolic imbalances commonly observed after childbirth, including reductions in triglyceride (Interaction effect, p = .017), insulin (Interaction effect, p = .032), and cortisol levels (Interaction effect, p < .001), which are recognized risk factors for postpartum depression. Taken together, these findings suggest that contactless online exercise interventions can mitigate postpartum depression by addressing metabolic dysregulation that frequently occurs after delivery, especially in situations of social isolation caused by the pandemic.
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Affiliation(s)
- Dong-Joo Hwang
- Exercise Biochemistry Laboratory, Korea National Sport University, Seoul, Korea
- Sport Science Institute, Korea National Sport University, Seoul, Korea
| | - Joon-Yong Cho
- Exercise Biochemistry Laboratory, Korea National Sport University, Seoul, Korea
| | - Ah-Hyun Hyun
- Exercise Biochemistry Laboratory, Korea National Sport University, Seoul, Korea.
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Barakat R, Silva-Jose C, Zhang D, Sánchez-Polán M, Refoyo I, Montejo R. Influence of Physical Activity during Pregnancy on Maternal Hypertensive Disorders: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Pers Med 2023; 14:10. [PMID: 38276226 PMCID: PMC10817323 DOI: 10.3390/jpm14010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/13/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
Gestational hypertension is a notable concern with ramifications for maternal and fetal health. Preemptive measures, including physical activity (PA), are crucial. There is a pressing need for comprehensive investigations into the impact of various forms of PA on hypertensive disorders. A systematic review and meta-analysis (CRD42022372468) following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed. Our review exclusively considered randomized clinical trials (RCTs) between 2010 and 2023, using the following databases: EBSCO, including Academic Search Premier, Education Resources Information Center, PubMed/MEDLINE, SPORTDiscus, and OpenDissertations; Clinicaltrials.gov; Web of Science; Scopus; the Cochrane Database of Systematic Reviews; and the Physiotherapy Evidence Database (PEDro). The primary outcome was hypertensive disorders occurring during pregnancy (14 studies). Diagnosed preeclampsia (15 studies) and blood pressure levels were also examined (17 studies). PA during pregnancy was significantly associated with a reduced risk of hypertensive disorders (RR = 0.44, 95% CI = 0.30, 0.66). The data also indicate a positive correlation between PA during pregnancy and both systolic (MD = -2.64, 95% CI = -4.79, -0.49) and diastolic (MD = -1.99, 95% CI = -3.68, -0.29) blood pressure levels. The relationship between PA and the incidence of diagnosed preeclampsia did not demonstrate a statistically significant association (RR = 0.81, 95% CI = 0.59, 1.11; p = 0.20). Random effects were used for all analyses. PA during pregnancy promises to improve maternal health by reducing the risk of gestational hypertension and positively affecting systolic and diastolic blood pressure.
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Affiliation(s)
- Rubén Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.S.-J.); (D.Z.); (M.S.-P.)
| | - Cristina Silva-Jose
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.S.-J.); (D.Z.); (M.S.-P.)
| | - Dingfeng Zhang
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.S.-J.); (D.Z.); (M.S.-P.)
| | - Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.S.-J.); (D.Z.); (M.S.-P.)
| | - Ignacio Refoyo
- Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Rocío Montejo
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, 41346 Gothenburg, Sweden;
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, 41346 Gothenburg, Sweden
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4
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Markofski MM, Johnston CA. Virtual Programming for Physical Activity Interventions: Integration of Behavioral Components. Am J Lifestyle Med 2023; 17:198-201. [PMID: 36896040 PMCID: PMC9989496 DOI: 10.1177/15598276221142753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The SARS-Cov-2 pandemic changed many contemporary experiences, including how healthcare and exercise programming are delivered. As a result of the pandemic, there was an increase in virtual services and programming and there continues to be a demand for virtual options. The results from Desir et al support the use of virtual visits to successfully change lifestyle factors, specifically nutrition and physical activity. The use of individualized dietary and exercise goals were important to the success of the intervention, and should not be disregarded. As virtual healthcare and exercise continues to evolve, to maximize behavior change, we should also consider how to include the social and community aspects of exercise. Regardless, it is encouraging to see that significant advances are being made in virtual programming and that the needed engagement can occur in a virtual setting.
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Affiliation(s)
- Melissa M. Markofski
- Department of Health and Human Performance, University of Houston, Houston, TX, USA
| | - Craig A. Johnston
- Department of Health and Human Performance, University of Houston, Houston, TX, USA
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He J, Yang W, He Q, Tang Y, Wang Y, Wang G, Jiang X, Ren J. Chinese pregnant women's knowledge, attitude, and practice of self-protection against coronavirus disease 2019 during the post-pandemic period: A structural equation modeling-based survey. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 87:103559. [PMID: 36714184 PMCID: PMC9869621 DOI: 10.1016/j.ijdrr.2023.103559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 01/03/2023] [Accepted: 01/22/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to investigate the Chinese pregnant women's levels of knowledge, attitude, and practice (KAP) of self-protection against coronavirus disease 2019 (COVID-19) during the post-pandemic period, to aid the development of targeted health education. An online questionnaire was conducted for 2156 Chinese pregnant women from October 1, 2021, to December 31, 2021, to collect socio-demographic and KAP information. Structural equation modeling (SEM) was used to determine self-protection-related factors. The mean age of the participants was 30 ± 4.1 years. SEM indicated that pregnant women's level of knowledge can directly and indirectly affect the practice of self-protection (r = 0.23) through their belief, with a correlation coefficient of 0.56 and 0.46 between knowledge and belief and belief and practice, respectively. The "basic protection" and "hospital visits after infection" exerted the greatest impact on knowledge formation, with correlation coefficients of 0.85 and 0.89, respectively. Attitude had a direct effect on practice with a correlation coefficient of 0.46. "Awareness of prevention and control" and "family and social support" had the greatest impact on belief formation, with correlation coefficients of 0.77 and 0.73, respectively. Pregnant Chinese women were generally familiar with COVID-19 knowledge, and their levels of knowledge and beliefs particularly affect the practice of self-protection. Health education aimed at improving pregnant women's knowledge and belief toward self-protection against COVID-19 may be an effective way to guide them toward positive practices and promote their health and that of their babies.
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Key Words
- AGFI, adjusted goodness of fit index
- BMI, body mass index
- CFI, comparative fix index
- CMIN/DF, Chi-square fit statistics/degree of freedom
- COVID-19
- COVID-19, coronavirus disease 2019
- GFI, goodness-of-fit index
- I-CVI, individual-item content validity index
- IFI, incremental fix index
- KAP theory
- KAP, knowledge attitude and practice
- MERS, Middle eastern respiratory syndrome
- Post-pandemic period
- Pregnant women
- RMSEA, root mean square error of approximation
- S-CVI, scale-content validity index
- SARS, severe acute respiratory syndrome
- SEM, structural equation modeling
- Self-protection
- TLI, Tucker-Lewis index
- UA, universal agreement
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Affiliation(s)
- Jingjing He
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Wenqian Yang
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Qiuyang He
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Yuxin Tang
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Yonghong Wang
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Guoyu Wang
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Xiaolian Jiang
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, SC 28/610000, China
| | - Jianhua Ren
- Department of nursing, West China Second University Hospital / West China School of Nursing, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan, SC 28/610000, China
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Nethery E, Hutcheon JA, Kotaska A, Law MR, Janssen P. Weight gain in pregnancy and infant birthweight after the onset of the COVID-19 pandemic: an interrupted time series analysis. Am J Clin Nutr 2023; 117:364-372. [PMID: 36863829 PMCID: PMC9972866 DOI: 10.1016/j.ajcnut.2022.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 09/07/2022] [Accepted: 09/12/2022] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Increased weight gain and decreased physical activity have been reported in some populations since the coronavirus disease 2019 (COVID-19) pandemic, but this has not been well characterized in pregnant populations. OBJECTIVES Our objective was to characterize the impact of the COVID-19 pandemic and associated countermeasures on pregnancy weight gain and infant birthweight in a US cohort. METHODS Washington State pregnancies and births (1 January, 2016 to 28 December, 2020) from a multihospital quality improvement organization were examined for pregnancy weight gain, pregnancy weight gain z-score adjusted for pregestational BMI and gestational age, and infant birthweight z-score, using an interrupted time series design that controls for underlying time trends. We used mixed-effect linear regression models, controlled for seasonality and clustered at the hospital level, to model the weekly time trends and changes on 23 March, 2020, the onset of local COVID-19 countermeasures. RESULTS Our analysis included 77,411 pregnant people and 104,936 infants with complete outcome data. The mean pregnancy weight gain was 12.1 kg (z-score: -0.14) during the prepandemic time period (March to December 2019) and increased to 12.4 kg (z-score: -0.09) after the onset of the pandemic (March to December 2020). Our time series analysis found that after the pandemic onset, the mean weight gain increased by 0.49 kg (95% CI: 0.25, 0.73 kg) and weight gain z-score increased by 0.080 (95% CI: 0.03, 0.13), with no changes in the baseline yearly trend. Infant birthweight z-scores were unchanged (-0.004; 95% CI: -0.04, 0.03). Overall, the results were unchanged in analyses stratified by pregestational BMI categories. CONCLUSIONS We observed a modest increase in weight gain after the onset of the pandemic among pregnant people but no changes in infant birthweights. This weight change could be more important in high BMI subgroups.
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Affiliation(s)
- Elizabeth Nethery
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.
| | - Jennifer A Hutcheon
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada; Department of Obstetrics & Gynaecology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew Kotaska
- Department of Obstetrics & Gynecology, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Obstetrics & Gynaecology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael R Law
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada; Centre for Health Services and Policy Research, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Patricia Janssen
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada; British Columbia Children's Hospital Research Institute, Vancouver, British Columbia, Canada
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Zhu Z, Xie H, Liu S, Yang R, Yu J, Yan Y, Wang X, Zhang Z, Yan W. Effects of physical exercise on blood pressure during pregnancy. BMC Public Health 2022; 22:1733. [PMID: 36096756 PMCID: PMC9469521 DOI: 10.1186/s12889-022-14074-z] [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: 05/05/2022] [Accepted: 08/22/2022] [Indexed: 12/03/2022] Open
Abstract
Objective Effect of physical exercise on pregnant women currently has become a hot topic in prenatal health care. In this study, A meta-analysis was conducted on account of Randomized Controlled Trial (RCT). It focused on evaluating the effect of physical exercise intervention on blood pressure so that could provide certain evidence for health care during pregnancy. Methods Results of relevant studies were retrieved from PubMed, Embase, Web of Science and the Cochrane Library, and all of these included studies were evaluated according to the Cochrane collaboration’s tool for assessing the risk of bias. Stata 15.1 was used for meta-analysis, and mean difference (MD) was used as statistic for pooled analysis. The effect values were combined by conventional meta-analysis and Bayesian meta-analysis respectively, and the consistency of pooled results was considered as well. Results A total of 18 RCT studies were included in the quantitative analysis. The conventional meta-analysis showed differences in blood pressure between intervention group and control group (P < 0.05). Systolic and diastolic blood pressures of intervention group were 3.19 mmHg (95% CI: -5.13, -1.25) and 2.14 mmHg (95% CI: -4.26, -0.03) lower than that of control group, respectively. Bayesian meta-analysis showed that both systolic and diastolic pressure among intervention group decreased by 3.34 mmHg (95% CrI: -5.15, -1.56) and 2.14 mmHg (95% CrI: -3.79, − 0.50), respectively. Subgroup analysis supported that as long as healthy pregnant women participated in exercises, their blood pressure could be slightly regulated, while hypertension susceptible pregnant women significantly lowered blood pressure. Conclusion Exercise intervention during pregnancy is beneficial to lower or normalize blood pressure, and this research provides clues for follow-up studies.
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Affiliation(s)
- Zhu Zhu
- Jiangsu Vocational Institute of Commerce, Nanjing, 211168, China
| | - Hang Xie
- Office of Clinical Research Center, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Shiping Liu
- Department of Orthopedics, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Ruizhe Yang
- Department of Public Health, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Juan Yu
- Department of Medicine, Gansu University of Chinese Medicine, Dingxi, 743000, China
| | - Yiping Yan
- College of Mathematics and Statistics, Northwest Normal University, Lanzhou, 730070, China
| | - Xu Wang
- Department of Endocrinology, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China
| | - Zhihua Zhang
- Yunyang People's Hospital of Danyang, Danyang, 212300, China.
| | - Wu Yan
- Department of Children Health Care, Children's Hospital of Nanjing Medical University, Nanjing, 210008, China.
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Corso M, Miarka B, Figueiredo T, Bragazzi N, Carvalho D, Dias I. Effects of aerobic, strength, and combined training during pregnancy in the blood pressure: A systematic review and meta-analysis. Front Physiol 2022; 13:916724. [PMID: 36111150 PMCID: PMC9468920 DOI: 10.3389/fphys.2022.916724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 08/01/2022] [Indexed: 11/16/2022] Open
Abstract
Gestational hypertension can lead to fetal complications, and, if untreated, high blood pressure during pregnancy may cause eclampsia and even death in the mother and fetus. Exercise is a strategy for preventing blood pressure disorders. There is little knowledge about the physiological impacts of different physical types of training on blood pressure during pregnancy. For that, this meta-analysis aimed to compare the effects of different physical exercise modalities (i.e., aerobic training-AT, strength training-ST, and combined training-AT + ST) on systolic blood pressure (SBP) and diastolic blood pressure (DBP) of pregnant women. A search was performed on PUBMED, LILACS, CINAHL, Sport discus, EMBASE, SCOPUS, and Cochrane Central Register of Controlled Trials to identify researchers. From 3,450 studies, 20 and 19 were included in the qualitative and quantitative analyses. AT studies presented a medium effect size (ES) on SBP [-0.29 (-2.95 to 2.36) p = 0.83], with substantial heterogeneity (I2 = 64%), and had a large impact on DBP [-1.34 (-2.98 to 0.30) p = 0.11], with moderate heterogeneity (I2 = 30%). ST researchers showed a large ES on SBP [-1.09 (-3.66 to 1.49) p = 0.41], with a reduced heterogeneity (I2 = 0%), and a medium ES on DBP [-0.26 (-2.77 to 2.19) p = 0.83] with moderate heterogeneity (I2 = 38%). AT + ST studies had a large ES on SBP [-1.69 (-3.88 to 0.49) p = 0.13] and DBP [-01.29 (-2.26 to 0.31) p = 0.01] with considerable (I2 = 83%) and moderate heterogeneity (I2 = 47%), respectively. These findings are essential for developing new research protocols to avoid gestational hypertension and preeclampsia. AT + ST had a large impact on the SBP and DBP reduction; however, there is a need for more similar procedures to reduce heterogeneity between studies, promoting consensual results. Systematic Review Registration: [PROSPERO], identifier [CRD42021256509].
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Affiliation(s)
- Marcelo Corso
- Physical Education Postgraduate Program, School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bianca Miarka
- Physical Education Postgraduate Program, School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Tiago Figueiredo
- Physical Education Program, Estácio de Sá University, Rio de Janeiro, Brazil
| | - Nicola Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Danilo Carvalho
- Physical Education Postgraduate Program, School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ingrid Dias
- Physical Education Postgraduate Program, School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Silva-Jose C, Sánchez-Polán M, Barakat R, Díaz-Blanco Á, Carrero Martínez V, García Benasach F, Alzola I, Mottola MF, Refoyo I. Exercise throughout Pregnancy Prevents Excessive Maternal Weight Gain during the COVID-19 Pandemic: A Randomized Clinical Trial. J Clin Med 2022; 11:3392. [PMID: 35743466 PMCID: PMC9225450 DOI: 10.3390/jcm11123392] [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: 03/17/2022] [Revised: 04/23/2022] [Accepted: 05/29/2022] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to examine the effects of a virtual exercise program throughout pregnancy during the COVID-19 pandemic on maternal weight gain. A randomized clinical trial (NCT NCT04563065) was performed. In total, 300 pregnant individuals were assessed for eligibility, and a total of 157 were randomized, of which 79 were in the control group (CG), and 78 were in the intervention group (IG). Those in the intervention group participated in a virtual supervised exercise program throughout pregnancy, 3 days per week. Fewer pregnant participants exceeded the weight gain recommendations in the IG group than in the CG (n = 4/5.9% vs. n = 31/43.1%, p = 0.001). Weight gain during pregnancy was lower in the IG than in the CG (9.96 ± 3.27 kg vs. 12.48 ± 4.87 kg, p = 0.001). Analysis of subgroups based on pre-pregnancy body mass index, showed significant differences in excessive maternal weight gain between study groups in normal-weight (IG, n = 0/0% vs. CG, n = 10/25%, p = 0.001) and those with overweight (IG, n = 2/18% vs. CG, n = 12/60%, p = 0.025). A virtual supervised exercise program throughout pregnancy could be a clinical tool to manage maternal weight gain during the COVID-19 pandemic by controlling excessive gain.
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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; (C.S.-J.); (R.B.)
| | - Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.S.-J.); (R.B.)
| | - Rubén Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (C.S.-J.); (R.B.)
| | - Ángeles Díaz-Blanco
- Gynecology and Obstetrics Department, Hospital Universitario Severo Ochoa de Leganés, 28911 Leganés, Spain;
| | - Vanessa Carrero Martínez
- Gynecology and Obstetrics Department, Hospital Universitario Puerta de Hierro de Majadahonda, 28222 Majadahonda, Spain; (V.C.M.); (F.G.B.)
| | - Fátima García Benasach
- Gynecology and Obstetrics Department, Hospital Universitario Puerta de Hierro de Majadahonda, 28222 Majadahonda, Spain; (V.C.M.); (F.G.B.)
| | - Irune Alzola
- Clínica Zuatzu, 20018 Donostia-San Sebastián, Spain;
| | - Michelle F. Mottola
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Lab, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Children’s Health Research Institute, The University of Western Ontario London, London, ON N6A 3K7, Canada;
| | - Ignacio Refoyo
- Sports Department, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
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Effect of Home-Based Tele-Pilates Intervention on Pregnant Women: A Pilot Study. Healthcare (Basel) 2022; 10:healthcare10010125. [PMID: 35052289 PMCID: PMC8775456 DOI: 10.3390/healthcare10010125] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 12/24/2021] [Accepted: 01/06/2022] [Indexed: 12/03/2022] Open
Abstract
Pilates is effective for training the core muscles and stabilizing the hip joints, which provides relief from pelvic pain and low back pain during pregnancy. However, there are no specific guidelines on appropriate physical exercises for pregnant women due to the current pandemic. We aimed to apply the exercise standard proposed by the American College of Obstetricians and Gynecologists to home-based tele-Pilates exercise (HTPE), to determine its effect on the physical and mental health of pregnant women. We randomly divided the subjects into the following two groups who completed 8 weeks of HTPE (50 min/day, 2 days/week): (a) Pilates exercise (PE, n = 7) and (B) non-Pilates exercise (CON, n = 7). HTPE was performed by adjusting the program every 3 weeks, based on pain and physical fitness levels. We measured body composition, muscles of the hip joint, pelvic tilt, Oswestry Disability Index (ODI), and Pittsburgh Sleep Quality Index (PSQI), before and after HTPE. Following HTPE, while the percentage of body fat and body mass index had significantly decreased, the body fat mass did not change in the PE group (p < 0.05). The PE group showed an increase in strength of the left and right hip flexion and hip abduction, compared to the CON group (p < 0.01). The ODI and PSQI were significantly decreased in the PE group (p < 0.05). Therefore, the 8-week HTPE program is an effective exercise for pregnant woman that reduces body fat metabolism and strengthens muscles of the hip joint, thus alleviating pregnancy-induced low back pain and insomnia.
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