1
|
Ana Y, van den Brand FA, van Schayck OCP, Babu GR. Relationship between physical activity during pregnancy and maternal health outcomes: evidence from the MAASTHI cohort study in Bengaluru, India. Front Sports Act Living 2025; 7:1265929. [PMID: 39949716 PMCID: PMC11821958 DOI: 10.3389/fspor.2025.1265929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 01/02/2025] [Indexed: 02/16/2025] Open
Abstract
Background Sedentary behavior is one of the major modifiable behavioral risk factors for non-communicable diseases. Physical activity (PA) is crucial during pregnancy but pregnant women may become sedentary, leading to adverse health outcomes. Our study aimed to explore the association between social support and PA levels during pregnancy and the relationship between sedentary behavior and adverse pregnancy health outcomes including delivery. Methods The study used a validated physical activity questionnaire to assess the physical activity levels of pregnant women. We collected detailed sociodemographic information, pregnancy characteristics, assessed social support. We assessed presence of depressive symptoms and conducted oral glucose tolerance tests, hemoglobin and blood pressure assessments, anthropometric measurements, and collected delivery details. We used linear logistic regression to assess the association between a continuous measure of physical activity level and maternal outcomes and performed multivariable logistic regression analysis to understand the association between sedentary behavior and maternal health outcomes and mode of delivery after adjusting for potential confounders. Results We interviewed 2,424 eligible pregnant women at baseline and 1,317 were considered in the final analysis after excluding those who missed follow-ups. We observed that one unit increase in physical activity level was associated with reduced prenatal depressive symptoms (β = -6.36, p < 0.001), fasting (β = 2.06, p = 0.04), and postprandial blood sugar levels (β = -0.99, p = 0.01), respectively. Pregnant women who had good social support tended to engage in higher levels of activity. In addition, women who engaged in sedentary behavior during pregnancy were 1.07 times more likely to be obese and 4.32 times more likely to have elective cesarean section (C-section) delivery than those who engaged in moderate activity. Conclusion The study found that physical activity during pregnancy has several beneficial effects on maternal prenatal health outcomes, including a reduced risk of obesity and C-section delivery, lower blood glucose levels, and improved mental health. Therefore, it is essential to adhere to the recommended guidelines for physical activity during pregnancy. Healthcare providers and policymakers in India should consider promoting physical activity as part of comprehensive routine prenatal care.
Collapse
Affiliation(s)
- Yamuna Ana
- Indian Institute of Public Health-Bengaluru, Public Health Foundation of India (PHFI), Bengaluru, India
| | - Floor A. van den Brand
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Limburg, Netherlands
| | - Onno C. P. van Schayck
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Limburg, Netherlands
| | - Giridhara R. Babu
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| |
Collapse
|
2
|
Satkunanathan P, Allard C, Doyon M, Perron P, Bouchard L, Hivert MF, Peters TM. Physical behaviours during pregnancy may alter the association of maternal insulin sensitivity with neonatal adiposity: a prospective pre-birth cohort of mother-child pairs. BMC Pregnancy Childbirth 2025; 25:41. [PMID: 39833733 PMCID: PMC11744830 DOI: 10.1186/s12884-025-07148-4] [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: 05/08/2024] [Accepted: 01/05/2025] [Indexed: 01/22/2025] Open
Abstract
BACKGROUND Lower maternal insulin sensitivity during pregnancy is associated with greater fetal adiposity. Physical activity can improve insulin sensitivity, but it is not known if physical behaviours influence the known association of maternal insulin sensitivity with offspring adiposity. This study aimed to investigate the moderating impact of physical behaviours on this association. METHODS Pregnant women (n = 812) from the Gen3G cohort were recruited during the first trimester of pregnancy and followed until delivery. At the first (V1) and second trimester (V2) hospital visits, Gen3G staff measured anthropometry, and participants reported sleep duration as well as leisure physical activity and sedentary behaviour via lifestyle questionnaires. We used plasma glucose and insulin values from the 75 g oral glucose tolerance test at V2 to calculate insulin sensitivity using the Matsuda index. We recorded birthweight from electronic medical records. Among a subset of neonates (n = 265), trained research staff measured skinfold thickness using a calibrated skinfold caliper following standardized protocols to estimate neonatal adiposity. Linear regression analyses assessed the association of insulin sensitivity with birthweight z-score and sum of neonatal skinfold thickness, adjusting for maternal age, race/ethnicity, gravidity, smoking, with and without adjustment for maternal body mass index at V1. We evaluated moderation by physical activity, sedentary behaviour, or nighttime sleep duration using interaction terms and stratified analyses for the association of maternal insulin sensitivity with offspring birthweight and with offspring adiposity. RESULTS Lower Matsuda index was associated with higher birthweight z-score (ß±SE= -0.180 ± 0.056, p = 0.001) and with higher sum of skinfold thickness (neonatal adiposity) (ß±SE=-0.877 ± 0.383, p = 0.02) in fully adjusted models. The association between Matsuda index and sum of skinfold thickness was weaker in women with higher levels of physical activity at V2 ([high ≥ 1.26 kcal/kg/day] ß±SE=-0.15 ± 0.65) compared to women with lower levels [low < 1.26 kcal/kg/day] ß±SE=-1.36 ± 0.51, P-interaction = 0.01). We also observed potential interactions of sleep and sedentary behaviour at V2 with Matsuda index for the association with birthweight z-score. We did not observe effect modification by levels of physical behaviours assessed at V1. CONCLUSION The association between lower insulin sensitivity and higher neonatal adiposity was attenuated in women with higher physical activity levels in the second trimester, independent of maternal body mass index.
Collapse
Affiliation(s)
- Piraveena Satkunanathan
- Division of Experimental Medicine, McGill University, Montreal, Québec, Canada
- Centre for Clinical Epidemiology, Lady Davis Research Institute, Montreal, Québec, Canada
| | - Catherine Allard
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Myriam Doyon
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
| | - Patrice Perron
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada
- Department of Medicine, Sherbrooke University, Sherbrooke, Québec, Canada
| | - Luigi Bouchard
- Biochemistry and Functional Genomics Department, Faculty of Medicine and Health Sciences (FMHS), Université de Sherbrooke, Sherbrooke, Québec, Canada
- Department of Laboratory Medicine, CIUSSS du Saguenay-Lac-Saint-Jean-Hôpital Universitaire de Chicoutimi, Chicoutimi, Québec, Canada
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Diabetes Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Tricia M Peters
- Centre for Clinical Epidemiology, Lady Davis Research Institute, Montreal, Québec, Canada.
- Division of Endocrinology and Metabolism, Department of Medicine, Jewish General Hospital, Montreal, Québec, Canada.
| |
Collapse
|
3
|
Gao J, Liu J. Association between physical activity and sedentary behavior and gestational diabetes mellitus: a Mendelian randomization analysis. Front Endocrinol (Lausanne) 2024; 15:1389453. [PMID: 39736862 PMCID: PMC11682963 DOI: 10.3389/fendo.2024.1389453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 11/29/2024] [Indexed: 01/01/2025] Open
Abstract
Introduction The evidence of association between physical activity (PA), sedentary behavior (SB) and gestational diabetes mellitus (GDM) remains controversial in observational studies, this study aimed to generate new hypotheses between PA, SB and GDM. Methods Our study performed Mendelian randomization (MR) analysis to explore the effects of three types of PA (moderate physical activity (MPA), moderate to vigorous physical activity (MVPA), accelerometer-based physical activity (ABPA)), three types of SB (television watching (TV), leisure computer use (PC), driving (DR)) on GDM and the mediating effect of body mass index (BMI). The inverse variance weighted method was used for the major analysis. Results In univariate MR analysis, we found that genetically predicted TV and PC among SB were associated with GDM (OR = 1.61, 95%CI 1.21-2.14, P = 0.001; OR = 0.71, 95%CI 0.51-0.98, P = 0.037), whereas DR and MP were not (OR = 1.68, 95%CI 0.21-13.3, P = 0.623; OR = 1.20, 95%CI 0.87-1.65, P = 0.271). However, no association was found between physical activity and GDM: MPA (OR = 0.40, 95%CI 0.08-2.06, P = 0.273), MVPA (OR = 0.96, 95%CI 0.58-1.57, P = 0.861), and ABPA (OR = 0.99, 95%CI 0.90-1.09, P = 0.838). Multivariate MR analysis found DM (OR = 1.64, 95%CI 1.13-2.36, P = 0.008) and that BMI was a mediating factor with a 62% mediating effect. Conclusions This study proposes a new hypothesis for the association between TV and GDM, which is mediated by BMI, providing evidence for reducing the risk of GDM during pregnancy by reducing television watching time.
Collapse
Affiliation(s)
- Jie Gao
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Jingfang Liu
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
- Department of Endocrinology, the First Hospital of Lanzhou University, Lanzhou, Gansu, China
| |
Collapse
|
4
|
Yi L, Habre R, Mason TB, Xu Y, Cabison J, Rosales M, Chu D, Chavez TA, Johnson M, Eckel SP, Bastain TM, Breton CV, Wilson JP, Dunton GF. Smartphone GPS-Based Exposure to Greenspace and Walkability and Accelerometer-Assessed Physical Activity During Pregnancy and Early Postpartum-Evidence from the MADRES Cohort. J Urban Health 2024; 101:1128-1142. [PMID: 39145858 PMCID: PMC11652437 DOI: 10.1007/s11524-024-00903-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/09/2024] [Indexed: 08/16/2024]
Abstract
A growing number of studies have associated walkability and greenspace exposure with greater physical activity (PA) in women during pregnancy. However, most studies have focused on examining women's residential environments and neglected exposure in locations outside the home neighborhood. Using 350 person-days (N = 55 participants) of smartphone global positioning system (GPS) location and accelerometer data collected during the first and third trimesters and 4-6 months postpartum from 55 Hispanic pregnant women from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) study, we examined the day-level effect of women's exposure to walkability and greenspace on their PA outcomes during pregnancy and in the early postpartum period. Moderate-to-vigorous physical activity [MVPA] minutes per day was assessed using accelerometers. Walkability and greenspace were measured using geographic information systems (GIS) within women's daily activity spaces (i.e., places visited and routes taken) recorded using a smartphone GPS and weighted by time spent. We used a generalized linear mixed-effects model to estimate the effects of daily GPS-derived environmental exposures on day-level MVPA minutes. Results showed that women engaged in 23% more MVPA minutes on days when they had some versus no exposure to parks and open spaces in activity spaces (b = 1.23; 95%CI: 1.02-1.48). In addition, protective effects of daily greenspace and walkability exposure on MVPA were stronger in the first and third trimesters, among first-time mothers, and among women who had high pre-pregnancy body mass index (BMI) and lived in least-safe neighborhoods. Our results suggest that daily greenspace and walkability exposure are important for women's PA and associated health outcomes during pregnancy and early postpartum.
Collapse
Affiliation(s)
- Li Yi
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA.
| | - Rima Habre
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Tyler B Mason
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Yan Xu
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA
| | - Jane Cabison
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Marisela Rosales
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Daniel Chu
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Thomas A Chavez
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Mark Johnson
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - John P Wilson
- Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
- Departments of Civil & Environmental Engineering, Computer Science, and Sociology, University of Southern California, Los Angeles, CA, USA
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| |
Collapse
|
5
|
Watkins VY, Zhao P, Frolova AI, Carter EB, Kelly JC, Odibo AO, England SK, Raghuraman N. The association between first trimester physical activity levels and perinatal outcomes. Am J Obstet Gynecol MFM 2024; 6:101534. [PMID: 39490897 PMCID: PMC11798543 DOI: 10.1016/j.ajogmf.2024.101534] [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: 07/08/2024] [Revised: 10/14/2024] [Accepted: 10/17/2024] [Indexed: 11/05/2024]
Abstract
OBJECTIVE Physical activity in pregnancy decreases the risk of adverse maternal and neonatal outcomes. This study evaluates the association between first trimester physical activity, assessed by Kaiser Physical Activity Survey (KPAS) scores, and adverse perinatal outcomes. STUDY DESIGN This is a secondary analysis of a prospective cohort study in which patients were administered the KPAS in each trimester. The primary outcomes were birthweight, large for gestational age (LGA), and small for gestational age (SGA) neonates. Secondary outcomes were composite neonatal morbidity (neonatal acidemia with pH<7.1, hypoxic ischemic encephalopathy, mechanical ventilation, hypoglycemia, and suspected sepsis), gestational diabetes, gestational hypertension, preeclampsia, inadequate and excess gestational weight gain. Outcomes were compared between patients with and without high physical activity levels during early pregnancy, defined as 1st trimester KPAS scores ≥75th percentile and <75th percentile, respectively. Multivariable logistic regression was used to adjust for confounders. RESULTS A total of 1,045 patients with a complete 1st trimester KPAS were included in this analysis and 262 patients were in the top quartile of physical activity levels in early pregnancy. Higher physical activity levels in the 1st trimester were associated with numerically but not clinically significantly higher birthweights (3191.3±696.1 vs 3076.3±719.8 g, P=.03) with no difference in rates of SGA (10.3% vs 13.3%, P=.25, aRR 0.79; 95% CI 0.52, 1.16) or LGA neonates (8.0% vs 7.3%, P=.80, aRR 1.14; 95% CI 0.68, 1.81). Higher physical activity levels were associated with decreased rates of composite neonatal morbidity (8.4% vs 15%, P<.01, aRR 0.59; 95% CI 0.37, 0.89) and gestational hypertension (6.5% vs 12.9%, P<.01, aRR 0.56; 95% CI 0.33, 0.89). Gestational weight gain and the incidence of gestational diabetes and preeclampsia were similar between groups. CONCLUSION Higher levels of physical activity in the first trimester are associated with higher birth weights and lower rates of composite neonatal morbidity and gestational hypertension.
Collapse
MESH Headings
- Humans
- Pregnancy
- Female
- Pregnancy Trimester, First
- Exercise/physiology
- Adult
- Prospective Studies
- Infant, Newborn
- Birth Weight/physiology
- Infant, Small for Gestational Age
- Pregnancy Outcome/epidemiology
- Pregnancy Complications/epidemiology
- Pregnancy Complications/diagnosis
- Pregnancy Complications/physiopathology
- Diabetes, Gestational/epidemiology
- Diabetes, Gestational/physiopathology
- Diabetes, Gestational/diagnosis
- Pre-Eclampsia/epidemiology
- Pre-Eclampsia/diagnosis
- Pre-Eclampsia/physiopathology
- Fetal Macrosomia/epidemiology
- Cohort Studies
- Logistic Models
- Infant, Newborn, Diseases/epidemiology
- Infant, Newborn, Diseases/diagnosis
- Infant, Newborn, Diseases/physiopathology
- Hypertension, Pregnancy-Induced/epidemiology
- Hypertension, Pregnancy-Induced/physiopathology
- Hypertension, Pregnancy-Induced/diagnosis
Collapse
Affiliation(s)
- Virginia Y Watkins
- Department of Obstetrics and Gynecology, Duke University Health System, Durham, NC (Watkins).
| | - Peinan Zhao
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO (Zhao, Frolova, Odibo, England, Raghuraman, and Kelly)
| | - Antonina I Frolova
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO (Zhao, Frolova, Odibo, England, Raghuraman, and Kelly)
| | - Ebony B Carter
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC (Carter)
| | - Jeannie C Kelly
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO (Zhao, Frolova, Odibo, England, Raghuraman, and Kelly)
| | - Anthony O Odibo
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO (Zhao, Frolova, Odibo, England, Raghuraman, and Kelly)
| | - Sarah K England
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO (Zhao, Frolova, Odibo, England, Raghuraman, and Kelly)
| | - Nandini Raghuraman
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO (Zhao, Frolova, Odibo, England, Raghuraman, and Kelly)
| |
Collapse
|
6
|
Watt GE, Hubbard ME, Mottola MF. The association of physical activity during pregnancy with birthweight extremes: A scoping review. J Sci Med Sport 2024; 27:684-690. [PMID: 38866653 DOI: 10.1016/j.jsams.2024.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 05/13/2024] [Accepted: 05/28/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVES Birthweight (BW) indicates newborn health and is a risk factor for development of chronic diseases later in life. The aim was to investigate whether or not prenatal physical activity (PA) influences BW extremes and how PA influences BW extremes in those diagnosed with pregnancy-related diseases. DESIGN We performed a scoping review. METHODS Searches were completed on five databases and studies identified were uploaded to Covidence. RESULTS Across the five databases 3114 studies were identified and after screening, 69 of these studies were used for the final review. Of the 61 studies that considered low BW (LBW)/small for gestational age (SGA) infants, the majority of results (69 %) indicated that PA during pregnancy had no significant impact on LBW or SGA infants. In addition, 11 % of studies reported a significant decrease in the prevalence of LBW infants, however two studies (3 %) reported a significant increase in LBW or SGA infants, likely relating to individuals with high body mass index and poor adherence to PA. Of the 41 studies that did report LGA/macrosomia, 34 % reported that PA significantly reduced the prevalence of higher BW infants. One study reported the association between meeting exercise recommendations and reducing the odds of LGA infants in those with pregnancy-related diseases. CONCLUSIONS We provide evidence on the association of prenatal PA with BW extremes. It is suggested that prenatal PA does not increase the risk of delivering LBW/SGA infants and may reduce the prevalence of large BW infants. Further research is needed to confirm these relationships and explain their underlying mechanisms.
Collapse
Affiliation(s)
- Grace Emma Watt
- R. Samuel McLaughlin Foundation - Exercise and Pregnancy Lab, University of Western Ontario, Canada; School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, Canada
| | - Madeline E Hubbard
- R. Samuel McLaughlin Foundation - Exercise and Pregnancy Lab, University of Western Ontario, Canada; School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, Canada; Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, Canada
| | - Michelle F Mottola
- R. Samuel McLaughlin Foundation - Exercise and Pregnancy Lab, University of Western Ontario, Canada; School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, Canada; Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, University of Western Ontario, Canada; Children's Health Research Institute, University of Western Ontario, Canada.
| |
Collapse
|
7
|
Sampathkumar S, Parkhi D, Ghebremichael-Weldeselassie Y, Sukumar N, Saravanan P. Effectiveness of pre-pregnancy lifestyle in preventing gestational diabetes mellitus-a systematic review and meta-analysis of 257,876 pregnancies. Nutr Diabetes 2023; 13:22. [PMID: 37973902 PMCID: PMC10654718 DOI: 10.1038/s41387-023-00251-5] [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: 02/08/2023] [Revised: 10/03/2023] [Accepted: 11/06/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Gestational Diabetes Mellitus (GDM) is hyperglycaemia first detected during pregnancy. Globally, GDM affects around 1 in 6 live births (up to 1 in 4 in low- and middle-income countries- LMICs), thus, urgent measures are needed to prevent this public health threat. OBJECTIVE To determine the effectiveness of pre-pregnancy lifestyle in preventing GDM. METHODS We searched MEDLINE, Web of science, Embase and Cochrane central register of controlled trials. Randomized control trials (RCTs), case-control studies, and cohort studies that assessed the effect of pre-pregnancy lifestyle (diet and/or physical activity based) in preventing GDM were included. Random effects model was used to calculate odds ratio (OR) with 95% confidence interval. The Cochrane ROB-2 and the Newcastle-Ottawa Scale were used for assessing the risk of bias. The protocol was registered in PROSPERO (ID: CRD42020189574) RESULTS: Database search identified 7935 studies, of which 30 studies with 257,876 pregnancies were included. Meta-analysis of the RCTs (N = 5; n = 2471) in women who received pre-pregnancy lifestyle intervention showed non-significant reduction of the risk of developing GDM (OR 0.76, 95% CI: 0.50-1.17, p = 0.21). Meta-analysis of cohort studies showed that women who were physically active pre-pregnancy (N = 4; n = 23263), those who followed a low carbohydrate/low sugar diet (N = 4; n = 25739) and those women with higher quality diet scores were 29%, 14% and 28% less likely to develop GDM respectively (OR 0.71, 95% CI: 0.57, 0.88, p = 0.002, OR 0.86, 95% CI: 0.68, 1.09, p = 0.22 and OR 0.72, 95% CI 0.60-0.87, p = 0.0006). CONCLUSION This study highlights that some components of pre-pregnancy lifestyle interventions/exposures such as diet/physical activity-based preparation/counseling, intake of vegetables, fruits, low carbohydrate/low sugar diet, higher quality diet scores and high physical activity can reduce the risk of developing gestational diabetes. Evidence from RCTs globally and the number of studies in LMICs are limited, highlighting the need for carefully designed RCTs that combine the different aspects of the lifestyle and are personalized to achieve better clinical and cost effectiveness.
Collapse
Affiliation(s)
- Swetha Sampathkumar
- Division of Health Sciences, Warwick Medical School, Gibbet Hill, University of Warwick, Warwick, Coventry, CV4 7AL, UK
| | - Durga Parkhi
- Division of Health Sciences, Warwick Medical School, Gibbet Hill, University of Warwick, Warwick, Coventry, CV4 7AL, UK
| | - Yonas Ghebremichael-Weldeselassie
- Division of Health Sciences, Warwick Medical School, Gibbet Hill, University of Warwick, Warwick, Coventry, CV4 7AL, UK
- School of Mathematics and Statistics, The Open University, Milton Keynes, UK
| | - Nithya Sukumar
- Division of Health Sciences, Warwick Medical School, Gibbet Hill, University of Warwick, Warwick, Coventry, CV4 7AL, UK
- Academic Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, CV10 7DJ, UK
| | - Ponnusamy Saravanan
- Division of Health Sciences, Warwick Medical School, Gibbet Hill, University of Warwick, Warwick, Coventry, CV4 7AL, UK.
- Academic Department of Diabetes, Endocrinology and Metabolism, George Eliot Hospital, Nuneaton, CV10 7DJ, UK.
| |
Collapse
|
8
|
Zhang D, Nagpal TS, Silva-José C, Sánchez-Polán M, Gil-Ares J, Barakat R. Influence of Physical Activity during Pregnancy on Birth Weight: Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Clin Med 2023; 12:5421. [PMID: 37629463 PMCID: PMC10455907 DOI: 10.3390/jcm12165421] [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: 07/12/2023] [Revised: 08/17/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Birth weight is a marker that is often referred to determine newborn health, potential growth trajectories and risk of future disease. Accordingly, interventions to promote appropriate and healthy birth weight have been extensively studied and implemented in pregnancy. In particular, physical activity in pregnancy is recommended to promote appropriate fetal development and newborn birth weight. This systematic review and meta-analyses aimed to summarize the effect of physical activity during pregnancy specifically from randomized controlled trials on the following outcomes: birth weight, macrosomia, low birth weight, being large for the gestational age, and being small for the gestational age (Registration No.: CRD42022370729). 63 studies (16,524 pregnant women) were included. There was a significant negative relationship between physical activity during pregnancy and macrosomia (z = 2.16; p = 0.03; RR = 0.79, 95% CI = 0.63, 0.98, I2 = 29%, Pheterogeneity = 0.09). No other significant relationships were found. Promoting physical activity during pregnancy may be an opportune time to reduce the risk of future chronic disease, such as obesity, through the prevention of macrosomia and the promotion of appropriate birth weights.
Collapse
Affiliation(s)
- Dingfeng Zhang
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (D.Z.); (C.S.-J.); (M.S.-P.); (R.B.)
| | - Taniya S. Nagpal
- Faculty of Kinesiology Sport and Recreation, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Cristina Silva-José
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (D.Z.); (C.S.-J.); (M.S.-P.); (R.B.)
| | - Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (D.Z.); (C.S.-J.); (M.S.-P.); (R.B.)
| | - Javier Gil-Ares
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (D.Z.); (C.S.-J.); (M.S.-P.); (R.B.)
| | - Rubén Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain; (D.Z.); (C.S.-J.); (M.S.-P.); (R.B.)
| |
Collapse
|
9
|
Saidi L, Godbout PD, Morais-Savoie C, Registe PPW, Bélanger M. Association between physical activity education and prescription during prenatal care and maternal and fetal health outcomes: a quasi-experimental study. BMC Pregnancy Childbirth 2023; 23:496. [PMID: 37407926 PMCID: PMC10320878 DOI: 10.1186/s12884-023-05808-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 06/22/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Physical activity (PA) during pregnancy is associated with healthy gestational weight gain (GWG) and a reduced risk of developing gestational diabetes (GD), gestational hypertension (GHT) and fetal macrosomia. However, in Canada, less than 20% of pregnant women meet PA recommendations. This study assessed associations between an intervention including PA education by prenatal nurses and a PA prescription delivered by physicians and fetal and maternal outcomes. METHODS This is a quasi-experimental study. Two groups of women who received their prenatal care at the obstetrics clinic of a university hospital were created. In the first group, 394 pregnant women followed at the clinic received standard care. In the second group, 422 women followed at the clinic received standard care supplemented with education on the relevance of PA during pregnancy and a prescription for PA. Data for both study groups were obtained from the medical records of the mothers and their newborns. Logistic regressions were used to compare the odds of developing excessive GWG, GD, GHT, and fetal macrosomia between the two study groups. RESULTS The addition of PA education and PA prescription to prenatal care was associated with 29% lower odds of developing excessive GWG (adjusted odds ratios (OR) 0.71, 95% confidence intervals (CI) 0.51-0.99), 73% lower odds of developing GHT (0.27, 0.14-0.53), 44% lower odds of fetal macrosomia (> 4 kg) (0.56, 0.34-0.93), and 40% lower odds of being large for gestational age (0.60, 0.36-0.99). The intervention was not associated with a difference in odds of developing GD (0.48, 0.12-1.94). CONCLUSIONS The inclusion of education and prescription of PA as part of routine prenatal care was associated with improvements in maternal and fetal health outcomes, including significantly lower odds of GWG, GHT and macrosomia.
Collapse
Affiliation(s)
- Latifa Saidi
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, 2500, boul. de l ’Université, Sherbrooke, Québec J1K 2R1 Canada
| | - Pierre D. Godbout
- School of Nursing, Université de Moncton, Campus de Shippagan, 725, Rue du Collège, Bathurst, NB E2A 3Z2 Canada
| | - Camille Morais-Savoie
- Centre de Formation Médicale du Nouveau-Brunswick, Université de Sherbrooke, Pavillon J-Raymond-Frenette, 50 Rue de La Francophonie St, Moncton, NB E1A 7R1 Canada
| | - Pierre Philippe Wilson Registe
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, 2500, boul. de l ’Université, Sherbrooke, Québec J1K 2R1 Canada
| | - Mathieu Bélanger
- Department of Family and Emergency Medicine, Université de Sherbrooke, Centre de Formation Médicale du Nouveau-Brunswick, Vitalité Health Network, Pavillon J-Raymond-Frenette, 18, Avenue Antonine-Maillet, Moncton, NB E1A 3E9 Canada
| |
Collapse
|
10
|
Santos PC, Leirós-Rodríguez R, Abreu S, Ferreira M, Alves O, Mota J. Physical activity during pregnancy and its effects on neonatal outcomes. Placenta 2022; 128:9-17. [PMID: 36037665 DOI: 10.1016/j.placenta.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 08/11/2022] [Accepted: 08/19/2022] [Indexed: 10/15/2022]
Abstract
INTRODUCTION Despite the acknowledgement that physical activity is beneficial during pregnancy and may result in positive health outcomes for the newborn child few studies have examined this issue. This research was deemed necessary with the primary objective of identifying possible associations between adherence to American College of Sports Medicine recommendations on neonatal outcome variables at birth. METHODS An observational, longitudinal and prospective study focused on a sample of 70 pregnant women (the power score achieved was estimated to be 0.3). Data was collected in three stages (1st and 2nd trimester of pregnancy and 48 h after delivery). The variables analyzed included the physical activity measurement (with accelerometry), neonatal outcomes at birth and the mother's anxiety, dietary intake, anthropometric measures and socio-demographic and lifestyle. RESULTS 21.4% women were active according to physical activity recommendations. There were no significant differences in neonatal outcomes at birth when comparing adherence to physical activity recommendations and the overall activity levels of the mothers. There were also no statistically significant differences in the birth weights of babies born to active and inactive mothers. Mother's anxiety level, weight gained and dietary intake were not statistically different according to compliance with physical activity behaviour or recommendations. DISCUSSION There is no relationship between adherence to physical activity recommendations on neonatal outcome variables at birth. There were also no significant associations with sociodemographic and lifestyle variables. There is a need to identify attitudes associated with negative physical activity behavior to reduce the incidence of comorbidities associated with sedentary lifestyles during pregnancy.
Collapse
Affiliation(s)
- Paula C Santos
- Department of Physiotherapy, Center for Research in Rehabilitation, School of Health, Polytechnic of Porto, Dr. António Bernardino de Almeida St., 400, 4200-072, Porto, Portugal; Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports-University of Porto (FADEUP) and Laboratory for Integrative and Translational Research in Population Health (ITR), Dr. Plácido da Costa St., 91, 4200-450 Porto, Portugal.
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Nursing and Physical Therapy Department, University of Leon, Astorga Ave, 15, 24401, Ponferrada, Spain.
| | - Sandra Abreu
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports-University of Porto (FADEUP) and Laboratory for Integrative and Translational Research in Population Health (ITR), Dr. Plácido da Costa St., 91, 4200-450 Porto, Portugal; Faculty of Psychology, Education and Sports, Lusófona University of Porto, Augusto Rosa St., 24, 4000-098, Porto, Portugal; Laboratory for Integrative and Translational Research in Population Health, Portugal.
| | - Margarida Ferreira
- Department of Physiotherapy. School of Health Vale do Sousa. Central de Gandra St., 1317, 4585-116, Gandra, Portugal.
| | - Odete Alves
- Health Unit of Alto Minho, Dr. Francisco Sá Carneiro St., 4980-633, Ponte da Barca, Portugal.
| | - Jorge Mota
- Research Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports-University of Porto (FADEUP) and Laboratory for Integrative and Translational Research in Population Health (ITR), Dr. Plácido da Costa St., 91, 4200-450 Porto, Portugal.
| |
Collapse
|
11
|
Bayisa D, Waltengus F, Lake S, Wakuma B, Bayisa L, Chala M, Regasa MT, Besho M, Mosisa G. Pregnant women's knowledge, attitudes, and associated factors toward physical exercise during pregnancy among those attending antenatal care at Bahir Dar city, Northwest Ethiopia. SAGE Open Med 2022; 10:20503121221115252. [PMID: 35983082 PMCID: PMC9379271 DOI: 10.1177/20503121221115252] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/06/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Exercise during pregnancy is among the cost-effective options that can significantly reduce the burden of chronic metabolic diseases leading to an adverse birth outcome. Despite the negative consequences of sedentary life among pregnant women, little is known about the pregnant mothers’ knowledge, attitude, and associated factors toward exercise during pregnancy in Ethiopia, particularly in the study area. Objective: To assess knowledge, attitude, and associated factors toward exercise during pregnancy among women attending antenatal care at Bahir Dar city, Northwest Ethiopia, 2020. Methodology: A health facility-based cross-sectional study design was employed among 475 pregnant women from March 12 to May 12, 2020. A systematic random sampling technique was used to select the study participants. Interviewer-administered questionnaire was used to collect the data from pregnant women attending the antenatal care unit. Data were coded and entered using Epidata version 3.1 and analyzed by Statistical Package for Social Science (SPSS) version 25. Binary and multivariable logistic regressions were used to identify possible determinants and an odds ratio was used to measure the strength of associations at a p-value of <0.05 Result: The study showed that 55.8% (95% CI: 48.45–59.12) of pregnant women were knowledgeable about benefits and contraindication of exercise during pregnancy; 53.3% (95% CI: 49.05–57.62) of them had positive attitudes toward exercise during pregnancy. Educational status adjusted odd ratio (AOR) = 3.95 (95% CI: 1.712–9.108), practicing physical exercise before becoming pregnant AOR = 3.64 (95% CI: 1.091–12.118), and women who heard about exercise during pregnancy AOR = 4.74 (95% CI: 2.563–8.756) were found to have statistically significant association with knowledge of women about exercise during pregnancy. Women who were knowledgeable about exercise during pregnancy AOR = 4.45 (95% CI: 2.39–8.29) and women who heard about exercise during pregnancy AOR = 4.2 (95% CI: 2.19–8.08) were more likely to have a positive attitude toward benefits of exercise during pregnancy. Conclusion: The level of mothers’ knowledge and attitude toward exercise during pregnancy in the study area was low. Educational status, physical exercise before pregnancy, ever heard about exercise during pregnancy were independent determinants of women’s knowledge, while ever heard and knowledgeable about exercise during pregnancy were determinants of favorable attitude toward exercise during pregnancy. Empowering women through health education about physical exercise during pregnancy should get due attention.
Collapse
Affiliation(s)
- Diriba Bayisa
- Department of Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Fikadu Waltengus
- Department of Midwifery, College of Health and Medical Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Selamawit Lake
- Department of Midwifery, College of Health and Medical Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Bizuneh Wakuma
- Department of Pediatric and Neonatal Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Lami Bayisa
- Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Merga Chala
- Department of Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Misganu Teshoma Regasa
- Department of Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Merga Besho
- Department of Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Getu Mosisa
- Department of Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| |
Collapse
|
12
|
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: 29] [Impact Index Per Article: 9.7] [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.
Collapse
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
| |
Collapse
|
13
|
Altemani AH, Alzaheb RA. The prevention of gestational diabetes mellitus (The role of lifestyle): a meta-analysis. Diabetol Metab Syndr 2022; 14:83. [PMID: 35706048 PMCID: PMC9199329 DOI: 10.1186/s13098-022-00854-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 06/05/2022] [Indexed: 11/11/2022] Open
Abstract
Gestational diabetes mellitus (GDM) is the most common complication of pregnancy. The disease is on the rise worldwide with deleterious consequences on the fetus, mother, and children. The study aimed to review the role of lifestyle in the prevention of GDM. We searched PubMed, SCOPUS, Web of Science, Cochrane Library, EBSCO, and Google Scholar from the first published article up to December 2021; articles were eligible if they were controlled trials, prospective cohorts, and case-control. Out of 5559 articles retrieved, 66 full texts were screened, and 19 studies were included in the meta-analysis. (6 studies assessed the effects of diet, and 13 were on exercise). The dietary intervention showed significant positive effect on GDM, odd ratio = 0.69, 95% CI, 0.56-84, P-value for overall effect = 0.002. The DASH diet was better than Mediterranean Diet (odd ratio, 0.71, 95% CI, 68-74, P-value < 0.001). Regarding exercise, no significant prevention was evident on GDM, odd ratio, 0.77, 95% CI, 0.55-1.06, P-value = 0.11. However, a significant prevention of gestational diabetes was found when the exercise was mild-moderate (odd ratio = 0.65, 95% CI, 0.53-80, P < 0.0001) and started in the first trimester (odd ratio, 0.57, 95% CI, 0.43-0.75, P < 0.0001. No significant effect was found when the exercise was vigorous (odd ratio = 1.09, 95% CI, 0.50-2.38, P = 0.83) and started during the second trimester of pregnancy (odd ratio, 1.08, 95% CI, 0.65-1.80, P = 0.77. Diet and early mild-moderate exercise were effective in GDM prevention. Exercise during the second trimester and moderate-vigorous were not. Further studies assessing the type, duration, and frequency of physical activity are needed.
Collapse
Affiliation(s)
- Abdullah H Altemani
- Department of Family and Community Medicine, Faculty of Medicine, University of Tabuk, Tabuk, 71491, Saudi Arabia.
| | - Riyadh A Alzaheb
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
| |
Collapse
|
14
|
Raab R, Hoffmann J, Spies M, Geyer K, Meyer D, Günther J, Hauner H. Are pre- and early pregnancy lifestyle factors associated with the risk of preterm birth? A secondary cohort analysis of the cluster-randomised GeliS trial. BMC Pregnancy Childbirth 2022; 22:230. [PMID: 35313852 PMCID: PMC8935257 DOI: 10.1186/s12884-022-04513-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 02/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background Maternal lifestyle is discussed as a modifiable determinant in the prevention of preterm birth. However, previous research on associations between individual lifestyle factors and preterm birth risk is inconclusive. In this secondary analysis, we investigated the associations between several modifiable antenatal lifestyle factors and the odds of preterm birth. Methods This secondary cohort analysis used data from the cluster-randomised controlled “healthy living in pregnancy” (GeliS) trial. Data were collected from early pregnancy to birth with maternity records, validated questionnaires and birth protocols. Women with complete datasets for all covariates were eligible for analysis. Multivariate logistic regression models, adjusted for recognised risk factors, were fitted to determine whether dietary quality, assessed with a healthy eating index (HEI), physical activity (PA) levels and antenatal anxiety/distress influenced the odds of preterm birth. Moreover, the combined association between pre-pregnancy body mass index (BMI) and HEI on the odds of preterm birth was explored. The independent associations of individual dietary components and types of PA on prematurity were assessed by adjusted logistic regression models. Results Overall, 1738 women were included in the analysis. A low HEI significantly increased the odds of preterm birth (OR 1.54 (CI 1.04 – 2.30), p = 0.033), while no associations with either low PA levels or antenatal anxiety/distress were observed. BMI significantly interacted with HEI on the association with prematurity (p = 0.036). Energy % from protein and the intake of average portions of vegetables and cereals were significantly negatively associated with the odds of preterm birth. There was no significant evidence of an association between different types of PA and prematurity. Conclusions This cohort analysis revealed that low dietary quality in early pregnancy may increase the chance of giving birth prematurely, while healthier dietary choices may help to prevent preterm birth. More research on pre- and early pregnancy modifiable lifestyle factors is warranted. Trial registration This trial is registered with the Clinical Trial Registry ClinicalTrials.gov (NCT01958307). Registration date 09 October 2013, retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04513-5.
Collapse
Affiliation(s)
- Roxana Raab
- Institute of Nutritional Medicine, School of Medicine, Else Kröner-Fresenius-Centre for Nutritional Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
| | - Julia Hoffmann
- Institute of Nutritional Medicine, School of Medicine, Else Kröner-Fresenius-Centre for Nutritional Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany.,European Foundation for the Care of Newborn Infants, Hofmannstrasse 7a, 81379, Munich, Germany
| | - Monika Spies
- Institute of Nutritional Medicine, School of Medicine, Else Kröner-Fresenius-Centre for Nutritional Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
| | - Kristina Geyer
- Institute of Nutritional Medicine, School of Medicine, Else Kröner-Fresenius-Centre for Nutritional Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
| | - Dorothy Meyer
- Institute of Nutritional Medicine, School of Medicine, Else Kröner-Fresenius-Centre for Nutritional Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
| | - Julia Günther
- Institute of Nutritional Medicine, School of Medicine, Else Kröner-Fresenius-Centre for Nutritional Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany
| | - Hans Hauner
- Institute of Nutritional Medicine, School of Medicine, Else Kröner-Fresenius-Centre for Nutritional Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992, Munich, Germany.
| |
Collapse
|
15
|
Watkins VY, O'Donnell CM, Perez M, Zhao P, England S, Carter EB, Kelly JC, Frolova A, Raghuraman N. The impact of physical activity during pregnancy on labor and delivery. Am J Obstet Gynecol 2021; 225:437.e1-437.e8. [PMID: 34081895 PMCID: PMC10564562 DOI: 10.1016/j.ajog.2021.05.036] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Physical activity in pregnancy is associated with decreased risks of adverse pregnancy outcomes such as gestational diabetes and preeclampsia. However, the relationship between the amount and type of physical activity during pregnancy and subsequent labor outcomes remains unclear. OBJECTIVE This study aimed to test the hypothesis that higher levels of physical activity across different lifestyle domains in pregnancy are associated with a shorter duration of labor. STUDY DESIGN This study is a secondary analysis of a prospective cohort study in which patients with singleton pregnancies without a major fetal anomaly were administered the Kaiser Physical Activity Survey in each trimester. The Kaiser Physical Activity Survey was designed specifically to quantify various types of physical activities in women and includes 4 summative indices-housework/caregiving, active living habits, sports, and occupation. The study included women at full-term gestations admitted for induction of labor or spontaneous labor. The primary outcome of this analysis was duration of the second stage of labor. Secondary outcomes were duration of the active stage, prolonged first and second stage, mode of delivery, rates of second-stage cesarean delivery, operative vaginal delivery, severe perineal lacerations, and postpartum hemorrhage. These outcomes were compared between patients with and without high physical activity levels, defined as overall Kaiser Physical Activity Survey score ≥75th percentile in the third trimester. Multivariable logistic regression was used to adjust for obesity and epidural use. In addition, a subgroup analysis of nulliparous patients was performed. RESULTS A total of 811 patients with complete Kaiser Physical Activity Survey data in the third trimester were included in this analysis. The median Kaiser Physical Activity Survey score was 9.5 (8.2-10.8). Of the 811 patients, 203 (25%) had higher levels of physical activity in pregnancy. There was no difference in the duration of the second stage of labor between patients with and without higher physical activity levels (1.29±2.94 vs 0.97±2.08 hours; P=.15). The duration of active labor was significantly shorter in patients with higher levels of physical activity (5.77±4.97 vs 7.43±6.29 hours; P=.01). Patients with higher physical activity levels were significantly less likely to have a prolonged first stage (9.8% vs 19.4%; P<.01; adjusted relative risk, 0.55; 95% confidence interval, 0.34-0.83). However, rates of prolonged second-stage cesarean delivery, operative vaginal deliveries, and perineal lacerations were similar between the 2 groups. CONCLUSION Patients who are more physically active during pregnancy have a shorter duration of active labor.
Collapse
Affiliation(s)
- Virginia Y Watkins
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO.
| | - Carly M O'Donnell
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Marta Perez
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Peinan Zhao
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Sarah England
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Ebony B Carter
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Jeannie C Kelly
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Antonina Frolova
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Nandini Raghuraman
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO
| |
Collapse
|
16
|
Chen Y, Ma G, Hu Y, Yang Q, Deavila JM, Zhu MJ, Du M. Effects of Maternal Exercise During Pregnancy on Perinatal Growth and Childhood Obesity Outcomes: A Meta-analysis and Meta-regression. Sports Med 2021; 51:2329-2347. [PMID: 34143412 DOI: 10.1007/s40279-021-01499-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Perinatal growth abnormalities program susceptibility to childhood obesity, which is further exaggerated by maternal overweight and obesity (MO) during pregnancy. Exercise is highly accessible, but reports about the benefits of maternal exercise on fetal growth and childhood obesity outcomes are inconsistent, reducing the incentives for pregnant women to participate in exercise to improve children's perinatal growth. OBJECTIVE This systematic review and meta-analysis aims to establish evidence-based efficacy of exercise in mothers with normal weight (MNW) and MO during pregnancy in reducing the risks of perinatal growth abnormalities and childhood obesity. In addition, the impacts of exercise volume are also assessed. METHODS The PubMed, ScienceDirect, Web of Science, and Cochrane Library databases were searched from inception to February 15, 2020. We included randomized controlled trials with exercise-only intervention or exercise with other confounders in pregnant MNW (body mass index, BMI 18.5-24.9 kg/m2) and MO (BMI ≥ 25 kg/m2), which were further subgrouped in the meta-analysis. Primary outcomes included birth weight, preterm birth, small for gestational age (SGA), large for gestational age (LGA), infant and childhood weight, and childhood obesity. A linear meta-regression analysis was also used to explore the effects of exercise volume on outcomes. RESULTS 99 studies were included in the meta-analysis (n = 596,876), and individual study quality ranged from fair to good according to the Newcastle-Ottawa scale assessment. Exercise only interventions in MNW reduced preterm birth by 15% (26 studies, n = 76,132; odds ratio [OR] 0.85; 95% CI 0.72, 1.01; I2 = 83.3%), SGA by 17% (33 studies, n = 92,351; OR 0.83; 95% CI 0.71, 0.98; I2 = 74.5%) and LGA by 17% (29 studies, n = 84,310; OR 0.83; 95% CI 0.74, 0.95; I2 = 60.4%). Exercise only interventions in MO reduced preterm birth by 33% (2 studies, n = 3,050; OR 0.67; 95% CI 0.70, 0.96; I2 = 0%), SGA by 27% (8 studies, n = 3,909; OR 0.73; 95% CI 0.50, 1.05; I2 = 40.4%) and LGA by 55% (9 studies, n = 81,581; OR 0.45; 95% CI 0.18, 1.11; I2 = 98.3%). Exercise only interventions in MNW reduced childhood obesity by 53% (3 studies, n = 6,920; OR 0.47; 95% CI 0.36, 0.63; I2 = 77.0%). However, no significant effect was observed in outcomes from exercise confounders in either MNW or MO. In the meta-regression, the volume of exercise-only intervention in MNW was negatively associated with birth weight, greatly driven by volumes more than 810 metabolic equivalents (MET)-min per week. Other outcomes were not associated with exercise volume. CONCLUSIONS This systematic review and meta-analysis suggests that exercise during pregnancy in both MNW and MO safely and effectively reduce the risks of preterm birth, SGA, and LGA. Furthermore, MNW exercise also reduces the risk of childhood obesity. Overall, regardless of prepregnancy BMI, maternal exercise during pregnancy provides an excellent opportunity to mitigate the high prevalence of adverse birth outcomes and childhood obesity.
Collapse
Affiliation(s)
- Yanting Chen
- Center for Reproductive Biology, School of Molecular Biosciences, Washington State University, Pullman, WA, 99164, USA.,Nutrigenoimics and Growth Biology Laboratory, Department of Animal Sciences, Washington State University, Pullman, WA, 99164, USA
| | - Guiling Ma
- College of Animal Science and Technology, Yangzhou University, Yangzhou, 225009, People's Republic of China
| | - Yun Hu
- College of Animal Science and Technology, Yangzhou University, Yangzhou, 225009, People's Republic of China
| | - Qiyuan Yang
- Department of Molecular, Cell and Cancer Biology, University of Massachusetts Medical School, Worcester, MA, 01655, USA
| | - Jeanene M Deavila
- Center for Reproductive Biology, School of Molecular Biosciences, Washington State University, Pullman, WA, 99164, USA.,Nutrigenoimics and Growth Biology Laboratory, Department of Animal Sciences, Washington State University, Pullman, WA, 99164, USA
| | - Mei-Jun Zhu
- School of Food Science, Washington State University, Pullman, WA, 99164, USA
| | - Min Du
- Center for Reproductive Biology, School of Molecular Biosciences, Washington State University, Pullman, WA, 99164, USA. .,Nutrigenoimics and Growth Biology Laboratory, Department of Animal Sciences, Washington State University, Pullman, WA, 99164, USA.
| |
Collapse
|
17
|
Movement Behavior during Pregnancy and Adverse Maternal-Fetal Outcomes in Women with Gestational Diabetes: A Pilot Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031114. [PMID: 33513843 PMCID: PMC7908077 DOI: 10.3390/ijerph18031114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 02/08/2023]
Abstract
Gestational diabetes mellitus (GDM) is a major complication in pregnancy. GDM is associated with a higher risk for adverse maternal–fetal outcomes. Associations between movement behavior, including physical activity (PA) and sedentary behavior (SB), and maternal–fetal outcomes are still unclear. The objective of this study was to investigate associations between movement behavior and adverse maternal–fetal outcomes in women with GDM. A total of 68 women with GDM (20–35 weeks, 32.1 ± 5.8 years) were included in this pilot case-control study. The cases were defined by the presence of an adverse composite maternal–fetal outcome (preterm birth, newborn large for gestational age, and neonatal hypoglycemia). Controls were defined as no adverse maternal–fetal outcome. PA intensities and domains, steps/day (pedometer), and SB were analyzed. A total of 35.3% of participants showed adverse maternal–fetal outcomes (n = 24). The controls showed a higher moderate-intensity PA level than the cases (7.5, 95%CI 3.6–22.9 vs. 3.1, 95%CI 0.4–10.3 MET-h/week; p = 0.04). The moderate-intensity PA level was associated with a lower risk for adverse maternal–fetal outcomes (OR 0.21, 95%CI 0.05–0.91). No significant associations were observed for other PA and SB measures (p > 0.05). In conclusion, moderate-intensity PA during pregnancy seems to have a protective role against adverse maternal–fetal outcomes in women with GDM.
Collapse
|
18
|
Hoirisch-Clapauch S, Brenner B. The role of the fibrinolytic system in female reproductive disorders and depression. THROMBOSIS UPDATE 2020. [DOI: 10.1016/j.tru.2020.100004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
|
19
|
Yong HY, Mohd Shariff Z, Mohd Yusof BN, Rejali Z, Bindels J, Tee YYS, van der Beek EM. High physical activity and high sedentary behavior increased the risk of gestational diabetes mellitus among women with excessive gestational weight gain: a prospective study. BMC Pregnancy Childbirth 2020; 20:597. [PMID: 33028258 PMCID: PMC7541260 DOI: 10.1186/s12884-020-03299-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/29/2020] [Indexed: 12/16/2022] Open
Abstract
Background Although physical activity (PA) in pregnancy benefits most women, not much is known about pregnancy-related changes in PA and its association with gestational diabetes mellitus (GDM) risk. The aim of this study was to identify the trajectory of PA during pregnancy and possible associations with the risk of GDM. Methods This was a prospective cohort study of 452 pregnant women recruited from 3 health clinics in a southern state of Peninsular Malaysia. PA levels at the first, second, and third trimester were assessed using the Pregnancy Physical Activity Questionnaire. GDM was diagnosed at 24–28 weeks of gestation following the Ministry of Health Malaysia criteria. Group-based trajectory modeling was used to identify PA trajectories. Three multivariate logistic models were used to estimate the odds of trajectory group membership and GDM. Results Two distinct PA trajectories were identified: low PA levels in all intensity of PA and sedentary behavior (Group 1: 61.1%, n = 276) and high PA levels in all intensity of PA as well as sedentary behavior (Group 2: 38.9%, n = 176). Moderate and high intensity PA decreased over the course of pregnancy in both groups. Women in group 2 had significantly higher risk of GDM in two of the estimated logistic models. In all models, significant associations between PA trajectories and GDM were only observed among women with excessive gestational weight gain in the second trimester. Conclusions Women with high sedentary behavior were significantly at higher risk of GDM despite high PA levels by intensity and this association was significant only among women with excessive GWG in the second trimester. Participation in high sedentary behavior may outweigh the benefit of engaging in high PA to mitigate the risk of GDM.
Collapse
Affiliation(s)
- Heng Yaw Yong
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Seri Kembangan, Selangor, Malaysia
| | - Zalilah Mohd Shariff
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Seri Kembangan, Selangor, Malaysia.
| | - Barakatun Nisak Mohd Yusof
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Seri Kembangan, Selangor, Malaysia
| | - Zulida Rejali
- Department of Obstetrics and Gynaecology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, Seri Kembangan, Selangor, Malaysia
| | - Jacques Bindels
- Danone Nutricia Research, Uppsalalaan 12, 3584, CT, Utrecht, The Netherlands
| | - Yvonne Yee Siang Tee
- Danone Specialized Nutrition (Malaysia) Sdn. Bhd, Suites 8.01 & 9.01, Levels 8 & 9, The Garden South Tower, Mid Valley City, Lingkaran Syed Putra, 59200, Kuala Lumpur, Malaysia
| | - Eline M van der Beek
- Department of Pediatrics, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
20
|
Physical Activity During Pregnancy and Preterm Birth: Findings From the 2015 Pelotas (Brazil) Birth Cohort Study. J Phys Act Health 2020; 17:1065-1074. [PMID: 32947261 DOI: 10.1123/jpah.2019-0604] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 06/08/2020] [Accepted: 07/16/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Physical activity (PA) during pregnancy is associated with several benefits in maternal and child outcomes, and its relationship with preterm birth is still conflicting. This study aims to examine the associations between PA during pregnancy and occurrence of preterm birth. METHODS PA was assessed by questionnaire (for each trimester) and accelerometry (second trimester) in women enrolled in a birth cohort study that started during pregnancy and included births that occurred between January 1 and December 31, 2015. Gestational age was based on the last menstrual period and ultrasonography. All deliveries before 37 weeks of gestation were considered preterm births. A Poisson regression model was used to measure associations controlling for potential confounders. RESULTS PA information was available for 4163 women and 13.8% of births were preterm. A total of 15.8% of women were engaged in PA during pregnancy. Multivariate analysis showed that only PA performed in the third trimester of pregnancy (prevalence ratio = 0.58; 95% confidence interval, 0.36-0.96) was associated with the outcome. CONCLUSIONS PA performed in the third trimester of pregnancy was associated with a protection to preterm birth. Pregnant women should be counseled to engage in PA to lower the risk of premature delivery.
Collapse
|
21
|
Xi C, Luo M, Wang T, Wang Y, Wang S, Guo L, Lu C. Association between maternal lifestyle factors and low birth weight in preterm and term births: a case-control study. Reprod Health 2020; 17:93. [PMID: 32527333 PMCID: PMC7291563 DOI: 10.1186/s12978-020-00932-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 05/24/2020] [Indexed: 12/16/2022] Open
Abstract
Background It has been reported that lifestyle factors may affect birth weight; however, few studies have explored the association between lifestyle factors and low birth weight in preterm and term births in China. The objective of this study was to explore the effect of lifestyle on low birth weight in preterm and term births. Methods This case-control study was conducted in fourteen hospitals in Jiangmen, Guangdong Province. Data were collected from August 2015 to May 2016 using a standard questionnaire. Data were analysed using logistic regression. Results Women who delivered preterm and were physically active (1–3 times per week and ≥ 4 times per week) had reduced odds of having low birth weight babies (aOR = 0.584, 95%CI = 0.394–0.867 and, aOR = 0.516, 95%CI = 0.355–0.752, respectively). Pregnant women who had insufficient gestational weight gain had increased odds of having low birth weight babies (aOR = 2.272, 95%CI = 1.626–3.176). Women exposed to passive smoking had an increased risk of delivering low birth weight infants (aOR = 1.404, 95%CI = 1.057–1.864). Insufficient gestational weight gain and excessive gestational weight gain were both significantly associated with low birth weight (aOR = 1.484, 95%CI = 1.103–1.998 and aOR = 0.369, 95%CI = 0.236–0.577, respectively) for term deliveries. In addition, parity, history of low birth weight, antenatal care and gestational hypertension were significantly associated with the likelihood of low birth weight. Conclusion Pregnant women without exercise contraindications should remain physically active. Pregnant women should be aware of the negative effects of smoke and be aware of strategies to protect themselves from passive smoke exposure. Hospitals should inform pregnant women of the importance appropriate gestational weight gain. These recommendations should be put into practice to decrease the prevalence of low birth weight infants.
Collapse
Affiliation(s)
- Chuhao Xi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Min Luo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Tian Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Yingxiang Wang
- Maternity and Child Health Care Hospital of Guangdong, Jiangmen, China
| | - Songbai Wang
- Maternity and Child Health Care Hospital of Guangdong, Jiangmen, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China. .,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China. .,Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.
| |
Collapse
|
22
|
Raguema N, Benletaifa D, Mahjoub T, Lavoie JL. Increased physical activity is correlated with improved pregnancy outcomes in women with preeclampsia: A retrospective study. Pregnancy Hypertens 2020; 21:118-123. [PMID: 32502931 DOI: 10.1016/j.preghy.2020.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 05/09/2020] [Accepted: 05/09/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Several studies have focused on the benefits of physical activity to prevent and treat preeclampsia, given that preeclampsia and cardiovascular disease share several risk factors. However, none of these studies have been conducted in Africa. Moreover, it has been demonstrated that exercise training has preventive effects on the development of preeclampsia in mouse models. Therefore, we evaluated the association between the practice of physical activity and the development of this pathology in a Tunisian cohort. STUDY DESIGN Sixty-one healthy pregnant Tunisian women and 45 women with preeclampsia were recruited and completed the Pregnancy Physical Activity Questionnaire to determine their level and type of physical activity during the entire pregnancy. MAIN OUTCOME MEASURE Continuous variables were compared using the Mann-Whitney U test, while categorical variables were compared using the Chi-square test. The correlation between preeclampsia features and energy expenditure were assessed using the Pearson's correlation test. RESULTS Energy expenditure analysis revealed that women with preeclampsia engaged in more sedentary activities than controls, while controls practiced more physical activities. Interestingly, we found a positive correlation between the total amount of energy spent and the duration of pregnancy in controls and women with preeclampsia. CONCLUSIONS Increasing physical activity is correlated with increasing pregnancy duration which is an index of maternal and fetal health. The practice of physical activities during pregnancy is associated with a healthier pregnancy, while sedentary activities is associated with the development of preeclampsia.
Collapse
Affiliation(s)
- Nozha Raguema
- Laboratory of Human Genome and Multifactorial Diseases (LR12ES07), Faculty of Pharmacy of Monastir, University of Monastir, 5000 Streest Ibn Sina, Monastir, Tunisia; Faculty of Sciences of Bizerte, University of Carthage, 7021 Jarzouna Bizerte, Tunisia; University Hospital Farhat-Hached, Unit of Reproductive Medicine, 4000 Street Ibn El Jazzar, Sousse, Tunisia; Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 St-Denis Street, Tour Viger, R08.452, Montréal, Québec H2X 0A9, Canada
| | - Dhafer Benletaifa
- Laboratory of Human Genome and Multifactorial Diseases (LR12ES07), Faculty of Pharmacy of Monastir, University of Monastir, 5000 Streest Ibn Sina, Monastir, Tunisia
| | - Touhami Mahjoub
- Laboratory of Human Genome and Multifactorial Diseases (LR12ES07), Faculty of Pharmacy of Monastir, University of Monastir, 5000 Streest Ibn Sina, Monastir, Tunisia
| | - Julie L Lavoie
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 St-Denis Street, Tour Viger, R08.452, Montréal, Québec H2X 0A9, Canada; School of Kinesiology and Physical Activity Sciences, Université de Montréal, 2100, boul. Édouard-Montpetit, Montréal, Québec H3T 1J4, Canada.
| |
Collapse
|
23
|
Zhu G, Qian X, Qi L, Xia C, Ming Y, Zeng Z, Liu Y, Yang Y, Zhang M, Zhang H. The intention to undertake physical activity in pregnant women using the theory of planned behaviour. J Adv Nurs 2020; 76:1647-1657. [PMID: 32153052 DOI: 10.1111/jan.14347] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 02/06/2020] [Accepted: 03/03/2020] [Indexed: 02/06/2023]
Abstract
AIM To identify the intention of Chinese pregnant women to undertake physical activity (PA) using the theory of planned behaviour. DESIGN A cross-sectional survey. METHODS From April - October 2017, a cross-sectional questionnaire was completed by 746 pregnant women from the Health Birth Cohort in Wuhan, China. The theory of planned behaviour variables as well as sociodemographic characteristics was recorded, and the Pregnancy PA Questionnaire was together used to assess their PA during pregnancy. RESULTS Only 11.3% of the women met the international guideline. The intention to undertake PA was found it to be positive in 63.9% of pregnant women. Structural equation modelling analysis revealed that behavioural attitudes, subjective norms, and perceived behavioural control (PBC) influenced PA by directly influencing the behaviour intention. Both behavioural attitude and subjective norms influenced PA by indirectly affecting the behaviour. Overall, the model described 60% variance of the behavioural intention to undertake PA during pregnancy. CONCLUSION PBC was confirmed to be a prominent factor in determining behavioural intention to undertake PA during pregnancy. Pregnant women should be helped and appropriately guided by health providers to overcome barriers to PA. EFFECT This study investigates the effect of perceived behavioural control (PBC) on the intention to undertake physical activity (PA). The findings suggest that nurses' and midwives' attention should be focused on how to promote the improvement of perceived behavioural control ability of pregnant women to improve pregnant women's PA intention. The attitude of pregnant women on taking up PA and their ability to control behaviours can be improved with support from family or healthcare providers.
Collapse
Affiliation(s)
- Gangjiao Zhu
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Xiangzi Qian
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Ling Qi
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Chang Xia
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Yu Ming
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Zhi Zeng
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Yuanxia Liu
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Yan Yang
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Mengtian Zhang
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Hongling Zhang
- College of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| |
Collapse
|
24
|
Walasik I, Kwiatkowska K, Kosińska Kaczyńska K, Szymusik I. Physical Activity Patterns among 9000 Pregnant Women in Poland: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051771. [PMID: 32182850 PMCID: PMC7084336 DOI: 10.3390/ijerph17051771] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/02/2020] [Accepted: 03/04/2020] [Indexed: 12/11/2022]
Abstract
The aim was to analyze the knowledge and experience of women regarding physical activity during their latest pregnancy. An anonymous questionnaire was completed electronically, in 2018, by 9345 women who gave birth at least once, with 52% of the women having performed exercises during pregnancy. Physically non-active respondents suffered from gestational hypertension (9.2% vs. 6.7%; p < 0.01) and gave birth prematurely (9% vs. 7%; p < 0.01) to newborns with a low birth weight significantly more often (6% vs. 3.6%; p < 0.001). Physically active women delivered vaginally more often (61% vs. 55%; p < 0.001) and were more likely to have a spontaneous onset of the delivery as compared with non-active women (73.8% vs. 70.7% p = 0.001). The women who were informed by gynaecologist about the beneficial influence of physical activity during pregnancy exercised significantly more often (67% vs. 44% p < 0.001). In addition, 13% of the women felt discrimination due to their physical activity during a pregnancy, 22% of respondents' physical activity was not accepted by their environment, and 39.1% of the women were told by others to stop physical exercise because it was bad for the baby's health. Physical activity during pregnancy is associated with improved fitness, decreased pregnancy ailments occurrence, and therefore influences the course of pregnancy and delivery in a positive way.
Collapse
Affiliation(s)
- Izabela Walasik
- Students Scientific Association at the 1st Department of Obstetrics and Gynecology, First Faculty of Medicine, Medical University of Warsaw, Plac Starynkiewicza 1/3, 02-015 Warsaw, Poland; (I.W.); (K.K.)
| | - Katarzyna Kwiatkowska
- Students Scientific Association at the 1st Department of Obstetrics and Gynecology, First Faculty of Medicine, Medical University of Warsaw, Plac Starynkiewicza 1/3, 02-015 Warsaw, Poland; (I.W.); (K.K.)
| | - Katarzyna Kosińska Kaczyńska
- 2nd Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Marymoncka st. 99/103, 01-813 Warsaw, Poland
- 1st Department of Obstetrics and Gynecology, First Faculty of Medicine, Medical University of Warsaw, Plac Starynkiewicza 1/3, 02-015 Warsaw, Poland;
- Correspondence: ; Tel.: +48-22-56-90-274
| | - Iwona Szymusik
- 1st Department of Obstetrics and Gynecology, First Faculty of Medicine, Medical University of Warsaw, Plac Starynkiewicza 1/3, 02-015 Warsaw, Poland;
| |
Collapse
|
25
|
Javadi M, Rafiei S, Zahedifar F, Barikani A. Relationships between maternal characteristics and infant birth weight. Int J Health Care Qual Assur 2019; 32:688-697. [PMID: 31111782 DOI: 10.1108/ijhcqa-05-2017-0081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Nowadays, the importance of infant birth weight (IBW) as a key factor in determining the future of physical and mental development of children is a growing concern. The purpose of this paper is to investigate the relationship between maternal characteristics and IBW among pregnant women who were referred to health centers in Qazvin city in the year 2016. DESIGN/METHODOLOGY/APPROACH A descriptive-analytical study was conducted among pregnant women in 28-36 weeks of gestation who referred to healthcare centers and facilities affiliated by the Qazvin University of Medical Sciences in April-June 2016. The associations between maternal physical activity, mothers' socioeconomic status and birth weight were examined by SPSS Software Package version 16 through linear and logistic regression tests. FINDINGS Linear regression modeling suggested that maternal weight (p=0.001), income (p=0.04), gestational age of delivery (p=0.00) and pre-pregnancy BMI (p=0.02) were positively associated with birth weight, while occupational and heavy physical activity (p=0.003 and 0.008, respectively) were negatively associated with IBW. In this study, low birth weight infants are compared to those with normal weight belonged to mothers who have spent more time in doing heavy physical activities (OR=1.11, 95% CI 1.01-1.23). Also infants with low birth weight compared to others in the normal weight category were born from mothers with lower pre-pregnancy BMI (OR=0.65, 95% CI 0.62-0.78), gestational age of delivery (OR=0.82, 95% CI 0.79-0.86), maternal weight (OR=0.86, 95% CI 0.84-0.88) and income (OR=0.79, 95% CI 0.69-0.83). PRACTICAL IMPLICATIONS The study findings revealed that certain maternal characteristics could play a significant role in IBW. Despite the importance, in most of developing countries (particularly Iran), future mothers are not advised about an appropriate weight gain during pregnancy or the optimal level of physical activity in such a period of time. Therefore, counseling pregnant women and giving them proper information on appropriate perinatal care would be helpful in order to have pregnancies with optimal outcomes. ORIGINALITY/VALUE The authors applied several statistical methods to analyze IBW among mothers with different maternal characteristics and predict birth weight based on contributing factors.
Collapse
Affiliation(s)
- Maryam Javadi
- Department of Nutrition, Children Growth Research Center, Qazvin University of Medical Sciences , Qazvin, Islamic Republic of Iran
| | - Sima Rafiei
- Department of Healthcare Management, School of Health, Qazvin University of Medical Sciences , Qazvin, Islamic Republic of Iran
| | - Fariba Zahedifar
- Department of Health Education, School of Health, Qazvin University of Medical Sciences , Qazvin, Islamic Republic of Iran
| | - Ameneh Barikani
- Department of Social Medicine, Children Growth Research Center, Qazvin University of Medical Sciences , Qazvin, Islamic Republic of Iran
| |
Collapse
|
26
|
Uzelpasaci E, Akbayrak T, Özgül S, Orhan C, Baran E, Nakip G, Beksac S, Topuz S. The Reliability and Validity of the Turkish Kaiser Physical Activity Survey for Pregnant Women. J Phys Act Health 2019; 16:962-967. [PMID: 31575822 DOI: 10.1123/jpah.2018-0573] [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: 10/03/2018] [Revised: 05/07/2019] [Accepted: 07/25/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Evaluation of physical activity by condition-specific surveys provides more accurate results than generic physical activity questionnaires. The aim of this study was to investigate the reliability and validity of the Kaiser Physical Activity Survey (KPAS) in Turkish pregnant women. METHODS In the translation and cultural adaptation of the KPAS, the 6-phase guidelines recommended in the literature were followed. The study included a total of 151 pregnant women who were assessed using the Turkish version of KPAS, the Pregnancy Physical Activity Questionnaire, and the SenseWear Pro3 Armband. To determine the test-retest reliability, the KPAS was reapplied after 7 days. The psychometric properties of KPAS were analyzed with respect to internal consistency, test-retest reliability, and concurrent validity. RESULTS Cronbach α coefficient indicating the internal consistency of the Turkish KPAS was found to be .60 to .80, showing moderate reliability. The intraclass correlation coefficient for test-retest reliability was very strong (intraclass correlation coefficient: .96-.98). The total KPAS scores were found to be moderately correlated with the total Pregnancy Physical Activity Questionnaire score and the total energy expenditure value on the SenseWear Pro3 Armband. CONCLUSIONS This study showed that KPAS is a valid and reliable instrument for evaluating physical activity in Turkish pregnant women in different aspects.
Collapse
|
27
|
Pastorino S, Bishop T, Crozier SR, Granström C, Kordas K, Küpers LK, O'Brien EC, Polanska K, Sauder KA, Zafarmand MH, Wilson RC, Agyemang C, Burton PR, Cooper C, Corpeleijn E, Dabelea D, Hanke W, Inskip HM, McAuliffe FM, Olsen SF, Vrijkotte TG, Brage S, Kennedy A, O'Gorman D, Scherer P, Wijndaele K, Wareham NJ, Desoye G, Ong KK. Associations between maternal physical activity in early and late pregnancy and offspring birth size: remote federated individual level meta-analysis from eight cohort studies. BJOG 2019; 126:459-470. [PMID: 30230190 PMCID: PMC6330060 DOI: 10.1111/1471-0528.15476] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Evidence on the impact of leisure time physical activity (LTPA) in pregnancy on birth size is inconsistent. We aimed to examine the association between LTPA during early and late pregnancy and newborn anthropometric outcomes. DESIGN Individual level meta-analysis, which reduces heterogeneity across studies. SETTING A consortium of eight population-based studies (seven European and one US) comprising 72 694 participants. METHODS Generalised linear models with consistent inclusion of confounders (gestational age, sex, parity, maternal age, education, ethnicity, BMI, smoking, and alcohol intake) were used to test associations between self-reported LTPA at either early (8-18 weeks gestation) or late pregnancy (30+ weeks) and the outcomes. Results were pooled using random effects meta-analyses. MAIN OUTCOME MEASURES Birth weight, large-for-gestational age (LGA), macrosomia, small-for-gestational age (SGA), % body fat, and ponderal index at birth. RESULTS Late, but not early, gestation maternal moderate to vigorous physical activity (MVPA), vigorous activity, and LTPA energy expenditure were modestly inversely associated with BW, LGA, macrosomia, and ponderal index, without heterogeneity (all: I2 = 0%). For each extra hour/week of MVPA, RR for LGA and macrosomia were 0.97 (95% CI: 0.96, 0.98) and 0.96 (95% CI: 0.94, 0.98), respectively. Associations were only modestly reduced after additional adjustments for maternal BMI and gestational diabetes. No measure of LTPA was associated with risk for SGA. CONCLUSIONS Physical activity in late, but not early, pregnancy is consistently associated with modestly lower risk of LGA and macrosomia, but not SGA. TWEETABLE ABSTRACT In an individual participant meta-analysis, late pregnancy moderate to vigorous physical activity modestly reduced birth size outcomes.
Collapse
Affiliation(s)
- S Pastorino
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - T Bishop
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - SR Crozier
- MRC Lifecourse Epidemiology Unit (University of Southampton)Southampton General HospitalSouthamptonUK
| | - C Granström
- Department of Epidemiology ResearchCentre for Fetal ProgrammingState Serum InstituteCopenhagenDenmark
| | - K Kordas
- Epidemiology and Environmental HealthSchool of Public Health and Health ProfessionsUniversity at BuffaloBuffaloNYUSA
| | - LK Küpers
- Department of EpidemiologyUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
- MRC Integrative Epidemiology UnitSchool of Social and Community MedicineUniversity of BristolBristolUK
| | - EC O'Brien
- Obstetrics & GynaecologyUCD Perinatal Research CentreSchool of MedicineUniversity College DublinNational Maternity HospitalDublinIreland
| | - K Polanska
- Department of Environmental EpidemiologyNofer Institute of Occupational MedicineLodzPoland
| | - KA Sauder
- Department of PediatricsUniversity of Colorado School of MedicineAuroraCOUSA
| | - MH Zafarmand
- Department of Public HealthAmsterdam Public Health Research Institute, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
- Department of Obstetrics & GynaecologyAmsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
- Department of Clinical EpidemiologyBiostatistics and BioinformaticsAmsterdam Public Health Research InstituteAmsterdam UMCUniversity of Amsterdamthe Netherlands
| | - RC Wilson
- Institute of Health and SocietyNewcastle UniversityNewcastleUK
| | - C Agyemang
- Department of Public HealthAmsterdam Public Health Research Institute, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | - PR Burton
- Institute of Health and SocietyNewcastle UniversityNewcastleUK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit (University of Southampton)Southampton General HospitalSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity Hospital Southampton NHS Foundation Trust and University of SouthamptonSouthamptonUK
| | - E Corpeleijn
- Department of EpidemiologyUniversity Medical Center GroningenUniversity of GroningenGroningenthe Netherlands
| | - D Dabelea
- Department of EpidemiologyColorado School of Public HealthUniversity of Colorado Anschutz Medical CampusDenverCOUSA
| | - W Hanke
- Department of Environmental EpidemiologyNofer Institute of Occupational MedicineLodzPoland
| | - HM Inskip
- MRC Lifecourse Epidemiology Unit (University of Southampton)Southampton General HospitalSouthamptonUK
- NIHR Southampton Biomedical Research CentreUniversity Hospital Southampton NHS Foundation Trust and University of SouthamptonSouthamptonUK
| | - FM McAuliffe
- Obstetrics & GynaecologyUCD Perinatal Research CentreSchool of MedicineUniversity College DublinNational Maternity HospitalDublinIreland
| | - SF Olsen
- Department of Epidemiology ResearchCentre for Fetal ProgrammingState Serum InstituteCopenhagenDenmark
| | - TG Vrijkotte
- Department of Public HealthAmsterdam Public Health Research Institute, Amsterdam UMCUniversity of AmsterdamAmsterdamthe Netherlands
| | - S Brage
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - A Kennedy
- 3U Diabetes Consortium and School of Health and Human PerformanceDublin City UniversityDublinIreland
- School of Biological SciencesDublin Institute of TechnologyDublinIreland
| | - D O'Gorman
- NIHR Southampton Biomedical Research CentreUniversity Hospital Southampton NHS Foundation Trust and University of SouthamptonSouthamptonUK
| | - P Scherer
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - K Wijndaele
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - NJ Wareham
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| | - G Desoye
- Department of Obstetrics & GynaecologyMedical University of GrazGrazAustria
| | - KK Ong
- MRC Epidemiology UnitUniversity of CambridgeCambridgeUK
| |
Collapse
|
28
|
Davenport MH, Ruchat SM, Poitras VJ, Jaramillo Garcia A, Gray CE, Barrowman N, Skow RJ, Meah VL, Riske L, Sobierajski F, James M, Kathol AJ, Nuspl M, Marchand AA, Nagpal TS, Slater LG, Weeks A, Adamo KB, Davies GA, Barakat R, Mottola MF. Prenatal exercise for the prevention of gestational diabetes mellitus and hypertensive disorders of pregnancy: a systematic review and meta-analysis. Br J Sports Med 2018; 52:1367-1375. [DOI: 10.1136/bjsports-2018-099355] [Citation(s) in RCA: 328] [Impact Index Per Article: 46.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2018] [Indexed: 12/11/2022]
Abstract
ObjectiveGestational diabetes mellitus (GDM), gestational hypertension (GH) and pre-eclampsia (PE) are associated with short and long-term health issues for mother and child; prevention of these complications is critically important. This study aimed to perform a systematic review and meta-analysis of the relationships between prenatal exercise and GDM, GH and PE.DesignSystematic review with random effects meta-analysis and meta-regression.Data sourcesOnline databases were searched up to 6 January 2017.Study eligibility criteriaStudies of all designs were included (except case studies) if published in English, Spanish or French, and contained information on the Population (pregnant women without contraindication to exercise), Intervention (subjective or objective measures of frequency, intensity, duration, volume or type of exercise, alone [“exercise-only”] or in combination with other intervention components [e.g., dietary; “exercise + co-intervention”]), Comparator (no exercise or different frequency, intensity, duration, volume and type of exercise) and Outcomes (GDM, GH, PE).ResultsA total of 106 studies (n=273 182) were included. ‘Moderate’ to ‘high’-quality evidence from randomised controlled trials revealed that exercise-only interventions, but not exercise+cointerventions, reduced odds of GDM (n=6934; OR 0.62, 95% CI 0.52 to 0.75), GH (n=5316; OR 0.61, 95% CI 0.43 to 0.85) and PE (n=3322; OR 0.59, 95% CI 0.37 to 0.9) compared with no exercise. To achieve at least a 25% reduction in the odds of developing GDM, PE and GH, pregnant women need to accumulate at least 600 MET-min/week of moderate-intensity exercise (eg, 140 min of brisk walking, water aerobics, stationary cycling or resistance training).Summary/conclusionsIn conclusion, exercise-only interventions were effective at lowering the odds of developing GDM, GH and PE.
Collapse
|
29
|
Nguyen CL, Pham NM, Lee AH, Nguyen PTH, Chu TK, Ha AVV, Duong DV, Duong TH, Binns CW. Physical activity during pregnancy is associated with a lower prevalence of gestational diabetes mellitus in Vietnam. Acta Diabetol 2018; 55:955-962. [PMID: 29948409 DOI: 10.1007/s00592-018-1174-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 06/04/2018] [Indexed: 12/14/2022]
Abstract
AIMS To assess the association between physical activity (PA) during pregnancy and the prevalence of gestational diabetes mellitus (GDM) accounting for sitting time. METHODS The study used data from a cohort study of 2030 pregnant women in Vietnam. Women were recruited from six hospitals in Ha Noi, Hai Phong, and Ho Chi Minh City. Baseline measurements including PA and GDM were taken at 24-28 weeks of gestation. PA was assessed during the past 3 months before the interview using the interviewer-administered Pregnancy Physical Activity Questionnaire. GDM was diagnosed at 24-28 weeks of gestation using the 2013 World Health Organization criteria. RESULTS 1987 out of 2030 pregnant women were included in the final analysis, of which 432 had GDM (21.7%). Women undertaking the highest level (upper tertile) of PA during pregnancy appeared to have a lower risk of GDM [odds ratio (OR) 0.70, 95% confidence interval (CI) 0.53-0.94, Ptrend 0.017] when compared to those at the lowest tertile of PA. Similarly, women with increased levels of moderate-intensive activity and household/caregiving activity during pregnancy were associated with reduced risks of GDM (OR 0.66, 95% CI 0.50-0.86, Ptrend 0.002 and OR 0.72, 95% CI 0.55-0.95, Ptrend 0.020, respectively). These apparent inverse associations were not attenuated by their sitting time. There were no significant associations between sitting time, light-intensity activity, vigorous-intensity activity, occupation, sports/exercise, commuting, or meeting exercise guidelines and GDM risk. CONCLUSIONS High levels of PA, particularly moderate-intensity and household/caregiving activities during pregnancy were associated with a lower prevalence of GDM independent of sitting time.
Collapse
Affiliation(s)
- C L Nguyen
- School of Public Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia.
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
| | - N M Pham
- School of Public Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - A H Lee
- School of Public Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
| | - P T H Nguyen
- School of Public Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - T K Chu
- School of Public Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - A V V Ha
- School of Public Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - D V Duong
- United Nations Population Fund, Hanoi, Vietnam
| | - T H Duong
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - C W Binns
- School of Public Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
| |
Collapse
|
30
|
Abstract
AIMS The present study evaluates association between physical activity and Gestational Diabetes Mellitus (GDM), for it can be an effective intervention for its management. Though physical activity helps maintain glucose homeostasis, evidences of GDM risk are less extensive. Therefore, this study also identifies its correlation with maternal blood glucose levels. MATERIALS AND METHODS A prospective case-control study was carried out among pregnant women attending regular antenatal clinic at two private hospitals. The study comprised of 100 cases and 273 matched controls. Data was collected by personal interviews using a standard questionnaire. Physical activity was assessed using long form of International Physical Activity Questionnaire (IPAQ) reported as Metabolic Equivalent-Minutes per week (MET-Minutes/Week). Statistical Package for Social Sciences (SPSS) was used for analysis. RESULTS Results shows high exposure rates for low-to-moderate physical activity among cases, across all domains and sub-activities. The odds of GDM engaged in domestic and gardening activities for <2999 MET-minutes per week are 10 times higher than involved for ≥3000 MET-minutes per week (P < 0.001). The study also shows poor or no correlation between physical activity during pregnancy and maternal blood glucose levels. CONCLUSION Despite existence of poor or no relationship with maternal blood glucose levels, prolonged sedentary behavior and decreased physical activities, especially domestic, are potential risk factors for GDM, a major finding of the study.
Collapse
Affiliation(s)
- Surabhi Mishra
- Senior Resident, Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Surekha Kishore
- Professor and Head, Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| |
Collapse
|
31
|
Leisure-Time Physical Activity in Pregnancy and Maternal-Child Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Cohort Studies. Sports Med 2018; 47:295-317. [PMID: 27282925 DOI: 10.1007/s40279-016-0565-2] [Citation(s) in RCA: 123] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Evidence suggests that leisure-time physical activity (LTPA) during pregnancy is associated with a reduced risk of preeclampsia, gestational diabetes mellitus (GDM), and preterm birth. However, these results are inconsistent when comparing cohort studies and randomized controlled trials (RCTs). OBJECTIVE The purpose of our study was to compare the associations between LTPA in pregnancy and maternal (GDM, preeclampsia, and weight gain during pregnancy) and child health outcomes (preterm birth, birthweight, and fetal growth) between RCTs and cohort studies. METHODS We performed a systematic search in PubMed, Web of Science, and EBSCO up to 31 August 2015. Inclusion criteria for experimental studies required randomized trials with a control group and exposure to a physical activity structured program. The inclusion criteria for cohort studies required information on LTPA during pregnancy as an exposure and at least one maternal-child health outcome. We assessed the methodological quality of all studies and performed a meta-analysis to produce summary estimates of the effects using random models. RESULTS We included 30 RCTs and 51 cohort studies. The meta-analysis of RCTs indicated that participation in LTPA was associated with lower weight gain during pregnancy, lower likelihood of GDM, and lower likelihood of delivering a large-for-gestational-age infant. Cohort studies indicated that participation in LTPA was associated with lower weight gain during pregnancy, lower likelihood of GDM, and lower risk of preterm delivery. CONCLUSIONS Our findings support the promotion of LTPA in pregnancy as a strategy to improve maternal and child health.
Collapse
|
32
|
Mijatovic-Vukas J, Capling L, Cheng S, Stamatakis E, Louie J, Cheung NW, Markovic T, Ross G, Senior A, Brand-Miller JC, Flood VM. Associations of Diet and Physical Activity with Risk for Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis. Nutrients 2018; 10:E698. [PMID: 29849003 PMCID: PMC6024719 DOI: 10.3390/nu10060698] [Citation(s) in RCA: 185] [Impact Index Per Article: 26.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 05/25/2018] [Accepted: 05/28/2018] [Indexed: 12/11/2022] Open
Abstract
Rising rates of gestational diabetes mellitus (GDM) and related complications have prompted calls to identify potentially modifiable risk factors that are associated with gestational diabetes mellitus (GDM). We systematically reviewed the scientific literature for observational studies examining specific dietary and/or physical activity (PA) factors and risk of GDM. Our search included PubMed, Medline, CINAHL/EBSCO, Science Direct and EMBASE, and identified 1167 articles, of which 40 met our inclusion criteria (e.g., singleton pregnancy, reported diet or PA data during pre-pregnancy/early pregnancy and GDM as an outcome measure). Studies were assessed for quality using a modified Quality Criteria Checklist from American Dietetic Association. Of the final 40 studies, 72% obtained a positive quality rating and 28% were rated neutral. The final analysis incorporated data on 30,871 pregnant women. Dietary studies were categorised into either caffeine, carbohydrate, fat, protein, calcium, fast food and recognized dietary patterns. Diets such as Mediterranean Diet (MedDiet), Dietary Approaches to Stop Hypertension (DASH) diet and Alternate Healthy Eating Index diet (AHEI) were associated with 15–38% reduced relative risk of GDM. In contrast, frequent consumption of potato, meat/processed meats, and protein (% energy) derived from animal sources was associated with an increased risk of GDM. Compared to no PA, any pre-pregnancy or early pregnancy PA was associated with 30% and 21% reduced odds of GDM, respectively. Engaging in >90 min/week of leisure time PA before pregnancy was associated with 46% decreased odds of GDM. We conclude that diets resembling MedDiet/DASH diet as well as higher PA levels before or in early pregnancy were associated with lower risks or odds of GDM respectively. The systematic review was registered at PROSPERO (www.crd.york.ac.uk/PROSPERO) as CRD42016027795.
Collapse
Affiliation(s)
- Jovana Mijatovic-Vukas
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- The School of Life and Environmental Sciences, The University of Sydney, Sydney 2006, Australia.
| | - Louise Capling
- Faculty of Health Sciences, The University of Sydney, Lidcombe 2141, Australia.
| | - Sonia Cheng
- Faculty of Health Sciences, The University of Sydney, Lidcombe 2141, Australia.
| | - Emmanuel Stamatakis
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- Prevention Research Collaboration, School of Public Health, The University of Sydney, Sydney 2006, Australia.
| | - Jimmy Louie
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- School of Biological Sciences, Faculty of Science, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - N Wah Cheung
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- Westmead Hospital, Western Sydney Local Health District, Westmead 2145, Australia.
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Westmead 2145, Australia.
- Department of Diabetes and Endocrinology, Westmead Hospital, Westmead 2145, Australia.
| | - Tania Markovic
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown 2050, Australia.
| | - Glynis Ross
- Royal Prince Alfred Hospital, Sydney Local Health District, Camperdown 2050, Australia.
- Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia.
| | - Alistair Senior
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- The School of Life and Environmental Sciences, The University of Sydney, Sydney 2006, Australia.
- School of Mathematics and Statistics, The University of Sydney, Sydney 2006, Australia.
| | - Jennie C Brand-Miller
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- The School of Life and Environmental Sciences, The University of Sydney, Sydney 2006, Australia.
| | - Victoria M Flood
- Charles Perkins Centre, The University of Sydney, Sydney 2006, Australia.
- Faculty of Health Sciences, The University of Sydney, Lidcombe 2141, Australia.
- Westmead Hospital, Western Sydney Local Health District, Westmead 2145, Australia.
| |
Collapse
|
33
|
Aune D, Schlesinger S, Henriksen T, Saugstad OD, Tonstad S. Physical activity and the risk of preterm birth: a systematic review and meta-analysis of epidemiological studies. BJOG 2017; 124:1816-1826. [PMID: 28374930 DOI: 10.1111/1471-0528.14672] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Physical activity has been inconsistently associated with risk of preterm birth, and the strength of the association and the shape of the dose-response relationship needs clarification. OBJECTIVES To conduct a systematic review and dose-response meta-analysis to clarify the association between physical activity and risk of preterm birth. SEARCH STRATEGY PubMed, Embase and Ovid databases were searched for relevant studies up to 9 February 2017. SELECTION CRITERIA Studies with a prospective cohort, case-cohort, nested case-control or randomized study design were included. DATA COLLECTION AND ANALYSIS Data were extracted by one reviewer and checked for accuracy by a second reviewer. Summary relative risks (RRs) were estimated using a random effects model. MAIN RESULTS Forty-one studies (43 publications) including 20 randomized trials and 21 cohort studies were included. The summary RR for high versus low activity was 0.87 [95% confidence interval (CI): 0.70-1.06, I2 = 17%, n = 5] for physical activity before pregnancy, and it was 0.86 (95% CI: 0.78-0.95, I2 = 0%, n = 30) for early pregnancy physical activity. The summary RR for a 3 hours per week increment in leisure-time activity was 0.90 (95% CI: 0.85-0.95, I2 = 0%, n = 5). There was evidence of a nonlinear association between physical activity and preterm birth, Pnonlinearity < 0.0001, with the lowest risk observed at 2-4 hours per week of activity. CONCLUSION This meta-analysis suggests that higher leisure-time activity is associated with reduced risk of preterm birth. Further randomized controlled trials with sufficient frequency and duration of activity to reduce the risk and with larger sample sizes are needed to conclusively demonstrate an association. TWEETABLE ABSTRACT Physically active compared with inactive women have an 10-14% reduction in the risk of preterm birth.
Collapse
Affiliation(s)
- D Aune
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,Bjørknes University College, Oslo, Norway
| | - S Schlesinger
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - T Henriksen
- Section of Obstetrics, Division of Obstetrics and Gynaecology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - O D Saugstad
- Department of Pediatric Research, Rikshospitalet, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - S Tonstad
- Department of Preventive Cardiology, Oslo University Hospital, University of Oslo, Oslo, Norway
| |
Collapse
|
34
|
Huang L, Fan L, Ding P, He YH, Xie C, Niu Z, Tian FY, Yuan S, Jia D, Chen WQ. The mediating role of placenta in the relationship between maternal exercise during pregnancy and full-term low birth weight. J Matern Fetal Neonatal Med 2017; 31:1561-1567. [DOI: 10.1080/14767058.2017.1319936] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Lihua Huang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Lijun Fan
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Peng Ding
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yan-Hui He
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chuanbo Xie
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhongzheng Niu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Fu-Ying Tian
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shixin Yuan
- Department of Science and Education, Shenzhen Women and Children's Hospital, Shenzhen, China
| | - Deqin Jia
- Department of Obstetrics, Foshan Women and Children's Hospital, Foshan, China
| | - Wei-Qing Chen
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
35
|
Misra DP, Slaughter-Acey J, Giurgescu C, Sealy-Jefferson S, Nowak A. Why Do Black Women Experience Higher Rates of Preterm Birth? CURR EPIDEMIOL REP 2017. [DOI: 10.1007/s40471-017-0102-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
36
|
Bø K, Artal R, Barakat R, Brown W, Dooley M, Evenson KR, Haakstad LAH, Larsen K, Kayser B, Kinnunen TI, Mottola MF, Nygaard I, van Poppel M, Stuge B, Davies GAL. Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 2-the effect of exercise on the fetus, labour and birth. Br J Sports Med 2016; 50:1297-1305. [PMID: 27733352 DOI: 10.1136/bjsports-2016-096810] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2016] [Indexed: 11/03/2022]
Abstract
This is Part 2 of 5 in the series of evidence statements from the IOC expert committee on exercise and pregnancy in recreational and elite athletes. Part 1 focused on the effects of training during pregnancy and on the management of common pregnancy-related symptoms experienced by athletes. In Part 2, we focus on maternal and fetal perinatal outcomes.
Collapse
Affiliation(s)
- Kari Bø
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway
| | - Raul Artal
- Department of Obstetrics/Gynecology and Women's Health, Saint Louis University, St Louis, Missouri, USA
| | - Ruben Barakat
- Facultad de Ciencias de la Actividad Física y del Deporte-INEF, Universidad Politécnica de Madrid, Madrid, Spain
| | - Wendy Brown
- Centre for Research on Exercise Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia
| | - Michael Dooley
- The Poundbury Clinic, King Edward VII Hospital London, Dorchester, UK
| | - Kelly R Evenson
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Epidemiology, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Lene A H Haakstad
- Department of Sport Sciences, Norwegian School of Sport Sciences, Oslo, Norway
| | - Karin Larsen
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Bengt Kayser
- Faculty of Biology and Medicine, Institute of Sport Science, University of Lausanne, Lausanne, Switzerland
| | - Tarja I Kinnunen
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - Michelle F Mottola
- R. Samuel McLaughlin Foundation-Exercise and Pregnancy Lab, The University of Western Ontario, London, Ontario, Canada
| | - Ingrid Nygaard
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah, USA
| | | | - Britt Stuge
- Division of Orthopaedic Surgery, Oslo University Hospital, Ullevål, Oslo, Norway
| | | | | |
Collapse
|
37
|
Aune D, Sen A, Henriksen T, Saugstad OD, Tonstad S. Physical activity and the risk of gestational diabetes mellitus: a systematic review and dose-response meta-analysis of epidemiological studies. Eur J Epidemiol 2016; 31:967-997. [PMID: 27485519 PMCID: PMC5065594 DOI: 10.1007/s10654-016-0176-0] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 06/14/2016] [Indexed: 12/16/2022]
Abstract
Physical activity has been inconsistently associated with risk of gestational diabetes mellitus in epidemiological studies, and questions remain about the strength and shape of the dose-response relationship between the two. We therefore conducted a systematic review and meta-analysis of cohort studies and randomized trials on physical activity and gestational diabetes mellitus. PubMed, Embase and Ovid databases were searched for cohort studies, and randomized controlled trials of physical activity and risk of gestational diabetes mellitus, up to August 5th 2015. Summary relative risks (RRs) were estimated using a random effects model. Twenty-five studies (26 publications) were included. For total physical activity the summary RR for high versus low activity was 0.62 (95 % CI 0.41-0.94, I2 = 0 %, n = 4) before pregnancy, and 0.66 (95 % CI 0.36-1.21, I2 = 0 %, n = 3) during pregnancy. For leisure-time physical activity the respective summary RRs for high versus low activity was 0.78 (95 % CI 0.61-1.00, I2 = 47 %, n = 8) before pregnancy, and it was 0.80 (95 % CI 0.64-1.00, I2 = 17 %, n = 17) during pregnancy. The summary RR for pre-pregnancy activity was 0.70 (95 % CI 0.49-1.01, I2 = 72.6 %, n = 3) per increment of 5 h/week and for activity during pregnancy was 0.98 (95 % CI 0.87-1.09, I2 = 0 %, n = 3) per 5 h/week. There was evidence of a nonlinear association between physical activity before pregnancy and the risk of gestational diabetes mellitus, pnonlinearity = 0.005, with a slightly steeper association at lower levels of activity although further reductions in risk were observed up to 10 h/week. There was also evidence of nonlinearity for physical activity in early pregnancy, pnonlinearity = 0.008, with no further reduction in risk above 8 h/week. There was some indication of inverse associations between walking (before and during pregnancy) and vigorous activity (before pregnancy) and the risk of gestational diabetes mellitus. This meta-analysis suggests that there is a significant inverse association between physical activity before pregnancy and in early pregnancy and the risk of gestational diabetes mellitus. Further studies are needed to clarify the association between specific types and intensities of activity and gestational diabetes mellitus.
Collapse
Affiliation(s)
- Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, UK.
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Abhijit Sen
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tore Henriksen
- Section of Obstetrics, Division of Obstetrics and Gynaecology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Ola Didrik Saugstad
- Department of Pediatric Research, Rikshospitalet, Oslo University Hospital, University of Oslo, Oslo, Norway
| | - Serena Tonstad
- Section of Preventive Cardiology, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital Ullevål, Oslo, Norway
| |
Collapse
|
38
|
Lindqvist M, Lindkvist M, Eurenius E, Persson M, Ivarsson A, Mogren I. Leisure time physical activity among pregnant women and its associations with maternal characteristics and pregnancy outcomes. SEXUAL & REPRODUCTIVE HEALTHCARE 2016; 9:14-20. [PMID: 27634659 DOI: 10.1016/j.srhc.2016.03.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 02/15/2016] [Accepted: 03/31/2016] [Indexed: 12/24/2022]
Abstract
BACKGROUND Physical activity during pregnancy is generally considered safe and beneficial for both the pregnant woman and her fetus. The overall aim was to investigate pregnant women's pre-pregnancy and early pregnancy physical activity and its associations with maternal characteristics and pregnancy outcomes. METHODS This cross-sectional study combined data from the Maternal Health Care Register in Västerbotten (MHCR-VB) and the Salut Programme Register (Salut-R). Data were collected from 3,868 pregnant women living in northern Sweden between 2011 and 2012. RESULTS Almost half of the participants (47.1%) achieved the recommended level of physical activity. Compared to the women who did not achieve the recommended level of exercise, these women had lower BMI, very good or good self-rated health, and a higher educational level. No significant associations could be established between physical activity levels and GDM, birth weight, or mode of delivery. CONCLUSIONS Positively, a considerably high proportion of Swedish pregnant women achieved the recommended level of physical activity. Factors associated with recommended physical activity level were BMI ≤30 kg/m(2), very good or good self-rated health, and higher educational level. Our findings emphasize the need for health care professionals to early detect and promote fertile and pregnant women towards health-enhancing physical activity, especially those with low levels of physical activity and overweight/obesity, to improve overall health in this population.
Collapse
Affiliation(s)
- Maria Lindqvist
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, 901 87 Umeå, Sweden.
| | - Marie Lindkvist
- Department of Statistics, Umeå University, 901 87 Umeå, Sweden; Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden
| | - Eva Eurenius
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden
| | | | - Anneli Ivarsson
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, 901 87 Umeå, Sweden
| | - Ingrid Mogren
- Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, 901 87 Umeå, Sweden
| |
Collapse
|
39
|
Bisson M, Lavoie-Guénette J, Tremblay A, Marc I. Physical Activity Volumes during Pregnancy: A Systematic Review and Meta-Analysis of Observational Studies Assessing the Association with Infant's Birth Weight. AJP Rep 2016; 6:e170-97. [PMID: 27127718 PMCID: PMC4848034 DOI: 10.1055/s-0036-1583169] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 03/03/2016] [Indexed: 12/16/2022] Open
Abstract
Objective This study aims to examine the association between different maternal physical activity exposures during pregnancy and infant's birth weight, body composition, and risk of inadequate weight. Methods Two reviewers (M.B. and J.L.G.) identified observational studies reporting total or leisure time activity during pregnancy and birth weight outcomes. Pooled analyses were performed to summarize the risk associated with high or moderate volumes of physical activity on birth weight. Results A total of 54 studies among 4,080 reported the association between physical activity and birth weight (37 studies) or risks of small or large birth weight. The association between physical activity and birth weight was evaluated by physical activity levels (low, moderate, or high). Despite heterogeneity, pooled results (23 studies) suggested that moderate levels of activity are associated with an increased birth weight (mean difference: 61.5 g, 95% confidence interval [CI]: 16.6, 106.5, 15 studies), while high levels were associated with lower birth weight (mean difference: -69.9 g, 95% CI: -114.8, -25.0, 15 studies). Data were insufficient to provide robust estimates for other outcomes. Conclusions The results of observational studies suggest an inverted u-shaped association between physical activity and birth weight, despite methodological variability. These results could help refining physical activity guidelines for pregnancy and provide guidance for future research.
Collapse
Affiliation(s)
- Michèle Bisson
- Department of Pediatrics, Centre Hospitalier Universitaire de Québec (CHU de Québec), Université Laval, Quebec, Canada
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec, Canada
| | - Joëlle Lavoie-Guénette
- Department of Pediatrics, Centre Hospitalier Universitaire de Québec (CHU de Québec), Université Laval, Quebec, Canada
| | - Angelo Tremblay
- Department of Kinesiology, Faculty of Medicine, Université Laval, Quebec, Canada
| | - Isabelle Marc
- Department of Pediatrics, Centre Hospitalier Universitaire de Québec (CHU de Québec), Université Laval, Quebec, Canada
| |
Collapse
|
40
|
|
41
|
Fantuzzi G, Righi E, Aggazzotti G. A Case-Control Study on Leisure Time Physical Activity (LTPA) during the Last Three Months of Pregnancy and Foetal Outcomes in Italy. Health (London) 2016. [DOI: 10.4236/health.2016.82016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
42
|
Abstract
Tackling increasing rates of obesity is likely to be a defining feature of health care over the next several decades. Adult obesity is a persistent and treatment-resistant problem. Consequently, an emerging theme in the literature is to commence prevention efforts earlier in the developmental time course. This view is based primarily on epidemiological data demonstrating a link between traits manifesting early during development and increased obesity risk in adulthood. Physical activity is a perennial factor in discussions of obesity prevention. However, the optimal timing and type of physical activity interventions to commence remains unclear. Critical developmental windows of plasticity may afford time-limited opportunities to shape body composition across the life course; however, physical activity has not been explicitly considered in these discussions. Although animal models suggest that physical activity commenced earlier in development has differential effects on obesity onset compared to physical activity commenced in adulthood, human research is lacking. In this conceptual review, we consider physical activity during critical developmental periods as a way to mitigate obesity risk later in life.
Collapse
Affiliation(s)
- S J Street
- Mater Health Services South Brisbane, Brisbane, Queensland, Australia.,Mater Research, Centre for Nutrition and Exercise, South Brisbane, Queensland, Australia
| | - J C K Wells
- Childhood Nutrition Research Centre, University College London Institute of Child Health, London, England
| | - A P Hills
- Mater Health Services South Brisbane, Brisbane, Queensland, Australia.,Mater Research, Centre for Nutrition and Exercise, South Brisbane, Queensland, Australia.,Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
| |
Collapse
|
43
|
Abstract
There is a growing body of evidence suggesting that nonpharmacological interventions have an appropriate place in the treatment of major depressive disorders (MDDs) as both stand-alone and supplemental treatments. Because women may be reluctant to use psychotropic medications due to strong values or treatment preferences during specific reproductive events, clinicians need to be able to offer empirically based alternatives to medication. In this review, we present recent findings from studies of acupuncture, bright light therapy, electroconvulsive therapy, omega fatty acid supplementation, physical activity, and psychosocial intervention for women experiencing depressive symptoms in the contexts of menstruation, pregnancy, postpartum, and menopause.
Collapse
|