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Okafor UB, Goon DT, van Niekerk RL. Towards the Developing and Designing of an Intervention to Promote Prenatal Physical Activity Using MomConnect (mHealth): A Formative Protocol. Methods Protoc 2025; 8:26. [PMID: 40126244 PMCID: PMC11932236 DOI: 10.3390/mps8020026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Revised: 02/17/2025] [Accepted: 02/20/2025] [Indexed: 03/25/2025] Open
Abstract
BACKGROUND AND AIM The use of mHealth, especially short-message text (SMS), has proven to be an effective intervention in promoting behavioral health outcomes in populations across different contexts and settings. While MomConnect, an mHealth technological device designed to enhance maternal and child health services in South Africa, offers various health-related contents aimed at improving maternal outcomes for pregnant and postpartum women, it currently lacks information on prenatal physical activity. However, physical activity and exercise during pregnancy is safe and beneficial for both the mother and the baby. This article outlines the protocol for designing and developing a prenatal physical activity and exercise text messaging content for the MomConnect device. To achieve this, the protocol aims to elucidate the preferences of prenatal physical activity and exercise text messages and ascertain the preferred amount of SMS messaging to inform the design of an intervention for the incorporation of prenatal physical activity and exercise text messages into the MomConnect device in South Africa. METHODS We will apply a user-centred design approach conducted in three phases. First, a scoping literature review and interviews with pregnant women will be conducted to inform the formative stage for developing a desirable prototype SMS. Secondly, healthcare providers and pregnant women will be interviewed to collate data on the preferred SMS. Lastly, a cross-sectional survey will be conducted to determine the preferred quantity of SMS messaging to be incorporated in the MomConnect device. EXPECTED OUTCOMES A preferred or desirable prenatal physical activity and exercise SMS text message will inform the design of SMS text messages to be incorporated into the content of the MomConnect device to promote prenatal physical activity and exercise participation among women in the Eastern Cape Province. This study will develop a tailored mHealth intervention to improve prenatal physical activity participation and health behaviors among pregnant women in South Africa.
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Affiliation(s)
- Uchenna Benedine Okafor
- Department of Public Health, University of Fort Hare, 5 Oxford Street, East London 5201, South Africa
| | - Daniel Ter Goon
- Faculty of Health Sciences, University of Limpopo, Sovenga 0727, South Africa;
| | - Rudolph Leon van Niekerk
- Department of Psychology, University of Fort Hare, 50 Church Street, East London 5201, South Africa;
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Ren S, Zhao Q, Luo L, You X, Jin A. Association of physical activity during pregnancy with labor and delivery in nulliparous patients. Eur J Obstet Gynecol Reprod Biol X 2025; 25:100361. [PMID: 39834627 PMCID: PMC11743882 DOI: 10.1016/j.eurox.2024.100361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 12/10/2024] [Accepted: 12/17/2024] [Indexed: 01/22/2025] Open
Abstract
Background Physical activity during pregnancy is a positive behavior for improving pregnancy outcomes, yet the relationship between physical activity during pregnancy and labor is still debated. Objective This study aimed to test our hypothesis that a higher level of physical activity during pregnancy is associated with a shorter labor duration. Study design This was a prospective cohort study of pregnant women with singleton pregnancies and no contraindications to physical activity during pregnancy. physical activity according to type and intensity were evaluated with the Chinese version of the Pregnancy Physical Activity Questionnaire. This questionnaire categorizes physical activities into different types and intensities and quantifies them. The primary study outcome was labor duration. The secondary outcomes were delivery mode, conversion from vaginal delivery to cesarean section, prolonged second stage of labor, perineal tears, episiotomy, and postpartum hemorrhage within 24 hours. Generalized additive models were used to identify both linear and nonlinear relationships between physical activity during pregnancy and labor. A segmented linear model was employed to calculate the saturation effect. Stratified logistic regression was used for subgroup analysis. Results In total, 226 women participated in the physical activity survey during pregnancy and gave birth at our hospital. The energy expenditure of physical activity during pregnancy was 145.70 (111.92, 181.69) weekly energy expenditure (MET-h•wk-1). After full adjustment for covariates, a nonlinear relationship was observed between physical activity during pregnancy and the duration of the first stage of labor. Different correlations were observed when the energy expenditure of physical activity during pregnancy was 142.28 MET-h•wk-1. In the two-part regression model, the inflection point of physical activity during pregnancy was at 142.28 MET-h•wk-1. When the energy expenditure of physical activity during pregnancy exceeded 142.28 MET-h•wk-1, each standard deviation increase in physical activity was associated with a decrease of 149.85 minutes in the duration of the first stage of labor (β:-149.85, 95 % CI: -247.54 to -52.17, P = 0.0080). Conclusions A nonlinear relationship between physical activity during pregnancy and duration of the first stage of labor ha been identified.When physical activity exceeds 142.28 MET-h•wk-1, each additional standard deviation reduces the first stage of labor by 149.85 minutes. Physical activity is not limited to exercise programs; daily activities such as cleaning, shopping, and walking to and from work are effective ways to increase energy expenditure and help individuals achieve the recommended level of physical activity.
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Affiliation(s)
- Shuqun Ren
- Department of Gynaecology, The First Affiliated Hospital of Shenzhen University/Shenzhen Second People’s Hospital, Guangdong, China
- Faculty of Humanities, Dongying technician College, Dongying, Shandong, China
| | - Qian Zhao
- Department of Gynaecology, The First Affiliated Hospital of Shenzhen University/Shenzhen Second People’s Hospital, Guangdong, China
| | - Liyin Luo
- Department of Radiation Oncology, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Xiaohong You
- Department of medicine, Shenzhen University, Shenzhen, Guangdong, China
| | - Aihong Jin
- Department of Gynaecology, The First Affiliated Hospital of Shenzhen University/Shenzhen Second People’s Hospital, Guangdong, China
- Department of medicine, Shenzhen University, Shenzhen, Guangdong, China
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Jogie JA. Workplace Ergonomic Adjustments and Supportive Policies During the Pregnancy of a Paint Sprayer: A Case Report. Cureus 2024; 16:e76492. [PMID: 39872581 PMCID: PMC11769718 DOI: 10.7759/cureus.76492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2024] [Indexed: 01/30/2025] Open
Abstract
A 29-year-old paint sprayer presented with mild lower back pain and fatigue related to prolonged standing and repetitive tasks in the first few weeks of pregnancy. An initial assessment included a review of her workstation, evaluation of posture, and standard prenatal tests such as routine blood work and ultrasound. These investigations showed normal fetal development and no complications. The employer modified her work environment, providing ergonomic seating, and reducing prolonged standing. She received counseling on safe physical activity and balanced nutrition to help maintain overall health. Her pregnancy progressed without problems, and she continued to work comfortably. This case shows that simple ergonomic changes and supportive policies can help expectant employees remain productive and well.
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Affiliation(s)
- Joshua A Jogie
- Faculty of Medical Sciences, The University of the West Indies, St. Augustine, TTO
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Wang X, Ren J, Wang H. Psychometric characteristics of the Chinese version of the Pregnancy Exercise Attitudes Scale (C-PEAS). BMC Pregnancy Childbirth 2024; 24:679. [PMID: 39425068 PMCID: PMC11490181 DOI: 10.1186/s12884-024-06817-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 09/10/2024] [Indexed: 10/21/2024] Open
Abstract
BACKGROUND Reasonable instruction and promotion of appropriate exercise are crucial to improving the exercise status of pregnant women and safeguarding the health of both mother and fetus. However, there is a lack of validated Pregnancy Exercise Attitude Scales with a complete evaluation system in China. This study aims to assess the validity and reliability of the Pregnancy Exercise Attitude Scale (C-PEAS) in Chinese to give medical professionals a reference for carrying out pregnancy care services and promoting the health of the mother and fetus. METHODS In this study, the scale was translated, back-translated, and cross-culturally adapted using the Brislin translation model to form the C-PEAS. 528 pregnant women were conveniently selected for the questionnaire survey to evaluate the scale's reliability. The scale's content validity was assessed by the content validity index, while its structural validity was investigated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Cronbach's alpha coefficient, McDonald's omega coefficient, split-half reliability, and retest reliability were used to evaluate the scale's internal consistency. RESULTS The C-PEAS contains two dimensions with 37 entries. The EFA supports a two-factor structure with a cumulative variance contribution of 62.927%. The CFA model was well fitted (χ2/df = 1.597, RMSEA = 0.048, IFI = 0.955, TLI = 0.952, and CFI = 0.955). The C- PEAS' Cronbach's alpha coefficient was 0.973, and the range of Cronbach's alpha values for the dimensions was 0.976, 0.944. McDonald's omega coefficient was 0.971, the half-point reliability of the scale was 0.856, and the retest reliability was 0.966. CONCLUSIONS The Chinese version of C-PEAS has good psychometric properties. It can be used as an effective measurement tool to evaluate the attitude of pregnant women to exercise during pregnancy.
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Affiliation(s)
- Xiaoting Wang
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou, Liaoning, China
| | - Jiaxin Ren
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou, Liaoning, China
| | - Hongxia Wang
- School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou, Liaoning, China.
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Zhang W, Zhang L, Xu P, Guo P, Mao M, Zhao R, Feng S. Physical activity levels and influencing factors among pregnant women in China: A systematic review and meta-analysis. Int J Nurs Stud 2024; 158:104841. [PMID: 38917748 DOI: 10.1016/j.ijnurstu.2024.104841] [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: 08/09/2023] [Revised: 05/21/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Physical activity during pregnancy has been recommended as an effective measure to prevent various pregnancy complications. However, global physical activity participation during pregnancy is not optimal, and the factors influencing physical activity participation during pregnancy need to be further investigated. In China, where there are no localized guidelines for physical activity during pregnancy, the prevalence of meeting recommended physical activity levels among Chinese pregnant women is still unclear. OBJECTIVES This study aimed to comprehensively review the prevalence of meeting recommended physical activity levels among pregnant women in China and to further explore the factors influencing physical activity participation during pregnancy. DESIGN This was a systematic review and meta-analysis. METHODS A systematic review was conducted in both English and Chinese databases from inception until August 1, 2023. Two reviewers independently screened literature, assessed study eligibility and extracted data. The Agency for Healthcare Research and Quality was used to evaluate methodological quality of included studies. The pooled prevalence was calculated using a random-effects model. Subgroup analyses were conducted to explore sources of heterogeneity. RESULTS A total of 12 cross-sectional studies, including 11,323 Chinese pregnant women with a mean age ranging from 27.0 to 33.0 years, met the inclusion criteria. The prevalence of meeting recommended physical activity levels among pregnant women in China was 21.0 % (95 % confidence interval (CI):12.5 %-29.5 %). A higher prevalence of meeting recommended physical activity levels was observed among pregnant women who were in their second trimester, who were living in the southern region, who were assessed by validated questionnaires, and who used 150 min physical activity per week as a criterion for meeting recommendation. CONCLUSIONS The findings suggested a low prevalence of meeting recommended physical activity levels among Chinese pregnant women, which was affected by a variety of factors. It is recommended that further research be conducted in the future to explore physical activity intervention strategies for women of childbearing age before and during pregnancy based on the factors affecting physical activity to improve physical activity compliance, maternal and child health and population quality. REGISTRATION NUMBER CRD42022372722 (PROSPERO).
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Affiliation(s)
- Wei Zhang
- Women's Hospital School of Medicine Zhejiang University, No.1 Xue Shi Road, Hangzhou 310006, Zhejiang Province, China; Zhejiang University School of Medicine, No.866 Yu Hang Tang Road, Hangzhou 310058, Zhejiang Province, China.
| | - Le Zhang
- Women's Hospital School of Medicine Zhejiang University, No.1 Xue Shi Road, Hangzhou 310006, Zhejiang Province, China.
| | - Ping Xu
- Women's Hospital School of Medicine Zhejiang University, No.1 Xue Shi Road, Hangzhou 310006, Zhejiang Province, China; Zhejiang University School of Medicine, No.866 Yu Hang Tang Road, Hangzhou 310058, Zhejiang Province, China.
| | - Pingping Guo
- Women's Hospital School of Medicine Zhejiang University, No.1 Xue Shi Road, Hangzhou 310006, Zhejiang Province, China; Zhejiang University School of Medicine, No.866 Yu Hang Tang Road, Hangzhou 310058, Zhejiang Province, China.
| | - Minna Mao
- Women's Hospital School of Medicine Zhejiang University, No.1 Xue Shi Road, Hangzhou 310006, Zhejiang Province, China; Zhejiang University School of Medicine, No.866 Yu Hang Tang Road, Hangzhou 310058, Zhejiang Province, China.
| | - Rujia Zhao
- Women's Hospital School of Medicine Zhejiang University, No.1 Xue Shi Road, Hangzhou 310006, Zhejiang Province, China; Zhejiang University School of Medicine, No.866 Yu Hang Tang Road, Hangzhou 310058, Zhejiang Province, China.
| | - Suwen Feng
- Women's Hospital School of Medicine Zhejiang University, No.1 Xue Shi Road, Hangzhou 310006, Zhejiang Province, China.
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Bakker W, Sandberg EM, Keetels S, Schoones JW, Kujabi ML, Maaløe N, Maswime S, van den Akker T. Inconsistent definitions of prolonged labor in international literature: a scoping review. AJOG GLOBAL REPORTS 2024; 4:100360. [PMID: 39040660 PMCID: PMC11261896 DOI: 10.1016/j.xagr.2024.100360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/24/2024] Open
Abstract
Objective Prolonged labor is the commonest indication for intrapartum cesarean section, but definitions are inconsistent and some common definitions were recently found to overestimate the speed of physiological labor. The objective of this review is to establish an overview of synonyms and definitions used in the literature for prolonged labor, separated into first and second stages, and establish types of definitions used. Data sources A systematic search was conducted in PubMed, Embase, Web of Science, Cochrane Library, Emcare, and Academic Search Premier. Study eligibility criteria All articles in English that (1) attempted to define prolonged labor, (2) included a definition of prolonged labor, or (3) included any synonym for prolonged labor, were included. Methods Data on study design, year of publication, country or region of origin, synonyms used, definition of prolonged first and/or second stage, and origin of provided definition (if not primarily established by the study) were collected into a database. Results In total, 3402 abstracts and 536 full-text papers were screened, and 232 papers were included. Our search established 53 synonyms for prolonged labor. Forty-three studies defined prolonged labor and 189 studies adopted a definition of prolonged labor. Definitions for prolonged first stage of labor were categorized into: time-based (n=14), progress-based (n=12), clinician-based (n=5), or outcome-based (n=4). For the 33 studies defining prolonged second stage, the majority of definitions (n=25) were time-based, either based on total duration or duration of no descent of the presenting part. Conclusions Despite efforts to arrive at uniform labor curves, there is still little uniformity in definitions of prolonged labor. Consensus on which definition to use is called for, in order to safely and respectfully allow physiological labor progress, ensure timely management, and assess and compare incidence of prolonged labor between settings.
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Affiliation(s)
- Wouter Bakker
- Athena Institute, VU University, Amsterdam, The Netherlands
- Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands
| | - Evelien M. Sandberg
- Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sharon Keetels
- Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jan W. Schoones
- Directorate of Research Policy, Leiden University Medical Center, Leiden, The Netherlands
| | - Monica Lauridsen Kujabi
- Global Health Section, Department of Public Health, University of Copenhagen, Denmark
- Department of Obstetrics and Gynecology, Aarhus University Hospital – Skejby Hospital, Aarhus, Denmark
| | - Nanna Maaløe
- Global Health Section, Department of Public Health, University of Copenhagen, Denmark
- Department of Obstetrics and Gynecology, Copenhagen University Hospital – Herlev Hospital, Copenhagen, Denmark
| | - Salome Maswime
- Global Surgery Division, Department of Surgery, University of Cape Town, Cape Town, South Africa
| | - Thomas van den Akker
- Athena Institute, VU University, Amsterdam, The Netherlands
- Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands
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Alizadeh-Dibazari Z, Abbasalizadeh F, Mohammad-Alizadeh-Charandabi S, Jahanfar S, Mirghafourvand M. Childbirth preparation and its facilitating and inhibiting factors from the perspectives of pregnant and postpartum women in Tabriz-Iran: a qualitative study. Reprod Health 2024; 21:106. [PMID: 38997718 PMCID: PMC11241919 DOI: 10.1186/s12978-024-01844-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 07/01/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND The World Health Organization recognizes childbirth preparation as an essential component of antenatal care, as it plays a crucial role in reducing maternal mortality and improving women's childbirth experience. Countries worldwide have implemented various interventions to assist women in preparing for childbirth, based on their own resources. This study was conducted with the aim of exploring the perspectives of pregnant and postpartum women on childbirth preparation and the facilitating and inhibiting factors, in Tabriz, Iran. METHODS This qualitative study was conducted with 25 participants, selected purposively among pregnant women in weeks 37 to 40 of gestation and postpartum women within 10 days to 6 weeks after childbirth. Data collection was done through semi-structured, in-depth individual interviews using an interview guide. The data was analyzed using content analysis method with conventional approach. RESULTS The perspectives of pregnant and postpartum women regarding childbirth preparation revealed that factors such as maternal health during pregnancy, having an antenatal care plan, improving health literacy, and developing a birth plan were identified as crucial elements for effective childbirth preparation. Additionally, mental and emotional preparation, support, financial planning, participation in preparation classes, and awareness of childbirth methods were recognized as facilitators. On the other hand, insufficient mental and emotional preparedness, inadequate support, weak antenatal care, information deficiencies, insufficient physical activity, and a lack of a birth plan were identified as barriers. CONCLUSION The findings highlight the multifaceted nature of childbirth preparedness, necessitating the involvement of families, the healthcare system, and the entire community. Utilizing the study results in strategic planning for pre-pregnancy, during pregnancy, and inter-pregnancy care can enhance childbirth preparedness and contribute to achieving Iran's population rejuvenation policy goals.
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Affiliation(s)
- Zohreh Alizadeh-Dibazari
- Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Abbasalizadeh
- Women Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Shayesteh Jahanfar
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Huang F, Chen H, Wu X, Li J, Guo J, Zhang X, Qiao Y. A model to predict delivery time following induction of labor at term with a dinoprostone vaginal insert: a retrospective study. Ir J Med Sci 2024; 193:1343-1350. [PMID: 37947994 PMCID: PMC11128390 DOI: 10.1007/s11845-023-03568-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Dinoprostone vaginal insert is the most common pharmacological method for induction of labor (IOL); however, studies on assessing the time to vaginal delivery (DT) following dinoprostone administration are limited. AIMS We sought to identify the primary factors influencing DT in women from central China, at or beyond term, who underwent IOL with dinoprostone vaginal inserts. METHODS In this retrospective observational study, we analyzed the data of 1562 women at 37 weeks 0 days to 41 weeks 6 days of gestation who underwent dinoprostone-induced labor between January 1st, 2019, and December 31st, 2021. The outcomes of interest were vaginal or cesarean delivery and factors influencing DT, including maternal complications and neonatal characteristics. RESULTS Among the enrolled women, 71% (1109/1562) delivered vaginally, with median DT of 740.50 min (interquartile range 443.25 to 1264.50 min). Of the remaining 29% (453/1562), who delivered by cesarean section, 11.9% (54/453) were multiparous. Multiple linear regression analysis showed that multiparity, advanced maternal age, fetal macrosomia, premature rupture of membranes (PROM), and daytime insertion of dinoprostone were the factors that significantly influenced DT. Time to vaginal delivery increased with advanced maternal age and fetal macrosomia and decreased with multiparity, PROM, and daytime insertion of dinoprostone. A mathematical model was developed to integrate these factors for predicting DT: Y = 804.478 - 125.284 × multiparity + 765.637 × advanced maternal age + 411.511 × fetal macrosomia-593.358 × daytime insertion of dinoprostone - 125.284 × PROM. CONCLUSIONS Our findings may help obstetricians estimate the DT before placing a dinoprostone insert, which may improve patient management in busy maternity wards and minimize potential risks.
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Affiliation(s)
- Fenghua Huang
- Department of Gynecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Huijun Chen
- Department of Gynecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Xuechun Wu
- Department of Gynecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Jiafu Li
- Department of Gynecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Juanjuan Guo
- Department of Gynecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Xiaoqin Zhang
- Department of Gynecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China
| | - Yuan Qiao
- Department of Gynecology and Obstetrics, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, China.
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Spicer MG, Dennis AT. Perioperative Exercise Testing in Pregnant and Non-Pregnant Women of Reproductive Age: A Systematic Review. J Clin Med 2024; 13:416. [PMID: 38256550 PMCID: PMC10816516 DOI: 10.3390/jcm13020416] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Women have classically been excluded from the development of normal data and reference ranges, with pregnant women experiencing further neglect. The incidence of Caesarean section in pregnant women, and of general operative management in young women (both pregnant and non-pregnant), necessitates the formal development of healthy baseline data in these cohorts to optimise their perioperative management. This systematic review assesses the representation of young women in existing reference ranges for several functional exercise tests in common use to facilitate functional assessment in this cohort. METHODS Existing reference range data for the exercise tests the Six Minute Walk Test (6MWT), the Incremental Shuttle Walk Test (ISWT) and Cardiopulmonary Exercise Testing (CPET) in young women of reproductive age were assessed using the MEDLINE (Ovid) database, last searched December 2023. Results were comparatively tabulated but not statistically analysed given underlying variances in data. RESULTS The role of exercise testing in the perioperative period as an assessment tool, as well as its safety during pregnancy, was evaluated using 65 studies which met inclusion criteria. CONCLUSION There is a significant lack of baseline data regarding these tests in this population, especially amongst the pregnant cohort, which limits the application of exercise testing clinically.
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Affiliation(s)
- Madeleine G. Spicer
- Department of Obstetrics and Gynaecology, Alice Springs Hospital, Alice Springs, NT 0870, Australia
| | - Alicia T. Dennis
- Department of Anaesthesia, Pain and Perioperative Medicine, Joan Kirner Women’s and Children’s Hospital, Western Health, St Albans, VIC 3021, Australia;
- School of Medicine, Faculty of Health, Deakin University, Melbourne, VIC 3125, Australia
- Departments of Critical Care, Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC 3010, Australia
- Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
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Lv Y, Hu R, Liang Y, Zhou Y, Lian Y, He T. Effect of daily physical activity on ambulatory blood pressure in pregnant women with chronic hypertension: A prospective cohort study protocol. PLoS One 2024; 19:e0296023. [PMID: 38198464 PMCID: PMC10781089 DOI: 10.1371/journal.pone.0296023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 11/23/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Physical activity, a first-line approach for the treatment of non-gestational hypertension globally, has been shown to benefit most pregnant women in many respects. The benefits and risks of prenatal physical activity in complicated pregnancies, such as preeclampsia and chronic hypertension, require further investigation. It is worth conducting studies to address questions about physical activity during pregnancy in women with chronic hypertension, such as the benefits and risks, frequency, duration, and intensity. This prospective cohort study aims to investigate whether moderate-intensity daily physical activity reduces ambulatory blood pressure in pregnant women with chronic hypertension. METHODS Pregnant women with chronic hypertension at 11+0 to 13+6 gestational weeks will be recruited from the outpatient clinic and divided into moderate- and light-intensity physical activity groups according to the intensity of the 7-day physical activity monitored using the model wGT3X-BT accelerometer. 24-h ambulatory blood pressure monitoring will be performed at enrollment as a baseline and will be repeated in the second and third trimesters. The primary outcome is the difference in the change in 24-h ambulatory systolic blood pressure from the first to the third trimester between the groups. Secondary outcomes include the difference of change in other ambulatory (24-h diastolic, daytime, and nighttime) and office blood pressure variables from the first to the second and third trimesters, the incidence of severe hypertension (≥160/110 mmHg), and changes in the type and dosage of antihypertensive medication. The primary and secondary outcomes related to changes in blood pressure from baseline to the second and third trimesters between the groups will be analyzed using Student's independent t-test or the Mann-Whitney U test. DISCUSSION This cohort study will provide a basis for randomized controlled trials and verify an easily achieved, economical, and non-fetotoxic approach for adjuvant blood pressure management in pregnant women with chronic hypertension. REGISTRY This study is registered with the Chinese Clinical Trials Registry (NO. ChiCTR2200062094). Date Registered: 21/07/2022.
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Affiliation(s)
- Yanxiang Lv
- Department of Obstetrics and Gynecology Intensive Care Unit, Northwest Women’s and Children’s Hospital, Xi’an City, Shaanxi Prov, China
| | - Rui Hu
- Department of Obstetrics and Gynecology Intensive Care Unit, Northwest Women’s and Children’s Hospital, Xi’an City, Shaanxi Prov, China
| | - Yan Liang
- Department of Obstetrics and Gynecology Intensive Care Unit, Northwest Women’s and Children’s Hospital, Xi’an City, Shaanxi Prov, China
| | - Ying Zhou
- Department of Obstetrics and Gynecology Intensive Care Unit, Northwest Women’s and Children’s Hospital, Xi’an City, Shaanxi Prov, China
| | - Yanan Lian
- Department of Obstetrics and Gynecology Intensive Care Unit, Northwest Women’s and Children’s Hospital, Xi’an City, Shaanxi Prov, China
| | - Tongqiang He
- Department of Obstetrics and Gynecology Intensive Care Unit, Northwest Women’s and Children’s Hospital, Xi’an City, Shaanxi Prov, China
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11
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Yan S, Jiang H, Yang Z, Tang X, Chen Z, Chen Z, Liu H, Zhang F. Physical activity trajectory during pregnancy and associations with maternal fatigue using a growth mixture modeling approach. Sci Rep 2024; 14:1020. [PMID: 38200232 PMCID: PMC10781982 DOI: 10.1038/s41598-024-51648-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/08/2024] [Indexed: 01/12/2024] Open
Abstract
The purpose of this study was to investigate the associations of physical activity trajectories with maternal fatigue. Pregnant women provided objectively assessed physical activity data by Pregnancy Physical Activity Questionnaire four times. Fatigue scale-14 was used to assess fatigue during pregnancy. Growth mixture modelling characterized physical activity trajectories across pregnancy. The generalized estimating equations was used to analyze the relationship between different physical activity profiles and fatigue in pregnant women. A total of 626 pregnant women were included in analysis in a teaching hospital in Nantong city. Fatigue (total, mental and physical) was not different between two groups based on total energy expenditure of PA (constantly high vs. constantly low). The pregnant women in "constantly high household PA" group had the higher fatigue compared to "constantly low household PA" (P < 0.05) and "constantly medium household PA" (P < 0.05). The pregnant women in "constantly high sport PA" group had lower fatigue compared to "constantly low sport PA" (P < 0.05). Household PA and sport PA were still an independent influencing factor for fatigue after controlling for confounding variables. Specifically, we observed that higher household PA and lower sport PA were associated with higher fatigue during pregnancy.
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Affiliation(s)
- Shuhan Yan
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China
- Health School attached to Shanghai University of Medicine & Health Sciences, 200237, Shanghai, China
| | - Hui Jiang
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China
- Affiliated hospital of Nantong university, Nantong, China
| | - Ziyi Yang
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China
| | - Xinyan Tang
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China
| | - Zihang Chen
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China
| | - Zhifang Chen
- Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong City, Jiangsu Province, China
| | - Huahua Liu
- Affiliated Maternity and Child Health Care Hospital of Nantong University, Nantong City, Jiangsu Province, China
| | - Feng Zhang
- School of Nursing, Nantong University, 19 QiXiu Road, Nantong City, Jiangsu Province, China.
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12
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Koca TT, Özer A. Low back pain and kinesiophobia in pregnant women. J Back Musculoskelet Rehabil 2024; 37:1373-1380. [PMID: 38607751 DOI: 10.3233/bmr-240006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
BACKGROUND During pregnancy, many pregnant women experience lumbopelvic pain due to mechanical, systemic, and hormonal reasons and this pain and fear of movement (kinesiophobia) causes daily life limitations. OBJECTIVE To examine low back pain (LBP), kinesiophobia, disability, and related conditions that develop together during pregnancy. METHODS The was a cross-sectional and analytical study. The presence, severity, and duration of pain in the lumbopelvic region were questioned. Postpartum LBP was evaluated using a self-administered questionnaire, disability using the Oswestry Disability Index (ODI), pain intensity using a visual analog scale (VAS), physical activity levels using the physical activity level during pregnancy questionnaire and the international physical activity questionnaire short form, and kinesiophobia was evaluated using the Tampa Scale for Kinesiophobia. RESULTS The study comprised 120 pregnant women with a mean age of 27.4 ± 6.1 years. It was observed that 42.3% of the pregnant had LBP (n= 69). The mean body mass index (BMI) was 73.6 ± 16.2 kg/m2, and the mean VAS score was 5.5 ± 2 cm. When we divided the group according to the presence of LBP, age (p= 0.49), gestational week (p= 0.75), and gravida (p= 0.81) were similar. BMI (p= 0.038) and ODI scores (p< 0.001) were higher in the group with LBP. CONCLUSION LBP in pregnant women has a higher frequency than in the normal population, regardless of age, gestational week, and gravida. Obesity appears to be a risk factor for LBP and increases disability. Kinesiophobia in pregnant women is significantly associated with obesity and disability. Unless there are contraindications, a physically active pregnancy process and regular exercise should be recommend.
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Affiliation(s)
- Tuba Tülay Koca
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Sütçü İmam University, Kahramanmaraş, Turkey
| | - Alev Özer
- Department of Obstetrics and Gynecology, Faculty of Medicine, Sütçü İmam University, Kahramanmaraş, Turkey
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Mészáros B, Kukor Z, Valent S. Recent Advances in the Prevention and Screening of Preeclampsia. J Clin Med 2023; 12:6020. [PMID: 37762960 PMCID: PMC10532380 DOI: 10.3390/jcm12186020] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/08/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Throughout the history of medicine, preeclampsia has remained an enigmatic field of obstetrics. In 2023, despite its prevalence and impact, preeclampsia's exact cause and effective treatment remain elusive; the current options are limited to delivery. The purpose of this review is to summarize the knowledge of the possible novel prophylactic therapies and screening methods for preeclampsia, thereby providing valuable insights for healthcare professionals and researchers. Aspirin and LMWH have already been widely used; meanwhile, calcium, vitamin D, and pravastatin show promise, and endothelin receptor antagonists are being explored. Stress reduction, dietary changes, and lifestyle modifications are also being investigated. Another interesting and fast-growing area is AI- and software-based screening methods. It is also key to find novel biomarkers, which, in some cases, are not only able to predict the development of the disease, but some of them hold promise to be a potential therapeutic target. We conclude that, while a definitive cure for preeclampsia may not be eligible in the near future, it is likely that the assessment and enhancement of preventive methods will lead to the prevention of many cases. However, it is also important to highlight that more additional research is needed in the future to clarify the exact pathophysiology of preeclampsia and to thus identify potential therapeutic targets for more improved treatment methods.
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Affiliation(s)
- Balázs Mészáros
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary
| | - Zoltán Kukor
- Department of Molecular Biology, Institute of Biochemistry and Molecular Biology, Semmelweis University, 1082 Budapest, Hungary
| | - Sándor Valent
- Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary
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Zhang W, Zhang L, Wang X, Xu P, Guo P, Mao M, Zhao R, Feng S. Prevalence of Chinese pregnant women meeting physical activity recommendation and its influencing factors: a protocol for systematic review and meta-analysis. BMJ Open 2023; 13:e072700. [PMID: 37648391 PMCID: PMC10471849 DOI: 10.1136/bmjopen-2023-072700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 08/16/2023] [Indexed: 09/01/2023] Open
Abstract
INTRODUCTION Regular physical activity during pregnancy is effective in preventing diseases and promoting the health outcomes of mothers and babies. However, the level of physical activity among them is not ideal. Especially in China, the proportion of pregnant women who meet the recommendation of physical activity in the guidelines is even lower. Thus, we aim to evaluate the prevalence of meeting physical activity recommendation and its influencing factors during pregnancy in China. METHODS AND ANALYSIS This protocol is developed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. PubMed, Web of Science, Scopus, CINAHL, MEDLINE, PsycINFO, EMBASE, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (Weipu) and WanFang Data will be comprehensively searched by two reviewers. Studies that report the prevalence of Chinese pregnant women meeting physical activity recommendation will be included. Two reviewers will independently assess eligibility, extract data and evaluate methodological quality. Data including authors, publication years, language, geographical region, tools, trimesters, prevalence and influence factors will be extracted. Data will be analysed by Stata V.11 statistical software. ETHICS AND DISSEMINATION No formal ethics approval is required for this protocol and no primary data are to be collected. Findings from this review may be useful to develop interventions for the physical activity of pregnant women in China. The results will be disseminated through peer-reviewed journals, conference presentations and public events. PROSPERO REGISTRATION NUMBER CRD42022372722.
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Affiliation(s)
- Wei Zhang
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Le Zhang
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaojuan Wang
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Ping Xu
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Pingping Guo
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Minna Mao
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Rujia Zhao
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
| | - Suwen Feng
- Nursing Department, Women's Hospital School of Medicine Zhejiang University, Hangzhou, Zhejiang, China
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Bu S, Li Y. Physical activity is associated with allostatic load: Evidence from the National Health and Nutrition Examination Survey. Psychoneuroendocrinology 2023; 154:106294. [PMID: 37216739 DOI: 10.1016/j.psyneuen.2023.106294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/14/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023]
Abstract
We determined the associations between physical activity and allostatic load, and whether it is a modifiable factor related to allostatic load. We obtained data from the National Health and Nutrition Examination Survey (NHANES) database collected between 2017 and March 2020. The relationship between physical activity and allostatic load was examined using a logistic regression model. In the unadjusted model, physical activity level was associated with allostatic load index (odds ratio [OR] = 0.664, 95% confidence interval [CI]: 0.550, 0.802, P<0.001), with this relationship being retained in the adjusted model (OR = 0.739, 95%CI: 0.603, 0.907; P = 0.004). Sedentary behaviour was also related to allostatic load index (OR = 1.236, 95%CI: 1.005, 1.520; P = 0.044). Our findings indicated that sufficient physical activity is associated with a lower allostatic load index, and sedentary behaviour is associated with a higher allostatic load index. Physical activity is a modifiable factor related to allostatic load.
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Affiliation(s)
- Sisi Bu
- School of Nursing, Anhui Medical University, Hefei 230032, Anhui, China
| | - Yuhong Li
- School of Nursing, Anhui Medical University, Hefei 230032, Anhui, China.
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Issac A, Nayak SG, T P, Balakrishnan D, Halemani K, Mishra P, P I, VR V, Jacob J, Stephen S. Effectiveness of breathing exercise on the duration of labour: A systematic review and meta-analysis. J Glob Health 2023; 13:04023. [PMID: 36896808 PMCID: PMC9999308 DOI: 10.7189/jogh.13.04023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
Background Prolonged labour intensifies labour pain, and failure to address labour pain may lead to abnormal labour and augments the usage of operative interventions. Prolonged labour is common among women, resulting in maternal morbidity, increased caesarean section (CS) rates, and postpartum complications. It may bring forth negative birth experiences that may increase the preference for CS. There is a dearth of evidence concerning the effectiveness of breathing exercises on the duration of labor. As per our knowledge, this is the first systematic review and meta-analysis on the effect of breathing exercises on the duration of labor. This systematic review and meta-analysis aimed to appraise the evidence concerning the effectiveness of breathing exercises on the duration of labour. Methods Electronic databases MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Web of Science, SCOPUS, and ClinicalKey were searched for randomized controlled trials, quasi-experimental studies published in the English language between January 2005 to March 2022 that reported on the effectiveness of breathing exercises on the duration of labour. Duration of labour was the primary analysed outcome. The secondary outcomes assessed were anxiety, duration of pain, APGAR scores, episiotomy, and mode of delivery. Meta-analysis was done using RevMan v5.3. Results The reviewed trials involved 1418 participants, and the study participants ranged from 70 to 320. The mean gestational weeks of the participants among the reported trials was 38.9 weeks. Breathing exercise shortened the duration of the intervention group's second stage of labour compared with the control group. Conclusions Breathing exercise is a beneficial preventive intervention in shortening the duration of second stage of labour. Registration The review protocol was registered with PROSPERO (CRD42021247126).
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Affiliation(s)
- Alwin Issac
- All India Institute of Medical Sciences, Bhubaneswar, India
| | | | | | | | | | - Prabhakar Mishra
- Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Indumathi P
- All India Institute of Medical Sciences, Bhubaneswar, India
| | - Vijay VR
- All India Institute of Medical Sciences, Bhubaneswar, India
| | - Jaison Jacob
- All India Institute of Medical Sciences, Bhubaneswar, India
| | - Shine Stephen
- All India Institute of Medical Sciences, Bhubaneswar, India
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Kuczera A, Opala-Berdzik A, Malá J, Sodowski M, Chmielewska D. Comparison of First Childbirth Characteristics between Elite Judo Athletes and Non-Athletes: The Preliminary Retrospective Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13218. [PMID: 36293804 PMCID: PMC9602800 DOI: 10.3390/ijerph192013218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
It has been speculated that elite athletes are more likely to have obstetric interventions during labor and delivery. So far, the impact of many years of competitive sports participation on childbirth characteristics has not been well-established. This preliminary retrospective case-control study aimed to determine whether the first labors of elite judo competitors required obstetric interventions more frequently and were longer than those of non-athletes. The study comprised 32 parous women: 16 elite judo athletes and 16 non-athletes. Women were included if they had access to the following obstetric data (from their first childbirth hospital discharge reports and/or first child's health record books): induction and augmentation of labor, mode of delivery, the duration of labor and its second stage, episiotomy, perineal tear, and the neonate's Apgar score. Electronic surveys were completed concerning childbirth characteristics, level of "eliteness" (judo athletes), and recreational physical activity (non-athletes). The statistical analysis showed no significant between-group differences in any of the first childbirth outcomes under analysis. The preliminary results indicate elite judo practice before first pregnancy had no negative impact on the rates of labor induction and augmentation, delivery mode, duration of labor, the rates of episiotomy and perineal tear, and the neonate's Apgar score. Due to the small sample size, the conclusions should be considered with caution.
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Affiliation(s)
- Anna Kuczera
- Students Scientific Association on the Analysis of the Influence of Pregnancy on the Musculoskeletal System, Physiotherapy Faculty, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland
| | - Agnieszka Opala-Berdzik
- Department of Physiotherapy in Internal Diseases, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland
| | - Jitka Malá
- Physiotherapy Department, Faculty of Physical Education and Sport, Charles University, 121 08 Prague, Czech Republic
| | - Marcin Sodowski
- Gynecology and Obstetrics Ward, City Hospital in Siemianowice Śląskie, 41-100 Siemianowice Slaskie, Poland
| | - Daria Chmielewska
- Electromyography and Pelvic Floor Muscles Laboratory, Department of Physical Medicine, Institute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland
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