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Pascual-Morena C, Cavero-Redondo I, Álvarez-Bueno C, Lucerón-Lucas-Torres M, Sanabria-Martínez G, Poyatos-León R, Rodríguez-Martín B, Martínez-Vizcaíno V. Exercise versus Metformin to Improve Pregnancy Outcomes among Overweight Pregnant Women: A Systematic Review and Network Meta-Analysis. J Clin Med 2021; 10:jcm10163490. [PMID: 34441786 PMCID: PMC8397096 DOI: 10.3390/jcm10163490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 12/16/2022] Open
Abstract
Being overweight is associated with pregnancy-related disorders such as gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), and excessive maternal weight gain (MWG). Exercise and metformin reduce the risk of these disorders. This network meta-analysis (NMA) aims to compare the effect of metformin and different types of exercise (aerobic, resistance and combined) on the risk of GDM, HDP, and MWG among overweight/obese pregnant women. Medline, EMBASE, Web of Science and Cochrane Library were searched from inception to June 2021. Meta-analyses and NMAs were performed. Sixteen randomized controlled trials were included. In the NMA, aerobic exercise showed an effect on GDM (RR = 0.51, 95% CI = 0.26, 0.97), and metformin a reduction in MWG (MWG = -2.93 kg, 95% CI = -4.98, -0.87). No intervention showed any effect on the reduction of HDP. Our study suggests that aerobic exercise may have the greatest effect in reducing the risk of GDM, and perhaps, the MWG. Strategies should be developed to increase adherence to this type of intervention among overweight women without contraindications. Although metformin could reduce MWG, medicalization of pregnancy in healthy women is not justified with the present results. More research is needed on the effect of the intensity and frequency of exercise sessions and the length of interventions.
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Affiliation(s)
- Carlos Pascual-Morena
- Health and Social Research Center, Universidad de Castilla—La Mancha, 16071 Cuenca, Spain; (C.P.-M.); (C.Á.-B.); (M.L.-L.-T.); (G.S.-M.); (R.P.-L.); (B.R.-M.); (V.M.-V.)
| | - Iván Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla—La Mancha, 16071 Cuenca, Spain; (C.P.-M.); (C.Á.-B.); (M.L.-L.-T.); (G.S.-M.); (R.P.-L.); (B.R.-M.); (V.M.-V.)
- Rehabilitation in Health Research Center (CIRES), Universidad de las Américas, Santiago 72819, Chile
- Correspondence:
| | - Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla—La Mancha, 16071 Cuenca, Spain; (C.P.-M.); (C.Á.-B.); (M.L.-L.-T.); (G.S.-M.); (R.P.-L.); (B.R.-M.); (V.M.-V.)
- Universidad Politécnica y Artística del Paraguay, Asunción 001518, Paraguay
| | - Maribel Lucerón-Lucas-Torres
- Health and Social Research Center, Universidad de Castilla—La Mancha, 16071 Cuenca, Spain; (C.P.-M.); (C.Á.-B.); (M.L.-L.-T.); (G.S.-M.); (R.P.-L.); (B.R.-M.); (V.M.-V.)
| | - Gema Sanabria-Martínez
- Health and Social Research Center, Universidad de Castilla—La Mancha, 16071 Cuenca, Spain; (C.P.-M.); (C.Á.-B.); (M.L.-L.-T.); (G.S.-M.); (R.P.-L.); (B.R.-M.); (V.M.-V.)
| | - Raquel Poyatos-León
- Health and Social Research Center, Universidad de Castilla—La Mancha, 16071 Cuenca, Spain; (C.P.-M.); (C.Á.-B.); (M.L.-L.-T.); (G.S.-M.); (R.P.-L.); (B.R.-M.); (V.M.-V.)
| | - Beatriz Rodríguez-Martín
- Health and Social Research Center, Universidad de Castilla—La Mancha, 16071 Cuenca, Spain; (C.P.-M.); (C.Á.-B.); (M.L.-L.-T.); (G.S.-M.); (R.P.-L.); (B.R.-M.); (V.M.-V.)
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla—La Mancha, 16071 Cuenca, Spain; (C.P.-M.); (C.Á.-B.); (M.L.-L.-T.); (G.S.-M.); (R.P.-L.); (B.R.-M.); (V.M.-V.)
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 3460000, Chile
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2
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Awoke MA, Skouteris H, Makama M, Harrison CL, Wycherley TP, Moran LJ. The Relationship of Diet and Physical Activity with Weight Gain and Weight Gain Prevention in Women of Reproductive Age. J Clin Med 2021; 10:2485. [PMID: 34199753 PMCID: PMC8199997 DOI: 10.3390/jcm10112485] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 11/16/2022] Open
Abstract
Reproductive-age women often see increased weight gain, which carries an increased risk of long-term overweight and obesity and adverse maternal and child health outcomes. Supporting women to achieve optimal weight through lifestyle modification (diet and physical activity) is of critical importance to reduce weight gain across key reproductive life-stages (preconception, pregnancy and postpartum). This review comprehensively summarizes the current state of knowledge on the contribution of diet and physical activity to weight gain and weight gain prevention in reproductive-aged women. Suboptimal diets including a higher proportion of discretionary choices or energy intake from fats, added sugars, sweets or processed foods are associated with higher weight gain, whereas increased consumption of core foods including fruits, vegetables and whole grains and engaging in regular physical activity are associated with reduced weight gain in reproductive age women. Diet and physical activity contributing to excessive gestational weight gain are well documented. However, there is limited research assessing diet and physical activity components associated with weight gain during the preconception and postpartum period. This review highlights the need for further research to identify key dietary and physical activity components targeting the critical windows of reproductive life-stages in women to best guide interventions to prevent weight gain.
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Affiliation(s)
- Mamaru Ayenew Awoke
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia; (M.A.A.); (M.M.); (C.L.H.)
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia;
| | - Maureen Makama
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia; (M.A.A.); (M.M.); (C.L.H.)
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia; (M.A.A.); (M.M.); (C.L.H.)
| | - Thomas Philip Wycherley
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, SA 5001, Australia;
| | - Lisa J. Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia; (M.A.A.); (M.M.); (C.L.H.)
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Baena-García L, Acosta-Manzano P, Ocón-Hernández O, Borges-Cosic M, Romero-Gallardo L, Marín-Jiménez N, Aparicio VA. Objectively measured sedentary time and physical activity levels in Spanish pregnant women. Factors affecting the compliance with physical activity guidelines. Women Health 2020; 61:27-37. [PMID: 33143596 DOI: 10.1080/03630242.2020.1828231] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The aims of this cross-sectional study were to describe objectively measured sedentary time (ST) and physical activity (PA) levels in Spanish pregnant women, to analyze the degree of compliance with PA guidelines during the early second trimester of pregnancy and to explore sociodemographic and clinical factors associated with meeting these PA guidelines. One hundred and thirty-four Caucasian pregnant women were recruited between October 2015 and October 2017 to participate in this study. Triaxial accelerometers were used to analyze ST andPA levels for seven consecutive valid days. Womenspent512 ± 92.1 minutes daily in sedentary behaviors, and 85 ± 108.2 minutes in moderate-to-vigorous physical activity (MVPA) in bouts of at least 10 minutes. They walked on average 7436 ± 2410steps per day. Only 22% of the study sample complied with the PA guidelines. Having an University degree was related with threefold higher odds of compliance with the PA guidelines (95% confidence interval: 0.096-0.913, p < .05). Binary logistic regressions showed that being primiparous was associated with fivefold higher odds of compliance with the PA guidelines (95% confidence interval 1.658-18.039, respectively, p < .01). Maternal age, BMI, marital status, working status, and previous miscarriages were not associated with compliance with PA guidelines. Pregnant women spent more than a third of the day in sedentary behaviors and the compliance with PA guidelines was less than desirable. Finally, not having an university degree or having children could be factors related to lower odds of compliance with these guidelines, and therefore require special attention from healthcare professionals.
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Affiliation(s)
- Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada , Granada, Spain
| | - Pedro Acosta-Manzano
- Sport and Health Research Centre, University of Granada , Spain.,Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada, Spain
| | - Olga Ocón-Hernández
- UGC of Gynaecology and Obstetrics, San Cecilio-Campus University Hospital , Granada, Spain
| | - Milkana Borges-Cosic
- Sport and Health Research Centre, University of Granada , Spain.,Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada, Spain
| | - Lidia Romero-Gallardo
- Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada, Spain
| | - Nuria Marín-Jiménez
- Sport and Health Research Centre, University of Granada , Spain.,Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada, Spain
| | - V A Aparicio
- UGC of Gynaecology and Obstetrics, San Cecilio-Campus University Hospital , Granada, Spain.,Department of Physiology, Institute of Nutrition and Food Technology and Biomedical Research Centre, University of Granada , Granada, Spain
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4
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Amezcua-Prieto C, Naveiro-Fuentes M, Arco-Jiménez N, Olmedo-Requena R, Barrios-Rodríguez R, Vico-Zúñiga I, Manzanares Galán S, Mozas-Moreno J, Jiménez-Moleón JJ, Gallo-Vallejo JL. Walking in pregnancy and prevention of insomnia in third trimester using pedometers: study protocol of Walking_Preg project (WPP). A randomized controlled trial. BMC Pregnancy Childbirth 2020; 20:521. [PMID: 32912184 PMCID: PMC7481758 DOI: 10.1186/s12884-020-03225-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/01/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Previous studies in pregnancy have not focused in evaluating the effect of walking during pregnancy and prevention of insomnia. Our general objective is to determine the effect of a walking program in preventing the appearance of insomnia in the third trimester of pregnancy, increasing sleep quality and improving quality of life throughout pregnancy. METHODS Randomized Controlled trial in parallel in healthy sedentary pregnant women (n = 265), Walking_Preg Project (WPP), from university hospital in Granada, Spain. At 12th gestational week (GW), they will be invited to participate and randomly assigned to one of the three arms of study: the intervention group I1 (pedometer, goal of 11,000 steps/day), intervention group I2 (pedometer, no goal) and control (no pedometer). Duration of intervention: 13-32 GW. At 12th, 19th and 31st GW the average steps/day will be measured in groups I1 and I2. At 13th, 20th and 32nd GW, Athens Insomnia Scale (AIS), Pittsburgh Sleep Quality Index (PSQI), Adherence to Mediterranean Diet (AMD), physical activity (short IPAQ), quality of life (PSI), and consumption of toxic substances (caffeine, illegal drugs, alcohol and tobacco) will be collected. Student t test or Mann-Whitney U will be used to compare 19th and 31st GW mean of daily steps between I1 and I2 groups. To compare differences between groups in terms of frequency of insomnia/quality of life for each trimester of pregnancy, Pearson's Chi-square test or Fisher's exact test will be used. To determine differences in hours of sleep and quality of sleep throughout each trimester of pregnancy, analysis of variance or Friedman test will be used. McNemar-Bowker test will be used to assess differences in life quality in pre-post analyses in the 3 arms. We will use Stata 15 statistical software. DISCUSSION promoting walking in second half of pregnancy through use of pedometer and health pre-registration of a goal to be achieved -'10,000-11,000 steps a day'- should prevent appearance of insomnia in third trimester, will increase sleep quality and quality of life in pregnant women. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03735381 . Registered 8th November, 2018.
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Affiliation(s)
- C Amezcua-Prieto
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Tower A, 8th Floor, Room 06, 18016, Granada, Spain.
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), 28029, Madrid, Spain.
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain.
| | - M Naveiro-Fuentes
- Obstetrics and Gynecology Service, Virgen de las Nieves University Hospital, 8014, Granada, Spain
| | - N Arco-Jiménez
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Tower A, 8th Floor, Room 06, 18016, Granada, Spain
| | - R Olmedo-Requena
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Tower A, 8th Floor, Room 06, 18016, Granada, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), 28029, Madrid, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
| | - R Barrios-Rodríguez
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Tower A, 8th Floor, Room 06, 18016, Granada, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), 28029, Madrid, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
| | - I Vico-Zúñiga
- Obstetrics and Gynecology Service, Virgen de las Nieves University Hospital, 8014, Granada, Spain
| | - S Manzanares Galán
- Obstetrics and Gynecology Service, Virgen de las Nieves University Hospital, 8014, Granada, Spain
| | - J Mozas-Moreno
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
- Obstetrics and Gynecology Service, Virgen de las Nieves University Hospital, 8014, Granada, Spain
| | - J J Jiménez-Moleón
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, Tower A, 8th Floor, Room 06, 18016, Granada, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), 28029, Madrid, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
| | - J L Gallo-Vallejo
- Obstetrics and Gynecology Service, Virgen de las Nieves University Hospital, 8014, Granada, Spain
- Department of Obstetrics and Gynecology, University of Granada, 18016, Granada, Spain
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5
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Level of physical activity and associated factors during pregnancy among women who gave birth in Public Zonal Hospitals of Tigray. BMC Res Notes 2019; 12:454. [PMID: 31337444 PMCID: PMC6651980 DOI: 10.1186/s13104-019-4496-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 07/17/2019] [Indexed: 11/18/2022] Open
Abstract
Objectives Physical activity in the general population is considered too low, and this is true for pregnant women. Moderate physical activity during pregnancy have many benefits for the mother and the developing baby. This study was aimed to assess the level of physical activity during pregnancy and associated factors in public zonal hospitals of Tigray, Ethiopia. A hospital based cross-sectional study was used and 458 study participants was selected using multistage sampling technique. The data were collected using standardized pregnancy physical activity questionnaire. Result Out of 442 women who participated in this study, only 21.9% were physically inactive. Parity [AOR = 7.68; 95% CI (3.193, 18.459)], maternal occupation [AOR = .015; 95% CI (.003, .083)], history of miscarriage [AOR = 8.045; 95% CI (3.325, 19.465)], maternal age AOR = 4.67; 95% CI (1.431, 15.254)], were the variables that showed statistical association with level of physical activity during pregnancy. Level of physical activity during pregnancy was generally high. Thus, it would be optimal if health professionals can take a more active role in promoting physical activity during pregnancy. Electronic supplementary material The online version of this article (10.1186/s13104-019-4496-5) contains supplementary material, which is available to authorized users.
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6
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Sealy-Jefferson S, Misra DP. Neighborhood Tax Foreclosures, Educational Attainment, and Preterm Birth among Urban African American Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E904. [PMID: 30871154 PMCID: PMC6466185 DOI: 10.3390/ijerph16060904] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/01/2019] [Accepted: 03/09/2019] [Indexed: 12/03/2022]
Abstract
Ecological evidence suggests that neighborhoods with more tax foreclosures also have more adverse birth outcomes. However, whether neighborhood-level tax foreclosures impact individual-level risk for adverse birth outcomes is unknown. We assessed whether living in a neighborhood with high tax foreclosures is associated with a woman's preterm birth (PTB) risk and tested for effect modification by educational attainment, among urban African American women from the Life Influence on Fetal Environments Study (2009⁻2011; n = 686). We linked survey and medical record data to archival, block-group level tax foreclosure data from the county treasurer. We used Modified Poisson regression with robust error variance and included a foreclosure X education interaction in adjusted models. In the overall sample, neighborhood tax foreclosures did not predict PTB (adjusted relative risk: 0.93, CI: 0.74, 1.16), but the association was modified by educational attainment (interaction p = 0.01). Among women with lower education (n = 227), neighborhood tax foreclosures did not predict PTB risk. The association for women with higher education (n = 401) was statistically significant for a reduction in risk for PTB (adjusted relative risk: 0.74, CI: 0.55, 0.98) among those who lived in neighborhoods with high versus low tax foreclosures. Future studies should seek to identify the mechanisms of this association.
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Affiliation(s)
- Shawnita Sealy-Jefferson
- College of Public Health, Division of Epidemiology, The Ohio State University, Columbus, OH 43210, USA.
| | - Dawn P Misra
- Department of Family Medicine and Public Health Sciences, Wayne State University School of Medicine, Detroit, MI 48202, USA.
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Cohen AK, Kazi C, Headen I, Rehkopf DH, Hendrick CE, Patil D, Abrams B. Educational Attainment and Gestational Weight Gain among U.S. Mothers. Womens Health Issues 2016; 26:460-7. [PMID: 27372419 DOI: 10.1016/j.whi.2016.05.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 05/13/2016] [Accepted: 05/26/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Education is an important social determinant of many health outcomes, but the relationship between educational attainment and the amount of weight gained over the course of a woman's pregnancy (gestational weight gain [GWG]) has not been established clearly. METHODS We used data from 1979 through 2010 for women in the National Longitudinal Survey of Youth (1979) cohort (n = 6,344 pregnancies from 2,769 women). We used generalized estimating equations to estimate the association between educational attainment and GWG adequacy (as defined by 2009 Institute of Medicine guidelines), controlling for diverse social factors from across the life course (e.g., income, wealth, educational aspirations and expectations) and considering effect measure modification by race/ethnicity and prepregnancy overweight status. RESULTS In most cases, women with more education had increased odds of gaining a recommended amount of gestational weight, independent of educational aspirations and educational expectations and relatively robust to sensitivity analyses. This trend manifested itself in a few different ways. Those with less education had higher odds of inadequate GWG than those with more education. Among those who were not overweight before pregnancy, those with less education had higher odds of excessive GWG than college graduates. Among women who were White, those with less than a high school degree had higher odds of excessive GWG than those with more education. CONCLUSION The relationship between educational attainment and GWG is nuanced and nonlinear.
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Affiliation(s)
- Alison K Cohen
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, California.
| | - Chandni Kazi
- Department of Molecular and Cell Biology, College of Letters and Science, University of California Berkeley, Berkeley, California
| | - Irene Headen
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, California
| | - David H Rehkopf
- Division of General Medical Disciplines, School of Medicine, Stanford University, Stanford, California
| | - C Emily Hendrick
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas
| | - Divya Patil
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, California
| | - Barbara Abrams
- Division of Epidemiology, School of Public Health, University of California Berkeley, Berkeley, California; Division of Community Health and Human Development, School of Public Health, University of California Berkeley, Berkeley, California
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Abstract
Although the physiology of the heart and vascular system has not changed, there are many things we have learned and are still learning today. Research related to heart adaptations during pregnancy has been performed since the 1930s. Since the mid-1950s, researchers began to look at changes in the maternal cardiovascular system during exercise while pregnant. Research related to exercise during pregnancy and offspring heart development began and has continued since the 1970s. We will review the normal female cardiovascular system adaptations to pregnancy in general. Additionally, topics related to maternal cardiac adaptations to pregnancy during acute exercise, as well as the chronic conditioning response from exercise training will be explored. Since physical activity during pregnancy influences fetal development, the fetal cardiac development will be discussed in regards to acute and chronic maternal exercise. Similarly, the influence of various types of maternal exercise on acute and chronic fetal heart responses will be described. Briefly, the topics related to how and if there is maternal-fetal synchrony will be explained. Lastly, the developmental changes of the fetal cardiovascular system that persist after birth will be explored. Overall, the article will discuss maternal cardiac physiology related to changes with normal pregnancy, and exercise during pregnancy, as well as fetal cardiac physiology related to changes with normal development, and exercise during pregnancy as well as developmental changes in offspring after birth.
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Affiliation(s)
- Linda May
- Assistant Professor, Foundational Sciences and Research, East Carolina University, Greenville, NC
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9
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Broberg L, Ersbøll AS, Backhausen MG, Damm P, Tabor A, Hegaard HK. Compliance with national recommendations for exercise during early pregnancy in a Danish cohort. BMC Pregnancy Childbirth 2015; 15:317. [PMID: 26614105 PMCID: PMC4661949 DOI: 10.1186/s12884-015-0756-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 11/20/2015] [Indexed: 11/28/2022] Open
Abstract
Background Exercise during pregnancy is associated with health benefits for both the mother and the fetus, and is therefore recommended in several national guidelines. Only few studies investigate whether these guideline recommendations are met. The aims of this study were 1. To assess the prevalence of pregnant women meeting the Danish recommendations for exercise during early pregnancy, 2. To identify pre-pregnancy factors associated with a lower probability for meeting the recommendations, and 3. To describe which types of exercise pregnant women prefer before and during pregnancy. Methods We conducted a cross-sectional study based on a questionnaire during the first trimester among 7,915 women participating in the prospective Copenhagen Pregnancy Cohort. Associations were estimated by multivariate regression analyses. Results In early pregnancy, 38 % of the study population met the recommendation for exercise from the Danish Health and Medicines Authority (≥3.5 hours a week). Multiparity, previous miscarriage use of assisted reproductive technology, no engagement in exercise before pregnancy, smoking, pregnancy following assisted reproductive technology, overweight, not understanding Danish language and a low educational level were all factors associated a lower probability for meeting the recommendations. The preferred types of exercise before and during pregnancy were bicycling, brisk walking, running and strength training. The proportion of women engaged in any type of exercise decreased in early pregnancy with the exception of swimming and aquatic exercise. Conclusions In this cohort, more than one-third met the Danish recommendation for exercise during early pregnancy. Exercise in pregnancy is still an issue to address because the most vulnerable groups of pregnant women do not exercise. This is a cause of concern because it may reflect social inequalities in health and highlights the need for a structural and systematic approach to preconception care and early antenatal counselling.
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Affiliation(s)
- Lotte Broberg
- Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. .,The Research Unit Women's and Children's Health, the Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
| | - Anne S Ersbøll
- Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. .,The Research Unit Women's and Children's Health, the Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
| | - Mette G Backhausen
- Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. .,The Research Unit Women's and Children's Health, the Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. .,Department of Gynaecology and Obstetrics, Roskilde University Hospital, Roskilde, Denmark.
| | - Peter Damm
- Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. .,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Ann Tabor
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,Centre for Fetal Medicine, Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
| | - Hanne K Hegaard
- Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark. .,The Research Unit Women's and Children's Health, the Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. .,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,Department of Health Sciences, Child, Family, and Reproductive Health, Faculty of Medicine, Lund University, Lund, Sweden.
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Domingues MR, Bassani DG, da Silva SG, Coll CDVN, da Silva BGC, Hallal PC. Physical activity during pregnancy and maternal-child health (PAMELA): study protocol for a randomized controlled trial. Trials 2015; 16:227. [PMID: 26003406 PMCID: PMC4446829 DOI: 10.1186/s13063-015-0749-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 05/07/2015] [Indexed: 12/16/2022] Open
Abstract
Background Preterm birth is associated with most cases of neonatal deaths and negative health outcomes, and hypertensive disorders. Hypertension is influenced by maternal behavior, such as physical activity. Physical activity is associated with better outcomes for mother and fetus, besides healthier weight gains during pregnancy. Few women are physically active during pregnancy and few clinical trials have been carried out with pregnant women. The aim of this paper is to describe the protocol of a controlled trial evaluating whether regular exercise during pregnancy may result in improved maternal-child health and neonatal outcomes. Methods/Design The PAMELA (Physical Activity for Mothers Enrolled in Longitudinal Analysis) trial is a randomized controlled trial nested in a birth cohort study. Eligible women belonging to the birth cohort will be invited (between the 16th and 20th week of gestation) to enroll in the trial. Baseline data (blood and urine samples, anthropometry and pulmonary function) will be collected at enrollment. The same assessments will be repeated eight and 16 weeks after baseline. After randomization, women will be allocated into either one of these groups: control, 426 women who will be advised to keep their usual daily activities; and intervention, 213 women who will engage in an exercise program, three sessions a week. At least 70 % attendance over 16 weeks will be required to be considered compliant to the intervention. Exercise protocol will include aerobics, strength and flexibility training. Maternal and child outcomes will be measured at the 36th week of gestation, at birth and at three, 12, 24 and 48 months postpartum. An intention-to-treat analysis will be performed. Discussion Few women are active during pregnancy and a vast majority decrease their activities or even quit exercising. We present a population-based regular exercise intervention focused on the prevention of hypertension, pre-eclampsia and preterm birth. Data on the underlying cohort will allow future analysis using different outcomes with low probability of recall bias or misclassification of exposure status. Results will potentially influence prenatal care counseling in regards to physical activity. Trial registration Clinicaltrials.gov identifier: NCT02148965, registered on 22 May 2014.
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Affiliation(s)
- Marlos Rodrigues Domingues
- Postgraduate Programme in Physical Education, Federal University of Pelotas, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil. .,GEEAF - Physical Activity Epidemiology Research Group, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil.
| | - Diego Garcia Bassani
- Centre for Global Child Health, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada. .,Department of Paediatrics, Faculty of Medicine, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
| | - Shana Ginar da Silva
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 96020220, Pelotas, Brazil.
| | - Carolina de Vargas Nunes Coll
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 96020220, Pelotas, Brazil.
| | | | - Pedro Curi Hallal
- Postgraduate Programme in Physical Education, Federal University of Pelotas, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil. .,GEEAF - Physical Activity Epidemiology Research Group, Rua Luís de Camões, 625, 96055630, Pelotas, Brazil. .,Postgraduate Programme in Epidemiology, Federal University of Pelotas, Rua Marechal Deodoro, 1160, 96020220, Pelotas, Brazil.
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Amezcua-Prieto C, Olmedo-Requena R, Jímenez-Mejías E, Hurtado-Sánchez F, Mozas-Moreno J, Lardelli-Claret P, Jiménez-Moleón JJ. Changes in leisure time physical activity during pregnancy compared to the prior year. Matern Child Health J 2013; 17:632-8. [PMID: 22569946 DOI: 10.1007/s10995-012-1038-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
To quantify changes in leisure time physical activity (LTPA) type, frequency, duration and intensity during the first half of pregnancy as compared with the year prior to pregnancy. A cross sectional study was conducted at the Maternal University Hospital in Granada, Spain. A total of 1,175 healthy pregnant women attending a scheduled visit during the 20-22nd gestational week were enrolled in the study. Information about socio-demographic, obstetric and life-style variables during the previous year and the first half of pregnancy were collected. LTPA was quantified by assigning metabolic equivalents to each activity according to frequency, intensity and duration. The prevalence of women who met the optimal physical activity recommendations before and during pregnancy was calculated, and the McNemar-Bowker symmetry test was used to assess changes in type, frequency, intensity and duration of activities between the two periods. Some sort of LTPA was performed before and during pregnancy by 68.6% of the pregnant women. Respectively, just 27.5% and 19.4% of women fulfilled LTPA recommendations prior to pregnancy and during pregnancy; 12.6% of the women meeting recommendations prior to pregnancy later did not meet those recommendations during gestation, and 4.5% showed the reverse trend. A light increase in walking as a LTPA, and a decrease in the rest of the LTPA type activities, were seen during pregnancy. Some 13.4% of women changed from moderate--the year before- to light LTPA- during pregnancy. Pregnancy involved a decrease in LTPA, not only regarding frequency, but also duration and intensity.
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Affiliation(s)
- Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, University of Granada, Avenida de Madrid, 11, 18071 Granada, Spain.
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