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Robert D. Catena, Nigel Campbell, Alexa L. Werner and Kendall M. Iverson

participants signed an informed consent prior to testing. Participants (Table  1 ) were tested at roughly 4-week intervals from 12 weeks of gestation to childbirth. Figure 1 —Flowchart illustrating the order of operations for this study. PCA indicates principal component analysis. Table 1 Participants

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Danielle Symons Downs, Krista S. Leonard, Jessica S. Beiler and Ian M. Paul

– 4 EX is safe and recommended for most pregnant women without obstetric or medical complications. For example, perinatal EX can reduce maternal risk for gestational diabetes, preeclampsia, excessive gestational weight gain (GWG) and fetal macrosomia, delivery complications, and future childhood

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Carina Bauer, Christine Graf, Anna M. Platschek, Heiko K. Strüder and Nina Ferrari

health risks for the mother and the growing child. It is known that maternal overweight/obesity during pregnancy is associated with a variety of comorbidities, for example, gestational diabetes and hypertensive diseases, including preeclampsia. 4 Furthermore, overweight and obese pregnant women are at

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Janelle M. Wagnild and Tessa M. Pollard

with a risk factor for gestational diabetes in the United Kingdom. Methods Study Sample Participants were pregnant women with a risk factor for gestational diabetes (eg, body mass index [BMI] ≥30 kg/m 2 , previous gestational diabetes, family history of diabetes) who were enrolled in a study examining

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Mira Kahn, Kim Robien and Loretta DiPietro

Background:

Preterm birth is a leading cause of infant death and the role of maternal physical activity on this risk remains unclear. This systematic review examined low, moderate and vigorous leisure-time physical activity (LTPA) during pregnancy and the outcome of preterm birth.

Methods:

Key words related to preterm birth and physical activity were used to search relevant databases (Medline, Cochrane, CINAHL, Sports Discuss and Scopus). Studies were excluded if they did not measure physical activity as an exposure in pregnant women, did not provide information on gestational age at delivery, and were not published in English. All study designs and sample sizes were considered.

Results:

The search generated 1472 studies. There were 27 studies included in this review of which 23 received high quality reporting scores. Eleven studies reported a lower risk of preterm birth for women who performed LTPA during pregnancy, while 14 studies reported null findings. Only 2 studies detected a significantly higher risk of preterm birth with LTPA during pregnancy.

Conclusion

This review of literature up to 2014 provides additional evidence to support the assertion that healthy pregnant women can engage in low, moderate, and even some vigorous levels of LTPA without risk for preterm birth.

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Katie Smith, L. Lanningham-Foster, Amy Welch and Christina Campbell

Background:

Innovative methods are warranted to optimize prenatal outcomes. This study’s objective was to determine if a web-based behavioral intervention (BI) can prevent excessive gestational weight gain (GWG) by increasing physical activity (PA).

Methods:

Participants were randomized to usual care (UC; n = 21) or BI (n = 24) between 10 to 14 weeks gestation. GWG, PA, and diet were assessed at baseline, mid-, and late pregnancy.

Results:

No differences in GWG or adherence to GWG recommendations presented between groups. Total UC MET-minutes significantly decreased from baseline to late-pregnancy (1,234 ± 372 MET-minutes, P = .013). Mid-pregnancy sustained PA was greater for BI than UC (20-minute PA bouts: 122 ± 106 vs. 46 ± 48 minutes/week, P = .005; 30-minute PA bouts: 74 ± 70 vs. 14 ± 24 minutes/week, P < .001), and greater for BI at mid-pregnancy compared with baseline (20-minute PA bouts: 61.3 ± 21.9; 30-minute PA bouts: 39.6 ± 14.8, both P < .05). BI energy intake at mid-pregnancy significantly increased from baseline (336 ± 127 kcals, P = .04) and was significantly greater than UC (2,503 ± 703 vs. 1,894 ± 594, P = .005).

Conclusions:

Sedentary pregnant women should increase PA but may need additional dietary counseling to prevent excessive GWG.

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Tamara R. Cohen, Hugues Plourde and Kristine G. Koski

Background:

The Pregnancy Physical Activity Questionnaire (PPAQ) assesses physical activity practices of pregnant women. The purpose of this study was to identify specific pregnancy practices that were associated with a healthy gestational weight gain (GWG).

Methods:

Associations between PPAQ scores, pedometer steps, energy intakes (EI), energy expenditures (EE), and rate of GWG were assessed for 61 pregnant women in their second or third trimester during a home visit. Principle component analyses (PCA) were used to cluster PPAQ questions into Factors associated with either rate or total GWG, physical activity (PA), EE, EI, and parity.

Results:

PCA identified 3 Factors: Factor 1 associated EE with parity and child care; Factor 2 clustered several structured exercise activities; and Factor 3 grouped walking, playing with pets, and shopping with pedometer steps. Only Factor 3 clustered steps with weekly rate of GWG. EI was not associated with PA or GWG.

Conclusions:

PCA analysis identified 15 of 32 PPAQ questions that were related to increased physical activity in pregnant women, but only walking and pedometer steps were associated with GWG. Our analysis supports daily walking as the preferred PA for achieving a healthy rate of GWG.

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Amy E. Montpetit, Hugues Plourde, Tamara R. Cohen and Kristine G. Koski

Background:

A “fit pregnancy” requires balancing energy expenditure with energy intake (EI) to achieve appropriate gestational weight gains (GWG), healthy infant birth weights (IBW), and minimal postpartum weight retention (PPWR). Our objective was to develop an integrated conceptual framework to assess the contribution of prepregnancy weight (PP-BMI), EI, and physical activity (PA) as determinants of GWG, IBW, and PPWR.

Methods:

Pregnant women (n = 59) were recruited from prenatal classes. Energy intake was estimated using 3 24-hr diet recalls and PA using a validated PA questionnaire and a pedometer. Telephone interviews at 6-weeks postpartum assessed self-reported GWG, IBW, and PPWR. Hierarchical multiple regression analyses were used to explore the potential predictors of GWG, IBW, and PPWR.

Results:

Prepregnancy BMI was associated with GWG, and EI was associated with IBW; each model captured only 6%–18% of the variability. In contrast, PPWR was predicted by PP-BMI, GWG, and EI, which together explained 61% of its variability, whereas GWG alone explained 51% of the variability in PPWR.

Conclusions:

Modeling the relationship using hierarchical models suggests that PP-BMI, prepartum PA, and EI differentially impact GWG, IBW, and PPWR.

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Roberta Bgeginski, Diogo A. DeSousa, Bruna M. Barroso, Janete Vettorazzi, Michelle F. Mottola, Felipe B. Schuch and José Geraldo L. Ramos

Background:

The Physical Activity Readiness Medical Examination (PARmed-X) for Pregnancy aims to facilitate the communication between the health care provider, the fitness professional and the pregnant woman. The purpose of the current study was to test the psychometric properties of the Brazilian Portuguese version of the PARmed-X for Pregnancy.

Methods:

Reliability and validity of psychometric properties of the Brazilian Portuguese version of the PARmed-X for Pregnancy were tested in 107 women recruited from the Hospital de Clínicas de Porto Alegre. Participants completed the first page of the instrument twice with a minimal interval of 1 week for test-retest reliability analysis. The absolute and relative contraindications to exercise on page 2 of the document were completed by the obstetrician.

Results:

Results indicated good evidence of construct validity. The isolated items in the PARmed-X document presented a large heterogeneity in kappa coefficients ranging from very low estimates to perfect estimates. The overall indication of prescription of physical activity, nonetheless, presented a good kappa coefficient of 0.749.

Conclusions:

The Brazilian Portuguese version of the PARmed-X for Pregnancy can be applied as a valid tool for medical screening by health care providers to help inform safe exercise prescription during pregnancy.

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Paul J. Collings, Diane Farrar, Joanna Gibson, Jane West, Sally E. Barber and John Wright

levels. Methods Born in Bradford (BiB) is a prospective birth cohort study of 12,453 women who were recruited at 26- to 28-weeks gestation and who delivered 13,818 live births between 2007 and 2010. Full study details are provided elsewhere. 14 In a pseudorandomly selected subgroup of BiB participants