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Danielle Symons Downs, Guy C. LeMasurier and Jennifer M. DiNallo

Background:

Research examining women’s pregnancy physical activity (PA) behaviors with objective measures is scant. Therefore, 2 studies were conducted to determine the feasibility of pregnant women wearing pedometers and to examine women’s self-reported and objectively measured PA behaviors.

Methods:

Participants were pregnant women (Study 1 N = 50, Study 2 N = 30) who completed the Leisure-Time Exercise Questionnaire (LTEQ) and wore a Yamax pedometer for 3 consecutive days during free living at 20- and 32-weeks gestation.

Results:

As predicted in Study 1, we found (a) 100% participant agreement in wearing the pedometer and (b) LTEQ min and pedometer-determined indices classified 67% to 86% of the participants as insufficiently active at 20-weeks gestation. In Study 2, as hypothesized, (a) mean steps/d, LTEQ total, strenuous, and mild min of PA were positively associated at 20- and 32-weeks gestation; (b) mean steps/d and LTEQ strenuous min significantly declined from 20- to 32-weeks gestation; and (c) more women were classified as sedentary and low active at 32-weeks (73%) compared with 20-weeks gestation (50%).

Conclusions:

These findings are consistent with previous epidemiological evidence documenting the decline in women’s PA behaviors across the trimesters. They also illustrate that pedometer-determined indices might be a useful tool facilitating PA adoption and maintenance during pregnancy.

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Yan Wang, Lea A. Cupul-Uicab, Walter J. Rogan, Merete Eggesbo, Gregory Travlos, Ralph Wilson and Matthew P. Longnecker

Background:

Pregnant women who are physically active have a lower risk of preeclampsia and gestational diabetes than women who are less active. One possible mechanism is a reduction in low-grade inflammation, as measured by plasma concentrations of C-reactive protein (CRP). The association between exercise and CRP in pregnant women, however, has not been adequately investigated.

Methods:

A total of 537 pregnant women, enrolled around the 17th week of gestation in the Norwegian Mother and Child Cohort Study in 2003 to 2004, were studied. Self-reported recreational exercise was recalled for both 3 months before pregnancy and early pregnancy. The total energy expenditure from recreational exercise (total recreational exercise, metabolic equivalent of task [MET]-hr/week) was estimated, and low-, moderate- and vigorous-intensity exercise was defined. Plasma CRP concentrations were measured during pregnancy.

Results:

In adjusted linear regression models, mean CRP concentration was 1.0% lower [95% CI = –1.9% to 0.2%] with each 1 MET-hr/week of total recreational exercise before pregnancy. In addition, vigorous-intensity exercise before pregnancy was more strongly related to a reduction in CRP levels than low- or moderate-intensity exercise. However, we observed no association between recreational exercise during pregnancy and plasma CRP levels.

Conclusion:

Recreational exercise before pregnancy, especially vigorous exercise, may reduce the risk of maternal inflammation during pregnancy.

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Danielle Symons Downs, Courtenay A. Devlin and Ryan E. Rhodes

Background:

Nearly 50% of U.S. women enter pregnancy as overweight or obese (OW/OB). There is a critical need to understand how to motivate OW/OB pregnant women for exercise behavior to improve their health and reduce adverse pregnancy outcomes.

Purpose:

To examine salient Theory of Planned Behavior belief predictors of normal weight (NW) and OW/OB pregnant women’s exercise behavior (EXB) across pregnancy.

Methods:

Pregnant women (N = 357) self-reported their exercise beliefs and behavior during each pregnancy trimester. Pearson correlations were used to examine exercise beliefs-behavior associations. Stepwise regressions were used to identify trimester (TRI) 1 and TRI 2 belief predictors of TRI 2 and TRI 3 EXB, respectively, for each weight status group. Belief endorsement was examined to identify critical beliefs.

Results:

TRI 1 EXB beliefs explained 58% of the total variance (22% NW, 36% OW/OB) in TRI 2 EXB. TRI 2 EXB beliefs explained 32% of the total variance (17% NW, 15% OW/OB) in TRI 3 EXB. Individual beliefs varied by weight status and trimester. Control beliefs emerged with the lowest endorsement; making them most critical to target for exercise interventions.

Conclusion:

Prenatal exercise interventions should be weight status specific and target salient beliefs/barriers unique to the pregnancy trimesters.

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Moise Muzigaba, Tracy L. Kolbe-Alexander and Fiona Wong

Background:

Facility-based and context-specific interventions to promote physical activity (PA) among pregnant women from economically underprivileged communities remain sparse and undocumented in South Africa. This study aimed to generate information about pregnant women’s views and experiences of PA during pregnancy, which will later be used to inform the development of a PA-based intervention targeting this group.

Methods:

Qualitative methods were used and framed on the Theory of Planned Behavior (TPB). Five focus group discussions were conducted at a Community Health Centre in Cape Town, each comprising a stratified random sample of between 8 and 6 pregnant women living in eight low socioeconomic status communities close to the facility. The participants included primi- and multigravida black and mixed racial ancestry women at different stages of pregnancy. Data were analyzed using a Framework approach.

Results:

PA was considered important for self and the baby for most participants. However, they reported a number of barriers for translating intentions into action including the lack of supportive environment, fear of hurting oneself and the growing baby, lack of time due to work and family responsibilities, and not knowing which and how much PA is safe to do. Some of the incentives to engage in PA included establishing community-based group exercise clubs, initiating antenatal PA education and PA sessions during antenatal visits.

Conclusion:

Based on our findings the need for an intervention to promote PA in pregnancy is evident. Such an intervention should, however, aim at addressing barriers reported in this study, particularly those related to the behavioral context.

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Vikram Nichani, Kim Dirks, Bruce Burns, Amy Bird, Susan Morton and Cameron Grant

Background:

Exposure to green space has been associated with increased physical activity. However, it is not clear whether this association is because active people preferentially live in greener areas. Relationships between exposure to green space and physical activity during pregnancy are not well defined. Our objective was to determine whether exposure to green space was associated with physical activity in pregnant women.

Methods:

The current study was completed within the Growing Up in New Zealand cohort study of 6772 pregnant women. The proportion of green space in each census area unit was determined and geocoded to residential address. The association between exposure to green space and physical activity was determined using logistic regression analyses after controlling for confounding variables.

Results:

Exposure to green space was not associated with participation in physical activity during first trimester and the remainder of pregnancy once preference for living in greener neighborhoods was taken into account.

Conclusions:

The lack of association between green space and physical activity found in this study does not necessarily mean that living in green space will not translate into better pregnancy health. Preference for living in greener neighborhoods should be considered when investigating relationships between green space and physical activity.

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Lisa Chasan-Taber, Marushka Silveira, Bess H. Marcus, Barry Braun, Edward Stanek and Glenn Markenson

Background:

Physical activity during pregnancy is associated with reduced risk of adverse maternal and fetal outcomes. However, the majority of pregnant women are inactive and interventions designed to increase exercise during pregnancy are sparse. We evaluated the feasibility and preliminary efficacy of an exercise intervention among a diverse sample of pregnant women.

Methods:

The B.A.B.Y. (Behaviors Affecting Baby and You) Study is conducted at a large tertiary care facility in Western Massachusetts. We randomized 110 prenatal care patients (60% Hispanic) to an individually tailored 12-week exercise intervention arm (n = 58) or to a health and wellness control arm (n = 52) at mean = 11.9 weeks gestation. Physical activity was assessed via the Pregnancy Physical Activity Questionnaire (PPAQ).

Results:

After the 12-week intervention, the exercise arm experienced a smaller decrease (−1.0 MET-hrs/wk) in total activity vs. the control arm (−10.0 MET-hrs/wk; P = .03), and a higher increase in sports/exercise (0.9 MET-hrs/wk) vs. the control arm (−0.01 MET-hrs/wk; P = .02). Intervention participants (95%) reported being satisfied with the amount of information received and 86% reported finding the study materials interesting and useful.

Conclusions:

Findings support the feasibility and preliminary efficacy of a tailored exercise intervention in increasing exercise in a diverse sample of pregnant women.

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Travis Anderson, Sandra J. Shultz, Nancy I. Williams, Ellen Casey, Zachary Kincaid, Jay L. Lieberman and Laurie Wideman

Evidence suggests menstrual cycle variation in the hormone relaxin may have an impact on ligament integrity and may be associated with risk of anterior cruciate ligament injury in physically active women. However, studies to date have only detected relaxin in a small number of participants, possibly due to inter-individual variability, frequency of sample collection, or analytical techniques. Therefore, the purpose of this study was to analyze serial serum samples in moderately active, eumenorrheic women to identify the proportion of women with detectable relaxin concentrations. Secondary analyses were conducted on two independent data sets. Data Set I (DSI; N = 66) participants provided samples for 6 days of menses and 8–10 days of the luteal phase. Data Set II (DSII; N = 15) participants provided samples every 2–3 days for a full menstrual cycle. Samples were analyzed via a relaxin-2 specific ELISA assay. Limit of detection (LOD) was calculated from the empirical assay data. LOD was calculated as 3.57 pg·ml−1. Relaxin concentrations exceeded the LOD in 90.91% (DSI) and 93.33% (DSII) of participants on at least 1 day of sampling. Actual peak values ranged from 0.0 pg·ml−1 to 118.0 pg·ml−1. Relaxin was detectable in a higher proportion of young women representing a broad range of physical activity levels when sampled more frequently. Future studies investigating relaxin should consider sampling on more than 1 day to accurately capture values among normal menstruating women.

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Eduardo L. Caputo, Paulo H. Ferreira, Manuela L. Ferreira, Andréa D. Bertoldi, Marlos R. Domingues, Debra Shirley and Marcelo C. Silva

decrease linearly throughout pregnancy until birth. 5 Low back pain (LBP) is one of the main causes of activity limitation during pregnancy, affecting more than 50% of pregnant women. 6 LBP during pregnancy significantly impacts women’s ability to perform simple tasks such as walking, bending, or daily

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Christopher P. Connolly, Deborah L. Feltz and James M. Pivarnik

Pregnant and postpartum women have reported a number of barriers that prevent them from being sufficiently physically active. Overcoming these barriers is critical to ensure the health benefits of physical activity to both mother and fetus. The primary focus of this review centers on the potential impact social support may have in overcoming each of the primary barriers to physical activity experienced during pregnancy and the postpartum period. A reasonable body of research exists regarding the relationships between social support and these barriers; however, few investigations have specifically attempted to mitigate the effects of these barriers via social support interventions. Within this review, the enabling influence of social support as it pertains to pregnant and postpartum women's physical activity is discussed. Recommendations are suggested for the application of social support in future research investigations involving physical activity during pregnancy and postpartum.

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Tanya Prewitt-White, Christopher P. Connolly, Yuri Feito, Alexandra Bladek, Sarah Forsythe, Logan Hamel and Mary Ryan McChesney

Pregnant women are recommended to engage in at least 150 minutes of moderate-intensity aerobic activity per week ( Physical Activity Guidelines Advisory Committee, 2008 ). An impressive array of health benefits during pregnancy and at childbirth supports this recommendation, including a reduced