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A pinboard by
Brian Helsel

I am a health researcher working on my PhD in Applied Health Research and Evaluation.

PINBOARD SUMMARY

Regular exercise during your pregnancy can improve the health of you and your baby.

Active Mom, Healthy Baby

Physical Activity Recommendations

The American College of Obstetricians and Gynecologists (ACOG) recommends that women participate in 30 minutes or more of moderate intensity exercise on most, if not all, days of the week if there are no medical complications. Most physical activity is safe, but activities that have a risk of impact or falling should be avoided.

What does research show?

By participating in regular physical activity, studies show that mothers are at lower risk of preterm births (defined as less than 37 weeks) and having babies that have a low birth weight (defined as less than 2,500 grams or approximately 5.5 pounds). In addition to infant health, maternal health can also be improved through physical activity. Regular physical activity has been shown to decrease depressive symptoms in the prenatal and postpartum period. It helps reduce stress, which could also contribute to having a low birth weight or preterm birth.

What types of physical activity should I be doing?

Types of physical activity that should be considered include both aerobic conditioning (ex: running, riding a bike, swimming) and resistance training (ex: lifting weights). Inactivity should also be considered when using physical exercise to improve maternal and infant health. Sedentary time takes away many of the benefits of physical activity.

Turn inactivity into activity

Time spent commuting, working at a desk, and participating in sedentary activities like watching television should be limited during the pregnancy, unless otherwise specified by your doctor. These sedentary activities can be turned into physical activities by actively commuting to work (ex: walking or riding a bike, if possible), parking in the back of the parking lot to increase walking time, taking frequent standing breaks throughout the work day, and visiting a park or doing an outdoor activity with friends.

An overview of this pinboard

This pinboard takes a look at the research surrounding the benefits of physical activity and the role of physical activity in improving pregnancy outcomes.

9 ITEMS PINNED

Physical Activity Patterns and Factors Related to Exercise during Pregnancy: A Cross Sectional Study.

Abstract: To assess the physical activity levels of pregnant women and to examine the characteristics associated with the practice of exercise and the activities of daily living during pregnancy.For this cross-sectional study, 1,279 women were recruited within 72 hours postpartum. They were interviewed about their socio-demographic data and obstetric history and were administered self-report questionnaires about exercise and daily physical activities during pregnancy. Data on the current pregnancy, labor, delivery, and newborn outcomes were collected from participants' medical records. To analyze factors related to the practice of exercise, we used the student t-test, X², and odds ratio (OR), with a corresponding 95% confident interval (CI), followed by a multiple logistic regression. The significance level was 5%.Compared to the pre-pregnancy period, the prevalence of physical activity among participants was lower throughout pregnancy (20.1%) (p = 0.01). Half of the women interrupted practicing physical exercise due to pregnancy. The lowest prevalence of exercise was observed in the first (13.6%) and third trimesters (13.4%). Less than half of women received exercise guidance during prenatal care meetings (47.4%). Walking was the most commonly reported exercise, followed by water aerobics. Factors positively associated with exercise practice were higher educational level (OR= 1.82; CI 95% 1.28-2.60), primiparity (OR=1.49; CI 95% 1.07-2.07), exercising before pregnancy (OR= 6.45; CI 95% 4.64-8.96), and exercise guidance during prenatal care (OR=2.54; CI 95% 1.80-3.57). Mildly intense exercise and domestic activities were most frequently reported among pregnant women. There were no differences in maternal and perinatal outcomes between active and sedentary pregnant women.The findings indicate that promoting physical activity remains a priority in public health policy, and women of childbearing age, especially those planning a pregnancy, should be encouraged to adopt an exercise routine or maintain an active lifestyle during pregnancy in order to avoid sedentary- and obesity-associated risks.

Pub.: 18 Jun '15, Pinned: 21 Apr '17

Maternal obesity and physical activity and exercise levels as pregnancy advances: an observational study.

Abstract: Increases in clinical complications associated with maternal obesity have generated interest in increasing physical activity (PA) and exercise levels as an intervention to improve pregnancy outcomes.The objective of this study was to examine the relationship between BMI categorisation and PA and exercise levels as pregnancy advances.This was an observational study in a large university maternity hospital. Women were recruited at their convenience before they left hospital after delivering a baby weighing 500 g or more. They completed a detailed customised physical activity and exercise questionnaire. BMI categorisation was based on the measurement of weight and height in early pregnancy.Of the 155 women recruited, 42.5 % (n = 66) were primigravidas and 10.3 % (n = 16) were smokers. Mean Body Mass Index (BMI) was 24.6 kg/m(2) and 14.2 % (n = 22) were obese, based on a BMI >29.9 kg/m(2). Overall, women decreased their exercise from an average 194 min (range 0-650 min) per week pre-pregnancy to 98 min antenatally (range 0-420 min) (p < 0.0001). Obese women exercised least pre-pregnancy and antenatally at 187.5 and 75 min per week, respectively, compared with 193.2 and 95.5 min per week in the normal BMI group and 239.3 and 106.7 min per week in the overweight group. The mean gestation at which all women reduced their activity levels was 29 weeks.We found that women decreased their PA  and exercise levels significantly in the third trimester and, thus, in the absence of a medical contra-indication there is considerable scope for an exercise intervention to improve activity  and exercise levels as pregnancy advances. However, an increase in PA levels in obese women needs further studies to determine whether it will improve the clinical outcomes for the woman and her offspring.

Pub.: 30 Jul '15, Pinned: 21 Apr '17

Exercise during pregnancy in normal-weight women and risk of preterm birth: a systematic review and meta-analysis of randomized controlled trials.

Abstract: Preterm birth (PTB) is the major cause of perinatal mortality in the United States. In the past, pregnant women have been recommended against exercise because of presumed risks of PTB. Physical activity has been theoretically related to PTB as it increases the release catecholamines, especially norepinephrine, which might stimulate myometrial activity. Conversely, exercise may reduce the risk of PTB by other mechanisms such as decreased oxidative stress or improved placenta vascularization. Therefore, the safety of exercise regarding PTB and its effects on gestational age at delivery remain controversial.To evaluate the effects of exercise during pregnancy on the risk of PTB.MEDLINE, EMBASE, Web of Sciences, Scopus, ClinicalTrial.gov, OVID and Cochrane Library were searched from the inception of each database to April 2016.Selection criteria included only randomized clinical trials (RCTs) of pregnant women randomized before 23 weeks to an aerobic exercise regimen or not. Types of participants included women mainly of normal weight with uncomplicated, singleton pregnancies without any obstetric contraindication to physical activity. The summary measures were reported as relative risk (RR) or as mean difference (MD) with 95% confidence intervals (CI). The primary outcome was the incidence of PTB <37weeks.Of the 2,059 women included in the meta-analysis, 1,022 (49.6%) were randomized to the exercise group and 1,037 (50.4%) to the control group. Aerobic exercise lasted about 35-90 minutes 3-4 times per week. Women who were randomized to aerobic exercise had a similar incidence of PTB<37 weeks (4.5% vs 4.4%; RR 1.01, 95% CI 0.68-1.50) and a similar mean gestational age at delivery (MD 0.05 week, 95% CI - 0.07 to 0.17) compared to controls. Women in the exercise group had a significantly higher incidence of vaginal delivery (73.6% vs 67.5%; RR 1.09, 95% CI 1.04-1.15) and significantly lower incidence of cesarean delivery (17.9% vs 22%; RR 0.82, 95% CI 0.69-0.97) compared to controls. The incidence of operative vaginal delivery (12.9% vs 16.5%; RR 0.78, 95% CI 0.61-1.01) was similar in both groups. Women in the exercise group had a significantly lower incidence of gestational diabetes mellitus (2.4% vs 5.9%; RR 0.41, 95% CI 0.24-0.68) and significantly lower incidence of hypertensive disorders (1.9% vs 5.1%; RR 0.36, 95% CI 0.19-0.69) compared to controls. No differences in low birth weight (5.2% vs 4.7%; RR 1.11, 95% CI 0.72-1.73) and mean birth weight (MD -10.46 grams, 95% CI -47.10 to 26.21) between exercise group and controls were found.Aerobic exercise for 35-90 minutes 3-4 times per week during pregnancy can be safely performed by normal-weight women with singleton, uncomplicated gestations, as this is not associated with an increased risk of PTB or with a reduction in mean gestational age at delivery. Exercise was associated with a significantly higher incidence of vaginal delivery and a significantly lower incidence of cesarean delivery, with a significantly lower incidence of gestational diabetes mellitus and hypertensive disorders, and therefore should be encouraged.

Pub.: 21 Jun '16, Pinned: 21 Apr '17

Effects of weekly-supervised exercise or physical activity counseling on fasting blood glucose in women diagnosed with gestational diabetes mellitus: a systematic review and meta-analysis of randomized trials.

Abstract: Exercise is an important part of gestational diabetes mellitus (GDM) lifestyle management. However, there is no meta-analysis analyzing the effects of exercise programs on fasting blood glucose (FBG) in women with GDM. A systematic review with meta-analysis was performed to evaluate the effect of weekly-supervised exercise (EXE group) or physical activity counseling (PA group) in women with GDM compared to usual prenatal (UPN group) on glycemic control.Eligible trials were identified from MEDLINE, EMBASE, Web of Science, Scopus and SportDiscus up to 11 December 2016. Data were retrieved from randomized controlled trials comparing UPN with UPN plus weekly-supervised (at least once a week) prenatal exercise or PA counseling for which FBG values pre and post intervention were available. Random-effects meta-analysis was performed for mean difference in FBG post exercise intervention.Our search yielded 781 publications of which 82 were assessed for eligibility, and eight were included in the meta-analysis. The overall effect on absolute FBG concentrations was not significant (P=0.11) compared to UPN. However, PA vs. UPN showed a significant reduction in the absolute FBG concentrations (WMD -3.88 mg/dL, 95% CI-7.33 to -0.42; I(2) , 48%; P for heterogeneity < 0.15).PA counseling in women with GDM showed a significant effect compared to UPN on FBG concentrations, possibly due to longer follow-up time compared to the EXE groups. This result highlights the importance of an early intervention that lasts to delivery for best practice of GDM management.

Pub.: 30 Dec '16, Pinned: 21 Apr '17

Exercise during pregnancy and risk of preterm birth in overweight and obese women: a systematic review and meta-analysis of randomized controlled trials.

Abstract: The incidence of overweight and obesity in pregnancy has risen significantly in the last decades. Overweight and obesity have been shown to increase the risk for some adverse obstetric outcome. Lifestyle interventions, such as diet, physical activity and behavior changes, may reduce these risks promoting weight loss and/or preventing excessive weight gain. The possible impact of exercise on the risk of preterm birth (PTB) in overweight or obese women is controversial. Therefore, the aim of our study was to evaluate the effect of exercise on the risk of PTB in overweight or obese pregnant women.MEDLINE, EMBASE, Web of Sciences, Scopus, ClinicalTrial. gov, OVID and Cochrane Library were searched from their inception to November 2016. This meta-analysis included only randomized controlled trials (RCTs) of pregnant women assigned before 25 weeks to an aerobic exercise regimen or not. Types of participants included overweight or obese (mean body mass index ≥25 kg/m(2) ) women with singleton pregnancies without any contraindication to physical activity. The summary measures were reported as relative risk (RR) or as mean difference (MD) with 95% confidence intervals (CI). The primary outcome was the incidence of PTB <37weeks.Nine trials, including 1,502 overweight or obese singleton gestations, were analyzed. Overweight and obese women who were randomized in early pregnancy to aerobic exercise for about 30-60 minutes 3-7 times per week had a lower percentage of PTB <37weeks (RR 0.62, 95% CI 0.41 to 0.95) compared to controls. The incidence of gestational age at delivery (MD 0.09 week, 95% CI -0.18 to 0.24) and cesarean delivery (RR 0.93, 95% CI 0.77 to 1.10) were similar in both groups. Women in the exercise group had a lower incidence of gestational diabetes mellitus (RR 0.61, 95% CI 0.41-0.90) compared to controls. No differences in birth weight (MD 16.91 grams, 95% CI -89.33 to 123.19), low birth weight (RR 0.58, 95% CI 0.25 to 1.34), macrosomia (RR 0.92, 95% CI 0.72 to 1.18) and stillbirth (RR 2.13, 95% CI 0.22 to 20.4) between exercise group and controls were found.Overweight and obese women with singleton pregnancy can be counseled that, compared to being more sedentary, aerobic exercise for about 30-60 minutes 3-7 times per week during pregnancy is associated with a reduction in the incidence of PTB. Aerobic exercise in overweight and obese pregnant women is also associated with a significant prevention of gestational diabetes mellitus, and should be therefore encouraged. This article is protected by copyright. All rights reserved.

Pub.: 29 Dec '16, Pinned: 21 Apr '17

Physical activity and the risk of preterm birth: a systematic review and meta-analysis of epidemiological studies.

Abstract: Physical activity has been inconsistently associated with risk of preterm birth, and the strength of the association and the shape of the dose-response relationship needs clarification.To conduct a systematic review and dose-response meta-analysis to clarify the association between physical activity and risk of preterm birth.PubMed, Embase and Ovid databases were searched for relevant studies up to February 9(th) 2017.Studies with a prospective cohort, case-cohort, nested case-control, or randomized study design were included.Data were extracted by one reviewer and checked for accuracy by a second reviewer. Summary relative risks (RRs) were estimated using a random effects model.Fourty one studies (43 publications) including twenty randomized trials, and 21 cohort studies were included. The summary RR for high vs. low activity was 0.87 (95% CI: 0.70-1.06, I(2) =17%, n=5) for physical activity before pregnancy, and it was 0.86 (95% CI: 0.78-0.95, I(2) =0%, n=30) for early pregnancy physical activity. The summary RR for a 3 hour per week increment in leisure-time activity was 0.90 (95% CI: 0.85-0.95, I(2) =0%, n=5). There was evidence of a nonlinear association between physical activity and preterm birth, pnonlinearity <0.0001, with the lowest risk observed at 2-4 hours per week of activity.This meta-analysis suggests that higher leisure-time activity is associated with reduced risk of preterm birth. Further randomized controlled trials with sufficient frequency and duration of activity to reduce the risk and with larger sample sizes are needed to conclusively demonstrate an association. This article is protected by copyright. All rights reserved.

Pub.: 05 Apr '17, Pinned: 21 Apr '17