Exercise in obese pregnant women: positive impacts and current perceptions Perspectives on weight gain and lifestyle practices during pregnancy among women with a history of macrosomia: a qualitative study in the Republic of Ireland Maternal age as risk factor of prematurity in Spain; Mediterranean area. Physical activity and psychological well-being in obese pregnant and postpartum women attending a weight-gain restriction programme. Developing a complex intervention for diet and activity behaviour change in obese pregnant women (the UPBEAT trial); assessment of behavioural change and process evaluation in a pilot randomised controlled trial Physical Activity During Pregnancy: Predictors of Change, Perceived Support and Barriers Among Women at Increased Risk of Gestational Diabetes Effects of an aquatic physical exercise program on glycemic control and perinatal outcomes of gestational diabetes: study protocol for a randomized controlled trial Healthy living in pregnancy: a cluster-randomized controlled trial to prevent excessive gestational weight gain - rationale and design of the GeliS study Rationale, design, and methodology for the optimizing outcomes in women with gestational diabetes mellitus and their infants study Physical activity during pregnancy and offspring cardiovascular risk factors: findings from a prospective cohort study Impact of compliance with different guidelines on physical activity during pregnancy and perceived barriers to leisure physical activity A Program of Exercise Throughout Pregnancy. Is it Safe to Mother and Newborn? Physical exercise during pregnancy and its influence in the type of birth. Strategies to Promote Physical Activity During Pregnancy
Overweight and obesity have significant implication s during pregnancy and childbirth . The objective of this review was to provide a comprehensive overview of the effect of physical activity on pregnancy outcomes , the change of  physical activity during pregnancy , and women ’s perception of being physically active during pregnancy , with a particular focus on women who are overweight or obese . Many studies have investigated the beneficial effect of exercise during pregnancy , including reduced risk of gestational diabetes , preeclampsia , and operative birth , in addition to improved cardiovascular function , overall fitness , psychological well-being , and mood stability . Benefits for the infant include reduced risks of prematurity and improved fetal growth , although there is more limited information about longer-term health benefits for both women and infants . The existing literature examining physical activity patterns during pregnancy has generally focused on women of all body mass index categories , consistently indicating a reduction in activity over the course of pregnancy . However , the available literature evaluating physical activity during pregnancy among women who are overweight or obese is more limited and contradictory . A number of studies identified barriers preventing women from being active during pregnancy , including pregnancy symptoms , lack of time , access to child care , and concerns about their safety and that of their unborn baby . Conversely , significant enablers included positive psychological feelings , family influence , and receiving advice from health professionals . Very few studies have provided insights about perceptions of being active during pregnancy in the overweight and obese population . There is a need for a detailed description of physical activity patterns during pregnancy in women who are overweight or obese , and more r and omized trials evaluating exercise interventions for women who are overweight or obese , with a focus on clinical outcomes Background Excessive  weight gain  during pregnancy is a major risk factor for macrosomia ( high birth weight delivery ) . This study aim ed to explore views about weight gain and lifestyle practice s during pregnancy among women with a history of macrosomia . Methods A qualitative descriptive study was conducted . Twenty-one second-time mothers whose first infant was macrosomic ( > 4 kg ) were recruited from a r and omised trial in a large maternity hospital in the Republic of Irel and .  Semi-structured interviews were conducted with participants at both 6 and 12 months after their second pregnancy . Inductive thematic analysis was used to identify distinct themes . Results The mothers believed in following their prenatal food cravings to meet their baby ’s needs , but this led some to eat excessively . Many of the women cut back heavily on physical activity during pregnancy due to perceived risks to the baby . Physical conditions and discomforts during pregnancy often limited maternal control over weight and lifestyle practice s. The women were not particularly concerned about weight gain during pregnancy and most did not favour the notion of introducing weight gain guidelines into routine antenatal care . Common differences perceived by the women between their first and second pregnancy included : increased concern about weight gain in their second pregnancy due to prior difficulties with postpartum weight loss and increased time dem and s in their second pregnancy impeded healthy lifestyle practice s. Most women did not alter their perspectives on weight gain and lifestyle practice s in their second pregnancy in response to having a macrosomic infant in their first pregnancy . Conclusions This analysis exposed numerous barriers to healthy pregnancy weight gain . The findings suggest that women may need to be advised to follow their prenatal food cravings in moderation . Pregnant women with children already may benefit from education on time-efficient methods of integrating healthy eating practice s and physical activity into their lifestyles . Women with a history of macrosomia may need information about the importance of avoiding high weight gain in subsequent pregnancies BACKGROUND Maternal age is a preponderant variable in the epidemiological analysis of the premature birth . Studies show that in the extreme ages of the maternal life there is a risk of premature birth that generates a high rate of neonatal morbidity . OBJECTIVES [ corrected ] Determine the effect on the extreme ages of women residents in the province of Alicante on the total of the premature births . METHOD An explanatory , retrospective case-control study was conducted during the period from January 1st , 2008 to December 31st , 2011 . The study was based on the revision of the newborn registers from the Neonatal Screening Center of the province of Alicante . All the preterm were included , this means between 22 & 36 complete weeks of pregnancy ( 5,295 out of 78,391 newborn which represents 6.75 % of prematurity ) , and a r and om sample of the deliveries with 37 weeks or more of pregnancy ( control group ) . The age of the mother was studied as independent variable and the prematurity as dependent variable . RESULTS Clearly shows an increased risk of prematurity among teenage mothers compared to the age group nearest to them , which is confirmed by a squared Chi test which gives a significantly different distribution ( p < 0,0001 ) and an OD for very preterm of 2,41 ( 1,51 - 3,24 ) and of preterm of 1,71 ( 1,32 - 2,19 ) . This probability is also higher among mothers over 40 years old with an OD of 1,86 ( 1,39 - 2,48 ) and 1,66 ( 1,44 - 1,91 ) for very preterm newborns and preterm newborns respectively . DISCUSSION The results clearly manifest that teenagers and older pregnant mothers are at higher prematurity and low birth weight risk , therefore imposes the need to trace educational interventions to minimize this problem from the results in this research OBJECTIVE the objective of the study was to compare the differences in psychological well-being and quality of life during pregnancy and post partum of obese physically active women and obese physically inactive women enroled in a weight gain restriction programme . We also wanted to explore whether physical activity influences weight change or health status during pregnancy . DESIGN a prospect i ve intervention study . SETTING antenatal care clinic . PARTICIPANTS a total of 74 obese pregnant women in a physically active group and 79 obese women in a physically inactive group . MEASUREMENTS the women kept diaries of their physical activity during pregnancy and answered the Beck Anxiety Inventory  , the Edinburgh Postnatal Depression Scale and Medical Study Short-Form Health Survey in gestational weeks 15 and 35 and 11 weeks post partum .  Physical activity  was measured in metabolic equivalents . FINDINGS the physically active women experienced fewer depressive symptoms and estimated an improved quality of life during their pregnancies as measured by physical functioning , bodily pain , social functioning , role limitations due to emotional problems and general mental health as compared with the physically inactive women . There were no differences between the groups in gestational weight gain or weight change from early pregnancy to post partum or in prevalence of complications . KEY CONCLUSIONS physical activity among obese pregnant women provides better psychological well-being and improved quality of life , but does not prevent weight change . IMPLICATION S FOR PRACTICE staff at Antenatal Care Clinics that face obese pregnant women , should encourage and emphasise the benefits of being physically active throughout pregnancy Background Complex interventions in obese pregnant women should be theoretically based , feasible and shown to demonstrate anticipated behavioural change prior to inception of large r and omised controlled trials ( RCTs ) . The aim was to determine if a ) a complex intervention in obese pregnant women leads to anticipated changes in diet and physical activity behaviours , and b ) to refine the intervention protocol through process evaluation of intervention fidelity . Methods We undertook a pilot RCT of a complex intervention in obese pregnant women , comparing routine antenatal care with an intervention to reduce dietary glycaemic load and saturated fat intake , and increase physical activity . Subjects included 183 obese pregnant women ( mean BMI 36.3 kg/m2).Diet was assessed by repeated triple pass 24-hour dietary recall and physical activity by accelerometry and question naire , at 16 + 0 to 18 + 6 and at 27 + 0 to 28 + 6 weeks ’ gestation in women in control and intervention arms . Attitudes to behaviour change and quality of life were assessed and a process evaluation undertaken . The full RCT protocol was undertaken to assess feasibility . Results Compared to women in the control arm , women in the intervention arm had a significant reduction in dietary glycaemic load ( 33 points , 95 % CI −47 to −20 ) , ( p < 0.001 ) and saturated fat intake ( −1.6 % energy , 95 % CI −2.8 to −0 . 3 ) at 28 weeks ’ gestation . Objective ly measured physical activity did not change . Physical discomfort and sustained barriers to physical activity were common at 28 weeks ’ gestation . Process evaluation identified barriers to recruitment , group attendance and compliance , leading to modification of intervention delivery . Conclusions This pilot trial of a complex intervention in obese pregnant women suggests greater potential for change in dietary intake than for change in physical activity , and through process evaluation illustrates the considerable advantage of performing an exploratory trial of a complex intervention in obese pregnant women before undertaking a large RCT .Trial registration Trial Registration Number : IS RCT The aim of this study was to examine the predictors of change in intensity-specific leisure-time physical activity ( LTPA ) during pregnancy , and the perceived support and barriers of LTPA in Finnish pregnant women at increased risk of gestational diabetes . The study population consisted of 399 pregnant women who participated in a r and omized controlled trial aim ing to prevent gestational diabetes . Evaluation of LTPA was based on a self-report at baseline , 26–28 , and 36–37 weeks ’ gestation . Data on predictors of change , perceived support and barriers were collected with question naires and from the maternity cards . Multinomial logistic regression was used to assess associations between the variables . The average weekly minutes of light-intensity LTPA were 179 at baseline , 161 at 26–28 weeks ’ gestation , and 179 at 36–37 weeks ’ gestation . The corresponding minutes of moderate-to-vigorous-intensity LTPA were 187 , 133 and 99 . At 26–28 weeks ’ gestation , the strongest predictors for light-intensity LTPA were meeting the PA recommendations prior to pregnancy , having polytechnic education and working part-time , while having a physically active spouse prior to pregnancy was the strongest predictor for moderate-to-vigorous-intensity LTPA . The people and /or factors that encouraged women to LTPA the most were the spouse , a child , other family members and weather , whereas tiredness , nausea , perceived health , work and lack of time restricted their LTPA the most . The strongest predictors for maintaining LTPA during pregnancy were pre-pregnancy LTPA , education , working part-time and a spouse ’s LTPA . Most common barriers were perceived health , work and lack of time Background Gestational diabetes mellitus ( GDM ) is increasing worldwide and has been associated with adverse perinatal outcomes and high risk for chronic disease both for the mother and for the child . Physical exercise is feasible for diabetic pregnant women and contributes to better glycemic control and to a decrease in adverse perinatal outcomes . However , there are no r and omized controlled trials ( RCT ) assessing the effects of aquatic physical exercise on GDM control and adverse maternal and fetal outcomes . Methods / Design An RCT will be conducted at Instituto de Medicina Integral Prof Fern and o Figueira ( IMIP ) , Brazil . A total of 72 pregnant women will be studied ; 36 gestational diabetics will undergo an aquatic physical exercise program in a thermal pool , 3 times per week over 2 months . The primary endpoint will be glucose level control and use of insulin ; secondary endpoints will be the following maternal and fetal outcomes : weight gain during pregnancy , blood pressure , pre-eclampsia diagnosis , intrauterus growth restriction , preterm birth , Cesarean section , macrosomia and maternal or neonatal intensive care admission . Endpoints between intervention and control group will analyzed by t test for unpaired data and χ2 test , and the level of significance will set at < 0.05 . Discussion The physical proprieties of water make aquatic exercises ideal for pregnant women . An aquatic physical exercise program developed for GDM women will be trialed in a thermal pool and under the supervision of physiotherapist to ensure compliance . It is expected that this study will provide evidence as to the effect of aquatic physical exercise on GDM control . Trial registration Clinical Trial.gov , NCT01940003 Background Recent studies suggest that excessive gestational weight gain ( GWG ) leads to adverse maternal and fetal outcomes including weight retention in the mother and an increased risk of childhood obesity in the offspring . The aim of the GeliS study is to examine the effect of a lifestyle intervention programme during pregnancy to avoid excessive GWG and , hence , to reduce pregnancy and obstetric complications as well as the risk of maternal and offspring obesity . Methods and design The GeliS study is a multicentre cluster-r and omized controlled trial . A total number of 2500 pregnant women ( singleton pregnancy ) with a pre-pregnancy BMI ≥ 18.5 kg/m2 and ≤ 40 kg/m2 will be recruited in practice s of gynaecologists and midwives in ten Bavarian regions . The intervention comprises three structured and individualised counselling sessions on a healthy diet , regular physical activity as well as weight monitoring during pregnancy and one session after delivery , respectively . The counselling sessions are attached to routine pre- and postnatal visits using st and ardised material s and procedures . In the control regions , general recommendations for a healthy lifestyle are given . An oral glucose tolerance test is offered to all participants .The primary outcome is the proportion of participants with excessive GWG . Secondary outcomes include pregnancy and obstetric complications such as frequency of gestational diabetes , preeclampsia and caesarean sections as well as weight retention in the mothers and BMI and other health variables in the offspring . A 5-year follow-up of both mothers and their infants is planned . Discussion The GeliS lifestyle intervention programme has been adapted to the existing routine health care system for pregnant women . If shown to be effective , it could be immediately implemented in routine care . Trial registration The study protocol is registered at the Clinical Trials.gov Protocol Registration System ( NCT01958307 ) Background Women who are diagnosed with gestational diabetes mellitus ( GDM ) are at increased risk for developing prediabetes and type 2 diabetes mellitus ( T2DM ) . To date , there have been few interdisciplinary interventions that target predominantly ethnic minority low-income women diagnosed with GDM . This paper describes the rationale , design and methodology of a 2-year , r and omized , controlled study being conducted in North Carolina . Methods / Design Using a two-group , repeated measures , experimental design , we will test a 14- week intensive intervention on the benefits of breastfeeding , underst and ing gestational diabetes and risk of progression to prediabetes and T2DM , nutrition and exercise education , coping skills training , physical activity ( Phase I ) , educational and motivational text messaging and 3 months of continued monthly contact ( Phase II ) . A total of 100 African American , non-Hispanic white , and bilingual Hispanic women between 22–36 weeks of pregnancy who are diagnosed with GDM and their infants will be r and omized to either the experimental group or the wait-listed control group . The first aim of the study is to determine the feasibility of the intervention . The second aim of study is to test the effects of the intervention on maternal outcomes from baseline ( 22–36 weeks pregnant ) to 10 months postpartum . Primary maternal outcomes will include fasting blood glucose and weight ( BMI ) from baseline to 10 months postpartum . Secondary maternal outcomes will include clinical , adiposity , health behaviors and self-efficacy outcomes from baseline to 10 months postpartum . The third aim of the study is to quantify the effects of the intervention on infant feeding and growth . Infant outcomes will include weight status and breastfeeding from birth through 10 months of age . Data analysis will include general linear mixed-effects models . Safety endpoints include adverse event reporting . Discussion Findings from this trial may lead to an effective intervention to assist women diagnosed with GDM to improve maternal glucose homeostasis and weight as well as stabilize infant growth trajectory , reducing the burden of metabolic disease across two generations . Trial registration Objectives The long-term consequences of  maternal physical activity during pregnancy for  offspring cardiovascular health are unknown . We examined the association of  maternal self-reported physical activity in pregnancy ( 18 weeks gestation ) with offspring cardiovascular risk factors at age 15 . Design Prospect i ve cohort study . Setting The Avon Longitudinal Study of Parents and Children ( ALSPAC ) . Participants 4665 maternal-offspring pairs ( based on a sample with multiple imputation to deal with missing data ) from the ALSPAC , a prospect i ve cohort based in the South West of Engl and with mothers recruited in pregnancy in 1991–1992 . Primary and secondary outcome measures Offspring cardiovascular risk factors at age 15 ; body mass index ( BMI ) , waist circumference , systolic blood pressure , diastolic blood pressure , glucose , insulin , low-density lipoprotein cholesterol , high-density lipoprotein cholesterol and triglycerides . Results Greater maternal physical activity  was associated with lower BMI , waist circumference , glucose and insulin in unadjusted analyses . The magnitude of associations was generally small with wide CIs , and most associations attenuated towards the null after adjusting for confounders . The strongest evidence of association after adjustment for confounders was for glucose , although the 95 % CI for this association includes the null ; a one SD greater physical activity during pregnancy was associated with a −0.013 mmol/L difference in offspring glucose levels ( equivalent to approximately one-third of a SD ; 95 % CI −0.027 to 0.001 mmol/L ) . Conclusions Our results suggest that maternal physical activity in pregnancy , measured at 18 weeks gestation , is unlikely to be an important determinant of later offspring cardiovascular health . There was some suggestion of association with offspring glucose , but given that all other associations ( including insulin ) were null after adjustment for confounders , this result should be interpreted with caution Abstract The aims of the this prospect i ve study were to analyse  physical activity ( PA )  engagement during the first and second trimesters , considering the different guidelines published on PA , to document the individual characteristics associated with the accomplishment of these guidelines and to examine pregnant women ’s perceived barriers to leisure PA , using a socioecological framework . A sample of 133 pregnant women in two stages – at 10–12 weeks ’ gestation ( T1 ) and 20–22 weeks ’ gestation ( T2 ) – were evaluated .  PA was assessed by accelerometry during the T1 and T2 evaluation stages . Socio-demographic characteristics , lifestyle factors and barriers to leisure PA  were assessed via question naire . A large proportion of women ( ranging from 32 % to 96 % ) did not reach the levels of PA recommended by the guidelines . There were no significant differences between T1 and T2 with regard to compliance with  PA recommendations . A decrease in PA levels from T1 to T2 was noted for all recommendations . No associations were found between participants ’ characteristics and adherence to the recommendations in T1 and T2 . No significant differences were found in barriers to leisure PA between T1 and T2 . The most commonly reported barriers to leisure PA  were intrapersonal , not health related . Our results indicate that there were no differences between trimesters regarding compliance of PA recommendations , and perceived barriers were similar in both trimesters Purpose . The aim of the present study was to examine the influence of a program of moderate physical exercise throughout pregnancy on maternal and fetal parameters . Design . The study design was a r and omized controlled trial . Setting . The study took place at the Hospital of Fuenlabrada in Madrid , Spain . Sample . Analyzed were 200 pregnant women ( 31.54 ± 3.86 years ) , all of whom had uncomplicated and singleton gestation . Of these subjects , 107 were allocated to the  exercise group  ( EG ) and 93 to the  control group ( CG ) . Intervention . Women from EG participated in a physical conditioning program throughout pregnancy , which included a total of 55- to 60-minute weekly sessions , 3 days per week . Measures . Pregnancy outcomes . Maternal : gestational age , weight gain , type of delivery , blood pressure during pregnancy , gestational diabetes ( n/% ) . Fetal : birth weight , birth size , head circumference , Apgar score , pH of umbilical cord . Analysis . Student 's unpaired t-test and χ2 test were used ; p values of ≤ .05 indicated statistical significance . Cohen 's d was used to determine the effect size . Results . There were significantly more pregnant women in the CG who gained excessive weight during their pregnancies than in the EG group ( CG : N = 31 , 35.6 % versus N = 22 , 21.2 % ; χ2 = 4.95 ; p = .02 ) . The effect size was small ( Phi value = .16 ) . Other pregnancy outcome showed no differences between groups . Conclusion . A regular and moderate physical exercise program throughout pregnancy is not a risk to maternal and fetal well-being , and it helps to control excessive weight gain OBJECTIVE To verify if medium intensity exercise performed during pregnancy can influence in the type of delivery , and to observe compliance to an exercise program among primiparous women with different levels of schooling . METHODS A study carried out at the Centro de Incentivo ao Aleitamento Materno , in São Sebastiao ( SP ) , between April 7 , 2008 , and April 14 , 2009 . A prospect i ve study involving 66 primiparous women who were divided into two groups :  an Exercise Group , engaged in regular physical activity during pregnancy , and the Control Group , that did not participate in regular physical activity during the same period . Significance level in this project was 5 % ( p = 0.05 ) . RESULTS The group that did engage in regular exercise had a higher rate of vaginal deliveries , with a statistically significance difference evaluated by the χ² test ( p = 0.031 ) . The pregnant women with the highest level of schooling showed greater compliance with the exercise program , with a statistically significant difference ( p = 0.01736 ) . CONCLUSION Physical exercise in primiparous women  increased the chances of vaginal deliveries , and there was greater compliance with the exercise program among those with a higher level of schooling when compared to those with a basic education Physical activity during pregnancy has been associated with significant health benefits ; however , most women in the United States do not meet the current guidelines . This systematic review evaluates evidence for interventions to improve physical activity during pregnancy in order to identify best practice s and inform future research . Electronic data bases ( PubMed , CINAHL , SportD ISCUS , Embase , ERIC , Psych Info , and ISI Web of Science ) were search ed in July 2011 for peer- review ed journal articles . Studies were included if they were English- language r and omized control trials that measured the efficacy of an intervention targeted at pregnant women and were design ed to change physical activity as a primary or secondary outcome . Out of 777 studies identified through the systematic search , 9 interventions were selected for inclusion by multiple review ers . Data were abstract ed using an abstract ion form modeled after the “ Guide to Community Preventive Services . ” Of the 9 interventions included in the review , 3 reported statistically significant positive results for physical activity . Although the interventions included a variety of strategies and techniques , none were uniquely associated with positive outcomes . Overall , this review suggests that little is known about the efficacy of interventions for physical activity during pregnancy . This study provides several recommendations for future research and intervention design
INTRODUCTION Regular physical activity is known to be very beneficial to health .
While it is important at all stages of life , during pregnancy doubts may arise about the suitability of physical exercise , as well as the type of activity , its frequency , intensity and duration .
AIMS To analyse major studies on the influence of physical activity on maternal and foetal parameters .