Change in level of physical activity during pregnancy in obese women: findings from the UPBEAT pilot trial

BMC Pregnancy and Childbirth

Ruth Bell⁵  Stephen C Robson¹  Lucilla Poston⁴  Tarja I Kinnunen²  Catherine Mcparlin³  Louise Hayes⁵ 

[1] Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK;School of Health Sciences, University of Tampere, Tampere, Finland;Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK;Division of Women’s Health, Women’s Health Academic Centre, King’s College, London, UK;Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX, UK

关键词: Socio-demographic factors;    MVPA;    Accelerometer;    Maternal obesity;   

Others  :  1136960
DOI  :  10.1186/s12884-015-0479-2

 received in 2014-10-29, accepted in 2015-02-12,  发布年份 2015

【 摘 要 】

Background

Maternal obesity is associated with an increased risk of pregnancy complications, including gestational diabetes. Physical activity (PA) might improve glucose metabolism and reduce the incidence of gestational diabetes. The purpose of this study was to explore patterns of PA and factors associated with change in PA in obese pregnant women.

Methods

PA was assessed objectively by accelerometer at 16 – 18 weeks’ (T0), 27 – 28 weeks’ (T1) and 35 – 36 weeks’ gestation (T2) in 183 obese pregnant women recruited to a pilot randomised trial of a combined diet and PA intervention (the UPBEAT study).

Results

Valid PA data were available for 140 (77%), 76 (42%) and 54 (30%) women at T0, T1 and T2 respectively. Moderate and vigorous physical activity as a proportion of accelerometer wear time declined with gestation from a median of 4.8% at T0 to 3% at T2 (p < 0.05). Total activity as a proportion of accelerometer wear time did not change. Being more active in early pregnancy was associated with a higher level of PA later in pregnancy. The intervention had no effect on PA.

Conclusions

PA in early pregnancy was the factor most strongly associated with PA at later gestations. Women should be encouraged to participate in PA before becoming pregnant and to maintain their activity levels during pregnancy. There is a need for effective interventions, tailored to the needs of individuals and delivered early in pregnancy to support obese women to be sufficiently active during pregnancy.

Trial registration

Current Controlled Trials ISRCTN89971375 webcite (Registered 28/11/2008).

【 授权许可】

   
2015 Hayes et al.; licensee BioMed Central.

【 参考文献 】

• [1]American Diabetes Association: Diagnosis and Classification of Diabetes Mellitus Diabetes Care 2010, 33(Suppl 1):S62-9.
• [2]Chu SY, Kim SY, Lau J, Schmid CH, Dietz PM, Callaghan WM, et al.: Maternal obesity and risk of gestational diabetes mellitus. Diabetes Care 2007, 30(8):2070-6.
• [3]Tobias DK, Zhang C, van Dam RM, Bowers K, Hu FB: Physical activity before and during pregnancy and risk of gestational diabetes mellitus: a meta-analysis. Diabetes Care 2011, 34(1):223-9.
• [4]ACOG: Exercise during pregnancy and the postpartum period Clin Obstet Gynecol 2003, 46(2):469-99.
• [5]Royal College of Obstetricians and Gynaecologists: Exercise in pregnancy. Statement No.4. Royal College of Obstetricians and Gynaecologists, London; 2006.
• [6]Downs DS, LeMasurier GC, DiNallo JM: Baby steps: pedometer-determined and self-reported leisure-time exercise behaviors of pregnant women. J Phys Act Health 2009, 6(1):63-72.
• [7]Evenson KR, Wen F: Prevalence and correlates of objectively measured physical activity and sedentary behavior among US pregnant women. Prev Med 2011, 53(1–2):39-43.
• [8]Rousham EK, Clarke PE, Gross H: Significant changes in physical activity among pregnant women in the UK as assessed by accelerometry and self-reported activity. Eur J Clin Nutr 2006, 60(3):393-400.
• [9]McParlin C, Robson SC, Tennant PWG, Besson H, Rankin J, Adamson AJ, et al.: Objectively measured physical activity during pregnancy: a study in obese and overweight women. BMC Pregnancy Childbirth 2010, 10:76.
• [10]Renault K, Nørgaard K, Andreasen KR, Secher NJ, Nilas L: Physical activity during pregnancy in obese and normal-weight women as assessed by pedometer. Acta Obstet Gynecol Scand 2010, 89(7):956-61.
• [11]Sui Z, Dodd JM: Exercise in obese pregnant women: positive impacts and current perceptions. Int J Womens Health 2013, 5:389-98.
• [12]Dodd JM, Crowther CA, Robinson JS: Dietary and lifestyle interventions to limit weight gain during pregnancy for obese or overweight women: a systematic review. Acta Obstet Gynecol Scand 2008, 87(7):702-6.
• [13]Choi J, Fukuoka Y, Lee JH: The effects of physical activity and physical activity plus diet interventions on bodyweight in overweight or obese women who are pregnant or in postpartum: A systematic review and meta-analysis of randomized controlled trials. Preventive Medicine 2013, 56(6):351-64.
• [14]Poston L, Briley AL, Barr S, Bell R, Croker H, Coxon K, et al.: Developing a complex intervention in obese pregnant women; assessment of behavioural change and process evaluation through a randomised controlled exploratory trial. BMC Pregnancy Childbirth 2013, 13(1):148. BioMed Central Full Text
• [15]Harrison CL, Thompson RG, Teede HJ, Lombard CB: Measuring physical activity during pregnancy. Int J Behav Nutr Phys Act 2011, 8:19. BioMed Central Full Text
• [16]Oostdam N, van Poppel MN, Wouters MG, Eekhoff EM, Bekedam DJ, Kuchenbecker WKH, et al.: No effect of the FitFor2 exercise programme on blood glucose, insulin sensitivity, and birthweight in pregnant women who were overweight and at risk for gestational diabetes: results of a randomised controlled trial. Br J Obstet Gynaecol 2012, 119:1098-107.
• [17]ActiLife5.Ink [computer program]. Version 5.10.0;2010-2011. Available from http://www.actigraphcorp.com/support/software/
• [18]Freedson PS, Melanson E, Sirard J: Calibration of the computer science and applications, inc. accelerometer. Med Sci Sports Exerc 1998, 30:777-81.
• [19]Gradmark A, Pomeroy J, Renstrom F, Steiginga S, Persson M, Wright A, et al.: Physical activity, sedentary behaviors, and estimated insulin sensitivity and secretion in pregnant and non-pregnant women. BMC Pregnancy Childbirth 2011, 11:44. BioMed Central Full Text
• [20]Renault KM, Norgaard K, Nilas L, Carlsen EM, Cortes D, Pryds O, et al.: The Treatment of Obese Pregnant Women (TOP) study: a randomized controlled trial of the effect of physical activity intervention assessed by pedometer with or without dietary intervention in obese pregnant women. Am J Obstet Gynecol 2014, 210(2):134. e131-139
• [21]Dodd JM, McPhee AJ, Turnbull D, Yelland LN, Deussen AR, Grivell RM, et al.: The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on neonatal health outcomes: the LIMIT randomised trial. BMC Med 2014, 12:163. BioMed Central Full Text
• [22]Troiano RP: Translating accelerometer counts into energy expenditure: advancing the quest. J Appl Physiol 2006, 100(4):1107-8.
• [23]Ning Y, Williams MA, Dempsey JC, Sorensen TK, Frederick IO, Luthy DA: Correlates of recreational physical activity in early pregnancy. J Matern Fetal Neonatal Med 2003, 13(6):385-93.
• [24]Pereira MA, Rifas-Shiman SL, Kleinman KP, Rich-Edwards JW, Peterson KE, Gillman MW: Predictors of change in physical activity during and after pregnancy: Project Viva. Am J Prev Med 2007, 32(4):312-9.
• [25]Brown MJ, Sinclair M, Liddle D, Hill AJ, Madden E, Stockdale J: A systematic review investigating healthy lifestyle interventions incorporating goal setting strategies for preventing excess gestational weight gain. PLoS ONE [Electronic Resource] 2012, 7(7):e39503.
• [26]National Institute for Health and Clinical Excellence (NICE): Behaviour change at population, community and individual levels. Department of Health, London; 2007.
• [27]Brown A, Avery A: Healthy weight management during pregnancy: what advice and information is being provided. J Hum Nutr Diet 2012, 25(4):378-87.
• [28]Stengel MR, Kraschnewski JL, Hwang SW, Kjerulff KH, Chuang CH: “What my doctor didn't tell me”: examining health care provider advice to overweight and obese pregnant women on gestational weight gain and physical activity. Womens Health Issues 2012, 22(6):e535-40.