Movement-Based Interventions in Pregnancy

The impact of physical activity during pregnancy on labor and delivery

Introduction: The pandemic caused by coronavirus disease 2019 has adversely affected the health of all individuals including pregnant women. The susceptibility of pregnant women and their foetuses to severe acute respiratory syndrome coronavirus 2 infection is not clearly known. The objective of this review is to summarise the available evidence on foetal and neonatal outcomes of pregnant women with confirmed coronavirus disease 2019.
 Methods: The review was conduced by searching the PubMed and MedRxiv databases for studies reporting outcome of pregnancy with confirmed coronavirus disease from December 2019 to April 2020 using combination of terms "pregnancy", "coronavirus disease 2019", "foetal outcome" and "neonatal outcome". Only peer reviewed articles reporting outcome of pregnancy with confirmed coronavirus disease 2019 were included in the review irrespective of language. Ongoing pregnancies, induced abortion, and pregnancies without outcome were excluded from analysis. Variables extracted and analysed included gestational age at delivery, mode of delivery, foetal and neonatal outcome. 
 Results: In total, 21 studies consisting 230 pregnant women including three twin pregnancies were enrolled in the study. Fever and cough were the most common symptoms reported in pregnant women. One hundred and sixty-two (70.4%) pregnant women underwent cesarean section and there were 68 (29.6%) preterm deliveries. Eight babies tested positive out of 161 newborns that were tested for coronavirus infection. Among adverse outcomes reported, there were two miscarriages, two still births and only one neonatal death.
 Conclusions: Outcome of pregnancy with coronavirus disease 2019 in late trimester appears to be favourable. Occurrence of preterm delivery and cesarean section appear higher among infected pregnant women in comparison to general population. There was no conclusive evidence of vertical transmission.

45 Physical activity in pregnancy: Predictive of labor outcomes?

Child Obesity Can Be Reduced With Vigorous Activity Rather Than Restriction of Energy Intake

This study aimed to determine the proportion of pathological results in the early 75-g OGTT among women with a history of late miscarriage or preterm birth after prophylactic cerclage. The effects of early-diagnosed gestational diabetes on pregnancy outcome, neonatal parameters, preconceptional BMI, and mode of delivery were also analyzed. In 140 pregnant women, a primary cerclage and a 75-g OGTT were performed between 16 and 21 weeks of gestation. Analysis was based on OGTT results (physiological vs. pathological). The primary endpoint was pregnancy outcome; secondary endpoints included neonatal parameters, preconceptional BMI, and mode of delivery. Eighty-nine women (63%) showed a pathological OGTT result substantially higher than in the general population. This was not significantly associated with late miscarriage or preterm birth (OR 2.18; p=0.13) but showed a trend toward increased risk. Neonatal outcomes were similar between groups. A preconceptional BMI>35 kg/m² was significantly related to a pathological OGTT (p=0.04). Women with a pathological OGTT had more cesarean deliveries (55.8% vs. 35.3%; p=0.02). In this high-risk cohort with a history of late miscarriage or preterm birth, 63% had a pathological early 75-g OGTT, indicating increased susceptibility to glucose metabolism disorders. Early glucose screening and individualized metabolic management are essential to improve pregnancy and perinatal outcomes.

Question order might affect self-reported regular physical activity (PA) measured with items from the Behavioral Risk Factor Surveillance System (BRFSS) PA module. A telephone survey was conducted using 2 forms (N = 1004, N = 212) with varying PA question order. The standard form presented moderate-PA, vigorous-PA, and walking questions, in that order, whereas the alternate form presented walking questions, followed by moderate-PA, and then vigorous-PA questions. Weighted, adjusted rates of vigorous PA, walking, meeting the Centers for Disease Control and Prevention (CDC) recommendation for moderate or vigorous PA, and moderate PA from each form were compared. Vigorous PA and walking were similar regardless of question order. Meeting the CDC recommendation for moderate or vigorous PA was reported less often with the alternate form among 18- to 34-year-olds. Less moderate PA was reported with the alternate form overall and among 18- to 34-year-olds, women, whites, and those with a high school education or less. Estimating PA and walking across sociodemographic strata with differing patterns of PA requires asking moderate-PA and vigorous-PA questions before walking questions. Asking walking questions first might lead to bias, especially for moderate PA. Walking, added to a survey with BRFSS moderate and vigorous PA items, should be placed after moderate and vigorous PA. Walking questions first may cause bias, especially for moderate PA.

Moderate and vigorous leisure time physical activity in older adults and Alzheimer's disease-related mortality in the USA: a dose–response, population-based study

Association of physical activity with mortality in the US dialysis population

Simple SummarySelf-efficacy has been identified as a crucial variable to reduce sedentarism in women with fibromyalgia. The present study aimed to evaluate the role of self-efficacy, the impact of fibromyalgia, and activity patterns on the objective physical activity levels. One hundred and twenty-three women with fibromyalgia participated in this cross-sectional study. Physical activity levels were assessed with accelerometers, while self-efficacy, activity patterns, and fibromyalgia impact were evaluated through questionnaires. Results revealed that self-efficacy for physical activity was directly related to light, moderate, and vigorous physical activity, as well as inversely related to sedentary time. Self-efficacy for walking and light physical activity seems to be more relevant than self-efficacy for moderate and vigorous physical activity to achieve higher levels of physical activity.Keeping high levels of physical activity is a challenge among chronic patients. In this regard, self-efficacy has been identified as a crucial variable to reduce sedentarism and physical inactivity in women with fibromyalgia. The current study aimed to evaluate the associations among objective physical activity levels, self-efficacy, activity patterns, and the impact of the disease, as well as to compare those variables between women with fibromyalgia with different self-efficacy levels. For this purpose, in this cross-sectional study, the physical activity levels of 123 women with fibromyalgia were assessed by accelerometers, together with self-efficacy, the impact of the disease, and activity patterns. Results revealed that self-efficacy for light or moderate physical activity was directly related to light (p < 0.01), moderate (p < 0.01), and vigorous physical activity (p < 0.05), as well as inversely related to sedentary time (p < 0.01). Moreover, the main differences were observed between those with low self-efficacy levels and the rest of the sample, while there were no differences between the high and the medium self-efficacy groups (p > 0.05). Thus, self-efficacy for walking and light physical activity seems to be more relevant than self-efficacy for moderate and vigorous physical activity to achieve higher levels of physical activity.

This study aimed to assess the correlation between different aspects of routinary physical activity with chronic neck pain severity indicators and salivary cortisol. This cross-sectional observational study included ninety-four office workers with non-specific chronic neck pain in the analyses. Pain related outcomes (pain intensity, pressure pain thresholds and disability), physical activity outcomes using the International Physical Activity Questionnaire, and salivary cortisol levels were evaluated. Pearson’s correlation analysis was used to investigate internal associations and regression models to explain and calculate which factors contribute to the variance of salivary cortisol and neck pain severity. Female sex (p < 0.01), sedentary behaviors (p < 0.05), and pain sensitivity (p < 0.05) were associated with greater cortisol levels (p < 0.05), but disability and pain intensity were not associated (p > 0.05). Worse disability, pain intensity, and pain pressure thresholds were also associated with lower routinary physical activity (p < 0.05). Regression models explained 20.6% of pain intensity (based on walking time to their workplace, age and pain sensitivity); 27.3% of disability (based on moderate physical activity at home, vigorous physical activity during leisure time and pain sensitivity); 54.2% of pain sensitivity (based on cycling time from home to their workplace, gender and vigorous activity during leisure time) and 38.2% of salivary cortisol concentration (based on systolic pressure, vigorous activity at work and both moderate and vigorous activity at home). Our results demonstrated the association between salivary cortisol concentration with moderate and vigorous physical activity, sitting time at work, and PPTs. However, salivary cortisol was not associated with disability or pain intensity.

BackgroundPrevious studies indicate that juvenile idiopathic arthritis (JIA) patients have lower levels of physical activity (PA), spend more time in sedentary PA and less time in moderate and vigorous PA...

We utilized a population database to address the paucity of data around pregnancy outcomes in women with Down syndrome (DS). We conducted a retrospective study using the Health Care Cost and Utilization Project-Nationwide Inpatient Sample Database over 11years, from 2004 to 2014. A delivery cohort was created using ICD-9 codes. ICD-9 code 758.0 was used to extract the cases of maternal DS. Pregnant women with DS (study group) were matched based on age, race, income, and health insurance type to women without DS (control) at a ratio of 1:20. There were a total of 9,096,788 deliveries during the study period. Of those, 184 pregnant women were found to have DS. The matched control group was 3680. After matching, most of the pregnancy and delivery outcomes, such as pregnancy-induced hypertension, gestational diabetes, preterm premature rupture of membrane, chorioamnionitis, cesarean section, operative vaginal delivery, or blood transfusion were similar between participants with and without DS. However, patients with DS were at increased risk of giving birth prematurely (aOR 3.09, 95% CI 2.06-4.62), and having adverse neonatal outcomes such as small for gestational age (aOR 2.70, 95% CI 1.54-4.73), intrauterine fetal demise (aOR 22.45, 95% CI 12.02-41.93), congenital anomalies (aOR 7.92, 95% CI 4.11-15.24), and fetal chromosomal abnormalities. Neonates to mothers with DS are at increased risk of prematurity and other neonatal adverse outcomes. Hence, counseling patients with DS about these risks and increased antenatal surveillance is advised.

This study was conducted to provide descriptive data of accelerometer-determined ambulatory physical activity in a sample of free-living college students and to examine college students' ambulatory physical activity patterns. All participants (245 females, age = 19.9 +/- 1.6 yr, body mass index (BMI) = 22.9 +/- 3.3 kg x m(-2); 209 males, age = 20.2 +/- 2.0 yr, BMI = 25.2 +/- 4.0 kg x m(-2)) wore an accelerometer for seven consecutive days. Accumulated physical activity (ct.d, ct x min(-1) x d(-1), and min x d(-1) spent at different intensities) and minutes per day spent in moderate or vigorous physical activity in sessions of at least 10 min were analyzed to describe the physical activity of the sample and examine physical activity patterns. The entire sample accumulated 362,750.1 +/- 112,824.1 ct x d(-1) (males = 383,787.2 +/- 112,001.3 vs females = 344,804.1 +/- 110,619.5 ct x d(-1), P < 0.01) and 46.7 +/- 18.9 min x d(-1) in moderate physical activity (males = 51.7 +/- 19.8 vs females = 42.5 +/- 17.0 min x d(-1), P < 0.01). They were more active on weekdays than weekend days (P < 0.05), and they spent 13.6 +/- 12.7 min x d(-1) (males = 13.2 +/- 12.0 vs females = 13.8 +/- 13.3, P > 0.05) in moderate or vigorous physical activity sessions of at least 10 min. Participants in this study accumulated a moderate amount of physical activity on most weekdays. Most participants, however, were not meeting the current moderate physical activity recommendation when moderate or vigorous physical activity sessions of at least 10 min were examined.

Decreased Ovarian Reserve: Is it an Independent Predictor of Adverse Obstetric Outcomes?

Objective A retrospective analysis was conducted to explore the impact of LEEP knife treatment of cervical intraepithelial neoplasia (CIN) on women's pregnancy outcomes and modes of delivery.Methods Fifty-eight women were recruited as the experimental group from our hospital.They accepted LEEP surgery for treatment of CIN during 2009 and became pregnant before December 2011.Sixty pregnant women without history of LEEP surgery were randomly selected as the control group from January 2010 to December 2011.A retrospective analysis of the study groups was conducted to investigate the pregnancy situations,two-wire receiver modes of delivery and pregnancy outcome of participants.Results There was no significant difference between the two groups on rates of abortion,vaginal delivery and cesarean section (P ＞ 0.05).The experimental group had significantly higher rates of preterm birth than control group (12.07％ vs.1.67％,x2 =5.049,P ＜ 0.05).No significant difference was observed between the two groups on rates of premature rupture of membranes,cervical laceration,postpartum hemorrhage,low birth weight and neonatal asphyxia(P ＞ 0.05).Conclusion LEEP knife treatment of CIN has no significant effect on mode of delivery or pregnancy outcome,but may increase the incidence of preterm birth.Management of pregnant women with history of CIN and LEEP surgery should be strengthened. Key words: LEEP surgery; Cervical intraepithelial neoplasia; Mode of delivery; Pregnancy outcome