• Optimization of women’s physical activity during pregnancy to prevent excessive gestational weight gain
en To content Full text of article

Optimization of women’s physical activity during pregnancy to prevent excessive gestational weight gain

HEALTH OF WOMAN. 2020.1(147): 56–60; doi 10.15574/HW.2020.147.56
S.O. Ostafiichuk
Ivano-Frankivsk national medical University

The objective: to study the effect of physical activity (PA) during pregnancy on the level of gestational weight gain (GWG) in women with different prepregnancy weight.
Materials and methods. 219 pregnant women were enrolled. Anthropometry and calculation of body mass index (BMI) were carried out. GWG was evaluated by the difference between the weight before delivery and prepregnancy.
The control group consisted of 117 women who were under routine antenatal supervision. The main group – 102 pregnant women, who were enrolled to the program of PA. The level of intensity of PA was estimated on the «International Physical Activity Questionnaire». The results were statistically analyzed using using Microsoft Excel-based statistical analysis package and Statistica 6.0 program pack (StatSoft Inc.,USA).
Results. It was proved that only moderate (r = – 0.68; p<0.001) and intensive (r = – 0.68; p<0.001) levels of PA have an inverse correlation with GWG, while low (r = 0.64; p<0.001) and sedentary (r = 0.79; p<0.001) activities contribute to weight gain. In the main group the moderate level of PA (82,2±9,8 MET-h/week) has increase in compared with the control group (54,5±10,0 MET-h/week) (p<0.05). A level of GWG (1.3±1.3) kg was lower in the main group 11.1±1.2 kg versus 14.5±1.2 kg in the control (p<0.05). In the main group, the number of pregnant women with the recommended GWG (64.7±4.7%) exceeded 2.9 times (p<0.001) with excessive and 4.7 times (p<0.001) with insufficient weight gain. Implementation of the PA program significantly reduced the risk of excessive GWG at normal weight (OR 0.42; 95% Cl: 0.20–0.86; p<0.05), overweight (OR 0.06; 95% Cl: 0.01–0.16; p<0.05) and obese women (OR 0.11; 95% Cl: 0.02–0.68; p<0.05). The proposed PA did not significantly decrease the risk of insufficient GWG in women with low prepregnancy BMI.
Conclusions. It has been proven that moderate PA increases the chances recommended GWG (4.48; 95% Cl: 2.53–7.91; p<0.001), while low PA is insufficient to prevent excessive weight gain (OR 2.01; 95% Cl: 1.07–3.92; p<0.05). Due to small percentage of pregnant women with an intensive level of PA in the present study, no statistically significant effect of this level on GWG was found (p=0.85).
Key words: pregnancy, gestational weight gain, physical activity.

REFERENCES

1. Aune D, Saugstad OD, Henriksen T, Tonstad S. 2014. Physical activity and the risk of preeclampsia: a systematic review and meta-analysis. Epidemiology 25(3):331–43. https://doi.org/10.1097/EDE.0000000000000036; PMid:24713878

2. Craig CL, Marshall AL, Sjostro MM, Bauman AE, Booth ML, Ainsworth BE et al. 2003. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 35(8):1381–95. https://doi.org/10.1249/01.MSS.0000078924.61453.FB; PMid:12900694

3. Defu M, Szeto IMY, Kai Y. 2015. Association between gestational weight gain according to prepregnancy body mass index and short postpartum weight retention in postpartum women. Clinical Nutrition. 34(2):291-5. https://doi.org/10.1016/j.clnu.2014.04.010; PMid:24819693

4. Dodd JM, Turnbull D, McPhee AJ, Deussen AR, Grivell RM, Yelland LN et al. 2014. Antenatal lifestyle advice for women who are overweight or obese: LIMIT randomised trial. BMJ. 348:g1285. https://doi.org/10.1136/bmj.g1285; PMid:24513442 PMCid:PMC3919179

5. Domenjoz I, Kayser B, Boulvain M. 2014. Effect of physical activity during pregnancy on mode of delivery. Am J Obstet Gynecol. 211(4):401.e1–401.e11. https://doi.org/10.1016/j.ajog.2014.03.030; PMid:24631706

6. Gillman MW, Ludwig DS. 2013. How early should obesity prevention start? N Engl J Med. 369:2173–5. https://doi.org/10.1056/NEJMp1310577; PMid:24224559

7. IOM. 2009. Weight Gain During Pregnancy: Reexamining the Guidelines. Institute of Medicine and National Research Council of the National Academies, Committee to Reexamine IOM, ed. Rasmussen KM and Yaktine AL. Washington D.C.: The National Academies Press.

8. Mudd M, Scheurer JM, Pruett M, Demerath EW, Kapur A, Ramel SE. 2019. Relations among maternal physical activity during pregnancy and child body composition. Obes Sci Pract. 5(3):246–50. https://doi.org/10.1002/osp4.332; PMid:31275598 PMCid:PMC6587308

9. Nakaz MOZ Ukraine 417. 2011. Methodychni rekomendatsii pro organizatsiyu ambulatornoi akushersko-ginekologichnoi dopomogy. Kyiv:25.

10. Poston L, Bell R, Croker H, Flynn AC, Godfrey KM, Goff L et al. 2015. Effect of a behavioural intervention in obese pregnant women (the UPBEAT study): a multicentre, randomised controlled trial. Lancet Diab Endoc. 10:767–77. https://doi.org/10.1016/S2213-8587(15)00227-2

11. Surina MN, Chvanova EA. 2018. Pregnancy course and outcomes in women with low body mass index. Fund Clin Med. 3(3):88-92. https://doi.org/10.23946/2500-0764-2018-3-3-65-70

12. Woodman S, Reina-Fernandez J, Goldberg J. 2014. Exercising in Pregnancy: What Advice Should be Given to Patients? Women’s Health. 10(6):547-48. https://doi.org/10.2217/WHE.14.41; PMid:25482478