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

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          Abstract

          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 (Registered 28/11/2008).

          Related collections

          Most cited references22

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          Calibration of the Computer Science and Applications, Inc. accelerometer.

          We established accelerometer count ranges for the Computer Science and Applications, Inc. (CSA) activity monitor corresponding to commonly employed MET categories. Data were obtained from 50 adults (25 males, 25 females) during treadmill exercise at three different speeds (4.8, 6.4, and 9.7 km x h(-1)). Activity counts and steady-state oxygen consumption were highly correlated (r = 0.88), and count ranges corresponding to light, moderate, hard, and very hard intensity levels were or = 9499 cnts x min(-1), respectively. A model to predict energy expenditure from activity counts and body mass was developed using data from a random sample of 35 subjects (r2 = 0.82, SEE = 1.40 kcal x min(-1)). Cross validation with data from the remaining 15 subjects revealed no significant differences between actual and predicted energy expenditure at any treadmill speed (SEE = 0.50-1.40 kcal x min(-1)). These data provide a template on which patterns of activity can be classified into intensity levels using the CSA accelerometer.
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            Diagnosis and classification of diabetes mellitus.

            (2008)
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              Physical Activity Before and During Pregnancy and Risk of Gestational Diabetes Mellitus

              OBJECTIVE Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is associated with a substantially elevated risk of adverse health outcomes for both mothers and offspring. Physical activity may contribute to the prevention of GDM and thus is crucial for dissecting the vicious circle involving GDM, childhood obesity, and adulthood obesity, and diabetes. Therefore, we aimed to systematically review and synthesize the current evidence on the relation between physical activity and the development of GDM. RESEARCH DESIGN AND METHODS Medline, EMBASE, and Cochrane Reviews were searched from inception to 31 March 2010. Studies assessing the relationship between physical activity and subsequent development of GDM were included. Characteristics including study design, country, GDM diagnostic criteria, ascertainment of physical activity, timing of exposure (prepregnancy or early pregnancy), adjusted relative risks, CIs, and statistical methods were extracted independently by two reviewers. RESULTS Our search identified seven prepregnancy and five early pregnancy studies, including five prospective cohorts, two retrospective case-control studies, and two cross-sectional study designs. Prepregnancy physical activity was assessed in 34,929 total participants, which included 2,813 cases of GDM, giving a pooled odds ratio (OR) of 0.45 (95% CI 0.28–0.75) when the highest versus lowest categories were compared. Exercise in early pregnancy was assessed in 4,401 total participants, which included 361 cases of GDM, and was also significantly protective (0.76 [95% CI 0.70–0.83]). CONCLUSIONS Higher levels of physical activity before pregnancy or in early pregnancy are associated with a significantly lower risk of developing GDM.
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                Author and article information

                Contributors
                louise.hayes@ncl.ac.uk
                catherine.mcparlin@ncl.ac.uk
                Tarja.I.Kinnunen@uta.fi
                lucilla.poston@kcl.ac.uk
                s.c.robson@ncl.ac.uk
                ruth.bell@ncl.ac.uk
                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central (London )
                1471-2393
                1 March 2015
                1 March 2015
                2015
                : 15
                : 52
                Affiliations
                [ ]Institute of Health & Society, Newcastle University, Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne, NE2 4AX UK
                [ ]Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
                [ ]Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
                [ ]School of Health Sciences, University of Tampere, Tampere, Finland
                [ ]Division of Women’s Health, Women’s Health Academic Centre, King’s College, London, UK
                Article
                479
                10.1186/s12884-015-0479-2
                4352291
                25886590
                2cc2836c-0d57-4b5e-b81b-dd9a6e57a6fa
                © Hayes et al.; licensee BioMed Central. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 29 October 2014
                : 12 February 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Obstetrics & Gynecology
                maternal obesity,accelerometer,mvpa,socio-demographic factors
                Obstetrics & Gynecology
                maternal obesity, accelerometer, mvpa, socio-demographic factors

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