Sugar-Sweetened Beverage Intake Among Pregnant and Non-pregnant Women of Reproductive Age

Maternal and Child Health Journal - Frequent sugar-sweetened beverage (SSB) intake is associated with weight gain in women, and pre-pregnancy overweight and excessive gestational weight gain are...     

Perceived Barriers to Physical Activity Among Pregnant Women

Objective Physical activity generally declines during pregnancy, but barriers to activity during this time period are not well understood. The objective was to examine barriers to physical activity in a large cohort of pregnant women and to explore these barriers in more depth with qualitative data derived from a separate focus group study using a socioecologic framework. Method A total of 1535 pregnant women (27–30 weeks’ gestation) enrolled in the Pregnancy, Infection, and Nutrition Study were asked an open-ended question about their primary barrier to physical activity; responses were coded into categories according to the socioecologic framework. To further elucidate, 13 focus groups of a total of 58 pregnant women (20–37 weeks’ gestation) were conducted among Hispanic, African American, and White participants. Results Among the 1535 pregnant women participating in the survey, 85% reported an intrapersonal barrier to physical activity, of which almost two-thirds were health related. Only 2% of the women reported their main barrier to physical activity as interpersonal and 3% reported a neighborhood or environmental barrier. These results were supported by the focus group data, overall and by race/ethnicity and body mass index. Although women discussed barriers to physical activity at a variety of levels, the intrapersonal level was the most frequently cited and discussed factor in both studies. Conclusions Since pregnancy may trigger the development of obesity and since physical activity is recommended for healthy pregnant women, it is imperative to promote physical activity in a more relevant way. These quantitative and qualitative studies revealed many barriers to physical activity among pregnant women and some suggestions for interventions.     

The Profiling of Diet and Physical Activity in Reproductive Age Women and Their Association with Body Mass Index

Pre-pregnancy, pregnancy and postpartum are critical life stages associated with higher weight gain and obesity risk. Among these women, the sociodemographic groups at highest risk for suboptimal lifestyle behaviours and core lifestyle components associated with excess adiposity are unclear. This study sought to identify subgroups of women meeting diet/physical activity (PA) recommendations in relation to sociodemographics and assess diet/PA components associated with body mass index (BMI) across these life stages. Cross-sectional data (Australian National Nutrition and Physical Activity Survey 2011–2012) were analysed for pre-pregnancy, pregnant and postpartum women. The majority (63–95%) of women did not meet dietary or PA recommendations at all life stages. Core and discretionary food intake differed by sociodemographic factors. In pre-pregnant women, BMI was inversely associated with higher whole grain intake (β = −1.58, 95% CI −2.96, −0.21; p = 0.025) and energy from alcohol (β = −0.08, −0.14, −0.005; p = 0.035). In postpartum women, BMI was inversely associated with increased fibre (β = −0.06, 95% CI −0.11, −0.004; p = 0.034) and PA (β = −0.002, 95% CI −0.004, −0.001; p = 0.013). This highlights the need for targeting whole grains, fibre and PA to prevent obesity across life stages, addressing those most socioeconomically disadvantaged.     

Correlates of Physical Activity Engagement among Pregnant Women with Overweight and Obesity

BackgroundExcess weight during pregnancy increases risk for adverse obstetrical outcomes. Physical activity (PA) may buffer these effects, although it is unclear what factors are associated with PA in women who begin pregnancy with overweight/obesity. The present study sought to characterize the demographic and psychological correlates of PA among women with prepregnancy overweight/obesity.MethodsPregnant women (N = 249; mean age, 28.48 ± 5.48 years; mean body mass index, 34.13 ± 7.07 kg/m²) at 12–20 weeks of gestation (mean, 15.68 ± 2.44 weeks of gestation) completed ratings of perceived stress and depressive symptoms and were interviewed using the pregnancy version of the Eating Disorders Examination. The Paffenbarger Physical Activity Survey was administered via interview to estimate energy expenditure. Continuous outcomes were evaluated via linear regression, while logistic regression was conducted to assess likelihood of meeting PA guidelines.ResultsMean weekly duration of moderate to vigorous PA was 109.50 ± 248.17 minutes, with 21% of women meeting federal PA guidelines of 150 minutes or more. Higher perceived stress (β = –0.217; p = .02) and eating psychopathology (β = –0.213; p < .01) were associated with lower total energy expenditure. Black women reported lower expenditure specifically from walking compared with White women (β = –0.180; p = .03). Depressive symptoms were not associated with PA. No estimate of PA predicted body mass index.ConclusionsPregnant women with overweight/obesity engage in modest amounts of PA early in pregnancy, although few meet PA guidelines. Greater perceived stress and eating psychopathology were associated with lower PA engagement. These factors should be monitored by obstetrics providers to identify women who may particularly benefit from counseling about PA during pregnancy.     

孕妇产前运动现状分析

目的：分析孕妇产前运动的现状,明确其影响因素,从而为孕期保健工作提供指导建议。方法以2012年3月－2012年11月间在武汉某医院妇幼保健科进行产前检查的所有孕妇作为研究对象进行现场调查,调查内容包括孕妇基本情况和产前运动情况。结果孕妇产前运动平均时间为1．34小时/周,其中自主运动、家务劳动、家庭照顾、工作类运动时间分别为0．48小时/周、0．36小时/周、0．16小时/周、0．23小时/周。不同特征孕妇各类运动时间所占比例不同,高文化程度、城市户籍的孕妇自主运动所占的比例较高,达到40％以上,农村户籍的孕妇家务劳动所占的比例较高,达到41％。结论我国孕妇产前运动时间不足,不同特征孕妇产前运动的种类和时间不同,有必要加强孕妇产前运动指导和健康教育。     

Diet Quality Indices and Physical Activity Levels Associated with Adequacy of Gestational Weight Gain in Pregnant Women with Gestational Diabetes Mellitus

The aim of this study was to evaluate the Diet Quality Index (DQI) and the Physical Activity (PA) levels associated with adequacy of gestational weight gain in pregnant women with gestational diabetes mellitus (GDM). A total of 172 pregnant women with a single fetus and a diagnosis of GDM participated. Food intake was self-reported on the food frequency questionnaire and DQI was quantified using the index validated and revised for Brazil (DQI-R). To assess PA, the Pregnancy Physical Activity Questionnaire was administered. Gestational weight gain was classified, following the criteria of the Institute of Medicine, into adequate (AWG), insufficient (IWG), or excessive (EWG) weight gain. A multinomial logistic regression analysis was performed, with level of significance <0.05. The participants were divided into 3 groups: AWG (33.1%), IWG (27.3%), and EWG (39.5%). The analysis indicated that if the pregnant women PA fell into tertile 1 or 2, then they had a greater chance of having IWG, whereas those with the lowest scores on the DQI-R, whose PA fell into tertile 2, and pregestational obesity women had the greatest chance of having EWG. This study has shown that low PA levels may contribute towards IWG. On the other hand, a low final DQI-R score, representing inadequate food habits, low PA levels, and pregestational obesity may increase the chance of EWG in patients with GDM.     

喀什地区育龄期妇女破伤风类毒素突击接种活动分析与评价

新疆维吾尔自治区喀什地区在５个新生儿破伤风高危县,对育龄期妇女开展了破伤风类毒素（ＴＴ）两针突击接种．登记育龄期妇女１３６１９０人,占总人口数的１３．７３％;估计应种数为１６３６４７人,登记率为８３．２２％（５４．３７％～９２．００％）．报告接种率分别为ＴＴ　９２．７３％（８７．３３％～９６．３２％）,ＴＴ２８６．１３％（４６．６０％～９３．００％）;估算接种率分别为ＴＴ１７９．３９％（５２．０４％～９１．９１％）,ＴＴ２７３、７４％（４．５３％～８４．４１％）;３个县的抽查接种率分别为ＴＴ１８７．７９％（１５１／１７２）,ＴＴ２７３．８４％（１２７／１７２）．     

Accuracy of Personal Breast Cancer Risk Estimation in Cancer-Free Women During Primary Care Visits

ABSTRACT

To determine the accuracy of personal breast cancer risk estimation, interviews were conducted of 110 women between November 2004 and May 2005 during primary care visits. The average age of the women was 39 years. Considering their lifetime breast cancer risk, 49% of women perceived their risk to be low, 35% average, and 11% high. Compared to Gail-model lifetime risk scores, 62% of women were inaccurate and underestimated or overestimated risk. Factors affecting accuracy of risk prediction were race, family history of cancer, alcohol use and exercise. Our study highlights the need for personalized breast cancer education between an individual woman and her health care provider.     

Diet and Physical Activity in Relation to Metabolic Syndrome among Urban Indian Men and Women

The relationship of diet and physical activity with metabolic syndrome (MS) was studied among 60 male and female (40–60 y) urban Indian MS patients. Intake of green leafy vegetables, other vegetables, fruits and milk were significantly (p ≤ .01) associated with reduced fat mass and waist circumference and increased lean body mass. Energy, carbohydrates, and fat intakes were significantly (p ≤ .01) correlated with increased body fat and waist circumference and reduced lean body mass. Energy, total and saturated fat intake were positively and significantly (p ≤ .05; .01) correlated with total cholesterol. Total fat was also significantly (p ≤ .05; .01) correlated with increased systolic blood pressure (r = 0.33), serum triglycerides (r = 0.33), LDL-C (r = 0.29) and VLDL-C (r = 0.28). Increased TDEE was significantly (p ≤ .01) associated with decreased body fat and waist circumference (r = 0.53 and 0.60) and increased lean body mass (r = 0.68).     

The Association Between Park Facilities and Duration of Physical Activity During Active Park Visits

Public parks provide places for urban residents to obtain physical activity (PA), which is associated with numerous health benefits. Adding facilities to existing parks could be a cost-effective approach to increase the duration of PA that occurs during park visits. Using objectively measured PA and comprehensively measured park visit data among an urban community-dwelling sample of adults, we tested the association between the variety of park facilities that directly support PA and the duration of PA during park visits where any PA occurred. Cross-classified multilevel models were used to account for the clustering of park visits (n?=?1553) within individuals (n?=?372) and parks (n?=?233). Each additional different PA facility at a park was independently associated with a 6.8% longer duration of PA bouts that included light-intensity activity, and an 8.7% longer duration of moderate to vigorous PA time. Findings from this study are consistent with the hypothesis that more PA facilities increase the amount of PA that visitors obtain while already active at a park.     

Determinants of Time of Start of Prenatal Care and Number of Prenatal Care Visits During Pregnancy Among Nepalese Women

This study is aimed at investigating the factors determining the timing of first prenatal care (PNC) visit and the number of PNC visits among a national representative sample of Nepali women. Data was drawn from the 2006 Nepal Demographic and Health Survey on women age 15-49 years old who had delivery within three years prior to the survey (N = 4,136). Multinomial logistic regression was used to study the association between socio-demographic variables and two outcome variables--the timing of first PNC and number of PNC visits. Most of the women (45%) started prenatal care after 3 months of pregnancy while 28% had no care. About 43% of women had 1-3 PNC visits, 29% had more than 3 visits. Age, education, parity and wealth were associated with both the timing of PNC and the number of PNC visits such that older women and those socioeconomically disadvantaged had late and fewer PNC visits compared to the younger ones and those with socioeconomic advantage, respectively. Women with higher parity and those in rural residencies were more likely to delay PNC, have fewer PNC or have no care at all. Majority of Nepali women do not attend prenatal care during the first trimester of pregnancy contrary to the WHO recommendation for women in developing countries. Programmes aimed at improving maternal health in general and participation in PNC in particular should target all Nepali women, especially those: in rural residencies, with no education, with high parity; older women and those from poor households.     

Leisure-Time Physical Activity Patterns and Correlates Among Pregnant Women in Ontario, Canada

Physical activity significantly impacts public health as it reduces the risk of chronic diseases and provides numerous protective factors during pregnancy. Although Canadian guidelines recommend regular physical activity for healthy pregnant women, little is known about their leisure-time physical activity patterns. This study compared the physical activity levels of pregnant and non-pregnant women and examined socio-demographic and health correlates of physical activity during pregnancy. Canadian Community Health Survey data (2005–2008) from 623 pregnant women and 20,392 non-pregnant women aged 15–49 years in Ontario, Canada were examined. The prevalence of regular physical activity (15 or more minutes on at least 3 days of the week) was 58.3 % [95 % CI 52.9, 63.4], among pregnant women and 66.9 % [95 % CI 65.8, 68.0] among non-pregnant women. However, the prevalence of meeting Canadian guidelines for physical activity during pregnancy (30 or more minutes on at least 4 days of the week) was only 23.3 %, [95 % CI 19.4, 27.7] among pregnant women and 33.6 % [95 % CI 32.7, 34.6] among non-pregnant women. Pregnant women were less likely to be meeting guidelines if they were single, divorced, separated or widowed, a visible minority, had a household income between $20,000 and $79,999, and reported being in good or fair/poor health; when it came to education, women who had completed high school were more likely to be meeting guidelines. Few pregnant women in Ontario are meeting guidelines for physical activity during pregnancy. Results indicate that promoting physical activity during pregnancy should remain a public health priority.     

Effects of Online Self-Regulation Activities on Physical Activity Among Pregnant and Early Postpartum Women

Physical and psychological changes that occur during pregnancy present a unique challenge for women's physical activity. Using a theory-based prospective design, this study examines the effects of pregnant women's (a) physical activity cognitions (self-efficacy, outcome expectancy, and safety beliefs) and (b) online self-regulation activities (goal-setting and self-monitoring) on subsequent changes in their physical activity intentions and behavior during pregnancy and immediately postpartum. The authors used data from three panel surveys administered to pregnant women enrolled in a web-based intervention to promote healthy pregnancy and postpartum weight, as well as log data on their use of self-regulatory features on the intervention website. Perceived self-efficacy and perceived safety of physical activity in pregnancy enhanced subsequent intentions to be physically active. Repeated goal-setting and monitoring of those goals helped to maintain positive intentions during pregnancy, but only repeated self-monitoring transferred positive intentions into actual behavior. Theoretically, this study offers a better understanding of the roles of self-regulation activities in the processes of goal-striving. The authors also discuss practical implications for encouraging physical activity among pregnant and early postpartum women.     

Sports and Leisure Time Physical Activity During Pregnancy in Nulliparous Women

To describe patterns of leisure time physical activity during pregnancy in relation to pre-pregnancy leisure time physical activity, socio-demographic characteristics, fertility history, and lifestyle factors. 4,718 nulliparous with singleton pregnancy and intended spontaneous vaginal delivery were included in the study at gestational week 33 from May 2004 to July 2005. Information was provided by self-administered questionnaires. Leisure time physical activity was categorised into four categories: competitive sport, moderate-to-heavy, light or sedentary. In this population of nulliparous women, 4% participated in competitive sport, 25% in moderate-to-heavy activities, 66% in light activities, and 5% in sedentary activities in the year prior to pregnancy. Physical activity before pregnancy was statistically significantly associated with age, pre-pregnancy BMI, chronic diseases, number of years at school, and smoking habits. The proportion of women who took part in competitive sports, and moderate-to-heavy activities decreased over the three trimesters of pregnancy. The proportion of women with light physical activity was stable during pregnancy while the proportion of women with sedentary activity increased from 6% to 29%. During the third trimester women performing competitive sports or moderate-to-heavy activities before pregnancy continued to have a higher level of physical activity than women with light activities or sedentary activities before pregnancy. In general the intensity and time spent on exercise decreased during pregnancy. Women with the highest level of exercise prior to pregnancy continued to be the most active during pregnancy. Among women with sedentary activities before pregnancy one-fourth changed to light activity during pregnancy.     

Factors Affecting Adequate Prenatal Care and the Prenatal Care Visits of Immigrant Women to Taiwan

This paper investigates prenatal care utilization, identifies factors affecting the adequacy of prenatal care, and explores the effect of adequate initial timing of prenatal care on total prenatal care visits among Taiwan new immigrant females. Data was obtained from the 2008 Prenatal Care Utilization among Taiwan New Immigrant Females Survey on women who either had at least one preschool-aged child or had delivered their infants but were still hospitalized (N = 476). The Adequacy of Prenatal Care Utilization Index was applied to rate the prenatal care adequacy. The logistic regression model was used to investigate factors associated with the adequacy of prenatal care utilization, and the linear regression model was estimated to identify the impact of influential factors on the prenatal care usage. Females’ nationality, employment, and transportation convenience increased the likelihood of receiving adequate prenatal care. Having adequate initial timing of prenatal care was found to be positively related to the frequency of prenatal care visits. Prenatal care utilization can be affected by factors within the health care system and by characteristics of the population; therefore, a measure of prenatal care utilization cannot distinguish these factors but reflects the result of all of them in varying combinations.     

银川市城区1085例已婚育龄妇女生殖健康状况分析

目的:了解城市已婚育龄妇女生殖健康状况,为开展生殖健康优质服务提供依据。方法:对银川市城区辖区单位1085例已婚育龄妇女进行妇女病普查。结果:妇科疾病患病率63.68％,发病率从高到低依次为宫颈疾病、阴道疾病、生殖器官肿瘤、乳腺增生、盆腔炎症,不同年龄妇女患病率不同。结论:已婚育龄妇女妇科疾病患病率较高,生殖健康知识缺乏,应加强生殖健康卫生知识宣传教育和妇女病普查普治工作,积极开展生殖健康优质服务。     

Dentists' Perceptions of Barriers to Providing Dental Care to Pregnant Women

PurposeThe purpose of the study was to understand US dentists' attitudes, knowledge, and practices regarding dental care for pregnant women and to determine the impact of recent papers on oral health and pregnancy and guidelines disseminated widely.MethodsIn 2006 and 2007, the investigators conducted a mailed survey of all 1,604 general dentists in Oregon; 55.2% responded). Structural equation modeling was used to estimate associations between dentists' attitudes toward providing care to pregnant women, dentists' knowledge about the safety of dental procedures, and dentists' current practice patterns.ResultsDentist's perceived barriers have the strongest direct effect on current practice and might be the most important factor deterring dentists from providing care to pregnant patients. Five attitudes (perceived barriers) were associated with providing less dental services: time, economic, skills, dental staff resistance, and peer pressure. The final model shows a good fit with a chi-square of 38.286 (p = .12; n = 772; df = 52) and a Bentler-Bonett normed fit index of .98 and a comparative fit index of .993. The root mean square error of approximation is .02.ConclusionFindings suggest that attitudes are significant determinants of accurate knowledge and current practice. Multidimensional approaches are needed to increase access to dental care and protect the oral health of women during pregnancy. Despite current clinical recommendations to deliver all necessary care to pregnant patients during the first, second, and third trimesters, dentists' knowledge of the appropriateness of procedures continues to lag the state of the art in dental science.     

Socioeconomic Inequalities Impact the Ability of Pregnant Women and Women of Childbearing Age to Consume Nutrients Needed for Neurodevelopment: An Analysis of NHANES 2007–2018

Adequate consumption of nutrients that support infant neurodevelopment is critical among pregnant women and women of childbearing age. Understanding the potential effects of socioeconomic inequalities on nutrient gaps in these life stages is thus important for informing strategies to mitigate negative health consequences. Usual intake (foods and dietary supplements) of neurodevelopment-related nutrients was determined from 24 h recalls among women of childbearing age and pregnant women (20–44 years) using data from 2007–2018 NHANES. Usual intake was compared across household food security, poverty-to-income ratio (PIR), and household participation in federal food and nutrition assistance programs. Intake of EPA + DHA was universally low with >95% of all women (pregnant and non-pregnant) below the DGA recommendation from foods alone. Women in households that participated in the Supplemental Nutrition Assistance Program had a significantly lower intake of multiple nutrients relative to those who did not participate. For example, 50% had intakes below the estimated average requirement (EAR) for vitamin A (versus 32%), 42% were below the EAR for calcium (versus 33%) and 65% were below the EAR for magnesium (versus 42%). Similar gradients were observed by PIR and household food security, and among pregnant women whereby gaps were more evident in those experiencing socioeconomic inequalities. The use of dietary supplements attenuated shortfalls for most nutrients. These findings highlight a critical need to support the nutritional requirements for women of childbearing age and pregnant women.