scholarly journals The role of midwives and obstetrical nurses in the promotion of healthy lifestyle during pregnancy

2021 ◽  
Vol 15 ◽  
pp. 263349412110318
Author(s):  
Mahnaz Bahri Khomami ◽  
Ruth Walker ◽  
Michelle Kilpatrick ◽  
Susan de Jersey ◽  
Helen Skouteris ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Pregnant Women ◽  
Healthy Eating ◽  
Healthcare Professionals ◽  
Healthy Lifestyle ◽  
Healthy Lifestyles ◽  
Gestational Weight ◽  
Healthy Lifestyle Promotion

Women with maternal obesity, an unhealthy lifestyle before and during pregnancy and excess gestational weight gain have an increased risk of adverse pregnancy and birth outcomes that can also increase the risk of long-term poor health for them and their children. Pregnant women have frequent medical appointments and are highly receptive to health advice. Healthcare professionals who interact with women during pregnancy are in a privileged position to support women to make lasting healthy lifestyle changes that can improve gestational weight gain and pregnancy outcomes and halt the intergenerational nature of obesity. Midwives and obstetrical nurses are key healthcare professionals responsible for providing antenatal care in most countries. Therefore, it is crucial for them to build and enhance their ability to promote healthy lifestyles in pregnant women. Undergraduate midwifery curricula usually lack sufficient lifestyle content to provide emerging midwives and obstetrical nurses with the knowledge, skills, and confidence to effectively assess and support healthy lifestyle behaviours in pregnant women. Consequently, registered midwives and obstetrical nurses may not recognise their role in healthy lifestyle promotion specific to healthy eating and physical activity in practice. In addition, practising midwives and obstetrical nurses do not consistently have access to healthy lifestyle promotion training in the workplace. Therefore, many midwives and obstetrical nurses may not have the confidence and/or skills to support pregnant women to improve their lifestyles. This narrative review summarises the role of midwives and obstetrical nurses in the promotion of healthy lifestyles relating to healthy eating and physical activity and optimising weight in pregnancy, the barriers that they face to deliver optimal care and an overview of what we know works when supporting midwives and obstetrical nurses in their role to support women in achieving a healthy lifestyle.

scholarly journals Individually Tailored, Adaptive Intervention to Manage Gestational Weight Gain: Protocol for a Randomized Controlled Trial in Women With Overweight and Obesity (Preprint)

2017 ◽  
Author(s):  
Danielle Symons Downs ◽  
Jennifer S Savage ◽  
Daniel E Rivera ◽  
Joshua M Smyth ◽  
Barbara J Rolls ◽  
...  
Keyword(s):  
Physical Activity ◽  
Randomized Controlled Trial ◽  
Weight Gain ◽  
Pregnant Women ◽  
Healthy Eating ◽  
Controlled Trial ◽  
Overweight And Obesity ◽  
Adaptive Intervention ◽  
Gestational Weight ◽  
Randomized Controlled

BACKGROUND High gestational weight gain is a major public health concern as it independently predicts adverse maternal and infant outcomes. Past interventions have had only limited success in effectively managing pregnancy weight gain, especially among women with overweight and obesity. Well-designed interventions are needed that take an individualized approach and target unique barriers to promote healthy weight gain. OBJECTIVE The primary aim of the study is to describe the study protocol for Healthy Mom Zone, an individually tailored, adaptive intervention for managing weight in pregnant women with overweight and obesity. METHODS The Healthy Mom Zone Intervention, based on theories of planned behavior and self-regulation and a model of energy balance, includes components (eg, education, self-monitoring, physical activity/healthy eating behaviors) that are adapted over the intervention (ie, increase in intensity) to better regulate weight gain. Decision rules inform when to adapt the intervention. In this randomized controlled trial, women are randomized to the intervention or standard care control group. The intervention is delivered from approximately 8-36 weeks gestation and includes step-ups in dosages (ie, Step-up 1 = education + physical activity + healthy eating active learning [cooking/recipes]; Step-up 2 = Step-up 1 + portion size, physical activity; Step-up 3 = Step-up 1 + 2 + grocery store feedback, physical activity); 5 maximum adaptations. Study measures are obtained at pre- and postintervention as well as daily (eg, weight), weekly (eg, energy intake/expenditure), and monthly (eg, psychological) over the study period. Analyses will include linear mixed-effects models, generalized estimating equations, and dynamical modeling to understand between-group and within-individual effects of the intervention on weight gain. RESULTS Recruitment of 31 pregnant women with overweight and obesity has occurred from January 2016 through July 2017. Baseline data have been collected for all participants. To date, 24 participants have completed the intervention and postintervention follow-up assessments, 3 are currently in progress, 1 dropped out, and 3 women had early miscarriages and are no longer active in the study. Of the 24 participants, 13 women have completed the intervention to date, of which 1 (8%, 1/13) received only the baseline intervention, 3 (23%, 3/13) received baseline + step-up 1, 6 (46%, 6/13) received baseline + step-up 1 + step-up 2, and 3 (23%, 3/13) received baseline + step-up 1 + step-up 2 +step-up 3. Data analysis is still ongoing through spring 2018. CONCLUSIONS This is one of the first intervention studies to use an individually tailored, adaptive design to manage weight gain in pregnancy. Results from this study will be useful in designing a larger randomized trial to examine efficacy of this intervention and developing strategies for clinical application. REGISTERED REPORT IDENTIFIER RR1-10.2196/9220

Development and Evaluation of a Theory-Based App for Managing Gestational Weight Gain for Overweight and Obese Pregnant Women: A Mixed-Method Pilot Study (Preprint)

2021 ◽  
Author(s):  
Ching-Fang Lee ◽  
Li-Kang Chi ◽  
Yvonne Hsiung ◽  
Jian-Pei Huang ◽  
Chun-Wei Chang
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Mixed Method ◽  
Moderate Intensity ◽  
Obese Women ◽  
Healthy Behavior ◽  
Gestational Weight ◽  
Methodological Guidelines

BACKGROUND Overweight and obese women’s excessive gestational weight gain (GWG) may be a health risk for both the mother and the fetus; excessive GWG leads to the retention of weight postpartum and thus obesity. Given the overwhelming number of existing pregnancy-related applications (apps), we lack only a few methodological guidelines for integrating theory, evidence and previously validated apps to help overweight and obese women manage their GWG during pregnancy. OBJECTIVE This two-phase study aimed to develop the MyHealthyWeight (MHW) app based on social-cognitive theory (SCT) and evaluate its effectiveness for overweight and obese women in helping prevent excessive GWG by enhancing adherence to optimal GWG goals and healthy behavior during pregnancy. METHODS First, we constructed and developed the MHW app based on SCT theory, and we later employed a mixed-method study to evaluate the effects of the app on overweight and obese pregnant women. RESULTS All participating overweight and obese pregnant women (100%) achieved their optimal GWG through increased self-efficacy and physical activity. Their total and moderate-intensity physical activity expenditures improved, while their sedentary and light-intensity levels of physical activity decreased. CONCLUSIONS This theory-based MHW app for weight management was greatly valued by the pregnant users. Its usefulness for health-care professionals in assisting overweight and obese pregnant women in preventing excessive GWG by promoting healthy behavior, in particular through physical exercise and a healthy diet, during pregnancy was also confirmed. CLINICALTRIAL NCT04553718

Greater energy demand of exercise during pregnancy does not impact mechanical efficiency

2020 ◽  
Vol 45 (5) ◽  
pp. 493-499 ◽  
Author(s):  
Kathryn M. Denize ◽  
Pegah Akbari ◽  
Danilo Fernandes da Silva ◽  
Francois Haman ◽  
Kristi B. Adamo
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Energy Demand ◽  
Movement Pattern ◽  
Late Pregnancy ◽  
Mechanical Efficiency ◽  
Moderate Intensity ◽  
Gestational Weight

Pregnant women are recommended to engage in 150 min of moderate-intensity physical activity per week to reduce pregnancy complications. Many women struggle to remain physically active throughout pregnancy, and there is no consensus about whether women adopt a less efficient movement pattern as they progress through pregnancy and experience gestational weight gain. This study assessed the change in energy expenditure and mechanical efficiency in pregnant women (PREG; n = 10) when performing a walking treadmill task in early, mid, and late pregnancy and also compared with an age- and body mass index-matched, nonpregnant (CON; n = 10) group. On average, the PREG group gained within the Institute of Medicine’s gestational weight gain guidelines (11.6 ± 3.6 kg) and were all inactive (measured using accelerometry), except for 1 participant, by the third trimester, as per the 2019 Canadian physical activity guidelines for pregnant women. Energy expended to complete the walking task increased throughout pregnancy and was higher than the controls (111.5 ± 24.6 kcal) in mid and late pregnancy (139.0 ± 22.2 kcal, p = 0.02, and 147.3 ± 24.6 kcal, p = 0.005, respectively), but not early pregnancy (129.9 ± 18.9 kcal, p = 0.08). Walking mechanical efficiency was similar within pregnant women at each time point and compared to nonpregnant controls. Our findings add to the growing body of evidence demonstrating that pregnant women can safely perform physical activity by showing that walking mechanical efficiency is unchanged at low to moderate intensities. Novelty Energy demand during exercise increases proportionally to weight gain across pregnancy trimesters. However, mechanical efficiency remains unchanged during low- to moderate-intensity walking.

scholarly journals Effectiveness of Physical Activity Interventions on Pregnancy-Related Outcomes among Pregnant Women: A Systematic Review

2019 ◽  
Vol 16 (10) ◽  
pp. 1840 ◽  
Author(s):  
Carmen W. H. Chan ◽  
Elce Au Yeung ◽  
Bernard M. H. Law
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Psychological Health ◽  
Activity Levels ◽  
Gestational Weight ◽  
Physical Activity Interventions ◽  
Physical Activity Levels ◽  
Physical And Psychological Health

Regular physical activity has been demonstrated to contribute to physical and psychological health. Nevertheless, pregnant women generally exhibit low levels of physical activity. Implementation of interventions that enhance the self-efficacy of pregnant women on increasing physical activity is required. This paper provides an in-depth review of studies reporting the effect of various physical activity interventions dedicated for pregnant women on pregnancy-related issues, including gestational weight gain, pain and depression, physical activity level, and quality of life among these individuals. Five databases were used in searching the literature. Findings of the included studies were presented narratively, and appraisal of their methodological quality was conducted using the quality assessment tool developed by Effective Public Health Practice Project. Review findings demonstrated that physical activity interventions are effective in enhancing physical activity levels of pregnant women. Further, they are potentially useful in alleviating pregnancy-related pain and psychological symptoms, reducing gestational weight gain, and increasing self-efficacy in enhancing physical activity levels among these individuals. Nevertheless, inconsistencies in findings between studies hamper the drawing of firm conclusions on these latter outcomes. Overall, studies demonstrated a positive effect of physical activity interventions on the well-being and physical and psychological health of pregnant women.

scholarly journals Effect of motivational interviewing on gestational weight gain and fetal growth in pregnant women with type 2 diabetes

2019 ◽  
Vol 7 (1) ◽  
pp. e000733
Author(s):  
Björg Ásbjörnsdóttir ◽  
Marianne Vestgaard ◽  
Lene Ringholm ◽  
Lise Lotte Torvin Andersen ◽  
Dorte Møller Jensen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Gain ◽  
Motivational Interviewing ◽  
Pregnant Women ◽  
Gestational Weight Gain ◽  
Healthy Eating ◽  
Routine Care ◽  
Gestational Weight ◽  
Reference Cohort

ObjectiveTo study how lifestyle coaching with motivational interviewing to improve adherence to healthy eating affects gestational weight gain and fetal growth in pregnant women with type 2 diabetes in a real-world setting.Research design and methodsA cohort study including a prospective intervention cohort of consecutive, singleton pregnant, Danish-speaking women with type 2 diabetes included between August 2015 and February 2018 and a historical reference cohort included between February 2013 and August 2015. The intervention consisted of a motivational interviewing to improve adherence to healthy eating in addition to routine care. The reference cohort received routine care only. The main outcomes were gestational weight gain and large for gestational age (LGA) infants.ResultsNinety-seven women were included in the intervention cohort and 92 in the reference cohort. Pre-pregnancy body mass index (32.8±6.9 kg/m2vs 32.4±7.4 kg/m2, p=0.70), gestational weight gain (9.2±5.8 kg vs 10.2±5.8 kg, p=0.25), HbA1c in early pregnancy (6.7%±1.1% vs 6.5%±1.3% (50±12 mmol/mol vs 48±14 mmol/mol), p=0.32) and late pregnancy (5.9%±0.5% vs 6.0%±0.6% (41±6 mmol/mol vs 42±7 mmol/mol), p=0.34) were comparable in the two cohorts. LGA infants occurred in 20% vs 31%, p=0.07, respectively, and after adjustment for maternal characteristics 14% vs 27% delivered LGA infants (p=0.04). Birth weight z-score was 0.24±1.36 vs 0.61±1.38, p=0.06.ConclusionsMotivational interviewing to improve adherence to healthy eating in addition to routine care in pregnant women with type 2 diabetes tended to reduce fetal overgrowth without major effect on gestational weight gain. Further studies investigating the cost-benefit of enhancing motivation are needed.Trial registration numberNCT02883127.

scholarly journals Effectiveness of a digital health intervention with a smartband and counselling App in gestational weight gain and physical activity in pregnant women with obesity (PAS & PES study): a randomised controlled trial (Preprint)

2021 ◽  
Author(s):  
Elena Gonzalez-Plaza ◽  
Jordi Bellart ◽  
Ángela Arranz ◽  
Leila Luján-Barroso ◽  
Esther Crespo ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Randomised Controlled Trial ◽  
Pregnant Women ◽  
Mobile Apps ◽  
Controlled Trial ◽  
Perinatal Outcomes ◽  
Gestational Weight ◽  
Randomised Controlled ◽  
Health Counselling

BACKGROUND Obesity during pregnancy is a public health problem in our society. Pregnant women with obesity with excessive gestational weight gain (GWG) present a higher probability of presenting maternal and perinatal complications. The use of mobile Apps and a wristband during pregnancy may contribute to promoting healthy lifestyles and, thus, improving maternal and neonatal health. OBJECTIVE The objectives were to evaluate the effectiveness of the use of a smartband and an App with health counselling together with virtual support from a midwife in relation to GWG and physical activity (PA) in pregnant women with pre-pregnancy obesity and analyse the impact on maternal and perinatal outcomes. In addition, we studied the frequency of use, usability and satisfaction with the mobile Apps used by the women in the intervention group (IG). METHODS This parallel 2-arm randomised controlled trial included 150 pregnant women with obesity. The IG received a complex combined digital intervention called Pas & Pes. The intervention was delivered with a smartband (Mi band 2©) linked to the App Mi Fit© plus personalised health information and 24h/day midwife support through another App (Hangouts ©). Women in the control group (CG) only received standard antenatal care. The Spanish version of the International Physical Activity Questionnaire Short Form (IPAQ-SF) and the System Usability Scale (SUS) were used. Satisfaction was measured in a 1-5 point Likert scale. RESULTS We analysed 120 pregnant women; 30 have been withdrawn due to the COVID-19 pandemic. The mean GWG in the IG was 7 kg (Q1=4-Q3=11) vs. 9.3 kg (Q1=5.9-Q3=3.3) in the CG, P=.04. At the end of the study, the adjusted mean weight gain per week was 0.500 kg/week (95% confidence interval [CI]: 0.41 to 0.58) for the CG and 0.350 kg/week (95%CI: 0.27-0.43) for the IG.Between gestation weeks 35-37, the women in the IG performed greater mean PA than the GC (1,980 metabolic equivalent of tasks [METs]-min/week vs. 1,386 METs/min-week, respectively; P=.01). No differences were observed between study groups in the incidence of maternal and perinatal outcomes. In the IG, 61% (36) of the pregnant women used the smartband daily, and 74.6% (44) evaluated the usability of the Mi Fit© App as excellent. The grade of satisfaction with the health counselling and virtual midwife support through an App obtained a mean score of 4.8 (SD: 0.6) points. CONCLUSIONS The use of a smartband and a health counselling App together with virtual midwife support and standard prenatal controls were effective for obtaining a lower GWG and increasing the performance of PA in pregnant women with obesity. CLINICALTRIAL This trial was registered in the Clinical Trial Register of the National Library of Medicine of United States (NCT03706872).

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