Abstract
BackgroundPregnancy and childbirth are associated with weight gain in women, and retention of weight gained during pregnancy can lead to obesity in later life. Diet and physical activity are factors that can influence the loss of retained pregnancy weight after birth. Exercise guidelines exist for pregnancy, but recommendations for exercise after childbirth are virtually nonexistent. The aim of this study was to evaluate the effect of physical activity intervention based on pedometer on physical activity level and anthropometric measures of women after childbirth.MethodsWe conducted a randomized controlled trial in which 66 women who had given birth 6 weeks to 6 months prior were randomly assigned to receive either a 12 week tailored program encouraging increased walking using a pedometer (intervention group, n = 32) or routine postpartum care (control group, n = 34). During the 12-week study period, each woman in the intervention group wore a pedometer and recorded her daily step count. The women were advised to increase their steps by 500 per week until they achieved the first target of 5000 steps per day and then continued to increase it to minimum of 10,000 steps per day by the end of 12th week. Assessed outcomes included anthropometric measures, physical activity level, and energy expenditure per week. Data were analyzed using the paired t-test, independent t-test, Mann-Whitney, chi-square, Wilcoxon, covariance analysis, and the general linear model repeated measures procedure as appropriate.ResultsAfter 12 weeks, women in the intervention group had significantly increased their physical activity and energy expenditure per week (4394 vs. 1651 calorie, p < 0.001). Significant differences between-group in weight (P = 0.001), Body Mass Index (P = 0.001), waist circumference (P = 0.001), hip circumference (P = 0.032) and waist-hip ratio (P = 0.02) were presented after the intervention. The intervention group significantly increased their mean daily step count over the study period (from 3249 before, to 9960 after the intervention, p < 0.001).ConclusionA physical activity intervention based on pedometer is an effective means to increase physical activity; reducing retention of weight gained during pregnancy and can improve anthropometric measures in postpartum women.Trial registrationISRCTN: IRCT201105026362N1
Highlights
Pregnancy and childbirth are associated with weight gain in women, and retention of weight gained during pregnancy can lead to obesity in later life
The Institute of Medicine (IOM) has updated their guidelines for weight gain during pregnancy according to the WHO recommendations, which are based on the woman’s Body Mass Index (BMI) before pregnancy
The primary aim of this study was to determine the effect of physical activity intervention program emphasizing walking using a pedometer on physical activity level and anthropometric measures in women after childbirth
Summary
Pregnancy and childbirth are associated with weight gain in women, and retention of weight gained during pregnancy can lead to obesity in later life. The factors most involved in retention of weight gained during pregnancy after birth are: BMI before pregnancy, weight gain during pregnancy, smoking cessation, diet, physical activity level and number of pregnancies [7]. A recent survey in Iran showed that diet and physical activity are the most important modifiable factors involved in pregnancy weight retention after childbirth [8]. Another systematic review which recruited eight randomized controlled trial and 18 observational studies showed that using pedometer was associated with significant increase in physical activity, decreases in BM I and blood pressure [17]. The primary aim of this study was to determine the effect of physical activity intervention program emphasizing walking using a pedometer on physical activity level and anthropometric measures in women after childbirth
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