Abstract
BackgroundWomen who are physically active during early pregnancy have notably lower odds of developing gestational diabetes than do inactive women. The purpose of the intervention was to examine whether intensified physical activity (PA) counseling in Finnish maternity care is feasible and effective in promoting leisure-time PA (LTPA) among pregnant women at risk of gestational diabetes.MethodsFourteen municipalities were randomized to intervention (INT) and usual care group (UC). Nurses in INT integrated five PA counseling sessions into routine maternity visits and offered monthly group meetings on PA instructed by physiotherapists. In UC conventional practices were continued. Feasibility evaluation included safety (incidence of PA-related adverse events; questionnaire), realization (timing and duration of sessions, number of sessions missed, attendance at group meetings; systematic record-keeping of the nurses and physiotherapists) and applicability (nurses’ views; telephone interview). Effectiveness outcomes were weekly frequency and duration of total and intensity-specific LTPA and meeting PA recommendation for health self-reported at 8-12 (baseline), 26-28 and 36-37 weeks’ gestation. Multilevel analysis with adjustments was used in testing for between-group differences in PA changes.ResultsThe decrease in the weekly days of total and moderate-to-vigorous-intensity LTPA was smaller in INT (N = 219) than in UC (N = 180) from baseline to the first follow-up (0.1 vs. -1.2, p = 0.040 and −0.2 vs. -1.3, p = 0.016). A similar trend was seen in meeting the PA recommendation (−11%-points vs. -28%-points, p = 0.06). INT did not experience more adverse events classified as warning signs to terminate exercise than UC, counseling was implemented as planned and viewed positively by the nurses.ConclusionsIntensified counseling had no effects on the duration of total or intensity-specific weekly LTPA. However, it was able to reduce the decrease in the weekly frequency of total and moderate-to-vigorous-intensity LTPA from baseline to the end of second trimester and was feasibly embedded into routine practices.Trial registrationISRCTN 33885819 ( http://www.isrctn.org)
Highlights
The health benefits of physical activity (PA) among the general population are well documented
The findings indicated no more miscarriages or adverse events listed as warning signs to terminate exercise during pregnancy [3,4] in INT than in usual care group (UC)
The present study indicates that intensified counseling with an option for a monthly thematic meeting on PA can reduce the decrease in the weekly frequency of total and moderate-intensity leisure-time PA (LTPA) compared to the conventional counseling until the end of the second trimester at 26-28 weeks’ gestation
Summary
The health benefits of physical activity (PA) among the general population are well documented. During pregnancy women’s PA tends to decrease [5,6] and shift from moderate to light-intensity [5,7,8] due to, for example, physical limitations [9,10] and fear of harming the fetus [10,11]. Examples of maternal advantages are improved cardiovascular function, limited pregnancy weight gain, decreased musculoskeletal discomfort, reduced incidence of muscle cramps and lower limb edema, improved mood stability and attenuation of gestational hypertension and gestational diabetes [15]. Women who are physically active during early pregnancy have notably lower odds of developing gestational diabetes than do inactive women. The purpose of the intervention was to examine whether intensified physical activity (PA) counseling in Finnish maternity care is feasible and effective in promoting leisure-time PA (LTPA) among pregnant women at risk of gestational diabetes
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