Abstract
Purpose: Physical activity (PA) typically declines throughout pregnancy. Low levels of PA are associated with excessive weight gain and subsequently increase risk of pre-eclampsia, gestational diabetes mellitus, hypertension disorders, delivery by caesarean section and stillbirth. Systematic reviews on PA during pregnancy have not explored the efficacy of behaviour change techniques or related theory in altering PA behaviour. This systematic review evaluated the content of PA interventions to reduce the decline of PA in pregnant women with a specific emphasis on the behaviour change techniques employed to elicit this change.
Search and Review Methodology: Literature searches were conducted in eight databases. Strict inclusion and exclusioncriteria were employed. Two reviewers independently evaluated each intervention using the behaviour change techniques (BCT) taxonomy to identify the specific behaviour change techniques employed. Two reviewers independently assessed the risk of bias using the guidelines from the Cochrane Collaboration. Overall quality was determined using the GRADE approach.
Findings: A total of 1140 potentially eligible papers were identified from which 14 studies were selected for inclusion. Interventions included counselling (n = 6), structured exercise (n = 6) and education (n = 2). Common behaviour change techniques employed in these studies were goal setting and planning, feedback, repetition and substitution, shaping knowledge and comparison of behaviours. Regular face-to-face meetings were also commonly employed. PA change over time in intervention groups ranged from increases of 28% to decreases of 25%. In 8 out of 10 studies, which provided adequate data, participants in the intervention group were more physically active post intervention than controls.
Conclusions and Implications: Physical activity interventions incorporating behaviour change techniques help reduce the decline in PA throughout pregnancy. Range of behaviour change techniques can be implemented to reduce this decline including goals and planning, shaping knowledge and comparison of outcomes. A lack of high quality interventions hampers conclusions of intervention effectiveness.
Search and Review Methodology: Literature searches were conducted in eight databases. Strict inclusion and exclusioncriteria were employed. Two reviewers independently evaluated each intervention using the behaviour change techniques (BCT) taxonomy to identify the specific behaviour change techniques employed. Two reviewers independently assessed the risk of bias using the guidelines from the Cochrane Collaboration. Overall quality was determined using the GRADE approach.
Findings: A total of 1140 potentially eligible papers were identified from which 14 studies were selected for inclusion. Interventions included counselling (n = 6), structured exercise (n = 6) and education (n = 2). Common behaviour change techniques employed in these studies were goal setting and planning, feedback, repetition and substitution, shaping knowledge and comparison of behaviours. Regular face-to-face meetings were also commonly employed. PA change over time in intervention groups ranged from increases of 28% to decreases of 25%. In 8 out of 10 studies, which provided adequate data, participants in the intervention group were more physically active post intervention than controls.
Conclusions and Implications: Physical activity interventions incorporating behaviour change techniques help reduce the decline in PA throughout pregnancy. Range of behaviour change techniques can be implemented to reduce this decline including goals and planning, shaping knowledge and comparison of outcomes. A lack of high quality interventions hampers conclusions of intervention effectiveness.
| Original language | English |
|---|---|
| Pages (from-to) | e66385 |
| Number of pages | 12 |
| Journal | PlosOne |
| Volume | 8 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published (in print/issue) - 14 Jun 2013 |
Bibliographical note
Reference text: . Organisation for Economic Co-operation and Development (2010) Health at aglance: Europe 2010: OECD.
2. Lee CF, Hwang FM, Liou YM, Chien LY (2011) A preliminary study on the
pattern of weight change from pregnancy to 6 months postpartum: A latent
growth model approach. Int J Obes (Lond) 35: 1079–1086.
3. Villamor E, Cnattingius S (2006) Interpregnancy weight change and risk of
adverse pregnancy outcomes: A population-based study. The Lancet 368: 1164–
1170.
4. Walsh JM, Murphy DJ (2007) Weight and pregnancy. BMJ: British Medical
Journal 335: 169.
5. World Health Organization (2010) Global recommendations on physical activity
for health. Geneva: World Health Organization: 8–10.
6. Caspersen CJ, Powell KE, Christenson GM (1985) Physical activity, exercise,
and physical fitness: Definitions and distinctions for health-related research.
Public Health Rep 100: 126.
7. ACOG, Committee on Obstetric Practice (2002) Committee opinion# 267:
Exercise during pregnancy and the postpartum period. Obstet Gynecol 99: 171–
173.
8. Artal R, O’Toole M (2003) Guidelines of the american college of obstetricians
and gynecologists for exercise during pregnancy and the postpartum period.
Br J Sports Med 37: 6–12.
9. Wolfe L, Mottola M (2002) PARmed-X for pregnancy. Ottawa: Canadian
Society for Exercise Physiology : 1–4.
10. Department of Health (2011) UK physical activity guidelines. 2012.
11. Royal College of Obstetricians and Gynaecologists (2006) Exercise in pregnancy,
statement no4.
12. Foxcroft KF, Rowlands IJ, Byrne NM, McIntyre HD, Callaway LK (2011)
Exercise in obese pregnant women: The role of social factors, lifestyle and
pregnancy symptoms. BMC pregnancy and childbirth 11: 4.
13. Poudevigne MS, OConnor PJ (2006) A review of physical activity patterns in
pregnant women and their relationship to psychological health. Sports Medicine
36: 19–38.
14. Clapp JF (1996) Morphometric and neurodevelopmental outcome at age five
years of the offspring of women who continued to exercise regularly throughout
pregnancy. J Pediatr 129: 856–863.
. Organisation for Economic Co-operation and Development (2010) Health at a
glance: Europe 2010: OECD.
2. Lee CF, Hwang FM, Liou YM, Chien LY (2011) A preliminary study on the
pattern of weight change from pregnancy to 6 months postpartum: A latent
growth model approach. Int J Obes (Lond) 35: 1079–1086.
3. Villamor E, Cnattingius S (2006) Interpregnancy weight change and risk of
adverse pregnancy outcomes: A population-based study. The Lancet 368: 1164–
1170.
4. Walsh JM, Murphy DJ (2007) Weight and pregnancy. BMJ: British Medical
Journal 335: 169.
5. World Health Organization (2010) Global recommendations on physical activity
for health. Geneva: World Health Organization: 8–10.
6. Caspersen CJ, Powell KE, Christenson GM (1985) Physical activity, exercise,
and physical fitness: Definitions and distinctions for health-related research.
Public Health Rep 100: 126.
7. ACOG, Committee on Obstetric Practice (2002) Committee opinion# 267:
Exercise during pregnancy and the postpartum period. Obstet Gynecol 99: 171–
173.
8. Artal R, O’Toole M (2003) Guidelines of the american college of obstetricians
and gynecologists for exercise during pregnancy and the postpartum period.
Br J Sports Med 37: 6–12.
9. Wolfe L, Mottola M (2002) PARmed-X for pregnancy. Ottawa: Canadian
Society for Exercise Physiology : 1–4.
10. Department of Health (2011) UK physical activity guidelines. 2012.
11. Royal College of Obstetricians and Gynaecologists (2006) Exercise in pregnancy,
statement no4.
12. Foxcroft KF, Rowlands IJ, Byrne NM, McIntyre HD, Callaway LK (2011)
Exercise in obese pregnant women: The role of social factors, lifestyle and
pregnancy symptoms. BMC pregnancy and childbirth 11: 4.
13. Poudevigne MS, OConnor PJ (2006) A review of physical activity patterns in
pregnant women and their relationship to psychological health. Sports Medicine
36: 19–38.
14. Clapp JF (1996) Morphometric and neurodevelopmental outcome at age five
years of the offspring of women who continued to exercise regularly throughout
pregnancy. J Pediatr 129: 856–863.
