Fit für Zwei – Eine Studie zu sitzendem Verhalten und körperlicher Aktivität in der Schwangerschaft

Zusammenfassung

Hintergrund In der Pilotstudie wurde die mit sitzendem Verhalten verbrachte Zeit sowie die körperliche Aktivität bei Schwangeren mit Hilfe eines Akzelerometers erfasst.

Methoden Für die Studie wurden 32 Schwangere rekrutiert, davon elf im ersten Trimester. Definierte Tragezeiträume für das Akzelerometer waren in den Trimestern die Wochen 9–12, 23–26 bzw. 36–39. Im Anschluss an die jeweils 7-tägige Messung erfolgte eine selbstadministrierte Befragung.

Ergebnisse Die Schwangeren waren im Mittel 30 Jahre alt, 50% unter ihnen erstgebärend, 68,8% hatten Hochschulreife. Das Akzelerometer wurde im Mittel 13 Stunden pro Tag getragen. In allen Trimestern wurde mehr als die Hälfte der Zeit sitzendes Verhalten aufgezeichnet. Moderat-anstrengende Aktivität war mit einem Anteil von 4,7% im zweiten Trimester höher, verglichen mit 2,5% im ersten und 3,8% im dritten Trimester. Die Empfehlungen der Fachgesellschaften, pro Woche 150 Minuten moderat-anstrengend aktiv zu sein, erfüllten 36% im ersten, 54% im zweiten und 58% im dritten Trimester. Verglichen mit Mehrgebärenden zeigten Erstgebärende im zweiten und dritten Trimester doppelt so hohe Zeitanteile in moderat-anstrengender Aktivität.

Fazit Sitzendes Verhalten dominiert mehr als die Hälfte der tagsüber erfassten Zeit bei Schwangeren. Etwa die Hälfte erfüllt die Empfehlungen internationaler Leitlinien im zweiten und dritten Trimester. Die Ergebnisse der Studie machen deutlich, dass sitzendes Verhalten und körperliche Aktivität stärker in den Fokus von Praxis und Forschung rücken sollte, um Schwangere zu einem aktivieren Lebensstil zu motivieren.

Abstract

Background In the pilot study sedentary behavior and physical activity were measured in pregnant women using an accelerometer.

Methods A total of 32 pregnant women were enrolled in the study; eleven of them were included in the first trimester. The defined wearing periods for the accelerometer in the first, second and third trimester were weeks 9–12, 23–26, and 36–39, respectively. A self-administered survey was carried out after a 7-day measurement.

Results The pregnant women were on average 30 years old, 50% were nulliparous, and 68.8% had a high school diploma. The accelerometer was worn on average of 13 hours per day. Sedentary behavior was recorded more than half of the wearing time for all trimesters. The proportion of time spent in moderate-to-vigorous activity was highest at 4.7% in the second trimester, compared to 2.5% in the first and 3.8% in the third. A proportion of women, ranging from 32% in the first, 54% in the second, and 58% in the third trimester did reach the levels of PA recommended by the guidelines. Nulliparous women in the second and third trimester spent twice as much time in moderate-to-vigorous activities compared to multiparous women.

Conclusion Pregnant women spent more than half of the monitored day in sedentary behaviors. Half of them did meet the recommendations for physical activity in the second and third trimester. The results show that sedentary behavior and physical activity should be considered more in clinical practice and research to motivate pregnant women to adopt a physically active lifestyle.

Schlüsselwörter

Schwangerschaft - Körperliche Aktivität - Sitzverhalten - Akzelerometrie

Key words

pregnancy - physical activity - sedentary behavior - accelerometry

^* Geteilte Erstautorenschaft. Beide Autorinnen haben zu gleichen Teilen zu diesem Manuskript beigetragen.

Publikationsverlauf

Eingereicht: 14. Januar 2022

Angenommen nach Revision: 01. Mai 2022

Artikel online veröffentlicht:
22. August 2022

• Literatur

• 1 American College of Obstertricians and Gynecologists. Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstet Gynecol 2020; 135: e178-e188
• 2 Thangaratinam S, Rogozinska E, Jolly K. et al. Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ 2012; 344: e2088
• 3 Davenport MH, Meah VL, Ruchat SM. et al. Impact of prenatal exercise on neonatal and childhood outcomes: a systematic review and meta-analysis. Br J Sports Med 2018; 52: 1386-1396
• 4 Ferrari N, Graf C. Körperliche Aktivität in der Schwangerschaft. Der Gynäkologe 2016; 49: 232-235
• 5 Fazzi C, Saunders DH, Linton K. et al. Sedentary behaviours during pregnancy: a systematic review. Int J Behav Nutr Phys Act 2017; 14: 32
• 6 Bull FC, Al-Ansari SS, Biddle S. et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med 2020; 54: 1451-1462
• 7 Evenson KR, Barakat R, Brown WJ. et al. Guidelines for Physical Activity during Pregnancy: Comparisons From Around the World. Am J Lifestyle Med 2014; 8: 102-121
• 8 Sanda B, Vistad I, Haakstad LAH. et al. Reliability and concurrent validity of the International Physical Activity Questionnaire short form among pregnant women. BMC Sports Science, Medicine and Rehabilitation 2017; 9: 7
• 9 Oliveira C, Imakawa TDS, Moises ECD. Physical Activity during Pregnancy: Recommendations and Assessment Tools. Rev Bras Ginecol Obstet 2017; 39: 424-432
• 10 Evenson KR, Wen F. Prevalence and correlates of objectively measured physical activity and sedentary behavior among US pregnant women. Prev Med 2011; 53: 39-43
• 11 Di Fabio DR, Blomme CK, Smith KM. et al. Adherence to physical activity guidelines in mid-pregnancy does not reduce sedentary time: an observational study. Int J Behav Nutr Phys Act 2015; 12: 27
• 12 Evenson KR, Moos MK, Carrier K. et al. Perceived barriers to physical activity among pregnant women. Matern Child Health J 2009; 13: 364-375
• 13 Gaston A, Cramp A.. Exercise during pregnancy: a review of patterns and determinants. J Sci Med Sport 2011; 14: 299-305
• 14 Schmidt T, Heilmann T, Savelsberg L. et al. Physical Exercise During Pregnancy – How Active Are Pregnant Women in Germany and How Well Informed?. Geburtshilfe Frauenheilkd 2017; 77: 508-515
• 15 Tremblay MS, Aubert S, Barnes JD. et al. Sedentary Behavior Research Network (SBRN) – Terminology Consensus Project process and outcome. International Journal of Behavioral Nutrition and Physical Activity 2017; 14: 75
• 16 Mendinueta A, Esnal H, Arrieta H. et al. What Accounts for Physical Activity during Pregnancy? A Study on the Sociodemographic Predictors of Self-Reported and Objectively Assessed Physical Activity during the 1st and 2nd Trimesters of Pregnancy. Int J Environ Res Public Health 2020; 17
• 17 Migueles JH, Cadenas-Sanchez C, Ekelund U. et al. Accelerometer Data Collection and Processing Criteria to Assess Physical Activity and Other Outcomes: A Systematic Review and Practical Considerations. Sports Med 2017; 47: 1821-1845
• 18 Freedson PS, Melanson E, Sirard J. Calibration of the Computer Science and Applications, Inc. accelerometer. Medicine and science in sports and exercise 1998; 30: 777-781
• 19 Ruifrok AE, Althuizen E, Oostdam N. et al. The relationship of objectively measured physical activity and sedentary behaviour with gestational weight gain and birth weight. J Pregnancy 2014; 2014: 567379
• 20 Huberty JL, Buman MP, Leiferman JA. et al. Trajectories of objectively-measured physical activity and sedentary time over the course of pregnancy in women self-identified as inactive. Prev Med Rep 2016; 3: 353-360
• 21 Hesketh KR, Evenson KR, Stroo M. et al. Physical activity and sedentary behavior during pregnancy and postpartum, measured using hip and wrist-worn accelerometers. Prev Med Rep 2018; 10: 337-345
• 22 Andersen MB, Ostenfeld EB, Fuglsang J. et al. Maternal prepregnancy body mass index and physical activity during pregnancy assessed by accelerometer. Am J Obstet Gynecol MFM 2020; 2: 100182
• 23 Rousham EK, Clarke PE, Gross H. Significant changes in physical activity among pregnant women in the UK as assessed by accelerometry and self-reported activity. Eur J Clin Nutr 2006; 60: 393-400
• 24 Evenson KR, Savitz DA, Huston SL. Leisure-time physical activity among pregnant women in the US. Paediatr Perinat Epidemiol 2004; 18: 400-407