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1.
JAMA Intern Med ; 182(2): 106-114, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1838104

ABSTRACT

IMPORTANCE: Excessive gestational weight gain (GWG) is common and associated with adverse pregnancy outcomes. Antenatal lifestyle interventions limit GWG; yet benefits of different intervention types and specific maternal and neonatal outcomes are unclear. OBJECTIVE: To evaluate the association of different types of diet and physical activity-based antenatal lifestyle interventions with GWG and maternal and neonatal outcomes. DATA SOURCES: A 2-stage systematic literature search of MEDLINE, Embase, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, and Health Technology Assessment Database was conducted from February 1, 2017, to May 31, 2020. Search results from the present study were integrated with those from a previous systematic review from 1990 to February 2017. STUDY SELECTION: Randomized trials reporting GWG and maternal and neonatal outcomes. DATA EXTRACTION AND SYNTHESIS: Data were extracted for random-effects meta-analyses to calculate the summary effect estimates and 95% CIs. MAIN OUTCOMES AND MEASURES: Outcomes were clinically prioritized, with mean GWG as the primary outcome. Secondary outcomes included gestational diabetes, hypertensive disorders of pregnancy, cesarean section, preterm delivery, large or small for gestational age neonates, neonatal intensive care unit admission, or fetal death. RESULTS: A total of 117 randomized clinical trials of antenatal lifestyle interventions (involving 34 546 women) were included. Overall lifestyle intervention was associated with reduced GWG (-1.15 kg; 95% CI, -1.40 to -0.91), risk of gestational diabetes (odds ratio [OR], 0.79; 95% CI, 0.70-0.89), and total adverse maternal outcomes (OR, 0.89; 95% CI, 0.84-0.94) vs routine care. Compared with routine care, diet was associated with less GWG (-2.63 kg; 95% CI, -3.87 to -1.40) than physical activity (-1.04 kg; 95% CI, -1.33 to -0.74) or mixed interventions (eg, unstructured lifestyle support, written information with weight monitoring, or behavioral support alone) (-0.74 kg; 95% CI, -1.06 to -0.43). Diet was associated with reduced risk of gestational diabetes (OR, 0.61; 95% CI, 0.45-0.82), preterm delivery (OR, 0.43; 95% CI, 0.22-0.84), large for gestational age neonate (OR, 0.19; 95% CI, 0.08-0.47), neonatal intensive care admission (OR, 0.68; 95% CI, 0.48-0.95), and total adverse maternal (OR, 0.75; 95% CI, 0.61-0.92) and neonatal outcomes (OR, 0.44; 95% CI, 0.26-0.72). Physical activity was associated with reduced GWG and reduced risk of gestational diabetes (OR, 0.60; 95% CI, 0.47-0.75), hypertensive disorders (OR, 0.66; 95% CI, 0.48-0.90), cesarean section (OR, 0.85; 95% CI, 0.75-0.95), and total adverse maternal outcomes (OR, 0.78; 95% CI, 0.71-0.86). Diet with physical activity was associated with reduced GWG (-1.35 kg; 95% CI, -1.95 to -0.75) and reduced risk of gestational diabetes (OR, 0.72; 95% CI, 0.54-0.96) and total adverse maternal outcomes (OR, 0.81; 95% CI, 0.69-0.95). Mixed interventions were associated with reduced GWG only. CONCLUSIONS AND RELEVANCE: This systematic review and meta-analysis found level 1 evidence that antenatal structured diet and physical activity-based lifestyle interventions were associated with reduced GWG and lower risk of adverse maternal and neonatal outcomes. The findings support the implementation of such interventions in routine antenatal care and policy around the world.


Subject(s)
Diabetes, Gestational , Gestational Weight Gain , Hypertension , Premature Birth , Cesarean Section , Diabetes, Gestational/epidemiology , Diabetes, Gestational/prevention & control , Diet , Exercise , Female , Humans , Infant, Newborn , Male , Pregnancy , Pregnancy Outcome/epidemiology , Premature Birth/epidemiology , Premature Birth/prevention & control , Weight Gain
2.
BMC Womens Health ; 21(1): 102, 2021 03 10.
Article in English | MEDLINE | ID: covidwho-1127705

ABSTRACT

BACKGROUND: This study aimed to investigate the relationship between quality of life (QoL) with anxiety, depression, corona disease anxiety, sexual function (SF), and marital satisfaction (MS) in married women during the Covid-19 pandemic. METHODS: We performed a cross-sectional study involving n = 296 married women. We used the Short Form Health Survey (SF-12), Marital Satisfaction Scale (MSS), Female Sexual Function Index (FSFI), Hospital Anxiety and Depression Scale, and coronary disease anxiety questionnaire, as determinants of QoL for data collection. Data were analyzed using the Pearson correlation coefficient and path analysis. RESULTS: There was a relationship between the components of QoL with SF, anxiety, depression, MS, general health, and contamination obsessions. The results of path analysis also showed that that SF, MS, anxiety, general health, and corona-related anxiety have a direct effect on women's QoL. General health has a more direct effect on QoL. CONCLUSION: The results of this study could help in a plan to improve the QoL of women during the coronavirus epidemic.


Subject(s)
COVID-19/psychology , Marriage , Quality of Life , Anxiety/epidemiology , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Iran/epidemiology , Pandemics , Personal Satisfaction , Sexual Health , Surveys and Questionnaires
3.
Health Qual Life Outcomes ; 19(1): 66, 2021 Mar 01.
Article in English | MEDLINE | ID: covidwho-1112437

ABSTRACT

BACKGROUND: The impact of COVID-19 pandemic on mental health of pregnant and lactating women is unclear. This study aimed to assess the impact of COVID-19 on psychological health, sexual function, and quality of life (QoL) in Iranian pregnant and lactating women and compare the results with non-pregnant/non-lactating women. METHOD: This comparative cross-sectional study was carried out on pregnant and lactating women, with non-pregnant/non-lactating women from May to Jun 2020. Patients were asked to complete three questionnaires: Hospital Anxiety and Depression Scale (HADS), Female Sexual Function Index (FSFI), and Short-Form Health Survey (SF-12). One-way ANOVA was used to reveal the statistical differences between the three groups. RESULT: The mean age of patients was 20.81 ± 5.92 years old. The mean (SD) score of HADS in pregnant, lactating and non-pregnant / non-lactating women were 12.11 (6.72), 11.98 (8.44) and 9.38 (6.2) respectively, and the results showed that the scores in pregnant, lactating women were higher than non-pregnant / non-lactating women (P < 0.001). Also the mean (SD) score of QOL and FSFI was 68.29 (9.47), 74.18 (12.65), 79.03 (10.48) and 22.71 (8.16), 22.72 (8.16), 26.19 (3.93) in three groups and the scores in pregnant, lactating women were lower than non-pregnant/non-lactating women (P < 0.001). CONCLUSION: The COVID-19 epidemic increases the risk of depression, anxiety, FSD, and lowers QoL in pregnant and lactating women, with the general population. This suggests the urgent need for psychological intervention in the maternal population during the epidemic.


Subject(s)
COVID-19/psychology , Lactation/psychology , Mental Health , Pregnancy/psychology , Quality of Life , Adolescent , Adult , Analysis of Variance , Anxiety/epidemiology , Breast Feeding , Cross-Sectional Studies , Depression/epidemiology , Female , Humans , Iran/epidemiology , Sexual Dysfunctions, Psychological/epidemiology , Surveys and Questionnaires , Young Adult
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