Work, leisure-time activity, and risk of preeclampsia and gestational hypertension

Department of Epidemiology, College of Public Health, University of Iowa, Iowa City 52242, USA. <>
American Journal of Epidemiology (Impact Factor: 5.23). 11/2004; 160(8):758-65. DOI: 10.1093/aje/kwh277
Source: PubMed


Few studies of preeclampsia have assessed physical activity level, yet recent evidence suggests that the pathologic mechanisms in preeclampsia are similar to those in cardiovascular disease, for which physical activity is shown to be protective. The authors assessed the independent and combined effects of work and regular leisure-time physical activity (LTPA) during early pregnancy on risk of de novo preeclampsia (n = 44) and gestational hypertension (n = 172) among women recruited from 13 obstetric practices in the New Haven, Connecticut, area between 1988 and 1991. Control subjects were normotensive throughout pregnancy (n = 2,422). Information on time at work spent sitting, standing, and walking and on LTPA before and during pregnancy was collected via face-to-face interviews. Logistic regression analyses suggested that women who engaged in any regular LTPA regardless of caloric expenditure (adjusted odds ratio (aOR) = 0.66, 95% confidence interval (CI): 0.35, 1.22), were unemployed (aOR = 0.64, 95% CI: 0.21, 2.00), or had nonsedentary jobs (aOR = 0.71, 95% CI: 0.37, 1.36) were at decreased risk of preeclampsia. Analyses of gestational hypertension showed no indication of a protective effect of workplace activity, LTPA, or unemployment. Consistent with other studies, these data suggest that regular physical activity during pregnancy may reduce preeclampsia risk.

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    • "Raziskave dokazujejo pozitiven vpliv priporočene gibalne aktivnosti na kakovost življenja obolelih za artritisom (Abell, et al., 2005; Heesch & Brown, 2008; Philpott, et al., 2010), ljudi s prekomerno telesno težo (Heath & Brown, 2009) in otrok, obolelih za juvenilnim idiopatičnim artritisom, hemofilijo, astmo in cistično fibrozo (Philpott, et al., 2010). Gibalna aktivnost ugodno vpliva tudi na nosečnice (Saftlas, et al., 2004), študente (Bray & Born, 2004; Bray & Kwan, 2006) in otroke (Evenson, et al., 2009). "
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    ABSTRACT: Introduction Physical activity can be beneficial to physical and mental health. The following article aims to identify factors influencing physical activity and possible measures to enhance these activities. The purpose of the article is to increase awareness among health and sports professionals to cooperate in the development and implementation of efficient measures in order to improve physical activity of the population. Methods This systematic literature review focuses on the factors influencing physical activity and health-related quality of life. It also pinpoints the measures to increase the physical activity. The review article includes researches indexed in the Web of Science—SCI-EXPANDED and SSCI databases published in the English language between the years of 2000 and 2010. Results include 46 sources while the theoretic framework cites an additional 43 sources. Results An individual's decision to be active is influenced by personal traits and by broader social and economic environment. The determining factors are age, gender and health status. Individual population groups are additionally influenced by different specific factors. Efficient measures to promote physical activity are based on the identified factors and should be directed towards those groups. Discussion and conclusion The variety of population groups and influencing factors serves as the basis to plan preventive action and interventions. Health, sports and related organizations should work hand-in-hand to develop targeted programs and take advantage of the existing legal framework.
    Full-text · Article · Jun 2014
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    • "Relative Risk .2 .5 .75 1 1.5 2 3 Study Relative Risk (95% CI) Cohort studies Nugteren, 2012 0.77 ( 0.37, 1.67) Fortner, 2011 0.70 ( 0.20, 2.00) Saftlas, 2004 0.72 ( 0.32, 1.59) Irwin, 1994 0.75 ( 0.52, 1.07) Subtotal 0.75 ( 0.56, 1.00) "
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    ABSTRACT: Physical activity has been hypothesized to reduce the risk of preeclampsia, but epidemiologic studies have not shown consistent results. Therefore, we conducted a systematic review and dose-response meta-analysis of epidemiologic studies. PubMed, Embase, and Ovid databases were searched for case-control and cohort studies of physical activity and preeclampsia up to 2 November 2012. We estimated summary relative risks (RRs) using a random effects model. Fifteen studies were included. The summary RR for high versus low prepregnancy physical activity was 0.65 (95% confidence interval [CI] = 0.47-0.89, I = 0%; n = 5). In the dose-response analysis, the summary RR was 0.72 (0.53-0.99; I = 0%; n = 3) per 1 hour per day and 0.78 (0.63-0.96; I = 0%; n = 2) per 20 metabolic equivalent task (MET)-hours per week. The summary RR for high versus low physical activity in early pregnancy was 0.79 (0.70-0.91; I = 0%; n = 11). In the dose-response analysis, the summary RR per 1 hour per day was 0.83 (0.72-0.95; I = 21%; n = 7) and 0.85 (0.68-1.07; I = 69%; n = 3) per 20 MET-hours per week. A nonlinear association was observed for physical activity before pregnancy and risk of preeclampsia (test for nonlinearity, P = 0.03), but not for physical activity in early pregnancy (test for nonlinearity, P = 0.37), with a flattening of the curve at higher levels of activity. Both walking and greater intensity of physical activity were inversely associated with preeclampsia. Our analysis suggests a reduced risk of preeclampsia with increasing levels of physical activity before pregnancy and during early pregnancy.
    Full-text · Article · May 2014 · Epidemiology (Cambridge, Mass.)
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    • "However, we demonstrated an association between educational level and BP even among higher SES pregnant mothers. Third, unmeasured possible mediators and confounders, e.g., maternal birth weight [32], exercise during pregnancy [33], and neighborhood effects [34], might exist. Fourth, since some of the participants were recruited beyond the first trimester, and pre-pregnancy body weight and height were self-reported by questionnaire, pre-pregnancy BMI might be underestimated. "
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    ABSTRACT: Background Research investigating the association between socioeconomic status (SES) and blood pressure (BP) during pregnancy is limited and its underlying pathway is unknown. The aim of this study was to investigate the mediators of the association between educational level as an indicator of the SES and BP in early and mid-pregnancy among Japanese women. Methods Nine hundred and twenty-three pregnant women in whom BP was measured before 16 weeks and at 20 weeks of gestation were enrolled in this study. Maternal educational levels were categorized into three groups: high (university or higher), mid (junior college), and low (junior high school, high school, or vocational training school). Results The low educational group had higher systolic (low vs. high, difference = 2.39 mmHg, 95% confidence interval [CI]: 0.59 to 4.19) and diastolic BP levels (low vs. high, difference = 0.74 mmHg, 95% CI: –0.52 to 1.99) in early pregnancy. However, the same associations were not found after adjustment for pre-pregnancy body mass index (BMI). BP reduction was observed in mid-pregnancy in all three educational groups and there was no association between educational level and pregnancy-induced hypertension. Conclusion In Japanese women, the low educational group showed higher BP during pregnancy than the mid or high educational groups. Pre-pregnancy BMI mediates the association between educational level and BP.
    Full-text · Article · Apr 2013 · BMC Public Health
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