The effect of physical exercise on postpartum fitness, hormone and lipid levels: a randomized controlled trial in primiparous, lactating women

Zourladani, A.; Zafrakas, Μenelaos; Chatzigiannis, B.; Papasozomenou, Panayiota; Vavilis, Dimitrios; Matziari, Chrysoula

doi:10.1007/s00404-014-3418-y

Cited by 26 publications

(27 citation statements)

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“…Eleven studies provided a named theory for the intervention, mostly social cognitive theory (n = 8) and transtheoretical model (n = 2) . Several others provided a rationale for the intervention without articulating the theory used (n = 4) . The remainder did not describe the rationale for the interventions.…”

Section: Resultsmentioning

confidence: 99%

A systematic review and meta‐analysis of intervention characteristics in postpartum weight management using the TIDieR framework: A summary of evidence to inform implementation

et al. 2019

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Postpartum weight retention is a significant contributor to obesity in reproductiveaged women, but the key implementation characteristics of postpartum weight management interventions have not been systematically identified to inform policy and practice. This study aimed to evaluate the intervention characteristics associated with weight loss in postpartum women using the Template for Intervention Description and Replication (TIDieR) framework. We searched MEDLINE, CINAHL, EMBASE, PSYCINFO, and EBM databases to identify lifestyle intervention RCTs in postpartum women (within 2 years after birth) published up to January 2018. From 4512 studies, 33 studies were included in the systematic review and meta-analysis (n = 4960 women). Health professional-delivered interventions had significantly greater weight loss than those delivered by nonhealth professionals (mean difference, 95% confidence interval: (−3.22 kg [−4.83, −1.61] vs −0.99 kg [−1.53, −0.45], P = 0.01 for subgroup differences)). Diet and physical activity combined had significantly greater weight loss compared with physical activity-only interventions (−3.15 kg [−4.34, −1.96] vs −0.78 kg [−1.73, 0.16], P = 0.009 for subgroup differences). The extent of weight loss was not influenced by intervention intensity (duration, number of sessions) and setting (individual or group). KEYWORDS implementation, lifestyle, postpartum women, systematic review, weight management 1 | INTRODUCTIONGlobal trends in obesity suggest that women aged 19 to 50 years gain weight more rapidly than men and women of other age groups. [1][2][3] Weight retention or weight gain after birth is a key contributor to obesity in women. Weight gain from early to middle adulthood has been shown to be associated with increased risk of major chronic diseases including type 2 diabetes and cardiovascular disease. 4 A recent systematic review and meta-analysis reported approximately half of all pregnancies had excessive gestational weight gain according to the Institute of Medicine recommendations. 5 There are large variations in weight retained after pregnancy between individuals; on average, women retain 0.5 to 3.5 kg from each pregnancy, 6 and a quarter to half of all women are 4.5 kg or heavier than prepregnancy weight by 1 year postpartum. 7-10 The inability to return to prepregnancy weight or halt weight gain during the postpartum period (birth to 2 years) carries † These authors contributed equally to this manuscript

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Section: Resultsmentioning

confidence: 99%

A systematic review and meta‐analysis of intervention characteristics in postpartum weight management using the TIDieR framework: A summary of evidence to inform implementation

et al. 2019

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“…Ten studies were conducted on premenopausal eumenorrheic women [ 22 – 32 ], one study on perimenopausal women [ 33 ], 13 studies on postmenopausal women [ 21 , 34 – 53 ], and 12 studies on women with polycystic ovary syndrome (PCOS) [ 54 – 67 ]. One study did not specify the hormonal status of participants [ 68 ], and one study was conducted on perpartum women [ 69 ] and two studies on postpartum women [ 70 , 71 ]. The mean age of participants varied between 15.5 and 71.0 years; the mean BMI varied between 19.9 and 39.0 kg/m 2 .…”

Section: Resultsmentioning

confidence: 99%

Effect of physical activity on sex hormones in women: a systematic review and meta-analysis of randomized controlled trials

2015

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IntroductionExposure to high levels of endogenous estrogens is a main risk factor for breast cancer in women, and in observational studies was found to be inversely associated with physical activity. The objective of the present study is to determine the effect of physical activity interventions on sex hormone levels in healthy women.MethodsElectronic databases (MEDLINE, EMBASE, CENTRAL), from inception to December 2014, and reference lists of relevant reviews and clinical trials were searched, with no language restrictions applied. Randomized controlled trials (RCTs) were included if they compared any type of exercise intervention to no intervention or other interventions, and assessed the effects on estrogens, androgens or the sex hormone binding globulin (SHBG) in cancer-free women. Following the method described in the Cochrane Handbook for Systematic Reviews of Interventions, data on populations, interventions, and outcomes were extracted, and combined using the inverse-variance method and a random-effects model. A pre-established protocol was drawn up, in which the primary outcome was the difference in circulating estradiol concentrations between the physical activity (experimental) and the control groups after intervention. Pre-specified subgroup analyses and sensitivity analysis according to the risk of bias were conducted.ResultsData suitable for quantitative synthesis were available from 18 RCTs (1994 participants) for total estradiol and from 5 RCTs (1245 participants) for free estradiol. The overall effect of physical activity was a statistically significant decrease of both total estradiol (standardized mean difference [SMD] -0.12; 95 % confidence interval [CI] -0.20 to −0.03; P = 0.01; I2 = 0 %) and free estradiol (SMD −0.20; 95 % CI −0.31 to −0.09; P = 0.0005; I2 = 0 %). Subgroup analyses suggest that this effect is independent of menopausal status and is more noticeable for non-obese women and for high intensity exercise. Meta-analysis for secondary outcomes found that physical activity induces a statistically significant decline of free testosterone, androstenedione, dehydroepiandrosterone–sulfate and adiposity markers, while a significant increase of SHBG was observed.ConclusionsAlthough the effect is relatively modest, physical activity induces a decrease in circulating sex hormones and this effect is not entirely explained by weight loss. The findings emphasize the benefits of physical activity for women.Electronic supplementary materialThe online version of this article (doi:10.1186/s13058-015-0647-3) contains supplementary material, which is available to authorized users.

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“…This is in line with a study by Zourdalani (2015) that found the implementation of low-intensity physical exercise programs seems to improve physical and overall fitness in postpartum women, including increased cardio-respiratory function, muscle strength, and endurance of the upper and abdominal limbs, stretching the musculoskeletal back and thighs, and a reduction in total body fat. Physiologically, muscle resistance is known to decrease after childbirth along with hormonal changes that occur (19)(20). With the presence of physical exercise, especially yoga can improve muscle strength, stretching, and relaxation so that the quality of postpartum life is increased (21)(22).…”

Section: Discussionmentioning

confidence: 99%

The THE EFFECTIVENESS OF POSTPARTUM YOGA ON UTERINE INVOLUTION AMONG POSTPARTUM WOMEN IN INDONESIA

Anggraeni

Herawati²,

Widyawati³

2019

IJNHS

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Sub uterine involution is one of the pathological symptoms of the postpartum period, which causes complications. This is indicated by the size of the fundus uterine, which is greater than the normal size and elongated outflow of lochia. One of the non-pharmacological methods for preventing sub uterine involution is postpartum yoga which focuses on physical and breathing exercises, strengthening of the pelvic floor muscles, and relaxation of autosuggestions. The study aimed to analyze the effectiveness of postpartum yoga on uterine involution. A quasi-experimental, pre-test and post-test with the control group was applied in this study. Thirty-eight postpartum women received postpartum yoga as the intervention group. The control group was comprised of 19 women. The gain score of uterine involution in the intervention group was 9.14 ± 1.27 and in the control group 7.20 ± 1.11. The Cohen’s effect size test is 1.63. The result of the mann whitney test showed that there was a significant difference between the intervention group and the control group with p value 0,000. The result of determination (R Square), postpartum yoga had an effect of 40.3% on uterine involution after being controlled simultaneously with parity, frequency of breastfeeding, and anxiety. Postpartum yoga is effective to strengthen the uterine muscles, facilitate blood circulation, and stimulate neurohormonal so it could accelerate uterine involution. Further studies could measure of fundus uterine daily. Future researchers can develop postpartum yoga research with other variables such as anxiety, urinary incontinence, quality of life for postpartum women, and hormonal variables including oxytocin, endorphins, and cortisol. Keywords: postpartum yoga, postpartum period, postpartum exercise, uterine involution

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The effect of physical exercise on postpartum fitness, hormone and lipid levels: a randomized controlled trial in primiparous, lactating women

Cited by 26 publications

References 26 publications

A systematic review and meta‐analysis of intervention characteristics in postpartum weight management using the TIDieR framework: A summary of evidence to inform implementation

A systematic review and meta‐analysis of intervention characteristics in postpartum weight management using the TIDieR framework: A summary of evidence to inform implementation

Effect of physical activity on sex hormones in women: a systematic review and meta-analysis of randomized controlled trials

The THE EFFECTIVENESS OF POSTPARTUM YOGA ON UTERINE INVOLUTION AMONG POSTPARTUM WOMEN IN INDONESIA

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