Heat production during exercise in pregnancy: discerning the contribution of total body weight.

Studies have reported enhanced thermoregulatory function as pregnancy progresses; however, it is unclear if differences in thermoregulation are attributed to weight gain or other physiological changes. This study aimed to determine if total body weight will influence thermoregulation (heat production (Hprod)), heart rate, and perceptual measurements in response to weight-bearing exercise during early to late pregnancy. A cross-sectional design of healthy pregnant women at different pregnancy time points (early, T1; middle, T2; late, T3) performed a 7-stage weight-bearing incremental exercise protocol. Measurements of Hprod, HR, and RPE were examined. Two experimental groups were studied: (1) weight matched and (2) non-weight matched, in T1, T2, and T3. During exercise, equivalent Hprod at T1 (326 ± 88 kJ), T2 (330 ± 43 kJ), and T3 (352 ± 52 kJ) (p = 0.504); HR (p = 0.830); and RPE (p = 0.195) were observed in the WM group at each time point. In the NWM group, Hprod (from stages 1-6 of the exercise) increased across pregnancy time points, T1 (291 ± 76 kJ) to T2 (347 ± 41 kJ) and T3 (385 ± 47 kJ) (p < 0.001). HR increased from T1 to T3 in the warm-up to stage 6 (p = 0.009). RPE did not change as pregnancy time point progressed (p = 0.309). Total body weight, irrespective of pregnancy time point, modulates Hprod and HR during exercise. Therefore, accounting for total body weight is crucial when comparing thermoregulatory function during exercise across pregnancy.

Characteristics Associated with Pelvic Floor Disorders among Female Canadian Armed Forces Members.

OBJECTIVES: Urinary incontinence (UI) and pelvic organ prolapse (POP) are prevalent pelvic floor disorders (PFDs) among the female population. In the military environment, being a non-commissioned member (NCM), and physically demanding occupations are factors associated with higher PFD risk. This study seeks to characterize the profile of female Canadian Armed Forces (CAF) members reporting symptoms of UI and/or POP. METHODS: Present CAF members (18-65 years) responded to an online survey. Only current members were included in the analysis. Symptoms of UI and POP were collected. Multivariate logistic regressions analyzed the relationships between PFD symptoms and associated characteristics. RESULTS: 765 active members responded to female-specific questions. The prevalence of self-reported POP and UI symptoms were 14.5% and 57.0%, respectively, with 10.6% of respondents reporting both. Advanced age (adjusted odds ratio [aOR]: 1.062, CI 1.038-1.087), a body mass index (BMI) categorized as obese (aOR: 1.909, [1.183-3.081]), parity ≥1 (e.g., aOR for 1: 2.420, [1.352-4.334]) and NCMs (aOR: 1.662, [1.144-2.414]) were factors associated with urine leakage. Parity of ≥2 (aOR: 2.351, [1.370-4.037]) compared to nulliparous and having a perception of a physically demanding job (aOR: 1.933, [1.186-3.148]) were associated with experiencing POP symptoms. Parity of ≥2 increased the odds of reporting both PFD symptoms (aOR: 5.709, [2.650-12.297]). CONCLUSION: Parity was associated with greater odds of experiencing symptoms of UI and POP. Higher age, higher BMI, and being an NCM were associated with more symptoms of UI, and the perception of having a physically demanding role increased the likelihood of reporting POP symptoms.

Exploring weight bias internalization in pregnancy.

BACKGROUND: Recent research has shown that pregnant individuals experience weight stigma throughout gestation, including negative comments and judgement associated with gestational weight gain (GWG). Weight bias internalization (WBI) is often a result of exposure to weight stigma and is detrimental to biopsychological health outcomes. The purpose of this study was to explore WBI in pregnancy and compare scores based on maternal weight-related factors including pre-pregnancy body mass index (BMI), obesity diagnosis and excessive GWG. METHODS: Pregnant individuals in Canada and USA completed a modified version of the Adult Weight Bias Internalization Scale. Self-reported pre-pregnancy height and weight were collected to calculate and classify pre-pregnancy BMI. Current weight was also reported to calculate GWG, which was then classified as excessive or not based on Institute of Medicine (2009) guidelines. Participants indicated if they were diagnosed with obesity by a healthcare provider. Inferential analyses were performed comparing WBI scores according to pre-pregnancy BMI, excessive GWG, and obesity diagnosis. Significance was accepted as p < 0.05 and effect sizes accompanied all analyses. RESULT: 336 pregnant individuals completed the survey, with an average WBI score of 3.9 ± 1.2. WBI was higher among those who had a pre-pregnancy BMI of obese than normal weight (p = 0.04, η2 = 0.03), diagnosed with obesity than not diagnosed (p < 0.001, Cohen's d = 1.3), and gained excessively versus not (p < 0.001, Cohen's d = 1.2). CONCLUSIONS: Pregnant individuals who have a higher BMI, obesity and gain excessively may experience WBI. Given that weight stigma frequently occurs in pregnancy, effective person-oriented strategies are needed to mitigate stigma and prevent and care for WBI.

Physical Activity and Weight Gain Throughout Pregnancy Are Associated With Umbilical Cord Markers.

OBJECTIVE: Maternal serum and umbilical cord (UC) lipid and glucose levels are influenced by a variety of maternal factors over the course of pregnancy, including maternal physical activity (PA) levels and gestational weight gain (GWG). However, previous research has not assessed the interaction of these 2 variables. This study investigated mid-gestation (24-28 weeks) and late gestation (34-38 weeks) maternal and UC serum lipid and glucose profiles in relation to maternal PA status and GWG, independently and in combination. METHODS: This study had a longitudinal design. Pregnant participants (n = 40) were categorized as active or inactive based on the 2019 Canadian Guideline for Physical Activity throughout Pregnancy, and GWG was categorized as insufficient, appropriate, or excessive based on 2009 Institute of Medicine recommendations. Fasting maternal serum was taken in mid- and late gestation, and venous UC serum was taken at birth. RESULTS: No relationship was found between maternal serum values and PA and/or GWG. Infants born to individuals who were physically active across pregnancy, or who were active in mid-pregnancy and had their activity status drop in late gestation, had lower UC total cholesterol levels than those who were inactive throughout pregnancy (P < 0.0001). Participants who had gained weight appropriately at mid-gestation had significantly lower UC glucose levels than those who gained weight insufficiently (P = 0.040) or excessively (P = 0.021). CONCLUSION: In our study, PA, and GWG (independently and in combination) may not have affected maternal serum; however, meeting PA recommendations at mid-gestation may provide prophylactic effects on UC serum, potentially providing long-term health benefits to the newborn.

Population characteristics associated with adherence to prenatal group-based exercise programs.

Community-based supervised group exercise may be an effective option to increase activity levels throughout pregnancy. Previous studies that have explored predictors of low adherence to exercise during pregnancy have not examined group-based settings. We analysed an international cohort of 347 pregnant women who participated in group-based prenatal exercise interventions (from <20 weeks to 34-36 weeks pregnant). Probable adherence predictors informed by previous literature that were assessed included: pre-pregnancy physical activity level and body mass index (BMI) classification, age, number of previous pregnancies, and education level. Adherence was measured by attendance. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated to explore the relationship between the selected predictors and high adherence (≥70%). Post-secondary education level versus only secondary (aOR 5.28; CI 1.67; 16.72) or primary level (aOR 13.82; CI 4.30; 44.45) presented greater likelihood to have high adherence to the exercise intervention than low adherence. Future research and public health initiatives should consider implementing strategies to overcome education-related barriers to improve accessibility to prenatal exercise.

The effects of intervening with physical activity in the early years (ages 3-5) on health-related quality of life: a secondary analysis of the Activity Begins in Childhood (ABC) trial.

PURPOSE: Limited research has measured the effect of physical activity (PA) interventions on health-related quality of life (HRQoL) among pre-school-aged children. This study evaluates the effect of the Activity Begins in Childhood (ABC) cluster-randomized controlled trial designed to increase PA in the ages 3-5 years on HRQoL. METHODS: This was a cluster-randomized controlled trial where the intervention group included PA education delivered to daycare providers only, or daycare providers and parents. In the current study, the two PA intervention groups were combined. The comparator group received standard daycare curriculum (COM). A total of 215 children were included (PA n = 161, COM n = 54). Parents completed the proxy Pediatric Quality of Life Inventory Generic Core Scale (PedsQL™ 4.0) to measure HRQoL at baseline and the end of the 6-month trial. HRQoL scores were analyzed as physical, psychosocial, and total domains. Baseline and 6-months measurements were compared for PA and COM groups, and mean changes in scores (95% confidence intervals) were measured using absolute values. RESULTS: No between-group differences were observed for the physical (p = 0.17), psychosocial (p = 0.95) or total scores (p = 0.20). Paired comparisons showed that only the PA group improved psychosocial- (PA mean difference = 2.18 (0.20, 4.15), p = 0.03; COM mean difference = 2.05 (- 1.03, 5.13), p = 0.19) and total-HRQoL scores (PA mean difference = 2.83 (1.83, 3.84), p < 0.001; COM mean difference = 0.19 (- 1.78, 2.16), p = 0.84) after 6 months. CONCLUSION: Although the within-PA group analysis showed an improvement in psychosocial and total HRQoL scores from baseline, no between-group differences were observed in the HRQoL over time among children aged 3-5 years.

Eating Habits, Advice from Family/Friends, and Limited Personal Effort May Increase the Likelihood of Gaining Outside Gestational Weight Gain Recommendations.

OBJECTIVES: The present study analyzed the association between (i) eating habits during pregnancy, (ii) advice from family or friends about gestational weight gain (GWG), and iii) personal effort to stay within weight gain limits, and meeting GWG recommendations. METHODS: Participants included pregnant and postpartum women who completed the validated electronic maternal health survey (EMat). Sociodemographic, lifestyle variables, and body mass index were covariates used in the analyses. RESULTS: Among all eligible women (1171), and a subset of women receiving a specific GWG target from HCP (365, 31.2%), participants who considered that their eating habits became less healthy, or could not evaluate if habits changed, had a higher likelihood of gaining above (adjusted odds ratio, aOR = 2.62; 95% CI 1.84; 3.73 for the total sample (TS); aOR = 4.79; CI 2.32;9.88 for the subset) GWG guidelines after adjusting for the covariates. Women who received advice from family or friends about how much weight they should gain while pregnant were more likely to experience GWG below (TS: aOR = 1.49; CI 1.02;2.17; subset: aOR = 1.95; CI 1.03;3.68) and above (TS: aOR = 1.42; CI 1.01;1.99; subset: aOR = 1.92; CI 1.06;3.48) guidelines, when compared to women who did not receive family/friends advice. Moreover, lower personal effort to stay within weight gain limits was associated with gaining below (TS: aOR = 1.77; CI 1.07;2.92; subset: aOR = 2.71; CI 1.30; 5.65) GWG guidelines. CONCLUSIONS FOR PRACTICE: Women self-reporting less healthy eating habits than before pregnancy, receiving advice from family/friends about GWG, and lower personal effort to stay within guidelines, had an increased odds of weight gain discordant with recommendations.

Endurance Running Training Individually Guided by HRV in Untrained Women.

da Silva, DF, Ferraro, ZM, Adamo, KB, and Machado, FA. Endurance running training individually guided by HRV in untrained women. J Strength Cond Res 33(3): 736-746, 2019-The aim of this study was to analyze the effects of heart rate variability (HRV)-guided training compared with a standardized prescription on (a) time to complete 5-km running performance (t5km), (b) peak treadmill running speed (Vpeak) and its time limit (tlim at Vpeak), and (c) autonomic cardiac modulation (i.e., parasympathetic activity and recovery) in untrained women. Additionally, we correlated changes in t5km with changes in Vpeak, tlim at Vpeak and autonomic cardiac modulation. Thirty-six untrained women were divided into a HRV-guided training group (HRVG) and a control group (CG). The CG followed a predefined program, alternating moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT). The determination of MICT or HIIT was based on the pretraining HRV for HRVG. MICT was performed if HRV was

Does a history of childbirth impact injury prevalence and mental health in female military members?

The effect of parity status on the prevalence and impact of musculoskeletal injury (MSKi) among female Canadian Armed Forces (CAF) members is unknown. This study aims to identify whether a history of childbirth and pregnancy-related complications are associated with MSKi occurrence among female members of the CAF. From September 2020 to February 2021, data were collected via an online questionnaire that assessed MSKi, reproductive health, and barriers to recruitment and retention in the CAF. Actively serving, female members were included in this analysis stratified by parous (n = 313) or nulliparous (n = 435) status. Descriptive analysis and binary logistic regressions were used to identify prevalence and adjusted odds ratios (aOR) of repetitive strain injuries (RSI), acute injuries, and body regions affected. Covariates included in aOR: age, body mass index, and rank. A p value of <0.05 was considered significant and 95% confidence intervals (CI) were reported. Female members with a history of childbirth were more likely to report an RSI (80.9% vs. 69.9%, OR = 1.57, CI: 1.03 to 2.40), and when stratified by body region, were more likely to have an RSI of the wrist (30.0% vs. 20.5%, aOR = 1.62, CI: 1.09 to 2.40), and foot (39.3% vs. 24.1%, aOR = 1.79, CI: 1.24 to 2.59). When compared to the nulliparous group, parity did not influence prevalence of acute injuries. MSKi and mental health perceptions were different for females who experienced postpartum depression, miscarriage, or preterm birth. Childbirth and pregnancy-related complications impact prevalence of some RSI among female CAF members. Thus, specific health and fitness support may be needed for parous female CAF members.

Sex disparities in self-reported musculoskeletal injuries in the Canadian Armed Forces.

Recent comprehensive systematic reviews indicate that females are at greater risk of musculoskeletal injuries (MSKi) than males in military populations. Considering the Canadian Armed Forces (CAF) goal of increasing female representation in the next few years, exploring these trends is essential. We aimed to determine the association between biological sex and MSKi in the CAF. An online survey was conducted with active-duty and former CAF members aged 18-65 years. Sex disparities in MSKi (acute or repetitive strain [RSI]) were analyzed using bivariate associations and binary logistic regressions with significance level at p < 0.05. Analyses were stratified by military environment (i.e., Army, Navy, and Air Force). From the 1947 respondents whose biological sex was reported, 855 were females and 1092 were males. Rates of RSI sustained by females and males while serving were 76.2% and 70.5% (p = 0.011), respectively, whereas 61.4% of females reported acute injuries compared to 63.7% of males (p = 0.346). Females were more likely to report overall RSI (adjusted odds ratio [aOR]: 1.397; 95% confidence intervals [CI]: 1.068-1.829), RSI having a greater impact on daily activities (aOR [95%CI]: 2.979 [2.093-4.239]) and greater impact on career progress/length (aOR [95%CI]: 1.448 [1.066-1.968]). Acute injuries, also more prevalent in females, were reported to have a greater impact on daily activities (aOR [95%CI]: 1.688 [1.198-2.379]). This study highlights sex disparities in MSKi prevalence and outcomes. Females within the CAF sample presented greater likelihood of reporting RSI, perceived impact of RSI on daily activities and career progress/length, and perceived impact of acute injuries on daily activities.

SmartMoms Canada: An evaluation of a mobile app intervention to support a healthy pregnancy.

BACKGROUND: There is a lack of cost-effective and readily available access to evidence-based information to manage healthy behaviours for pregnant individuals. Mobile health (mHealth) tools offer a cost-effective, interactive, personalized option that can be delivered anywhere at a time most convenient for the user. This study protocol was primarily developed to, i) assess the feasibility of the SmartMoms Canada intervention in supporting participants to achieve gestational weight gain (GWG) guidelines. The secondary objectives are to, ii) assess user experience with the app, measured by adherence to the program via app software metrics and frequency of use, iii) determine the impact of SmartMoms Canada app usage on the adoption of healthful behaviours related to nutrition, physical activity and sleep habits, improvements in health-related quality of life, pregnancy-related complications, and symptoms of depression, and iv) investigate the potential extended effects of the app on postpartum health-related outcomes. METHODS: This is a feasibility trial. Pregnant individuals aged 18-40 years with pre-gravid body mass index between 18.5 and 39.9 kg/m2, carrying a singleton fetus, having Wi-Fi access, and at ≤20 weeks' gestation will be recruited. Eligible people will be followed from recruitment until 12 months postpartum. DISCUSSION: SmartMoms Canada is the first bilingual Canadian-centric app designed for pregnant people. This mHealth intervention, with its ability to supply frequent interactions, provides pregnancy- related health knowledge to users, potentially leading to an improvement in pregnancy-related outcomes and behaviours, and, ultimately a reduction in the present economic burden related to in-person interventions. TRIAL REGISTRATION: ISRCTN, ISRCTN16254958. Registered 20 December 2019, http://www.isrctn.com/ ISRCTN16254958.

Evaluation of Afterschool Activity Programs' (ASAP) Effect on Children's Physical Activity, Physical Health, and Fundamental Movement Skills.

BACKGROUND: Physical literacy-focused afterschool activity programs (ASAPs) can be an effective strategy to improve children's health-related parameters. We sought to compare physical activity, body composition, aerobic capacity, and fundamental movement skills between physical literacy-focused ASAP and a standard recreational ASAP. METHOD: A pre-post (6 months) comparison study was conducted in 5- to 12-year-old children in a physical literacy-focused ASAP (physical literacy group, n = 14) and children attending a standard recreational ASAP (comparison group, n = 15). Physical activity guideline adherence was assessed using accelerometry, body composition was analyzed using bioelectrical impedance, aerobic capacity was estimated using the Progressive Aerobic Cardiovascular Endurance Run test, and fundamental movement skills were evaluated using the Test of Gross Motor Development-2. RESULTS: There were no significant differences between groups at baseline. After 6 months, the physical literacy group exhibited a significant improvement in their total raw score for the Test of Gross Motor Development-2 (p = .016), which was likely due to improvements in object control skills (p = .024). The comparison group significantly increased body mass index (p = .001) and body fat (p = .009) over time. No significant between-group differences were found; however, there was a trend for improved aerobic capacity in the physical literacy group (d = 0.58). CONCLUSIONS: Engagement in the physical literacy-focused ASAP contributed to an attenuated increase in adiposity and an improvement in object control skills.

Weight stigma and prenatal physical activity: Exploring the perspectives of pregnant women living with obesity.

OBJECTIVE: To identify sources of weight stigma in physical activity (PA)-related milieus reported by pregnant women living with obesity. We also report person-informed strategies to improve the delivery of PA promotions and prescriptions to prevent weight stigma and improve maternal PA. DESIGN: This is a qualitative descriptive study and semi-structured interviews were conducted. SETTING AND PARTICIPANTS: Purposive sampling including pregnant women living with obesity, with a body mass index ≥35.0 kg/m2, ≥18 years of age, and receiving specialized prenatal care were recruited from an obstetrics clinic in Kingston, Canada. MEASUREMENT AND FINDINGS: Data were assessed by a content analysis, whereby coded themes represented sources of weight stigma related to prenatal PA. Demographic characteristics (pre-pregnancy body mass index, age, gestational age) were summarized and presented as means and standard deviations. In-depth interview data were collected from eight women. Average pre-pregnancy BMI, age, and gestational age were 44.6±4.8 kg/m2, 32.0±4.1 years, 31.1±5.8 weeks, respectively. Two sources of weight stigma related to prenatal PA were identified: 1. Lack of visual representation - online images and images found in exercise promotional material do not include women who have obesity; 2. Lack of individualized recommendations - currently available prenatal PA guidelines and/or recommendations from healthcare providers do not always consider individual physical barriers or health goals women may have. KEY CONCLUSION AND IMPLICATIONS FOR PRACTICE: By increasing body positive representation of pregnant women exercising and offering person-centered prenatal PA recommendations, maternal PA may improve including women living with obesity. Findings from this work can inform future PA interventions, health promotion programming, and prescriptions from prenatal care providers to implement person-oriented strategies to prevent weight stigma and improve the delivery of care for pregnant women living with obesity.

The short-term effect of a mHealth intervention on gestational weight gain and health behaviors: The SmartMoms Canada pilot study.

Gestational weight gain (GWG) has been shown to impact several maternal-infant outcomes. Since healthcare provider guidance on weight gain and healthy behaviors alone has failed to help women to meet guidelines during pregnancy, a practical adjunctive approach is to deliver evidence-based behavior change programs through mobile interventions. The present study aimed to assess the short-term effect of the SmartMoms Canada app to promote adequate GWG and healthy behaviors. Twenty-nine pregnant women were recruited in this app-based intervention trial to test whether a higher app usage (≥ 3.8 min·week-1) between 12-20 gestational weeks and 24-28 gestational weeks improved GWG, diet, physical activity, and sleep, compared to women with a lower app usage (< 3.8 min·week-1). Two-way mixed ANOVA for repeated measures was used to estimate the effect of the app usage and time, as well as their interaction on GWG and healthy behaviors. The likelihood ratio was used to examine the association between app usage categorization and GWG classification. Cramer's V statistic was used to estimate the effect size for interpretation of the association. Pregnant women using the SmartMoms Canada app more frequently had a higher moderate-to-vigorous physical activity (MVPA) daily average when compared with women with a lower usage (mean difference: 17.84 min/day, 95% CI: 2.44; 33.25). A moderate effect size (28.6% vs. 15.4%; Cramer's V = 0.212) was found for the association between app categorization and rate of GWG, representing a greater adherence to the GWG guidelines in women in the higher app usage group vs. the lower app usage group. Considering other physical activity, diet, and sleep variables, no app categorization effect was observed. A short-term higher usage of SmartMoms Canada app has a positive effect on objectively-measured MVPA.

Taking a patient-oriented approach in exercise interventions for pregnant women: a commentary.

Taking a patient-oriented approach to developing lifestyle interventions includes incorporating the patient into the program's design, delivery, and evaluation. This commentary assumes that a patient-oriented approach has not yet been implemented and tested in exercise-based interventions designed for pregnant women. We outline and define a patient-oriented approach to conduct exercise-based research and review previous physical activity interventions designed for pregnant women to determine whether a patient-oriented approach was applied. In addition, pregnant women living with obesity may have unique barriers to engaging in prenatal exercise interventions that have not been previously addressed, such as having experienced weight stigma before pregnancy in healthcare and fitness settings. We propose suggestions for future trials to effectively take a patient-oriented approach when designing and implementing prenatal exercise interventions to address patient-informed barriers and incorporate suggested facilitators for physical activity. Given that prenatal activity levels are low and pregnant women may have unique barriers to engaging in exercise interventions, a patient-oriented approach may be an effective strategy to improve inclusivity and equity and, as a result, increase uptake and adherence to the intervention.

RéSUMé: L'adoption d'une démarche axée sur le patient ou la patiente, dans l'élaboration d'interventions sur le mode de vie, consiste à intégrer celui-ci ou celle-ci dans la conception, l'exécution et l'évaluation des programmes. Dans notre commentaire, nous présumons qu'une démarche axée sur la patiente n'a pas encore été appliquée et testée dans les interventions fondées sur l'exercice conçues pour les femmes enceintes. Nous décrivons et définissons une démarche axée sur la patiente pour faire de la recherche fondée sur l'exercice, et nous examinons des interventions antérieures d'activité physique conçues pour les femmes enceintes afin de déterminer si une démarche axée sur la patiente a été appliquée. Par ailleurs, les femmes enceintes vivant avec l'obésité peuvent faire face à des obstacles particuliers qui n'ont pas encore été étudiés avant de pouvoir participer à des interventions d'exercice prénatales, comme d'avoir été stigmatisées en raison de leur poids, avant la grossesse, dans des milieux de soins de santé et de conditionnement physique. Nous avançons des suggestions pour que les essais futurs adoptent bien une démarche axée sur la patiente lors de la conception et de la mise en œuvre d'interventions d'exercices prénatals, afin de tenir compte des obstacles mentionnés par les patientes et d'intégrer les moyens qu'elles suggèrent pour favoriser l'activité physique. Comme les niveaux d'activité prénatals sont faibles et que les femmes enceintes peuvent faire face à des obstacles particuliers avant de pouvoir participer à des interventions fondées sur l'exercice, une démarche axée sur la patiente pourrait être un moyen efficace d'améliorer l'inclusivité et l'équité, et par conséquent, d'accroître le recours et l'assiduité à l'intervention.

The Effect of Maternal Physical Activity and Gestational Weight Gain on Placental Efficiency.

INTRODUCTION: Adherence to physical activity (PA) and gestational weight gain (GWG) recommendations during pregnancy has been shown to improve maternal and fetal health outcomes, including reducing the risk for chronic diseases. Limited research has evaluated the effect of meeting PA in combination with GWG recommendations on placental efficiency (Pl-E), a surrogate marker of the placenta's ability to exchange nutrients and gas based on surface area. The purpose of this study was to measure and compare Pl-E based on meeting PA and GWG recommendations. METHOD: Healthy pregnant women (n = 61) wore accelerometers in their second and third trimesters to objectively measure PA. Women were classified as active or inactive at each time point based on meeting the 2019 Canadian prenatal PA guidelines. Total GWG was calculated as weight measured in the third trimester minus self-reported prepregnancy weight, and were categorized as insufficient (n = 19), adequate (n = 22), and excessive (n = 20) according to the 2009 Institute of Medicine guidelines. Placental weight (PW) and birth weight (BW) were measured within 30 min of delivery and 24-48 h postdelivery, respectively. Pl-E was determined in three ways: BW:PW ratio, residual BW, and measured BW, with a higher value indicating better Pl-E. Pl-E was compared by PA and GWG status using a two-way ANOVA. RESULTS: No differences were found in the BW:PW ratio or residual BW corresponding to PA and GWG status. Measured BW was significantly higher in newborns of women who gained weight excessively compared with those who gained insufficient weight (P < 0.05). CONCLUSION: These findings suggest that prenatal PA does not compromise Pl-E; however, further research is required to evaluate the potential mechanistic benefits of meeting PA and GWG guidelines on the placenta.

Adaptation of Anaerobic Field-Based Tests for Wheelchair Basketball Athletes.

Purpose: The aim of this study was to propose field-based tests to estimate the anaerobic power of wheelchair basketball athletes. Methods: Eleven lower class wheelchair basketball players performed the Wingate test (WT) and two field-based tests (repeated sprints) of 15 (S-15) and 20 (S-20) meters. The WT provides data in Watts (W). The S-15 and S-20 are recorded in seconds and converted to W using the Running-based Anaerobic Sprint Test (RAST) equation. The participants also completed other field-based tests, such as right and left handgrip strength (HGS) tests and the medicine ball chest pass test. In addition, body mass and height were measured, and the body composition was estimated. The field-based tests and anthropometric measures were used to estimate WT peak power (PP) and mean power (MP) using multiple linear regressions. Results: The field-based tests underestimated the anaerobic power measured with the WT (in W). However, a linear regression model based on S-15 PP, right HGS, height, and body mass explained 76% (P= .040) of the WT PP variance. Another model based on S-15 MP and right HGS explained 72% (P= .006) of the WT MP variance. Both models had excellent reliability (ICC > 0.90). Conclusion: WT PP can be estimated using S-15 PP (W), right HGS, height, and body mass. The WT MP is predicted using S-15 MP (W) and right HGS. Therefore, a combination of field-based tests and anthropometric measures seem to be appropriate to determine anaerobic power of lower class wheelchair basketball athletes.

Women's Suggestions for How To Reduce Weight Stigma in Prenatal Clinical Settings.

OBJECTIVE: To describe the experiences of weight stigma in prenatal clinical settings among high-risk pregnant women living with obesity and to obtain women's perspectives regarding changes to prenatal health care practices that may reduce weight stigma. DESIGN: Qualitative descriptive study. SETTING/LOCAL PROBLEM: High-risk obstetrics clinic. Weight stigma experienced in prenatal clinical settings can negatively influence maternal health and well-being as well as communication with health care providers. PARTICIPANTS: Nine pregnant women with obesity who were receiving specialized prenatal care in their third trimester. INTERVENTION/MEASUREMENTS: Women participated in semistructured telephone interviews. Data were inductively analyzed using a content analysis, whereby coded data were organized to represent experiences of or suggestions provided by pregnant women to reduce weight stigma in prenatal clinical settings. RESULTS: Experiences of weight stigma included poor communication, generalizations made about health and lifestyle behaviors, and focusing only on excess body weight during clinical appointments as the cause of negative health outcomes. To reduce weight stigma, women suggested that health care providers practice sensitive communication, offer individualized care for weight management, and reduce the focus on body weight by also independently addressing comorbidities or other health indicators. CONCLUSION: Women interviewed for this study provided suggestions that can be implemented in prenatal clinical settings to reduce weight stigma and improve the delivery of equitable health care.