A systematic review of changes in women’s physical activity before and during pregnancy and the postnatal period

Objectives: To determine the magnitude and type of naturally occuring physical activity changes in women around the time of pregnancy. Background: This systematic review synthesises the results of studies examining naturally occurring physical activity in women before they become pregnant and the magnitude and type of changes during pregnancy and the postnatal period. Methods: Electronic databases were searched for relevant articles and PRISMA guidelines for selection of articles were used. Only studies examining naturally occurring, non-intervention changes in regular activity levels were included. The quality assessment was based on protocols of the Cochrane Database of Systematic Reviews. Of the initial 720 titles, 24 studies met the inclusion criteria and were included in the final review. Results: Compared to pre-pregnancy, the magnitude of physical activity decreased over the course of pregnancy and postnatally and the types of activities tended to be of lesser intensity than pre-pregnancy. The quality of the research was varied; methodological limitations included using subjective methods of assessment of physical activity (9/24), failing to report reliabilities or validity of measures used (8/24), no information on parity (13/24) or level of fitness prior to pregnancy (11/24). Conclusion: The evidence suggests a marked decrease in the amount and type of moderate to strenuous physical activity during the transition to motherhood, which does not always increase again postpartum. Patient education targeting specific physical activities at regular intervals during and after pregnancy to improve long-term maternal health is necessary

Initiation and Duration of Breastfeeding in an Aboriginal Community in South Western Sydney

The Gudaga Study is a prospective, longitudinal birth cohort study of Australian urban Aboriginal children. Mothers of Aboriginal infants were recruited using a survey of all mothers admitted to the maternity ward of an outer urban hospital in Sydney. These data established initiation rates among Gudaga infants and those of non-Aboriginalinfants born locally (64.7% and 75.2%, respectively) and factors associated with breastfeeding. Older (relative risk, 1.24; confidence interval, 1.01-1.44), more educated (relative risk, 1.30; confidence interval, 1.11-1.48) mothers who intended to breastfeed (relative risk, 2.22; confidence interval, 2.12-2.3) were more likely to breastfeed. Smokers (relative risk, 0.72) and mothers of Aboriginal infants (relative risk, 0.78) were less likely to initiate breastfeeding. Breastfeeding rates for Gudaga infants dropped rapidly, with 26.3% breastfeeding at 2 months. Local health services providers can benefit from such information as they target relevant prenatal, perinatal, and postnatal services for Aboriginal mothers and their infants