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Physical Activity and Sedentary Behavior During Pregnancy

Not Applicable
Not yet recruiting
Conditions
Pregnant Woman
Interventions
Behavioral: In person PA sessions
Behavioral: Interactive videoconference PA sessions
Behavioral: In person and by videoconference (mixed format) PA sessions.
Registration Number
NCT06585085
Lead Sponsor
University Hospital, Clermont-Ferrand
Brief Summary

Our main objective is to evaluate the intervention that best enables women's adherence to physical activity (PA).

Our hypothesis is that identifying types of interventions suitable for pregnant women (in-person PA sessions, videoconferences or mixed format) could help improve their PA level and simultaneously reduce their sedentary behavior (SB).

Detailed Description

PA has beneficial effects on physical, psychological, and social health, and its regular practice helps to prevent numerous chronic diseases. During pregnancy, PA also has many benefits for women's physical condition, weight gain, gestational hypertension, lower back and pelvic pain, and postpartum depressive symptoms and may also reduce fetal macrosomia and positively affect neurogenesis, language development, memory, and other learning-associated cognitive functions. (CNSF 2021). PA is thus recommended to all pregnant women for 150 to 180 minutes a week, adapted to their health status, physical condition, and course of pregnancy. It is also recommended that women limit their Sedentary Behaviour (SB) (to ≤7 waking h/day) during pregnancy.

No French study has assessed the impact of a PA program during pregnancy, and no published study has proposed videoconference PA sessions during pregnancy. Pregnant women's adherence to PA is a limiting factor found in many interventional studies. Possible changes in maternal behavior in practicing PA and reducing SB during pregnancy could also favorably affect the health of mother and child and thus subsequent PA. Given PA's many benefits and SB's harmful effects during pregnancy, assessing programs that enable pregnant women to both increase PA levels and reduce SB seems pertinent and valuable.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
Female
Target Recruitment
630
Inclusion Criteria
  • Pregnant women of more of 18 years and who are being monitored for pregnancy in the Clermont-Ferrand metropolitan area,
  • Planned to give birth in a maternity unit localized in Clermont-Ferrand metropolitan area (CHU Estaing or Clinique de la Chataigneraie),
  • Agreeing to be randomized, to follow the physical activity program offered in the Clermont-Ferrand metropolitan area, and to follow up as part of the study,
  • Able to give informed consent to participate in the research,
  • Affiliated to a social security scheme
  • And between 14+0d and 21+6d weeks of gestation.

Non inclusion Criteria:

  • Women under guardianship, curators, deprived of liberty or under court protection,
  • With a history of recurrent miscarriage,
  • Presenting a multiple pregnancy,
  • Hemoglobinemia <9g/dL or symptomatic anemia,
  • Presenting eating disorders or a BMI ≤ 18.5 or a BMI ≥ 40,
  • With orthopedic limitations,
  • Presenting cardiovascular or pulmonary disease,
  • Uncontrolled thyroid disease,
  • Presenting a high level of smoking,
  • With significant health problems,
  • Premature rupture of membranes,
  • Premature labor during this pregnancy or a history of at least 2 premature births,
  • Persistent vaginal bleeding,
  • Cervical incompetence,
  • Evidence of intrauterine growth restriction,
  • Uncontrolled epilepsy,
  • Diabetes (previous or gestational, diagnosed in the 1st trimester) or chronic hypertension,
  • Or having a planned home birth.
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
BIn person PA sessionsIn-person supervised PA sessions
CInteractive videoconference PA sessionsInteractive videoconference PA sessions
DIn person and by videoconference (mixed format) PA sessions.In person and by videoconference (mixed format) PA sessions
Primary Outcome Measures
NameTimeMethod
Women's adherence to PA at the end of the second trimesterbetween 24 and 30 weeks of gestation

measurement of the PA level, measured by accelerometer, expressed in MET.minutes/week by wearing a tri-axial accelerometer on the hip

Secondary Outcome Measures
NameTimeMethod
women's adherence in terms of reduction of Sedentary Behaviors at the end of the 2nd trimesterbetween 24 and 30 weeks of gestation

measurement of sedentary time (defined as a state of wakefulness characterized by an energy expenditure less than or equal to 1.5 METs) between getting up and going to bed using a tri-axial hip accelerometer

Impact of physical activity on maternal antenatal morbidityAt delivery

occurrence of maternal pathology during pregnancy (gestational arterial hypertension \[PAS ≥ 140 mm Hg and a PAD ≥ 90 mm Hg occurring after 20 weeks of gestation\] and/or, pre-eclampsia \[hypertension with albuminuria \> 0.3g/L per 24 hours\] and/or gestational diabetes diagnosed by orally induced hyperglycaemia after 23 SA)

Impact of sedentary behaviour on the experience of childbirth4 weeks postpartum

Evaluation using the Questionnaire for Assessing the Childbirth Experience (QACE)

Women's participation at PA sessionsAfter 39 weeks of gestation, end of planned participation in sessions

For women in groups B, C and D, rate of sessions completed on the number of eligible sessions according to their randomization group and the socio-demographic criteria

Pregnancy and Postpartum Evolution of PA Timeat 4 distinct times: between 24+0d and 30+0d weeks of gestation, between 32+0d and 37+6d weeks of gestation, between 6 and 10 weeks postpartum and between 20 and 24 weeks postpartum

PA time measured with a tri-axial accelerometer at the hip

Evolution in sedentary behavior during pregnancy and postpartumat 4 distinct times: between 24 and 30 weeks of gestation, between 32+0day and 37+6day weeks of gestation, between 6 and 10 weeks postpartum and between 20 and 24 weeks postpartum

sedentary time (defined as wakefulness characterized by an energy expenditure less than or equal to 1.5 METs) between getting up and going to bed will be compared according to each intervention modality. Sedentary behavior will be measured by wearing a tri-axial accelerometer on the hip

Women's perception of the determinants of their level of physical activity and sedentary behaviourduring the 31 days after at the inclusion in the study and between 35 and 39 weeks of gestation

Qualitative study by means of semi-structured telephone interviews with a minimum of 100 women, i.e. a minimum of 25 women per group, a number to be adapted according to the data saturation that will be obtained

Impact of sedentary behaviour on maternal antenatal morbidityAt delivery

occurrence of maternal pathology during pregnancy (gestational arterial hypertension \[PAS ≥ 140 mm Hg and a PAD ≥ 90 mm Hg occurring after 20 weeks of gestation\] and/or, pre-eclampsia \[hypertension with albuminuria \> 0.3g/L per 24 hours\] and/or gestational diabetes diagnosed by orally induced hyperglycaemia after 23 SA)

Impact of physical activity on perpartum maternal morbidity24 hours after delivery

A composite criterion: "occurrence of 3rd or 4th degree perineal lesions and/or occurrence of immediate postpartum haemorrhage (blood loss \> 500mL in the 24 hours after delivery)"

Impact of sedentary behaviour on perpartum maternal morbidity24 hours after delivery

A composite criterion: "occurrence of 3rd or 4th degree perineal lesions and/or occurrence of immediate postpartum haemorrhage (blood loss \> 500mL in the 24 hours after delivery)"

Impact of physical activity on postpartum maternal morbidity6 months postpartum

: presence of a depressive state assessed by the Edinburgh Depression Scale (EPDS) (with a discriminant threshold of the EPDS ≥ 11)

Impact of physical activity on the quality of life of pregnant women at 6 months postpartumbetween 20 and 24 weeks postpartum

Score obtained from the WHOQOL-Bref questionnaire

Impact of sedentary behaviour on postpartum maternal morbidity6 months postpartum

: presence of a depressive state assessed by the Edinburgh Depression Scale (EPDS) (with a discriminant threshold of the EPDS ≥ 11)

Impact of physical activity on the experience of childbirth4 weeks postpartum

Evaluation using the Questionnaire for Assessing the Childbirth Experience (QACE)

Impact of physical activity on the quality of life of pregnant women at the end of the 2nd trimester of pregnancybetween 24 and 30 weeks of gestation

Score obtained in the WHOQOL-Bref questionnaire

Impact of sedentary behaviour on the quality of life of pregnant women at the end of the 2nd trimester of pregnancybetween 24 and 30 weeks of gestation

Score obtained in the WHOQOL-Bref questionnaire

Impact of physical activity on the quality of life of pregnant women at the end of the 3rd trimester of pregnancybetween 32 and 37 SA+6day weeks of gestation

Score obtained in the WHOQOL-Bref questionnaire

Impact of sedentary behaviour on the quality of life of pregnant women at the end of the 3rd trimester of pregnancybetween 32 and 37 SA+6day weeks of gestation

Score obtained in the WHOQOL-Bref questionnaire

Impact of physical activity on the quality of life of pregnant women at 2 months postpartumbetween 6 and 10 weeks postpartum

Score obtained from the WHOQOL-Bref questionnaire

Impact of sedentary behaviour on the quality of life of pregnant women at 2 months postpartumbetween 6 and 10 weeks postpartum

Score obtained from the WHOQOL-Bref questionnaire

Impact of sedentary behaviour on the quality of life of pregnant women at 6 months postpartumbetween 20 and 24 weeks postpartum

Score obtained from the WHOQOL-Bref questionnaire

Impact of physical activity on the occurrence of urinary incontinence in the 2nd trimester of pregnancybetween 24 and 30 weeks of gestation

ICIQ-SF questionnaire score - International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form

Impact of sedentary behaviour on the occurrence of urinary incontinence in the 2nd trimester of pregnancybetween 24 and 30 weeks of gestation

ICIQ-SF questionnaire score - International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form

Impact of physical activity on the occurrence of urinary incontinence in the 3rd trimester of pregnancybetween 32 and 37 SA+6day weeks of gestation

ICIQ-SF questionnaire score - International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form

Impact of sedentary behaviour on the occurrence of urinary incontinence in the 3rd trimester of pregnancybetween 32 and 37 SA+6day weeks of gestation

ICIQ-SF questionnaire score - International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form

Impact of physical activity on the occurrence of urinary incontinence at 6 months postpartumbetween 20 and 24 weeks postpartum

Score on the ICIQ-SF questionnaire - International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form

Impact of sedentary behaviour on the occurrence of urinary incontinence at 6 months postpartumbetween 20 and 24 weeks postpartum

Score on the ICIQ-SF questionnaire - International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form

Impact of physical activity on sexual quality of lifebetween 20 and 24 weeks postpartum

Score on the FSFI Female Sexual Function Index questionnaire

Impact of sedentary behaviour on sexual quality of lifebetween 20 and 24 weeks postpartum

Score on the FSFI Female Sexual Function Index questionnaire

Impact of physical activity on early neonatal morbidityAt delivery

a composite criterion: "Apgar score \<7 at 5 min and/or arterial pH \<7.10 and/or transfer and/or intra-hospital transfer to a neonatal unit"

Impact of sedentary behaviour on early neonatal morbidityAt delivery

a composite criterion: "Apgar score \<7 at 5 min and/or arterial pH \<7.10 and/or transfer and/or intra-hospital transfer to a neonatal unit"

Impact of physical activity on the newborn's birth weightAt delivery

occurence of large for gestational age newborns (birth weight greater than the 95th percentile according to gestational age according to Audipog curves)

Impact of sedentary behaviour on the newborn's birth weightAt delivery

occurence of large for gestational age newborns (birth weight greater than the 95th percentile according to gestational age according to Audipog curves)

Cost-effectiveness analysis from the point of view of health insurance of the proposed intervention methodsData collected during the pregnancy and until 2 month of post-partum

Cost-effectiveness incremental study (including modelling of the gains linked to the reduction in C-section)

cost-utility study analysis from the point of view of health insurance of the proposed intervention methodsData collected during the pregnancy and until 6 month of post-partum

Cost-utility study (based on the usefulness felt by women) from the point of view of health insurance using the EQ5D-5L (5 Level Euroqol 5 Dimensions) and a mapping analysis of the WHOQOL-Bref

Trial Locations

Locations (1)

CHU de Clermont-Ferrand

🇫🇷

Clermont-Ferrand, France

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