References

ACOG Committee opinion no. 548: weight gain during pregnancy. Obstet Gynecol. 2013; 121:(1)210-12 https://doi.org/https://doi.org/10.1097/01.AOG.0000425668.87506.4c

Ashrafinia F, Mirmohammadali M, Rajabi H The effects of Pilates exercise on sleep quality in postpartum women. J Bodyw Mov Ther. 2014; 18:(2)190-9 https://doi.org/https://doi.org/10.1016/j.jbmt.2013.09.007

Beck CT. The effects of postpartum depression on child development: A meta-analysis. Arch Psychiatr Nurs. 1998; 12:(1)12-20 https://doi.org/https://doi.org/10.1016/S0883-9417(98)80004-6

Bhati S, Richards K. A systematic review of the relationship between postpartum sleep disturbance and postpartum depression. J Obstet Gynecol Neonatal Nurs. 2015; 44:(3)350-7 https://doi.org/https://doi.org/10.1111/1552-6909.12562

Borodulin KM, Evenson KR, Wen F, Herring AH, Benson AM. Physical activity patterns during pregnancy. Med Sci Sports Exerc. 2008; 40:(11)1901-8 https://doi.org/https://doi.org/10.1249/MSS.0b013e31817f1957

Borodulin K, Evenson KR, Herring AH. Physical activity patterns during pregnancy through postpartum. BMC Womens Health. 2009; 9:(1) https://doi.org/https://doi.org/10.1186/1472-6874-9-32

Brennan PA, Hammen C, Andersen MJ, Bor W, Najman JM, Williams GM. Chronicity, severity, and timing of maternal depressive symptoms: relationships with child outcomes at age 5. Dev Psychol. 2000; 36:(6)759-766 https://doi.org/https://doi.org/10.1037/0012-1649.36.6.759

Brennan PA, Le Brocque R, Hammen C. Maternal depression, parent-child relationships, and resilient outcomes in adolescence. J Am Acad Child Adolesc Psychiatry. 2003; 42:(12)1469-77 https://doi.org/https://doi.org/10.1097/00004583-200312000-00014

Brown WJ, Trost SG. Life transitions and changing physical activity patterns in young women. Am J Prev Med. 2003; 25:(2)140-3 https://doi.org/https://doi.org/10.1016/S0749-3797(03)00119-3

Butkov N, Lee-Chiong TL. Fundamentals of sleep technology.Philadelphia, PA: Lippincott Williams & Wilkins; 2007

Centers for Disease Control and Prevention. Data and statistics: Facts about physical activity. 2015. https://www.cdc.gov/physicalactivity/data/facts.htm (accessed 2 May 2018)

Cohen J. Statistical Power Analysis for the Behavioral Sciences, 2nd edn. Hillsdale, NJ: Lawrence Earlbaum Associates; 1988

Colten HR, Altevogt BM. Functional and Economic Impact of Sleep Loss and Sleep-Related Disorders.Washington, DC: National Academic Press; 2006

Davis JN, Hodges VA, Gillham MB. Physical activity compliance: differences between overweight/obese and normal-weight adults. Obesity (Silver Spring). 2006; 14:(12)2259-65 https://doi.org/https://doi.org/10.1038/oby.2006.265

de Souza L, Benedito-Silva AA, Pires MLN, Poyares D, Tufik S, Calil HM. Further validation of actigraphy for sleep studies. Sleep. 2003; 26:(1)81-5 https://doi.org/https://doi.org/10.1093/sleep/26.1.81

Dixon JB. The effect of obesity on health outcomes. Mol Cell Endocrinol. 2010; 316:(2)104-8 https://doi.org/https://doi.org/10.1016/j.mce.2009.07.008

Dørheim SK, Bondevik GT, Eberhard-Gran M, Bjorvatn B. Sleep and depression in postpartum women: a population-based study. Sleep. 2009; 32:(7)847-55 https://doi.org/https://doi.org/10.1093/sleep/32.7.847

Drago R. Time on the job and time with their kids: cultures of teaching and parenthood in the US. Fem Econ. 2001; 7:(3)1-31 https://doi.org/https://doi.org/10.1080/14664372.2001.10090723

Durham HA, Morey MC, Lovelady CA, Brouwer RJN, Krause KM, Østbye T. Postpartum physical activity in overweight and obese women. J Phys Act Health. 2011; 8:(7)988-93 https://doi.org/https://doi.org/10.1123/jpah.8.7.988

Ekelund U, Sjöström M, Yngve A Physical activity assessed by activity monitor and doubly labeled water in children. Med Sci Sports Exerc. 2001; 33:(2)275-81 https://doi.org/https://doi.org/10.1097/00005768-200102000-00017

Gibson LY, Byrne SM, Davis EA, Blair E, Jacoby P, Zubrick SR. The role of family and maternal factors in childhood obesity. Med J Aust. 2007; 186:(11)591-5

Gunderson EP, Rifas-Shiman SL, Oken E Association of fewer hours of sleep at 6 months postpartum with substantial weight retention at 1 year postpartum. Am J Epidemiol. 2007; 167:(2)178-87 https://doi.org/https://doi.org/10.1093/aje/kwm298

Guszkowska M. Effects of exercise on anxiety, depression and mood. Psychiatr Pol. 2004; 38:(4)611-20

Harrison Y, Horne JA. The impact of sleep deprivation on decision making: A review. J Exp Psychol Appl. 2000; 6:(3)236-49 https://doi.org/https://doi.org/10.1037/1076-898X.6.3.236

Hildebrand M, Van Hees VT, Hansen BH, Ekelund U. Age group comparability of raw accelerometer output from wrist- and hip-worn monitors. Med Sci Sports Exerc. 2014; 46:(9)1816-24 https://doi.org/https://doi.org/10.1249/MSS.0000000000000289

Kosmadopoulos A, Sargent C, Darwent D, Zhou X, Roach GD. Alternatives to polysomnography (PSG): A validation of wrist actigraphy and a partial-PSG system. Behav Res Methods. 2014; 46:(4)1032-41 https://doi.org/https://doi.org/10.3758/s13428-013-0438-7

Marcus BH, Pinto BM, Simkin LR, Audrain JE, Taylor ER. Application of theoretical models to exercise behavior among employed women. Am J Health Promot. 1994; 9:(1)49-55 https://doi.org/https://doi.org/10.4278/0890-1171-9.1.49

McCall C, McCall WV. Comparison of actigraphy with polysomnography and sleep logs in depressed insomniacs. J Sleep Res. 2012; 21:(1)122-7 https://doi.org/https://doi.org/10.1111/j.1365-2869.2011.00917.x

Montgomery-Downs HE, Insana SP, Clegg-Kraynok MM, Mancini LM. Normative longitudinal maternal sleep: the first 4 postpartum months. Am J Obstet Gynecol. 2010; 203:(5)465 e1-e7 https://doi.org/https://doi.org/10.1016/j.ajog.2010.06.057

Morgenthaler TI, Lee-Chiong T, Alessi C Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders. An American Academy of Sleep Medicine report. Sleep. 2007; 30:(11)1445-59 https://doi.org/https://doi.org/10.1093/sleep/30.11.1445

NHS Choices. Physical activity guidelines for adults. 2015. https://www.nhs.uk/Livewell/fitness/Pages/physical-activity-guidelines-for-adults.aspx (accessed 2 May 2018)

Nehring I, Schmoll S, Beyerlein A, Hauner H, von Kries R. Gestational weight gain and long-term postpartum weight retention: a meta-analysis. Am J Clin Nutr. 2011; 94:(5)1225-31 https://doi.org/https://doi.org/10.3945/ajcn.111.015289

Öhlin A, RÖssner S. Trends in eating patterns, physical activity and socio-demographic factors in relation to postpartum body weight development. Br J Nutr. 1994; 71:(04)457-70 https://doi.org/https://doi.org/10.1079/BJN19940155

Pereira MA, Rifas-Shiman SL, Kleinman KP, Rich-Edwards JW, Peterson KE, Gillman MW. Predictors of change in physical activity during and after pregnancy: project Viva. Am J Prev Med. 2007; 32:(4)312-19 https://doi.org/https://doi.org/10.1016/j.amepre.2006.12.017

Quillin SIM. Infant and mother sleep patterns during 4th postpartum week. Issues Compr Pediatr Nurs. 1997; 20:(2)115-23 https://doi.org/https://doi.org/10.3109/01460869709026882

Reilly JJ, Methven E, McDowell ZC Health consequences of obesity. Arch Dis Child. 2003; 88:(9)748-52 https://doi.org/https://doi.org/10.1136/adc.88.9.748

Stremler R, Hodnett E, Lee K, MacMillan S, Mill C, Ongcangco L, Willan A. A behavioral-educational intervention to promote maternal and infant sleep: a pilot randomized, controlled trial. Sleep. 2006; 29:(12)1609-15 https://doi.org/https://doi.org/10.1093/sleep/29.12.1609

Sullivan GM, Feinn R. Using effect size—or why the P value is not enough. J Grad Med Educ. 2012; 4:(3)279-82 https://doi.org/https://doi.org/10.4300/JGME-D-12-00156.1

Swartz AM, Strath SJ, Bassett DRO, O'Brien WL, King GA, Ainsworth BE. Estimation of energy expenditure using CSA accelerometers at hip and wrist sites. Med Sci Sports Exerc. 2000; 32:(9)S450-S456 https://doi.org/https://doi.org/10.1097/00005768-200009001-00003

Teychenne M, Ball K, Salmon J. Sedentary behavior and depression among adults: a review. Int J Behav Med. 2010; 17:(4)246-54 https://doi.org/https://doi.org/10.1007/s12529-010-9075-z

Thomas K, Foreman S. Infant sleep and feeding pattern: effects on maternal sleep. J Midwifery Womens Health. 2005; 50:(5)399-404 https://doi.org/https://doi.org/10.1016/j.jmwh.2005.04.010

Treuth MS, Butte NF, Puyau M. Pregnancy-related changes in physical activity, fitness, and strength. Med Sci Sports Exerc. 2005; 37:(5)832-7 https://doi.org/https://doi.org/10.1249/01.MSS.0000161749.38453.02

Tudor-Locke C, Barreira TV, Schuna JM, Mire EF, Katzmarzyk PT. Fully automated waist-worn accelerometer algorithm for detecting childrens sleep-period time separate from 24-h physical activity or sedentary behaviors. Appl Physiol Nutr Metab. 2014; 39:(1)53-7 https://doi.org/https://doi.org/10.1139/apnm-2013–0173

Tudor-Locke C, Brashear MM, Johnson WD, Katzmarzyk PT. Accelerometer profiles of physical activity and inactivity in normal weight, overweight, and obese US men and women. Int J Behav Nutr Phys Act. 2010; 7:(1) https://doi.org/https://doi.org/10.1186/1479-5868-7-60

Van Hees VT, Gorzelniak L, Leon ECD Separating movement and gravity components in an acceleration signal and implications for the assessment of human daily physical activity. PLoS One. 2013; 8:(4) https://doi.org/https://doi.org/10.1371/journal.pone.0061691

Verhoef M, Love EJ, Rose SA. Womens social roles and their exercise participation. Women Health. 1993; 19:(4)15-29 https://doi.org/https://doi.org/10.1300/J013v19n04_02

Vladutiu CJ, Evenson KR, Borodulin K, Deng Y, Dole N. The association between physical activity and maternal sleep during the postpartum period. Matern Child Health J. 2014; 18:(9)2106-14 https://doi.org/https://doi.org/10.1007/s10995-014-1458-3

Vladutiu CJ, Evenson KR, Jukic AM, Herring AH. Correlates of self-reported physical activity at 3-and 12-months postpartum. J Phys Act Health. 2015; 12:(6)814-22 https://doi.org/https://doi.org/10.1123/jpah.2014-0147

Wilkinson S, Huang CM, Walker LO, Sterling BS, Kim M. Physical activity in low-income postpartum women. J Nurs Scholarsh. 2004; 36:(2)109-14 https://doi.org/https://doi.org/10.1111/j.1547-5069.2004.04022.x

Wolfson AR, Crowley SJ, Anwer U, Bassett JL. Changes in sleep patterns and depressive symptoms in first-time mothers: last trimester to 1-year postpartum. Behav Sleep Med. 2003; 1:(1)54-67 https://doi.org/https://doi.org/10.1207/S15402010BSM0101_6

Xiao RS, Kroll-Desrosiers AR, Goldberg RJ, Pagoto SL, Person SD, Waring ME. The impact of sleep, stress, and depression on postpartum weight retention: A systematic review. J Psychosom Res. 2014; 77:(5)351-8 https://doi.org/https://doi.org/10.1016/j.jpsychores.2014.09.016

Postpartum physical activity and sleep levels in overweight, obese and normal-weight mothers

02 June 2018
Research
02 June 2018
Volume 26 · Issue 6

Abstract

Background

Lack of physical activity and sleep can lead to serious health consequences. One population likely to experience both of these issues is postpartum mothers.

Aim

To compare physical activity and sleep of overweight/obese and normal weight postpartum mothers.

Methods

The study recruited 21 mothers in the first 6 months postpartum, who were classified as normal weight or overweight. Activity and sleep levels were gathered via wrist-worn accelerometers at three intervals between 3–6 months postpartum.

Findings

Overall, there was a significant (P<0.05) increase in physical activity. When separated by body mass index (BMI) classification, the ‘normal weight’ group displayed a significant increase in physical activity, while the ‘overweight/obese’ group did not. Normal-weight participants also had the larger increase in physical activity from visit two to three. All participants significantly decreased in sleep levels from visit two to three.

Conclusions

Discrepancies appeared between the physical activity of overweight/obese and normal-weight mothers. Interventions before and after pregnancy may be key in improving these issues.

Lack of physical activity and sleep are two key risk factors for numerous physical and psychological health-related issues (Colten and Altevogt, 2006; Center for Disease Control (CDC), 2015). Lack of physical activity is linked to an increased risk of physical health issues, such as cardiovascular disease and type 2 diabetes; mental health issues, including depression and anxiety; and cognitive issues, such as deficiencies in learning and judgement (Guszkowska, 2004; CDC, 2015). Lack of sleep duration is also associated with numerous chronic diseases, including hypertension, diabetes, depression, obesity, and cancer, along with increased mortality, reduced quality of life, and impaired cognitive function (Colten and Altevogt, 2006).

One population likely to lack physical activity and sleep is postpartum mothers. Postpartum mothers are less active than women of the same age without children (Verhoef et al, 1993; Marcus et al, 1994; Drago, 2001) and mothers with older children (Marcus et al, 1994; Brown and Trost, 2003). Furthermore, postpartum mothers have reported getting 1–2 fewer hours of sleep than their non-postpartum counterparts (Quillin, 1997; Thomas and Foreman, 2005). Along with negative consequences for the mother, lack of physical activity and sleep in postpartum mothers may have implications for their child, such as reduced alertness and decision-making (Harrison and Horne, 2000). Additionally, lack of physical activity and sleep have both been linked to an increased risk of depression in mothers, which is associated with adverse cognitive and emotional development in their children (Beck, 1998; DØrheim et al, 2009; Teychenne et al, 2010). Specifically, maternal depressive symptoms at 6 months postpartum have been associated with lower vocabulary scores and higher rates of behavioral issues in children at age 5 years (Brennan et al, 2000).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month

Register
Or continue by

Signing in with your registered email address

Postpartum
Physical activity
Sleep
Accelerometer