| 1. |
- Rindner, Lena, 1959, et al.
(författare)
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Prognostic factors for future mental, physical and urogenital health and work ability in women, 45-55 years: a six-year prospective longitudinal cohort study.
- 2020
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Ingår i: BMC women's health. - : Springer Science and Business Media LLC. - 1472-6874. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Impaired health due to stress is a common cause of long-term illness in women aged 45-55years. It is a common cause for visits to primary health care (PHC) and may influence work-ability. The aim of this study was to investigate prognostic factors for future mental, physical and urogenital health as well as work-ability in a population of average women aged 45-55years.This longitudinal cohort study initially assessed 142 women from PHC centers in southwestern Sweden. One houndred and ten accepted participation and were followed for 6years. They were assessed using the self-reported questionnaires: the Menopause Rating Scale (MRS), the Montgomery-Asberg Depression Rating Scale (MADRS-S), the Short-Form Health Survey (SF-36). Descriptive data are presented of health, education, relationships and if they are working. Multicollinearity testing and logistic regression were used to test the explanatory variables.Severity of symptoms in the MRS somatic and urogenital domains decreased while they increased in the psychological and depressive domains. Having tertiary education was associated with decreased overall mental health, vitality and social role functioning. Living with a partner was associated with increased physical role functioning, social role functioning and emotional role functioning.Quality of life seems to be enhanced by a good relationship with the partner, social support and work/life balance. Therefore, to improve women health women should early discuss ways in which these issues can be incorporated as they pursue their academic or career goals. Hence, we emphasize the importance of supporting women to gain increased awareness about a healthy life balance and to have realistic goals in work as well as in their social life.
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| 2. |
- Berg, Marie, 1955, et al.
(författare)
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Att bli förälder
- 2010
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Ingår i: Att stödja och stärka : vårdande vid barnafödande / Marie Berg, Ingela Lundgren (red.). - 9789144068206 ; , s. 69-84
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Bokkapitel (refereegranskat)
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| 3. |
- Berg, Marie, 1955, et al.
(författare)
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Minimizing pregnancy weight gain in women with obesity - a challenge for midwives
- 2017
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Ingår i: 31st International Confederation for Midwives Triennal Conference, 18-22 June, Toronto, Canada.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Maternal Obesity is an increasing ill health issue associated with increased risk of complications for mother and child, both in a short perinatal perspective and in a life-long perspective. The risk aggravates with increasing maternal BMI and aggravates with increasing gestational weight gain. Purpose/Objective: To investigate whether a lifestyle intervention project at primary care level, offered by midwives to pregnant women with BMI ≥30 would lower gestational weight gain and lower BMI at 3 months after childbirth. Secondary aims were to study if such intervention had positive impact on maternal and child health, to assess the cost efficacy of the intervention, and to explore participating women´s respectively midwives’ experiences. Method: The project was performed years 2011-2013 in Gothenburg, Sweden as a case control study of pregnant women with BMI ≥30 in early pregnancy (n=1165). A control group (n=700) got usual care. Intervention group (n=465) were offered 1) systematised counselling, motivational sessions with midwife concerning nutrition and physical activity 2) group discussions and completing food diary with dietician, 3) aqua aerobics class with midwife/physiotherapist 4) guidance to suitable and locally available health activities 5) availability of pedometers and walking poles. Key Findings: A pilot study show significant positive effect (±SD) on gestational weight gain in the intervention group (8.6±4.9 kg vs. 12.5±5.1kg), and significant better maternal weight at the postnatal checkup. A greater proportion of the intervention group restricted their gestational weight gain to < 7 kg (36% vs. 16%). Full findings will be presented at conference comprising: main outcome whole group (n=1165), cost effectiveness of intervention, and experiences of participating midwives and women. Discussion: To establish good evidence based routines for pregnant women with obesity is important and especially by midwives. This study will inform us if this relatively low intensive intervention can improve maternal and child health in pregnancy, childbirth and first months postpartum. References: Haby K, Glantz A, Hanås R, Premberg Å. Mighty Mums - An antenatal health care intervention can reduce gestational weight gain in women with obesity. Midwifery 2015; 31 (7):685- 692. Marchi, J., Berg, M., Dencker, A., Olander, E. K., & Begley, C. Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews. Obes. Rev. 2015;16(8):621-38. doi: 10.1111/obr.12288. Epub 2015 May 28.
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| 4. |
- Dencker, Anna, 1956, et al.
(författare)
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Adopting a healthy lifestyle when pregnant and obese – an interview study three years after childbirth.
- 2016
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background Obesity during pregnancy is increasing and is related to life-threatening and ill-health conditions in both mother and child. Initiating and maintaining a healthy lifestyle when pregnant with body mass index (BMI)≥30 kg/m2 can improve health and decrease risks during pregnancy and of long-term illness for the mother and the child. To minimise gestational weight gain women with BMI≥30 kg/m2 in early pregnancy were invited to a lifestyle intervention including advice and support on diet and physical activity in Gothenburg, Sweden. The aim of this study was to explore the experiences of women with BMI≥30 kg/m2 regarding minimising their gestational weight gain, and to assess how health professionals’ care approaches are reflected in the women’s narratives. Methods Semi-structured interviews were conducted with 17 women who had participated in a lifestyle intervention for women with BMI≥30 kg/m2 during pregnancy 3 years earlier. The interviews were digitally recorded and transcribed in full. Thematic analysis was used. Results The meaning of changing lifestyle for minimising weight gain and of the professional’s care approaches is described in four themes: the child as the main motivation for making healthy changes; a need to be seen and supported on own terms to establish healthy routines; being able to manage healthy activities and own weight; and need for additional support to maintain a healthy lifestyle. Conclusions To support women with BMI≥30 kg/m2 to make healthy lifestyle changes and limit weight gain during pregnancy antenatal health care providers should 1) address women’s weight in a non-judgmental way using BMI, and provide accurate and appropriate information about the benefits of limited gestational weight gain; 2) support the woman on her own terms in a collaborative relationship with the midwife; 3) work in partnership to give the woman the tools to self-manage healthy activities and 4) give continued personal support and monitoring to maintain healthy eating and regular physical activity habits after childbirth involving also the partner and family.
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| 5. |
- Dencker, Anna, 1956, et al.
(författare)
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Support to adopt a healthy lifestyle for pregnant women with BMI > 30
- 2016
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Ingår i: The NJF Congress (Nordiskt Jordemorförbund), Gothenburg, 12-14 May 2016. - 9789163742699
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Konferensbidrag (refereegranskat)abstract
- Background A change towards healthy habits during pregnancy and in early motherhood, including weight control, increased physical activity and optimal diet habits will promote health for the woman with body mass index (BMI) ≥ 30 kg/m2, her fetus/ child, as well as for the whole family. To optimise a healthy lifestyle from early pregnancy in women with BMI ≥ 30 kg/m2 an intervention called Mighty Mums, including advice and support on diet and physical activity was carried out in the maternity health care in Gothenburg, Sweden. . Aim To explore women´s experiences 3 years after participating in a lifestyle intervention targeting pregnant women with BMI ≥ 30 kg/m2. Methods Qualitative interviews were performed with 17 mothers who had participated in a lifestyle intervention 3 years earlier. The interviews were semi-structured and thematic analysis was used. Results All interviews were transcribed verbatim and read in full in the first analysis step. Second, initial codes were identified in the data. All features with a meaning were coded and initial codes were condensed and formed four themes. Conclusions The expected child was the main motivation for the women to participate in the intervention. The women needed to be seen and get personal support from the antenatal health care midwife and receive help to be able to control the selection and implementation of healthy activities. Extra support during pregnancy helped temporarily but there was still a need of support to maintain a healthy lifestyle in the long run.
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| 6. |
- Gyllensten, Hanna, 1979, et al.
(författare)
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Cost effectiveness of a controlled lifestyle intervention for pregnant women with obesity.
- 2021
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Ingår i: BMC pregnancy and childbirth. - : Springer Science and Business Media LLC. - 1471-2393. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- The Mighty Mums antenatal lifestyle intervention is a person-centered behavioral intervention focusing on nutrition and physical activity for pregnant women with obesity (body mass index [BMI] ≥30). The aim of this study was to evaluate the costs and clinical outcomes of adding the Mighty Mums intervention to standard antenatal care.Participants in the intervention group (n=434) received motivational talks with their midwife and a selection of physical and/or nutritional activities in addition to antenatal care. Control participants (n=867) from adjacent geographic areas received standard antenatal care. Costs for staff, unit costs for specific activities, and registered costs for specialized antenatal care were analyzed for associations with gestational weight gain and self-reported health. Results are reported for the intention-to-treat (ITT) population and a per protocol (PP) population identified by participation in the intervention. Analyses included bootstrapped linear regressions adjusted for background characteristics that differed significantly between groups.The average costs were SEK 9727 higher (95% confidence interval [CI]: 6677 to 12,777) among participants in the intervention group than in the control ITT population and SEK 8655 (95% CI 4586 to 12,724) higher than in the PP population. The cost increase per 1kg reduction in gestational weight gain was SEK 12,369 in the ITT population and SEK 7209 for the PP population.Participation in the Mighty Mums intervention was associated with higher costs, but also reduced gestational weight gain. The cost per kilogram reduction in gestational weight gain was low, particularly in the PP population. A future decision to implement this behavioral intervention in standard care should take into account society's willingness to pay per unit reduction in gestational weight gain.The study is registered at ClinicalTrials.gov , Identifier: NCT03147079 .
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| 7. |
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| 8. |
- Haby, Karin, 1960, et al.
(författare)
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A Lifestyle Intervention During Pregnancy and Its Effects on Child Weight 2.5 Years Later
- 2022
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Ingår i: Maternal and Child Health Journal. - : Springer Science and Business Media LLC. - 1092-7875 .- 1573-6628. ; 26, s. 1881-1890
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to evaluate if overweight and obesity in the offspring is reduced by a low-intensity antenatal primary care intervention with focus on diet and physical activity for pregnant women with obesity, comparing children to mothers receiving the intervention with children to mothers who did not. Methods: This study is a follow-up of children 2.5years of age after their mothers’ participation in a non-randomised controlled intervention intending to limit gestational weight gain. All study participants received standard antenatal care. The intervention group received lifestyle support via motivational talks with midwife and support from dietician. Data on child weight were collected by medical records, letter and phone. Results: There was no significant difference between the groups 2.5years after intervention (International Obesity Task Force ISO-BMI 25 (child BMI corresponding to adult BMI of 25): 20% vs. 21%; ISO-BMI 30: 4.6% vs. 1.3%). The mother’s BMI at the beginning of pregnancy significantly influenced child BMI at 2.5years (r = 0.13, p = 0.014, r2 = 0.017). For each unit of increase in maternal BMI at enrollment, the probability of child ISO-BMI ≥ 25 increased by 7.5% (p = 0.021) and of ≥ 30, by 12.9% (p = 0.017). Conclusion: The frequency of overweight and obesity of the children at 2.5years of age was significantly correlated to the mother’s BMI, but not correlated to the mothers’ participation in the antenatal lifestyle intervention. Thus, it seems important to address obesity and lifestyle issues before and between pregnancies. Trial registration The study has been registered at ClinicalTrials.gov, Identifier: NCT03147079.
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| 9. |
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| 10. |
- Haby, Karin, 1960, et al.
(författare)
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Lifestyle intervention in pregnant women with BMI ≥30
- 2018
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Ingår i: NEON, The Network in Epidemiology and Nutrition. From evidence to practice. April 18-19 2018.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background Obesity (BMI ≥30) during pregnancy is becoming an increasing public health issue and is associated with adverse maternal and perinatal outcomes. Excessive gestational weight gain (GWG) further increases the risks of adverse outcomes. However, lifestyle intervention can help pregnant women with obesity to limit their GWG. This study evaluated whether an antenatal lifestyle intervention programme for pregnant women with obesity, with emphasis on nutrition and physical activity, could influence GWG and maternal and perinatal outcomes. Methods The intervention was performed in a city in Sweden 2011–2013. The study population was women with BMI ≥30 in early pregnancy who received standard antenatal care and were followed until postpartum check-up. The intervention group (n = 459) was provided with additional support for a healthier lifestyle, including motivational talks with the midwife, food advice, prescriptions of physical activity, walking poles, pedometers, and dietician consultation. The control group was recruited from the same (n = 105) and from a nearby antenatal organisation (n = 790). Results In the per-protocol population, the intervention group had significantly lower GWG compared with the control group (8.9 ± 6.0 kg vs 11.2 ± 6.9 kg; p = 0.031). The women managed to achieve GWG <7 kg to a greater extent (37.1% vs. 23.0%; p = 0.036) and also had a significantly lower weight retention at the postpartum check-up (-0.3 ± 6.0 kg vs. 1.6 ± 6.5 kg; p = 0.019) compared to the first visit. The most commonly used components of the intervention, apart from the extra midwife time, were support from the dietician and retrieval of pedometers. Overall compliance with study procedures, actual numbers of visits with logbook activity, and dietician contact correlated significantly with GWG. There was no statistically significant difference in GWG (10.3 ± 6.1 kg vs. 11.2 ± 6.9 kg) between the intervention and control groups in the intention-to-treat population. Conclusion Pregnant women with obesity who follow a lifestyle intervention programme in primary health care can limit their weight gain during pregnancy and show less weight retention after pregnancy. This modest intervention can easily be implemented in a primary care setting.
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