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Less exercise in pregnancy after past miscarriage

New research finds lower motivation to exercise and poorer psychological health among women with a history of miscarriage and those who are overweight or obese before pregnancy.

Additionally, women who were less likely to exercise had higher rates of anxiety and depression, according to researchers who surveyed 113 women, 41 of which had a prior miscarriage, and 72 who were overweight or obese.

“What this tells us is that women who have experienced a prior miscarriage may not know about the benefits of exercise in their next pregnancy for managing their psychological health,” says lead author Danielle Downs, professor of kinesiology and obstetrics and gynecology at Penn State. “From a public health perspective, women with a former miscarriage should look at exercise as a tool in their next pregnancy as a way to manage anxiety and depressive symptoms.”

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Similarly, overweight and obese women may be at higher risk for experiencing anxiety and depressive symptoms during early pregnancy compared to healthy weight women, and may also benefit from exercise, Downs says.

Miscarriage stigma

Women reported their depressive or anxiety symptoms and exercise motivation and behavior in the first, second, and third trimesters via mailed surveys.

Women with a history of miscarriage had higher depressive or anxiety symptoms and lower positive attitude and perceived control for exercise in early-mid pregnancy compared to women without a history of miscarriage.

Miscarriage is the most common complication of early pregnancy and occurs in approximately 24 percent of pregnancies, according to the American College of Obstetricians and Gynecologists.

Although common, it is not a topic that is widely discussed, as it can be painful and traumatic for families, and often associated with shame and fear. Some women may not even know they experienced a miscarriage, as oftentimes miscarriage can be mistaken for a late menstrual period, Downs says.

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These same reasons may be why miscarriage is often underreported, Downs says.

“Miscarriage followed by a new pregnancy, and the grief as well as excitement that happens during this time, makes for a complicated psychological period,” says Downs. “Exercise is something that health care providers can recommend for these women as a tool to possibly manage the symptoms of anxiety, depression, and fear of losing another baby.”

Promoting exercise

Overweight and obese women had higher first- and second-trimester pregnancy depressive or anxiety symptoms; engaged in less pre-pregnancy exercise; and had lower levels of exercise intention, attitude, and perceived behavior control throughout pregnancy than healthy-weight women.

“Given that pre-pregnancy activity level is a strong predictor of perinatal exercise and motivational determinants, and that overweight and obese women are at higher risk for inactivity, high gestational weight gain, and anxiety and depressive symptoms throughout pregnancy, efforts are needed to promote exercise and stress management in these women—especially overweight and obese women with a history of miscarriage,” Downs says.

Downs cautions that “one size doesn’t fit all pregnant women. Women should talk to their doctors regarding any exercise regimen.”

Downs suggests that interventions and health care provider communications aimed at promoting perinatal exercise behavior and psychological health should take into account pre-pregnancy weight status and pregnancy history to identify strategies to help women, particularly overweight and obese women with a history of miscarriage, to overcome exercise barriers.

Additional authors of the paper are from the New Balance Foundation Obesity Prevention Center at Boston Children’s Hospital and the School of Nutrition Health and Promotion at Arizona State University.

The National Heart, Lung, and Blood Institute of the National Institutes of Health supported the work, which appears in the journal Midwifery.

Source: Penn State

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