Maternal Physical Activity in the Third Trimester and Delayed Onset of Lactogenesis

Abstract

Background Delayed onset of lactogenesis (DOL) is an important cause of failed lactation. Excessive gestational weight gain and postpartum depression will increase the risk of DOL, but appropriate physical activity (PA) during pregnancy may effectively prevent excessive gestational weight gain, improve postpartum negative mood, benefiting breastfeeding. However, the relationship between PA during pregnancy and DOL is still unclear. Objective To investigate the PA level in the third trimester and its association with DOL, providing a basis for early prevention of DOL and ensuring breastfeeding success. Methods A prospective study design was adopted. Participants were women in their third trimester who underwent prenatal examination and later delivery in the 901 Hospital, Joint Logistic Support Force of the Chinese People's Liberation Army, from December 2020 to August 2021. General information (including demographic and obstetric data) , PA and sedentary behaviour time (evaluated by the International Physical Activity Questionnaire-Short Form) , postpartum depression (evaluated by the Edinburgh Postnatal Depression Scale) , and DOL were investigated and collected. Unconditional Logistic regression analysis was used to explore the relationship between PA level in the third trimester and DOL. Results A total of 261 cases were selected, and 247 of them (94.7%) who returned responsive questionnaires were finally enrolled. The prevalence of DOL was 27.9% (69/247) . Respondents with and without DOL had significant differences in gestational weight gain, depression prevalence, and prevalence of infant formula feeding within 48 hours after delivery (P<0.1) . The prevalence of having appropriate and inappropriate PA in the third trimester was 73.3% (181/247) and 26.7% (66/247) , respectively. The prevalence of duration of sedentariness ≥6.5 h/d was 15.8% (39/247) . Respondents with DOL had lower prevalence of having appropriate PA, and higher prevalence of duration of sedentariness ≥6.5 h/d than did those without (P<0.05) . Unconditional Logistic regression analysis showed that inappropriate PA level 〔OR=0.421, 95%CI (0.223, 0.797) 〕 and longer duration of sedentariness ≥6.5 h/d〔OR=0.193, 95%CI (0.090, 0.414) 〕 in the third trimester were associated with increased risk of DOL (P<0.05) . Conclusion Inappropriately increasing the level of PA during pregnancy and reducing the duration of sedentariness per day could reduce the risk of DOL and effectively improve the rate of successful breastfeeding.

Keywords

• lactation|delayed onset of lactogenesis|pregnant women|pregnancy trimester, third|physical exertion|sedentary behavior|root cause analysis