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Title: Macrosomia in uncomplicated pregnancies : an investigation of physical activity, maternal nutrition and women's experiences
Author: Reid, Esther Winifred
ISNI:       0000 0004 2742 3599
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2012
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Fetal macrosomia is associated with maternal and neonatal morbidity. Aims of thesis: • Systematically review the evidence in relation to physical activity, maternal nutrition and macrosomia • Conduct a prospective cohort study (Phase 1) exploring physical activity and maternal nutrition as potentially modifiable risk factors for fetal macrosomia • Conduct a qualitative study (Phase 2) using semi structured interviews to explore women's experiences of delivering a large for gestational age infant. Methods Population: Low risk pregnant women predicted to deliver macrosomic babies (study group) or appropriate for gestational age (AGA) babies (control group). Phase 1: Participants wore a SenseWear® physical activity armband and completed a food diary (four consecutive days) in the third trimester of pregnancy. Demographic and obstetric data were collected from maternity records. Phase 2: Interviews were conducted at 3-4 months postpartum with a subgroup of women who delivered macrosomic babies. Results 112 women participated in the study. Women who delivered macrosomic babies (≥4000g) spent significantly more time at very low levels of physical activity <1 MET) than other women (p=0.007). Intake of PUFA n-3 was significantly higher in women who were predicted to deliver macrosomic babies but delivered AGA babies at full term of this pregnancy (p=0.015). Women predicted to deliver macrosomic babies were more likely to be overweight (BMI> 25 kg/m-) at booking (p=O.017) and have attained third level education (p=0.024). Predicted macrosomia was strongly associated with Caesarean section (p=0.10) compared with the control group (43%vs22%). Experiences of delivering a macrosomic baby are influenced by previous experiences, relationships with health professionals and personal perceptions of macrosomia. Conclusion Findings from this study provide evidence that a more sedentary maternal lifestyle during the third trimester of pregnancy is associated with macrosomia. The evidence from this study forms the basis for future research and has implications for both practice and public health policy.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available