The effectiveness of the pedometer is greater when establishing a goal to achieve. The pedometer is a cost-effective tool that increases the motivation to walk and increase the number of steps per day by 2000 to 2500 compared to those who do not use it. Moreover, improves cardiorespiratory capacity, decreases stress and anxiety and improves sleep quality, increases quality of life and reduces weight gain during pregnancy. Walking during pregnancy regulates, prevents or delays the increase in blood pressure and cholesterol in healthy women, decreases the prevalence of type 2 diabetes mellitus and improves glycaemic control of pregnant women with GDM. However, the number of steps/days counted in the first trimester of pregnancy does not exceed 5000 steps, which is half of those recommended (10,000-11,000) and decreases as the gestation progresses. Walking is one of the recommended activities in the guidelines of PA in pregnant women in Canada, Japan, Norway and Spain and the most carried out during pregnancy. To make an objective assessment of this, a woman who counts less than 5000 steps/day on average could be considered sedentary. In fact, pregnant women spend more than 50% of their time in sedentary activities. However, only 20.3–30% of pregnant women are active.
In addition, the practice of regular PA (> 150 min/week) also increases the quality of sleep in adults and in pregnancy. It has been documented that practice of physical activity (PA) prevents the onset of insomnia in adults, postmenopausal women and pregnant women. Insomnia is also involved in unplanned caesarean sections, prolonged labour, premature placental abruption, delayed intrauterine growth and prematurity. Insomnia is associated with an increase of gestational diabetes mellitus (GDM), depression in pregnancy and postpartum, arterial hypertension and preeclampsia as a result of the increase in cytokine levels derived from sleep deprivation. The prevalence of insomnia at the beginning of pregnancy is around 40%, reaching over 60% in the third trimester of pregnancy.
#Insomnia during first trimester trial
Trial registrationĬ Identifier: NCT03735381. Promoting walking in second half of pregnancy through use of pedometer and health pre-registration of a goal to be achieved –'10,000–11,000 steps a day’– should prevent appearance of insomnia in third trimester, will increase sleep quality and quality of life in pregnant women. We will use Stata 15 statistical software. McNemar-Bowker test will be used to assess differences in life quality in pre-post analyses in the 3 arms. To determine differences in hours of sleep and quality of sleep throughout each trimester of pregnancy, analysis of variance or Friedman test will be used.
To compare differences between groups in terms of frequency of insomnia/quality of life for each trimester of pregnancy, Pearson’s Chi-square test or Fisher’s exact test will be used. Student t test or Mann-Whitney U will be used to compare 19th and 31st GW mean of daily steps between I1 and I2 groups. At 13th, 20th and 32nd GW, Athens Insomnia Scale (AIS), Pittsburgh Sleep Quality Index (PSQI), Adherence to Mediterranean Diet (AMD), physical activity (short IPAQ), quality of life (PSI), and consumption of toxic substances (caffeine, illegal drugs, alcohol and tobacco) will be collected. At 12th, 19th and 31st GW the average steps/day will be measured in groups I1 and I2. At 12th gestational week (GW), they will be invited to participate and randomly assigned to one of the three arms of study: the intervention group I1 (pedometer, goal of 11,000 steps/day), intervention group I2 (pedometer, no goal) and control (no pedometer). Randomized Controlled trial in parallel in healthy sedentary pregnant women ( n = 265), Walking_Preg Project (WPP), from university hospital in Granada, Spain. Our general objective is to determine the effect of a walking program in preventing the appearance of insomnia in the third trimester of pregnancy, increasing sleep quality and improving quality of life throughout pregnancy.
Previous studies in pregnancy have not focused in evaluating the effect of walking during pregnancy and prevention of insomnia.
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