The effect of pregnancy and the duration of postpartum convalescence on the physical fitness of healthy women: A cohort study of active duty servicewomen receiving 6 weeks versus 12 weeks convalescence

Abstract

Introduction Pregnancy profoundly affects cardiovascular and musculoskeletal performance requiring up to 12 months for recovery in healthy individuals. Objective To assess the effects of extending postpartum convalescence from 6 to 12 weeks on the physical fitness of Active Duty (AD) soldiers as measured by the Army Physical Fitness Test (APFT) and Body Mass Index (BMI). Methods We conducted a retrospective study of AD soldiers who delivered their singleton pregnancy of ≥ 32weeks gestation at a tertiary medical center. Pre- and post-pregnancy APFT results as well as demographic, pregnancy, and postpartum data were collected. Changes in APFT raw scores, body composition measures, and failure rates across the 6-week and 12-week convalescent cohorts were assessed. Multivariable regressions were utilized to associate risk factors with failure. Results Four hundred sixty women met inclusion criteria; N = 358 in the 6 week cohort and N = 102 in the 12 week cohort. Demographic variables were similar between the cohorts. APFT failure rates across pregnancy increased more than 3-fold in both groups, but no significant differences were found between groups in the decrement of performance or weight gain. With the combined cohort, multivariable regression analysis showed failure on the postpartum APFT to be independently associated with failure on the pre-pregnancy APFT (OR = 16.92, 95% CI 4.96–57.77), failure on pre-pregnancy BMI (OR = 8.44, 95% CI 2.23–31.92), elevated BMI at 6–8 weeks postpartum (OR = 4.02, 95% CI 1.42–11.35) and not breastfeeding at 2 months (OR = 3.23, 95% CI 1.48–7.02). Within 36 months of delivery date, 75% of women had achieved pre-pregnancy levels of fitness. Conclusion An additional 6 weeks of convalescence did not adversely affect physical performance or BMI measures in AD Army women following pregnancy. Modifiable factors such as pre- and post-pregnancy conditioning and weight, weight gain in pregnancy and always breastfeeding were found to be significant in recovery of physical fitness postpartum.

Occupational and Environmental Challenges for Women

“…Given that most women in nontraditional professions are in their childbearing years, it seems pertinent to study occupational challenges faced during the peripartum period. Military data suggest that fitness declines during pregnancy and the immediate postpartum period (4,49). At 6 months postpartum, most military servicewomen have not returned to their prepregnancy fitness state (49).…”

“…Military data suggest that fitness declines during pregnancy and the immediate postpartum period (4,49). At 6 months postpartum, most military servicewomen have not returned to their prepregnancy fitness state (49). Many physiologic changes persist in peripartum women over one year after delivery, thus, impairing return to peak athletic performance levels (50).…”

Factor Analysis and Mental Health Prevention of Employee Turnover under the Profit-Centered Development of Modern Service Industry

“…These four indexes of the members of two groups are measured both before and after the experiment to analyze the changes in the data. Based on the actual data, the accuracy of the analysis results of the data is ensured [16][17][18].…”

Associations Between Rank, Sex, and Parity With Musculoskeletal Injuries Sustained During Annual Military Physical Fitness Test

“…Some of these shifts may contribute to the increased risk of injury exhibited by servicewomen returning to duty after pregnancy (17). Physical fitness test performance deficits have also been noted to last beyond the postpartum period in U.S. military service women (19,33). The minimum standard of PES evaluations, such as the FORCE test, must be achieved for members to resume duty after returning from medical leave or pregnancy.…”

“…Some of these shifts may contribute to the increased risk of injury exhibited by servicewomen returning to duty after pregnancy (17). Physical fitness test performance deficits have also been noted to last beyond the postpartum period in U.S. military service women (19,33).The minimum standard of PES evaluations, such as the FORCE test, must be achieved for members to resume duty after returning from medical leave or pregnancy. As the components included in the FORCE evaluation are based on common tasks, this investigation could indicate whether specific physical rehabilitation after childbirth is required to alleviate job-related injury risk.…”