PREVALENCE OF DIETARY SUPPLEMENTS CONSUMPTION AND EXERCISE AMONG PREGNANT WOMEN IN AL MADINAH AND THEIR EFFECT ON MODE OF DELIVERY.

Objective: To assess prevalence of dietary supplements consumption and exercise among pregnant women in AL Madinah and their effect on mode of delivery. Methods: Retrospective study was conducted in AL included who were randomly selected and different ages, social levels and education levels. the was electronic questionnaire, the questionnaire consisted of three sections, the included questions about socio-demographic characteristics, while the second included questions to assess some potential risk factors, and third section included questions to (39) Diabetes risk‖ of GDM‖ those who do not have healthy lifestyles should be encouraged to view the preconception period and pregnancy as opportunities to embrace healthier routines (1) . This study conducted to assess the effect of exercise, supplement and herbs during pregnancy in Al-Madinah Al-Monwarah 2016. There was a low prevalence of chronic diseases among participants at this study by 28.1%. our finding closes to the results of an American study which reported that 27% of pregnant women suffered from a chronic disease (41) . This similarity in the results due to the convergence of life conditions and medical care between KSA and USA. The most common chronic diseases at our study was Iron deficiency with 11.90%. In recent study Prevalence of anemia (Hb<11gm/dl) on pregnant women in Pakistan was found to be 96% (42) . This difference prevalence of anemia between the two countries naturally because of the different economic levels and types of food between the two countries. Also, pressure was one of the common chronic diseases among our participants with 3.33%. ‏ This percentage is much lower than the rates in other countries, (17 %) in Nigeria (43) , (17.2%)in Finland (44) . This difference is due to the difference in the nature of life, the level of economic, quality of food, and the pressure faced by women between Saudi Arabia and those countries. Nulliparous and grand multiparous women had been reported in previous studies to be at increased risk of hypertensive disorders of pregnancy, especially Pregnancy induced hypertension (PIH) and Pre-eclamptic toxemia (PET) (43) . The prevalence of smoking among women in our study was low by 2.86%. But in a study in Lebanon almost one quarter (23%) of participants reported smoking during pregnancy (45) . The prevalence of smoking in Lebanon is higher than in Saudi Arabia was due to a kind of fanaticism in the customs, traditions and religious restraint that prevents smoking in general and prevents the women in particular in Saudi Arabia. Regular aerobic exercise during pregnancy has been shown to improve or maintain physical fitness (46,37) . Although the evidence is limited, some benefit to pregnancy outcomes has been shown, and there is no evidence of harm when not contraindicated. Observational studies of women who exercise during pregnancy have shown benefits such as low-back pain, is an excellent alternative (51) . Studies have shown that exercise during pregnancy can lower glucose levels in women with GDM (52, 53) , or help prevent preeclampsia (54) Exercise has shown only a modest decrease in overall weight gain (1–2 kg) in normal weight, overweight, and obese women (55, 56) . 40.95% of participants at this study practice exercise during Pregnancy. In Brazil, 12.9% of women reported to engage in some type of physical activity during pregnancy (57) . in the United States, one study reported that only 15.8% of pregnant women are engaged in exercise during pregnancy at the recommended level (58) . our result higher that than the results of other studies in Brazil and United States because most of the women in the United States and Brazil are the workers and therefore do not have enough time to exercise, unlike women in Arabia. Walking was the most prevalence exercise that practiced among our participants during Pregnancy. It is safe sport, could be done without the need for equipment, and does not cause tired so much. According to our results there was no effect of doing exercise at Normal delivery, but doing exercise affect at Cesarean delivery. This means doing exercise reduce the need to Cesarean delivery. This is consistent with Zeanah et al., whose reported significantly fewer cesarean sections in women who performed 40 min of moderate intensity exercise regularly during pregnancy (59) , and Melzer et al., whose reported that inactive women were 3.7 times more likely to require operative delivery than active women who did at least 30 min of moderate physical activity per day (60) . But this contrary to Barakat et al., whose reported that Light-intensity resistance training that is performed over the second and third trimester of pregnancy does not affect the type of delivery (61) . It is certain that the reduction of C-sections limits the costs and complications compared with Normal delivery. Having chronic problem affected by doing exercise in our study. These results are considered logical because, Physical inactivity is a primary cause of most chronic diseases. Physical inactivity is a modifiable risk cardiovascular disease