Impact of an Exercise Intervention on Physical Activity During Pregnancy: The Behaviors Affecting Baby and You Study

Abstract

Objectives. We examined the impact of a prenatal exercise intervention on physical activity in 260 women at risk for gestational diabetes mellitus. Methods. We randomized participants in the Behaviors Affecting Baby and You (BABY) Study, which took place from 2007 to 2012, to either a 12-week individually tailored, motivationally matched exercise intervention (n = 132) or to a comparison health and wellness intervention (n = 128). We assessed physical activity with the Pregnancy Physical Activity Questionnaire. We used linear mixed models to evaluate the impact of the interventions on change in physical activity according to intensity and type, total walking, and sedentary behavior. Results. Compared with the health and wellness arm, the exercise arm had significantly greater increases in sports or exercise activity (0.3 vs 5.3 metabolic equivalent of task [MET] hours/week; P < .001), and smaller declines in total activity (–42.7 vs –2.1 MET hours/week; P = .02) and activities of moderate to vigorous intensity (–30.6 vs −10.6 MET hours/week; P = .05), and was more likely to achieve recommended guidelines for physical activity (odds ratio = 2.12; 95% confidence interval = 1.45, 3.10). Conclusions. These findings extend the previous literature by demonstrating the benefits of a clinically feasible exercise intervention in an ethnically and socio-economically diverse population. Given the increased risk of adverse maternal health outcomes in ethnic minority groups, these findings may have important implications for reducing health disparities.

Self-report Pregnancy Physical Activity Questionnaire overestimates physical activity

“…This gross overestimation of PA and the lack of correlation between the PPAQ and the Actical®-measured PA call into question the findings from the recently published studies that used the PPAQ to measure PA during pregnancy. [11][12][13] Given our findings that the PPAQ significantly overestimates PA, it is possible that the conclusions from the previous studies may not represent true relationships. The use of directly measured PA would have provided more reliable measures for PA, potentially leading to different results and interpretations.…”

“…Numerous self-report PA questionnaires correlate poorly with directly measured PA during pregnancy, with questionnaires often overpredicting time spent in moderate intensity PA, and underpredicting time spent in light PA or sedentary time. [5][6][7] Despite this evidence, in the past year three papers were published on PA and gestational weight gain (GWG) that used self-reported estimates of PA, [8][9][10] and at least three studies were published using the Pregnancy and Physical Activity Questionnaire (PPAQ) to measure PA. [11][12][13] The original development and validation of the PPAQ reports weak to moderate correlations between the PPAQ and directly measured PA, 14 however, p-values were not reported. A second investigation reported moderate correlations between a Frenchtranslated PPAQ and directly measured light and moderate intensity PA, but not for sedentary or vigorous activity.…”

Sedentary behaviours during pregnancy: a systematic review

“…Women were also asked if they were ‘mostly sitting’ during their usual daily activities.PoorEvenson, et al (2011) [11]USA359Cross-sectionalPregnant women ≥16 years.ActiGraph accelerometer.Objective.Activities expending <100 counts per minute.IntermediateGollenberg, et al (2010) [36]USA1006CohortLatina ethnicity, age 16–40 years old, singleton pregnancy, and no prior participation in the study.Modified version of the Kaiser Physical Activity Survey (KPAS).Non-objective.Hours spent TV watching per day and frequency of sitting at work.IntermediateGradmark, et al (2011) [47]Sweden101Cross-sectionalNormal weight and overweight women without diabetes were studied.Actiheart monitor.Objective.Epochs with valid heart rate data and zero accelerometry counts/min.IntermediateHawkins, et al (2014 Im.) [48]USA260Randomized controlled trialWomen in their first trimester of pregnancy, between 16 and 40 years old, and at high risk for GDM.Pregnancy Physical Activity Questionnaire (PPAQ).Non-objective.The amount of time spent watching TV or videos, or sitting or standing at home, work, or during transportation.GoodHawkins, et al (2014 PA) [10]USA294Cross-sectionalWomen in the 2003–2006 NHANES study cycles who self-reported currently being pregnant, were 16 year or older, and who had available data on C reactive protein, physical activity, and SB.ActiGraph accelerometer.Objective.Activities expending <100 counts per minute.IntermediateHayes, et al (2014) [49]UK183Randomized controlled trialAll obese (BMI ≥ 30 K/m 2 ) pregnant women.- Acti-Graph accelerometer.- Objective.- Accelerometry: any minute with ≤100 counts/min.Good- Recent Physical Activity Questionnaire (RPAQ).- Non-objective.- RPAQ, minutes spent on activities <1.5 MET.Hegaard, et al (2010) [32]Denmark4558CohortDanish-speaking pregnant women.Self-reported questionnaires.Non-objective.Those who chose “mostly sitting” to describe most correctly her level of leisuretime activity.IntermediateHegaard, et al (2011) [35]Denmark4718…”

The Association Between Physical Activity During Pregnancy and Gestational Diabetes Mellitus: A Case-Control Study

“…Participation in physical activity decreases blood glucose concentration, increases insulin sensitivity, improves cardiovascular fitness and leads to a lower body fat (25). Evidence indicates the existence of these beneficial effects during pregnancy, with respect to insulin sensitivity and B cell response (26, 27). Han et al did not observe any overall benefit of exercise during pregnancy (16).…”