Patterns of leisure-time physical activity across pregnancy and adverse pregnancy outcomes

Abstract

BackgroundAlthough leisure-time physical activity (PA) contributes to overall health, including pregnancy health, patterns across pregnancy have not been related to birth outcomes. We hypothesized that women with sustained low leisure-time PA would have excess risk of adverse pregnancy outcomes, and that changing patterns across pregnancy (high to low and low to high) may also be related to risk of adverse pregnancy outcomes.MethodsNulliparous women (n = 10,038) were enrolled at 8 centers early in pregnancy (mean gestational age in weeks [SD] = 12.05 [1.51]. Frequency, duration, and intensity (metabolic equivalents) of up to three leisure activities reported in the first, second and third trimesters were analyzed. Growth mixture modeling was used to identify leisure-time PA patterns across pregnancy. Adverse pregnancy outcomes (preterm birth, [PTB, overall and spontaneous], hypertensive disorders of pregnancy [HDP], gestational diabetes [GDM] and small-for-gestational-age births [SGA]) were assessed via chart abstraction.ResultsFive patterns of leisure-time PA across pregnancy were identified: High (35%), low (18%), late decreasing (24%), early decreasing (10%), and early increasing (13%). Women with sustained low leisure-time PA were younger and more likely to be black or Hispanic, obese, or to have smoked prior to pregnancy. Women with low vs. high leisure-time PA patterns had higher rates of PTB (10.4 vs. 7.5), HDP (13.9 vs. 11.4), and GDM (5.7 vs. 3.1, all p < 0.05). After adjusting for maternal factors (age, race/ethnicity, BMI and smoking), the risk of GDM (Odds ratio 2.00 [95% CI 1.47, 2.73]) remained higher in women with low compared to high patterns. Early and late decreasing leisure-time PA patterns were also associated with higher rates of GDM. In contrast, women with early increasing patterns had rates of GDM similar to the group with high leisure-time PA (3.8% vs. 3.1%, adjusted OR 1.16 [0.81, 1.68]). Adjusted risk of overall PTB (1.31 [1.05, 1.63]) was higher in the low pattern group, but spontaneous PTB, HDP and SGA were not associated with leisure-time PA patterns.ConclusionsSustained low leisure-time PA across pregnancy is associated with excess risk of GDM and overall PTB compared to high patterns in nulliparous women. Women with increased leisure-time PA early in pregnancy had low rates of GDM that were similar to women with high patterns, raising the possibility that early pregnancy increases in activity may be associated with improved pregnancy health.Trial registrationRegistration number NCT02231398.Electronic supplementary materialThe online version of this article (10.1186/s12966-018-0701-5) contains supplementary material, which is available to authorized users.

Factors Associated with the Leisure-Time Physical Activity (LTPA) during the First Trimester of the Pregnancy: The Cross-Sectional Study among Pregnant Women in Serbia

“…The initiation of the PA during the first trimester is associated with lower risk for development of gestational diabetes [15][16][17][18]. Additionally, early initiation of PA during pregnancy is associated with a lower likelihood of preeclampsia [19,20] and better sleep quality [21]. This leads to further need for examination of factors that influence the PA level during the first trimester.…”

Physical activity and exercise during pregnancy in Africa: a review of the literature

“…Physical activity (PA) as a modifiable health risk factor has been shown to contribute to the maternal health of women and their offspring. Several studies have reported the benefits of PA and exercise during pregnancy, which include reduced risk of excessive gestational weight gain [1][2][3][4][5], decreased risk of gestational diabetes [1,[6][7][8][9], and reduced risk of preeclampsia [10][11][12][13][14]. Evidence also indicates that PA during pregnancy lowers rates of preterm births [15,16], improves sleep [17,18], reduces the risk of caesarean section and postpartum recovery time [19][20][21], and reduces length of labour and delivery complications [22].…”

Encouraging Physical Activity during and after Pregnancy in the COVID-19 Era, and beyond

“…Despite significant efforts in recent years, there remains a marked decline in PA levels during and after pregnancy [ 4 , 5 , 6 ]. Importantly, a reduction in PA has also been observed among others in the family unit, extending from pregnancy into the postpartum period [ 7 ], demonstrating the wide reaching impact on PA of this major life event.…”