Physical inactivity in early pregnancy and the determinants in an urban city setting of Kuala Lumpur, Malaysia

Abstract

Background Physical inactivity in pregnancy has been associated with excessive gestational weight gain, hypertensive disorders, gestational diabetes mellitus and postpartum depression. Despite these risks, physical inactivity level remains high especially in higher income countries. The prevalence of physical inactivity among women in Malaysia aged ≥16 years was 28.2% in 2019 exceeding men by 6.1%. However, little is known regarding the subpopulation of pregnant women especially in Kuala Lumpur which is the most urbanized and highly populated city in Malaysia. Therefore, the aim of this study is to measure the physical inactivity prevalence among first trimester pregnant women in Kuala Lumpur and to identify its determining factors. Methods This was a cross-sectional study in which 339 first trimester pregnant women were sampled from 13 maternal and child health clinics located in all four parliament districts of Kuala Lumpur. Self-administered questionnaires which contained the Malay version of the pregnancy physical activity questionnaire (PPAQ) were used. Descriptive analysis was conducted to determine the physical inactivity prevalence followed by simple and multiple logistic regression to identify the determinants of physical inactivity with significant level of 5%. Results The prevalence of physical inactivity was 38.3%. The highest activity was seen in the household activity domain, despite only 24.8% of the respondents were housewives/unemployed. There was little to no participation observed in the vigorous intensity category. The determinants of physical inactivity were primigravida (aOR 3.54 95% CI 1.40, 8.97), education level (aOR 3.77 95% CI 1.35, 10.52) and body mass index (aOR 0.88 95% CI 0.80, 0.97) which explained 22.6% variation of physical inactivity in the final adjusted model. Conclusion The prevalence of physical inactivity among first trimester pregnant mothers in this study was 38.3%, and the highest activity was seen in the household category. Health education on physical activity in pregnancy should be focused on those who are primigravida and have no tertiary education. The educational content should be updated and tailored to current pandemic situation where self-isolation is the new norm, by advocating for home-based, moderate to vigorous intensity physical activities.

Vitamin D Deficiency and Its Association With Vitamin D Receptor Gene Variants Among Malaysian Women With Hypertensive Disorders in Pregnancy: Protocol for a Nutrigenomics Study

“…The questionnaire was adapted from the studies of Syed Nor et al [ 18 ], Jamil et al [ 19 ], and Humayun et al [ 20 ] (see Multimedia Appendix 1 ). Permission was obtained from all authors to adopt their questionnaires and translate them into the Malay language.…”

A socio-ecological model of factors influencing physical activity in pregnant women: a systematic review

“…Personal factors included socio-demographic and biological, behavioral, and psychological factors. Age was not considered to be associated with PA in pregnant women ( 28 , 32 , 37 , 40 , 41 , 43 , 54 , 55 ) by most researchers. Being older appears to be associated with higher MVPA compliance ( 24 , 38 , 48 ).…”

“…In one paper, there was a suggestion that PA intensity could be increased by encouraging more PA before pregnancy ( 40 ). Low education ( 32 , 35 , 36 , 43 , 46 , 54 ), first parity ( 29 , 36 , 43 ), lack of knowledge and skills ( 27 , 33 , 44–46 , 53 , 55 ), pregnancy symptoms ( 25 , 27 , 28 , 32 , 33 , 35 , 43 , 44 , 51–53 , 55 ), lack of time ( 25 , 27 , 33 , 39 , 44 , 53 ), low income ( 27 , 33 , 39 , 45 , 51 , 53 ), lack of motivation/goal ( 25 , 51 , 53 , 55 ), and safety concerns ( 25 , 27 , 29 , 31 , 33 , 34 , 44–46 , 49 , 51 , 53 , 55 ) were all identified by the researchers as barriers. The lack of time mainly came from family commitments ( 44 ), while low education, first parity, and lack of knowledge and skills were all related to safety concerns.…”

Factors influencing physical inactivity status among Chinese pregnant women: a cross-sectional study

“…First, we used backward elimination to remove variables with a p-value >0.2. Second, considering maternal age, level of education, pre-pregnancy BMI, parity, and history of spontaneous abortions to be clinically relevant or related to the level of PA in previous studies [19,20,23], we also added these ve variables into the model. Finally, maternal age, level of education, current employment status, personal monthly income, pre-pregnancy BMI, regular exercise before pregnancy, alcohol consumption before pregnancy, history of spontaneous abortions, parity, stage of pregnancy, nausea and vomiting during pregnancy, and prenatal sleep quality were entered as independent variables into the logistic regression model.…”

“…Researchers have showed that pregnant women who are younger, less well educated, and unemployed and those with multiple children and a lower income are less likely to engage in an adequate amount of PA [11,12,17,18]. Obstetric variables associated with PA in pregnancy include history of miscarriage, parity, and exercise and smoking status before pregnancy [19][20][21]. Even though there is no scienti c evidence linking prenatal exercise with adverse outcomes, some obstetric caregivers and pregnant women continue to be skeptical about the safety of prenatal exercise.…”