Factors Influencing Attitudes Toward Physical Activity and Exercise Education in Pregnant Women
Keywords:fitness, physical activity, education, confidence, pregnancy, exercise
Background: The aim of this study was to report on attitudes of pregnant women regarding exercise and exercise education and to identify factors influencing their interest in receiving exercise education.
Methods: A cross-sectional survey was completed by 134 women being evaluated for a routine obstetrical visit. Self-reported information regarding demographics, physical activity participation, confidence in knowledge about pregnancy exercise guidelines, and interest in receiving information about exercise during pregnancy was obtained. Descriptive statistics were used to summarize the data. Multiple logistic regressions were performed to measure associations between patient characteristics and exercise decline, confidence, and interest.
Results: Participants had a mean age of 33.6 ± 4.3 years, mean BMI of 27.9 ± 5.0, and a mean gestational age of 26 ± 10 weeks. Reported level of physical activity decreased during pregnancy for 73.9 % of women. A significant association was found between pre-pregnancy physical activity (OR 2.00 (1.21-3.52), p = 0.010) and exercise decline. Significant, independent relationships were identified between increased confidence in exercise education and younger patient age (OR 0.89(0.82-0.98), p = 0.015), previous pregnancies (OR 0.43 (0.21-0.86), p = 0.060), higher level of pre-pregnancy exercise (OR 1.73 (1.19-2.53), p = 0.004), and more education received from physicians (OR 1.94 (1.54-2.49), p < 0.001). Interest in education was associated with higher level of physical activity before pregnancy (OR 1.75(1.21-2.57), p = 0.004) and lower amount of education received from physicians (OR 0.78(0.63-0.97), p = 0.025).
Conclusions: Women commonly report a decline in exercise during pregnancy, particularly among women with high levels of physical activity prior to pregnancy. Attitudes toward pregnancy exercise education were found to be correlated with patient characteristics including age, nulliparity, level of physical activity before pregnancy, and education received from physicians. These associations can be used to identify target populations for future interventions.
Hinman SK, Smith KB, Quillen DM, Smith MS. Exercise in Pregnancy: A Clinical Review. Sports Health. 2015;7(6):527-531. doi:10.1177/1941738115599358 DOI: https://doi.org/10.1177/1941738115599358
Owe KM, Nystad W, Bø K. Association between regular exercise and excessive newborn birth weight. Obstet Gynecol. 2009;114(4):770-776. doi:10.1097/AOG.0b013e3181b6c105 DOI: https://doi.org/10.1097/AOG.0b013e3181b6c105
Magro-Malosso ER, Saccone G, Di Tommaso M, Roman A, Berghella V. Exercise during pregnancy and risk of gestational hypertensive disorders: a systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2017;96(8):921-931. doi:10.1111/aogs.13151 DOI: https://doi.org/10.1111/aogs.13151
Ruchat SM, Mottola MF. The important role of physical activity in the prevention and management of gestational diabetes mellitus. Diabetes Metab Res Rev. 2013;29(5):334-346. doi:10.1002/dmrr.2402 DOI: https://doi.org/10.1002/dmrr.2402
Wang C, Wei Y, Zhang X, et al. A randomized clinical trial of exercise during pregnancy to prevent gestational diabetes mellitus and improve pregnancy outcome in overweight and obese pregnant women. Am J Obstet Gynecol. 2017;216(4):340-351. doi:10.1016/j.ajog.2017.01.037 DOI: https://doi.org/10.1016/j.ajog.2017.01.037
Liu J, Laditka JN, Mayer-Davis EJ, Pate RR. Does physical activity during pregnancy reduce the risk of gestational diabetes among previously inactive women?. Birth. 2008;35(3):188-195. doi:10.1111/j.1523-536X.2008.00239.x DOI: https://doi.org/10.1111/j.1523-536X.2008.00239.x
Cordero Y, Mottola MF, Vargas J, Blanco M, Barakat R. Exercise Is Associated with a Reduction in Gestational Diabetes Mellitus. Med Sci Sports Exerc. 2015;47(7):1328-1333. doi:10.1249/MSS.0000000000000547 DOI: https://doi.org/10.1249/MSS.0000000000000547
Kołomańska-Bogucka D, Mazur-Bialy AI. Physical Activity and the Occurrence of Postnatal Depression-A Systematic Review. Medicina (Kaunas). 2019;55(9):560. Published 2019 Sep 2. doi:10.3390/medicina55090560 DOI: https://doi.org/10.3390/medicina55090560
Nakamura A, van der Waerden J, Melchior M, Bolze C, El-Khoury F, Pryor L. Physical activity during pregnancy and postpartum depression: Systematic review and meta-analysis. J Affect Disord. 2019;246:29-41. doi:10.1016/j.jad.2018.12.009 DOI: https://doi.org/10.1016/j.jad.2018.12.009
Gaston A, Prapavessis H. Tired, moody and pregnant? Exercise may be the answer. Psychol Health. 2013;28(12):1353-1369. doi:10.1080/08870446.2013.809084 DOI: https://doi.org/10.1080/08870446.2013.809084
Gjestland K, Bø K, Owe KM, Eberhard-Gran M. Do pregnant women follow exercise guidelines? Prevalence data among 3482 women, and prediction of low-back pain, pelvic girdle pain and depression. Br J Sports Med. 2013;47(8):515-520. doi:10.1136/bjsports-2012-091344 DOI: https://doi.org/10.1136/bjsports-2012-091344
Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstet Gynecol. 2020;135(4):e178-e188. doi:10.1097/AOG.0000000000003772 DOI: https://doi.org/10.1097/AOG.0000000000003772
Lü Y, Feng Y, Ma S, Jiang Y, Ma L. Changes in physical activity across pregnancy among Chinese women: a longitudinal cohort study. BMC Womens Health. 2021;21(1):236. Published 2021 Jun 6. doi:10.1186/s12905-021-01377-3 DOI: https://doi.org/10.1186/s12905-021-01377-3
Amezcua-Prieto C, Olmedo-Requena R, Jímenez-Mejías E, et al. Changes in leisure time physical activity during pregnancy compared to the prior year. Matern Child Health J. 2013;17(4):632-638. doi:10.1007/s10995-012-1038-3 DOI: https://doi.org/10.1007/s10995-012-1038-3
Hegaard HK, Damm P, Hedegaard M, et al. Sports and leisure time physical activity during pregnancy in nulliparous women. Matern Child Health J. 2011;15(6):806-813. doi:10.1007/s10995-010-0647-y DOI: https://doi.org/10.1007/s10995-010-0647-y
Merkx A, Ausems M, Budé L, de Vries R, Nieuwenhuijze MJ. Factors affecting perceived change in physical activity in pregnancy. Midwifery. 2017;51:16-23. doi:10.1016/j.midw.2017.05.007 DOI: https://doi.org/10.1016/j.midw.2017.05.007
Evenson KR, Wen F. Prevalence and correlates of objectively measured physical activity and sedentary behavior among US pregnant women. Prev Med. 2011;53(1-2):39-43. doi:10.1016/j.ypmed.2011.04.014 DOI: https://doi.org/10.1016/j.ypmed.2011.04.014
Amezcua-Prieto C, Olmedo-Requena R, Jiménez-Mejías E, Mozas-Moreno J, Lardelli-Claret P, Jiménez-Moleón JJ. Factors associated with changes in leisure time physical activity during early pregnancy. Int J Gynaecol Obstet. 2013;121(2):127-131. doi:10.1016/j.ijgo.2012.11.021 DOI: https://doi.org/10.1016/j.ijgo.2012.11.021
Mitro SD, Peddada S, Gleason JL, et al. Longitudinal Changes in Physical Activity during Pregnancy: National Institute of Child Health and Human Development Fetal Growth Studies. Med Sci Sports Exerc. 2022;54(9):1466-1475. doi:10.1249/MSS.0000000000002947 DOI: https://doi.org/10.1249/MSS.0000000000002947
Garland M, Wilbur J, Semanik P, Fogg L. Correlates of Physical Activity During Pregnancy: A Systematic Review with Implications for Evidence-based Practice. Worldviews Evid Based Nurs. 2019;16(4):310-318. doi:10.1111/wvn.12391 DOI: https://doi.org/10.1111/wvn.12391
Currie S, Sinclair M, Murphy MH, Madden E, Dunwoody L, Liddle D. Reducing the decline in physical activity during pregnancy: a systematic review of behaviour change interventions. PLoS One. 2013;8(6):e66385. Published 2013 Jun 14. doi:10.1371/journal.pone.0066385 DOI: https://doi.org/10.1371/journal.pone.0066385
Hayman M, Reaburn P, Alley S, Cannon S, Short C. What exercise advice are women receiving from their healthcare practitioners during pregnancy?. Women Birth. 2020;33(4):e357-e362. doi:10.1016/j.wombi.2019.07.302 DOI: https://doi.org/10.1016/j.wombi.2019.07.302
Evins C, Dennis J, Mostert K, et al. Exercise Counseling in Pregnancy: Do Women Perceive Receiving the Information They Need?. Am J Lifestyle Med. 2021;15(4):441-452. Published 2021 Feb 16. doi:10.1177/1559827621991851 DOI: https://doi.org/10.1177/1559827621991851
Skjold I, Benvenuti MB, Haakstad LA. Why do so many pregnant women give up exercise? An Italian cross-sectional study. Womens Health (Lond). 2022;18:17455057221117967. doi:10.1177/17455057221117967 DOI: https://doi.org/10.1177/17455057221117967
Whitaker KM, Becker C, Healy H, Wilcox S, Liu J. Women's Report of Health Care Provider Advice and Gestational Weight Gain: A Systematic Review. J Womens Health (Larchmt). 2021;30(1):73-89. doi:10.1089/jwh.2019.8223 DOI: https://doi.org/10.1089/jwh.2019.8223
Huberty J, Dinkel D, Beets MW, Coleman J. Describing the use of the internet for health, physical activity, and nutrition information in pregnant women. Matern Child Health J. 2013;17(8):1363-1372. doi:10.1007/s10995-012-1160-2 DOI: https://doi.org/10.1007/s10995-012-1160-2
Serçekuş P, Değirmenciler B, Özkan S. Internet use by pregnant women seeking childbirth information. J Gynecol Obstet Hum Reprod. 2021;50(8):102144. doi:10.1016/j.jogoh.2021.102144 DOI: https://doi.org/10.1016/j.jogoh.2021.102144
Lee Y, Moon M. Utilization and Content Evaluation of Mobile Applications for Pregnancy, Birth, and Child Care. Healthc Inform Res. 2016;22(2):73-80. doi:10.4258/hir.2016.22.2.73 DOI: https://doi.org/10.4258/hir.2016.22.2.73
Hayman MJ, Alfrey KL, Waters K, et al. Evaluating Evidence-Based Content, Features of Exercise Instruction, and Expert Involvement in Physical Activity Apps for Pregnant Women: Systematic Search and Content Analysis. JMIR Mhealth Uhealth. 2022;10(1):e31607. Published 2022 Jan 19. doi:10.2196/31607 DOI: https://doi.org/10.2196/31607
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