. 2018 Jul 11;15(1):68.

doi: 10.1186/s12966-018-0701-5.

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

Janet M Catov¹, Corette B Parker², Bethany Barone Gibbs³, Carla M Bann², Benjamin Carper², Robert M Silver⁴, Hyagriv N Simhan⁵, Samuel Parry⁶, Judith H Chung⁷, David M Haas⁸, Ronald J Wapner⁹, George R Saade¹⁰, Brian M Mercer¹¹, C Noel Bairey-Merz¹², Philip Greenland¹³, Deborah B Ehrenthal¹⁴, Shannon E Barnes⁸, Anthony L Shanks⁸, Uma M Reddy¹⁵, William A Grobman¹⁶; NICHD NuMoM2b and NHLBI NuMoM2b Heart Health Study Network

Affiliations

¹ Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, 204 Craft Avenue, Suite A208, Pittsburgh, PA, 15213, USA. catovjm@upmc.edu.
² RTI International, Research Triangle Park, NC, USA.
³ Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA, USA.
⁴ Department of Obstetrics and Gynecology, University of Utah and Intermountain Healthcare, Salt Lake City, UT, USA.
⁵ Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, 204 Craft Avenue, Suite A208, Pittsburgh, PA, 15213, USA.
⁶ Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA.
⁷ Department of Obstetrics and Gynecology, University of California, Irvine, Irvine, CA, USA.
⁸ Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, IN, USA.
⁹ Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA.
¹⁰ Department of Obstetrics and Gynecology, University of Texas Medical Branch, University of Texas, Galveston, TX, USA.
¹¹ Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH, USA.
¹² Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
¹³ Division of Cardiology, Department of Medicine, Northwestern University, Chicago, IL, USA.
¹⁴ Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA.
¹⁵ Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
¹⁶ Department of Obstetrics, Gynecology-Maternal Fetal Medicine & Preventive Medicine, Northwestern University, Chicago, IL, USA.

PMID: 29996930
PMCID: PMC6042402
DOI: 10.1186/s12966-018-0701-5

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

Janet M Catov et al. Int J Behav Nutr Phys Act. 2018.

. 2018 Jul 11;15(1):68.

doi: 10.1186/s12966-018-0701-5.

Authors

Affiliations

¹ Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, 204 Craft Avenue, Suite A208, Pittsburgh, PA, 15213, USA. catovjm@upmc.edu.
² RTI International, Research Triangle Park, NC, USA.
³ Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA, USA.
⁴ Department of Obstetrics and Gynecology, University of Utah and Intermountain Healthcare, Salt Lake City, UT, USA.
⁵ Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, 204 Craft Avenue, Suite A208, Pittsburgh, PA, 15213, USA.
⁶ Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA.
⁷ Department of Obstetrics and Gynecology, University of California, Irvine, Irvine, CA, USA.
⁸ Department of Obstetrics and Gynecology, School of Medicine, Indiana University, Indianapolis, IN, USA.
⁹ Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA.
¹⁰ Department of Obstetrics and Gynecology, University of Texas Medical Branch, University of Texas, Galveston, TX, USA.
¹¹ Department of Obstetrics and Gynecology, Case Western Reserve University, Cleveland, OH, USA.
¹² Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
¹³ Division of Cardiology, Department of Medicine, Northwestern University, Chicago, IL, USA.
¹⁴ Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA.
¹⁵ Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
¹⁶ Department of Obstetrics, Gynecology-Maternal Fetal Medicine & Preventive Medicine, Northwestern University, Chicago, IL, USA.

PMID: 29996930
PMCID: PMC6042402
DOI: 10.1186/s12966-018-0701-5

Abstract

Background: Although 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.

Methods: Nulliparous 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.

Results: Five 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.

Conclusions: Sustained 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 registration: Registration number NCT02231398 .

Keywords: Gestational diabetes; Physical activity; Pregnancy; Preterm birth.

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Conflict of interest statement

Ethics approval and consent to participate

All local institutional review boards approved the study protocol, and participants provided written informed consent prior to enrollment.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

**Fig. 1**
Leisure-time physical activity per week for nuMoM2b study visits

See this image and copyright information in PMC

References

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

Ethics approval and consent to participate

Consent for publication

Competing interests

Publisher’s Note

Figures

References

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