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

Catov, Janet M. and Parker, Corette B. and Gibbs, Bethany Barone and Bann, Carla M. and Carper, Benjamin and Silver, Robert M. and Simhan, Hyagriv N. and Parry, Samuel and Chung, Judith H. and Haas, David M. and Wapner, Ronald J. and Saade, George R. and Mercer, Brian M. and Bairey-Merz, C. Noel and Greenland, Philip and Ehrenthal, Deborah B. and Barnes, Shannon E. and Shanks, Anthony L. and Reddy, Uma M. and Grobman, William A. (2018) Patterns of leisure-time physical activity across pregnancy and adverse pregnancy outcomes. International Journal of Behavioral Nutrition and Physical Activity, 15 (68). pp. 1-10. ISSN 1479-5868

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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.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Catov, Janet M.
Parker, Corette B.
Gibbs, Bethany Baronebbarone@pitt.edubbarone
Bann, Carla M.
Carper, Benjamin
Silver, Robert M.
Simhan, Hyagriv N.
Parry, Samuel
Chung, Judith H.
Haas, David M.
Wapner, Ronald J.
Saade, George R.
Mercer, Brian M.
Bairey-Merz, C. Noel
Greenland, Philip
Ehrenthal, Deborah B.
Barnes, Shannon E.
Shanks, Anthony L.
Reddy, Uma M.
Grobman, William A.
Date: 2018
Date Type: Publication
Journal or Publication Title: International Journal of Behavioral Nutrition and Physical Activity
Volume: 15
Number: 68
Publisher: BMC
Page Range: pp. 1-10
DOI or Unique Handle: 10.1186/s12966-018-0701-5
Schools and Programs: School of Education > Health and Physical Activity
Refereed: Yes
Uncontrolled Keywords: pregnancy, physical activity, gestational diabetes, preterm birth
ISSN: 1479-5868
Official URL:
Funders: National Heart, Lung, and Blood Institute, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health Office of Behavioral and Social Sciences Research, National Institutes of Health National Center for Research Resources and National Center for Advancing Translational Sciences to Clinical and Translational Science Institutes at Indiana University, University of California, Irvine
Article Type: Research Article
Date Deposited: 04 May 2020 17:29
Last Modified: 04 May 2020 17:29


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