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

Abstract

Physical activity is known to decline during pregnancy and the postnatal period, yet physical activity is recommended during this time due to the significant health benefits for mothers and their offspring. As a result of the COVID-19 pandemic and the restrictions imposed to reduce infection rates, pregnant and postnatal women have experienced disruption not just to their daily lives but also to their pregnancy healthcare experience and their motherhood journey with their new infant. This has included substantial changes in how, when and why they have engaged with physical activity. While some of these changes undoubtedly increased the challenge of being sufficiently active as a pregnant or postnatal woman, they have also revealed new opportunities to reach and support women and their families. This commentary details these challenges and opportunities, and highlights how researchers and practitioners can, and arguably must, harness these short-term changes for long-term benefit. This includes a call for a fresh focus on how we can engage and support those individuals and groups who are both hardest hit by COVID-19 and have previously been under-represented and under-served by antenatal and postnatal physical activity research and interventions.

Lifestyle Habits among Pregnant Women in Denmark during the First COVID-19 Lockdown Compared with a Historical Period—A Hospital-Based Cross-Sectional Study

“…During the pandemic, there has been an increased focus on healthy lifestyle, since it has been debated, whether e.g., smoking and obesity could increase the risk of the severity of COVID-19 infection [ 68 , 69 ]. This could potentially increase the existing risk of underreporting unhealthy behaviors [ 64 , 65 , 70 ] during the pandemic compared to before. If this was the case, pregnant women in the COVID-19 group may underreport alcohol consumption and smoking to a higher degree than pregnant women in the Historical group, which may potentially overestimate our findings regarding these outcomes.…”

“…Our findings indicate that it is important to address lifestyle habits as part of antenatal counseling when a national lockdown is initiated. To maintain the recommended level of exercise during pregnancy, women should be advised to perform types of exercise that are feasible during a lockdown [ 70 ]. This is especially relevant when women are required to work from home and thereby reduce their level of physical activity linked to commuting, or if the training facilities they usually attend are closed.…”

Obesogenic Programming Effects during Lactation: A Narrative Review and Conceptual Model Focusing on Underlying Mechanisms and Promising Future Research Avenues

“…Moreover, effects on maternal weight outcomes were often small and established in efficacy trials with biased samples [ 57 ]. To prevent childhood obesity, there is a need of more effective and implementable maternal lifestyle interventions [ 57 ] that start during the preconception period [ 58 ], use a socioecological framework and theory-informed intervention design [ 59 ], include well-known effective core components and strategies for behavioral change [ 60 ], and use a flexible person-centered rather than a one-size-fits-all approach [ 61 ]. Maternal lifestyle interventions may also pay more attention to automatic processes underlying lifestyle behaviors [ 62 ].…”

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“…One of the limitations to recruiting online is selection bias, with individuals from BAME and lower income backgrounds being less likely to be represented. Atkinson and colleagues have called for long-term strategies to build relationships with hard to reach groups [3].…”

“…In the UK, pregnant women were placed in the vulnerable category on the 16 th March 2020, and, therefore, advised to reduce social contact through social distancing [2]. The current available evidence indicates that pregnant women with pre-existing comorbidities, high maternal age and high body mass index who contract COVID-19 may be more likely to be admitted to an intensive care unit and preterm birth rates are higher in pregnant women with COVID-19 than in pregnant women without the virus [3].…”