Physical Activity Level during Pregnancy in South Africa: A Facility-Based Cross-Sectional Study

Abstract

Physical activity participation during pregnancy confers many maternal and foetal health benefits to the woman and her infant and is recommended by various health bodies and institutions. However, in South Africa, scant information exists about the physical activity status and its determinants among pregnant women. The aim of this study was to assess the physical activity level and associated factors among pregnant women. This cross-sectional study enrolled 1082 pregnant women attending public health facilities in Buffalo City Municipality, Eastern Cape, South Africa. Information on socio-demographic and maternal characteristics were obtained, and the Pregnancy Physical Activity Questionnaire was used to assess physical activity during pregnancy. Multiple logistic regression analyses were used to assess associations between physical activity and the predictor variables during pregnancy. Adjusted odds ratios with 95% confidence interval were applied to estimate factors associated with physical activity levels. Statistical significance was set at p < 0.05. Only 278 of the women (25.7%) met recommendations for prenatal activity (≥150 min moderate intensity exercise per week). The average time spent in moderate–vigorous physical activity was 151.6 min (95% CI: 147.2–156.0). Most of the women participated in light exercises with a mean of 65.9% (95% CI: 64.8–67.0), and 47.6% (95% CI: 46.3–48.9) participated in household activities. The majority of the women did not receive physical activity advice during prenatal care sessions (64.7%). Factors negatively associated with prenatal physical activity were lower age (<19 years) (adjusted odd ratio (AOR) = 0.3; CI: 0.16–0.76), semi-urban residence (AOR = 0.8; CI: 0.55–1.03), lower educational level (AOR = 0.5; CI: 0.20–0.71), unemployment (AOR = 0.5; CI: 0.29–0.77) and nulliparity (AOR = 0.6; CI: 0.28–1.31). However, prenatal physical activity was positively associated with starting physical activity in the first trimester (AOR = 1.9; CI: 1.06–3.31) compared to other trimesters. The findings of this study demonstrated low levels of physical activity during pregnancy in South Africa. The majority of women did not meet the recommendation of 150 min of moderate intensity activity per week. Light intensity and household activities were the most preferred form of activity. The factors affecting physical activity of women in this present study include lower age, semi-urban setting, low educational level, unemployment and nulliparity. In order to increase activity levels, future work should seek to improve knowledge, access and support for physical activity in pregnant women in South Africa. This should include education and advocacy regarding physical activity for professionals involved in maternal health provision.

Clinical Practice Guidelines That Address Physical Activity and Exercise During Pregnancy: A Systematic Review

“…However, research has found that physical activity in women decreases from prepregnancy to pregnancy 11,12 . In fact, the majority of pregnant women do not meet the recommended amount of duration for daily physical activity 13–15 . The reported reasons include physical discomfort, fatigue, lack of time or motivation, and concerns about safety for the women and/or fetus 16,17 .…”

Physical Activity in High-Risk Pregnancies

“…A qualitative study explored the experiences of Taiwanese mothers after a successful ART treatment. The women interviewed reported less physical activity overall, to the extent of even choosing to stay at home during pregnancy [16]. Even if no direct comparison between women who became pregnant in a natural way and women after ART was conducted, the findings confirmed that the overall physical activity is reduced in the group after ART.…”

Development and Validation of Prenatal Physical Activity Intervention Strategy for Women in Buffalo City Municipality, South Africa

“…However, prenatal physical activity and exercise have not been widely studied within the context of South Africa. To address this lack, a prenatal physical activity intervention strategy has been developed specifically for South Africa and is on the first empirical findings [24][25][26][27]. This timely move provides a unique contribution to, and lays the groundwork for, future prenatal physical activity intervention strategies, not only in the Eastern Cape Province but throughout South Africa as a whole.…”

“…A multi-stage approach was utilized, with Phase I focussing on the empirical findings on facilitators of or barriers to prenatal physical participation in Buffalo City Municipality, Eastern Cape Province, which then lays the groundwork for the development of a prenatal physical activity strategy [24][25][26][27]. Therefore, the results of the studies above have provided us with guidance into developing an effective prenatal physical activity strategy that promotes the practice of prenatal physical activity.…”

“…Moreover, within the specific context of South Africa, the literature does not contain any research into the development of prenatal strategies that promote physical activity practices in pregnant women. In order to address this lack, our empirical findings on different aspects of prenatal physical activity in pregnant women, and midwives' views of related counselling [24][25][26][27] informed and supported the need to develop and validate intervention strategies to promote physical activity and exercise during pregnancy in Buffalo City Municipality, Eastern Cape Province, South Africa.…”