Physical activity levels during pregnancy and gestational weight gain among women who are overweight or obese

Abstract

Issue addressed: There is contradictory research assessing physical activity patterns during pregnancy and postpartum among women who are overweight or obese. The aim of this study was to evaluate physical activity among overweight and obese women over the course of pregnancy and the initial postpartum period. Methods: Three hundred and five overweight or obese pregnant women completed physical-activity questionnaires at three time points during pregnancy and at 4-months postpartum. Results: Physical activity declined between early pregnancy and 28-weeks gestation (P < 0.001) and declined further at 36-weeks gestation (P < 0.001) before increasing significantly at 4-months postpartum (P < 0.001). However, reported activity at 4-months postpartum remained significantly lower than that reported in early pregnancy (P < 0.001). There was no significant difference either cross-sectionally or for changes over pregnancy and postpartum for total levels or categories of physical activity for women with different body mass index (BMI) or gestational weight gain (GWG). BMI was the only independent predictor of the change in total physical activity over the study and GWG, with women with higher BMI having larger decline of physical activity (b = 0.114, s.e. = 0.750, P = 0.032) and less GWG (b = À0.253, s.e. = 0.063, P < 0.001). Conclusions: Physical activity declined significantly between early pregnancy and 28-weeks gestation, with a further decline to 36-weeks gestation. At 4-months postpartum, physical activity significantly increased but not to the level of that reported at early pregnancy. So what?The promotion of appropriate physical activity should be implemented early in pregnancy and postpartum to prevent the decline in activity we have observed in overweight and obese women. Future research should also explore the barriers and enablers to women engaging in exercise during pregnancy and the postpartum period.

Physical Activity Patterns in Normal-Weight and Overweight/Obese Pregnant Women

“…Similarly, a small study, carried out using both a questionnaire and heart rate monitoring in 23 Swedish normal-weight women, reported a small PA decline between 14 and 32 weeks of gestation [21]. Similar findings were also reported in a study carried out in 305 overweight or obese women who filled in a questionnaire at different time points during pregnancy, and reported a decline in PA between early and middle-late pregnancy [13]. Finally, a small prospective study, aimed at comparing accelerometers and self-reported PA measures and carried out at different time points during pregnancy in a sample of 57 women from the UK, reported a significant decline in PA volume from 12–16 to 34–38 week of gestation [11].…”

“…Only a few previous studies have assessed PA patterns throughout gestation, with inconsistent findings [8,10,11,12,13,14,21]. These studies have reported either a progressive decrease in PA during pregnancy [8,11], or no change [10], or higher PA levels in the second than in the first or the third trimester of gestation [12,14].…”

“…Only a few studies have investigated the PA levels of pregnant women at each trimester of gestation, with mixed results [8,11,12,13,14]. Some studies have found a progressive decrease in PA across trimesters of gestation [8,11,13], whereas other studies have reported higher PA levels at the second trimester than at the first or the third ones [12,14]. Unfortunately, owing to the limitations of studies (in particular the retrospective or cross-sectional nature of most of them), differences in the time points of pregnancy in which data were collected, the heterogeneity in methods used to assess PA volume, and the different characteristics of subjects, any conclusions on these aspects are vague.…”

Health in Preconception, Pregnancy and Postpartum Global Alliance: International Network Pregnancy Priorities for the Prevention of Maternal Obesity and Related Pregnancy and Long-Term Complications

“…Prior meta-analyses have indicated the importance of physical activity in pregnancy in optimising gestational weight gain and improving birth outcomes [17]. While often considered in the whole context of lifestyle, additional research should focus specifically on physical activity in pregnancy, given the decline that commonly occurs in women during this life phase [34][35][36]. Recent research suggests that declining activity in pregnancy now negates any need to increase energy intake, particularly in the first trimester [37].…”

Physical Activity During Pregnancy and After Delivery

“…There are many risk factors for preeclampsia indicating heterogeneity of this disease with obesity being one of them (Jeyabalan, 2013). In respect to other risk factors like pregnancy specific issues (previous number of pregnancies, number of fetuses, specific genetic disorders), maternal preexisting conditions (age, race, BMI, pregestational diabetes, hypertension, renal disease, antiphospholipid syndrome, some autoimmune diseases) family history of preeclampsia and smoking, obesity is modifiable and the only risk factor that can be positively affected by physical activity (Sui, Moran, & Dodd, 2013). As expected, together with obesity, excessive gestational weight gain results from decreased physical activity during pregnancy which additionally highlights the importance of adapted and controlled physical activity during pregnancy.…”