Review of Self‐reported Physical Activity Assessments for Pregnancy: Summary of the Evidence for Validity and Reliability

Abstract

Background: Epidemiological studies and surveillance systems of pregnant women often rely on collection of physical activity through self‐report. This systematic review identified and summarised self‐reported physical activity assessments with evidence for validity and reliability among pregnant women. Methods: Peer‐reviewed articles published through 2011 were included if they assessed validity and/or reliability of an interviewer‐ or self‐administered physical activity questionnaire or diary among pregnant women. Results: We identified 15 studies, including 12 studies that assessed questionnaires and 4 studies that assessed diaries, conducted in Australia, Finland, Norway, the UK, the US and Vietnam. For questionnaires, 92% (11/12) assessed mode, all assessed frequency and/or duration and 58% (7/12) collected information on perceived intensity. All but one study (92%) assessed validity of the questionnaires. Questionnaires compared with objective measures (accelerometers, pedometers) ranged from slight to fair agreement, while comparison with other self‐reported measures ranged from substantial to almost perfect agreement. Five studies (42%) assessed test–retest reliability of the questionnaires, ranging from substantial to almost perfect agreement. The four studies on diaries were all assessed for validity against objective measures, ranging from slight to substantial agreement. Conclusions: Selection of valid and reliable physical activity measures that collect information on dose (type, frequency, duration, intensity) is recommended to increase precision and accuracy in detecting associations of physical activity with maternal and fetal outcomes.

Measuring Physical Activity in Pregnancy Using Questionnaires: A Meta-Analysis

“…However, accelerometers are not able to measure precisely upper body movements, weight-bearing activities, cycling and swimming 10,29 . Cut-off points from accelerometer-calibration studies needed to categorize counts into levels of intensity are not validated for pregnant women.…”

“…It has also been validated in non-pregnant women 36 . Self-reported measurements of PA are the most common method in epidemiological studies of pregnant women 10 , which makes their validity and reliability critical for making conclusions and developing future guidelines. Neither self-reporting nor objective measures are perfect for assessment of PA in pregnancy.…”

“…However, physical activity questionnaires (PAQs) are prone to measurement error and bias 8,9 Objective measurements are not subject to self-report error, but they have other limitations, like inability to measure various types of PA, inaccurate measurement of upper body movement, stationary exercise, weight lifting, and water activities. Also, cut-off points necessary to translate accelerometer data into intensity categories have not been developed for pregnant women 10 . Pedometers cannot diff erentiate intensity level of PA and they are only able to assess walking and running.…”

“…Only several PA questionnaires have been developed and evaluated for validity and reliability in pregnant population. Still, they are the most common method used in surveillance and epidemiological studies of the impact of PA during pregnancy on health outcomes because of their cost and time-eff ectiveness 10,15,16 . Results of these studies impact PA guidelines for pregnant women and, since their fi ndings are based on PAQs, it is very important that these PAQs are valid and reliable.…”

Obesity and Physical Activity During Pregnancy and Postpartum: Evidence, Guidelines, and Recommendations

“…To date, assessment of physical activity during pregnancy and postpartum is predominately conducted via self-report, such as with questionnaires or diaries, rather than with objective measurements, such as accelerometers or pedometers [ 96 ]. Several advantages of self-report measures include the lower burden it places on the participant and the reduction in equipment cost as compared to objective assessment of physical activity.…”