National trends in self-reported physical activity and sedentary behaviors among pregnant women: NHANES 1999–2006
Introduction
The health benefits of physical activity during pregnancy include possible prevention of gestational diabetes, support of healthy gestational weight gain, and improved mental health (ACOG, 2002, Davies et al., 2003, Pivarnik et al., 2006, Royal College of Obstetricians and Gynaecologists, 2006). The most recent 2002 American College of Obstetrics and Gynecology (ACOG) guidelines for exercise during pregnancy (ACOG, 2002) recommend ≥ 30 min of moderate exercise a day on most, if not all, days of the week, provided that there are no medical or obstetric complications. In 2008, the United States (US) government released physical activity guidelines for Americans, including recommending specifically for pregnant women that they attain at least 150 min of moderate intensity aerobic activity per week if not already highly active or doing vigorous intensity activity (U.S. Department of Health and Human Services, 2008). Healthy pregnant women who engaged in vigorous aerobic activity or are highly active prior to pregnancy are encouraged to continue physical activity.
Given the benefits of and recommendation for physical activity during pregnancy, surveillance of these patterns and trends is appropriate. To date, at least two US population-based studies describe physical activity among pregnant women nationally. The earliest is from the 1988 National Maternal and Infant Health Survey (Zhang and Savitz, 1996). The survey of almost 10,000 women indicated that approximately 35% reported exercising before and during pregnancy. Walking was the most popular activity, followed by swimming and aerobic exercise. This report is limited by the fact that women were contacted, on average, 17 months after delivery to recall exercise performed before and during pregnancy. In addition, information on duration and frequency of specific activities was not reported.
The second US population-based study utilized the Behavioral Risk Factor Surveillance System (BRFSS) data, a national random-digit-dialed telephone survey. In the year 2000, approximately two-thirds of pregnant women reported any leisure activity in the past month, with walking as the most common activity, followed by gardening, swimming laps, and aerobics (Evenson et al., 2004, Petersen et al., 2005). Pregnant women reporting any leisure activity in the past month increased nonsignificantly from 1994 (64%) to the year 2000 (67%), but the percentage of pregnant women meeting moderate to vigorous guidelines (based on leisure activities) for physical activity nonsignificantly declined from 1994 (20%) to 2000 (16%). Unfortunately, the BRFSS did not collect month of gestation; therefore, gestational age could confound these results, especially if the ages differed over the survey periods.
To further understand national patterns of physical activity among pregnant women, we analyzed data from a US surveillance system that included measures of gestational age, provided data over time with a shorter recall period, and inquired about other modes of physical activity beyond leisure activity. The aims of this study were to describe the prevalence, trends, and correlates of physical activity among this national sample of pregnant women over an 8-year period, from 1999 to 2006. The time period is of interest, since the most recent ACOG recommendations for physical activity during pregnancy were released in 2002 (ACOG, 2002).
Section snippets
Methods
The 1999 to 2006 National Health and Nutrition Examination Survey (NHANES) data were used for this study; more detail on NHANES and the measurement of pregnancy and correlates we explored can be found in Appendix A.
Sample description
NHANES included 1280 pregnant women at least 16 years of age between 1999 and 2006 (n = 302 in 1999–2000, n = 340 in 2001–02, n = 271 in 2003–04, and n = 367 in 2005–06). Pregnancy was determined by either self-report of pregnancy or with a positive laboratory result. Among the sample, 1055 were positive from both self-report and the laboratory sample, while 34 women self-reported their pregnancy but had a missing (n = 25) or negative (n = 9) laboratory result and 191 women had a positive laboratory result
Prevalence and trends
In this study, we reported on national prevalence and trends in physical activity among pregnant women from 1999 to 2006. The time period is of interest, since the most recent ACOG recommendations for physical activity during pregnancy were released in 2002 (ACOG, 2002). Participation in any transportation and any moderate to vigorous leisure activity was stable over time, while participation in any moderate to vigorous household activities and moderate leisure activities increased from
Conclusions
These results extend prior national surveillance studies (Evenson et al., 2004, Petersen et al., 2005, Zhang and Savitz, 1996), by exploring a broad range of physical activities (i.e., beyond leisure activity), including gestational age, and gathering physical activity reports when women are pregnant rather than relying on distant recall. We found that participation in any moderate to vigorous household activities and moderate leisure activities among pregnant women increased from 1999–2002 to
Conflict of interest
The authors declare that there are no conflicts of interest.
Acknowledgments
Funding for this study was provided by the American Heart Association. The authors thank Ginny Lee for reviewing an earlier draft of this manuscript and for the helpful comments of the anonymous reviewers.
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