학술논문

Patterns of leisure-time physical activity across pregnancy and adverse pregnancy outcomes
Document Type
article
Source
International Journal of Behavioral Nutrition and Physical Activity. 15(1)
Subject
Reproductive Medicine
Biomedical and Clinical Sciences
Public Health
Health Sciences
Clinical Research
Contraception/Reproduction
Nutrition
Prevention
Pediatric
Perinatal Period - Conditions Originating in Perinatal Period
Reproductive health and childbirth
Metabolic and endocrine
Good Health and Well Being
Adult
Black or African American
Diabetes
Gestational
Exercise
Female
Gestational Age
Hispanic or Latino
Humans
Hypertension
Pregnancy-Induced
Infant
Newborn
Infant
Small for Gestational Age
Leisure Activities
Obesity
Odds Ratio
Pregnancy
Pregnancy Outcome
Premature Birth
Smoking
Young Adult
Physical activity
Gestational diabetes
Preterm birth
NICHD NuMoM2b and NHLBI NuMoM2b Heart Health Study Network
Medical and Health Sciences
Education
Nutrition and dietetics
Epidemiology
Sports science and exercise
Language
Abstract
BackgroundAlthough leisure-time physical activity (PA) contributes to overall health, including pregnancy health, patterns across pregnancy have not been related to birth outcomes. We hypothesized that women with sustained low leisure-time PA would have excess risk of adverse pregnancy outcomes, and that changing patterns across pregnancy (high to low and low to high) may also be related to risk of adverse pregnancy outcomes.MethodsNulliparous women (n = 10,038) were enrolled at 8 centers early in pregnancy (mean gestational age in weeks [SD] = 12.05 [1.51]. Frequency, duration, and intensity (metabolic equivalents) of up to three leisure activities reported in the first, second and third trimesters were analyzed. Growth mixture modeling was used to identify leisure-time PA patterns across pregnancy. Adverse pregnancy outcomes (preterm birth, [PTB, overall and spontaneous], hypertensive disorders of pregnancy [HDP], gestational diabetes [GDM] and small-for-gestational-age births [SGA]) were assessed via chart abstraction.ResultsFive patterns of leisure-time PA across pregnancy were identified: High (35%), low (18%), late decreasing (24%), early decreasing (10%), and early increasing (13%). Women with sustained low leisure-time PA were younger and more likely to be black or Hispanic, obese, or to have smoked prior to pregnancy. Women with low vs. high leisure-time PA patterns had higher rates of PTB (10.4 vs. 7.5), HDP (13.9 vs. 11.4), and GDM (5.7 vs. 3.1, all p