Physical Activity and Diet During Pregnancy: What Low-Income, Pregnant African American Women Think

Antenatal physical activity: a qualitative study exploring women's experiences and the acceptability of antenatal walking groups

Background

Regular physical activity (PA) can be beneficial to pregnant women, however, many women do not adhere to current PA guidelines during the antenatal period. Patient and public involvement is essential when designing antenatal PA interventions in order to uncover the reasons for non-adherence and non-engagement with the behaviour, as well as determining what type of intervention would be acceptable. The aim of this research was to explore women’s experiences of PA during a recent pregnancy, understand the barriers and determinants of antenatal PA and explore the acceptability of antenatal walking groups for further development.

Methods

Seven focus groups were undertaken with women who had given birth within the past five years. Focus groups were transcribed and analysed using a grounded theory approach. Relevant and related behaviour change techniques (BCTs), which could be applied to future interventions, were identified using the BCT taxonomy.

Results

Women’s opinions and experiences of PA during pregnancy were categorised into biological/physical (including tiredness and morning sickness), psychological (fear of harm to baby and self-confidence) and social/environmental issues (including access to facilities). Although antenatal walking groups did not appear popular, women identified some factors which could encourage attendance (e.g. childcare provision) and some which could discourage attendance (e.g. walking being boring). It was clear that the personality of the walk leader would be extremely important in encouraging women to join a walking group and keep attending. Behaviour change technique categories identified as potential intervention components included social support and comparison of outcomes (e.g. considering pros and cons of behaviour).

Conclusions

Women’s experiences and views provided a range of considerations for future intervention development, including provision of childcare, involvement of a fun and engaging leader and a range of activities rather than just walking. These experiences and views relate closely to the Health Action Process Model which, along with BCTs, could be used to develop future interventions. The findings of this study emphasise the importance of involving the target population in intervention development and present the theoretical foundation for building an antenatal PA intervention to encourage women to be physically active throughout their pregnancies.

Association of physical activity and sedentary behavior with biological markers among U.S. pregnant women

BACKGROUND

To examine the association between objectively measured light-intensity and moderate-to-vigorous-intensity physical activity (MVPA), sedentary behaviors, and biological markers in a national sample of U.S. pregnant women, as few studies have examined these relationships among this population.

METHODS

The sample of noninstitutionalized U.S. civilians was selected by a complex, multistage probability design. Data from the 2003-2006 National Health and Examination Survey were used. Two hundred six pregnant women were included in the data analysis. Physical activity and sedentary data were objectively measured via accelerometry (ActiGraph 7164). Biomarker data was obtained in the mobile examination center from urine, blood samples, blood pressure, and anthropometric measurements. Urine and blood samples were obtained to determine pregnancy status, C-reactive protein (CRP), high-density lipoprotein (HDL) cholesterol, total cholesterol, and cotinine as well as fasting glucose, fasting triglycerides, and fasting low-density lipoprotein (LDL) cholesterol data. Multivariable regression was employed to examine the association between physical activity, sedentary behavior, and biomarker levels.

RESULTS

There was a positive association between sedentary behavior and CRP levels (beta coefficient [b]=0.001, p=0.02) and LDL cholesterol (b=0.12, p=0.02). There was an inverse association between light-intensity physical activity and CRP (b=-0.003; p=0.008) and diastolic blood pressure (b=-0.03; p=0.02), with those engaging in higher levels of MVPA having higher HDL cholesterol (b=6.7; p=0.01).

CONCLUSION

Physical activity and sedentary behavior were favorably associated with various biomarkers among pregnant women, suggesting that healthcare providers should encourage pregnant women to participate in safe forms of physical activity behaviors while also reducing their amount of time spent in sedentary behaviors.