Demographic, Socioeconomic, and Health-Related Predictors of Objectively Measured Sedentary Time and Physical Activity During Pregnancy

Leisure Physical Activity, Sedentary Behavior, and Cardiovascular Health 2-7 yr after Pregnancy in the nuMoM2b Heart Health Study Cohort

PURPOSE

This study aimed to evaluate whether higher moderate- to vigorous-intensity physical activity (MVPA) and lower sedentary behavior (SB) are related to better cardiovascular health (CVH) after pregnancy.

METHODS

In the nuMoM2b Heart Health Study cohort, Life's Essential 8 health factors (body mass index [BMI], blood pressure, glucose, and lipids) were assessed in the first trimester of pregnancy and 2-7 yr later ( n = 3985). The four health factors were scored with Life's Essential 8 criteria (0 = poorest; 100 = ideal) and averaged to calculate a CVH health factor score (CVH hf) . Self-reported leisure MVPA and SB were assessed at follow-up. Linear regression evaluated associations of MVPA levels and SB quartiles with follow-up CVH hf after adjustment for first trimester CVH hf and covariates. Analyses were repeated after stratification by history of hypertensive disorders of pregnancy (HDP) or gestational diabetes (GDM).

RESULTS

Over follow-up (mean 3.2 yr after delivery), CVH hf declined from 85.6 to 81.6 points (-4.0 points, P < 0.001). The decline was greatest in lipid (-8.4 points, P < 0.001) and BMI scores (-5.6 points, P < 0.001). Healthier activity profiles (higher MVPA level and lower SB quartile) were each associated with higher CVH hf at follow-up: 0.7 points higher per level of MVPA, P < 0.001; 0.5 points lower per quartile of SB, P = 0.0042. Higher MVPA level associated with healthier BMI, glucose, and lipid scores; lower SB quartile associated with healthier BMI and blood pressure scores ( P < 0.05). Although HDP/GDM history was associated with lower CVH hf , patterns of CVH hf across healthier leisure MVPA levels and SB quartiles were similar in those with and without HDP or GDM.

CONCLUSIONS

Higher MVPA and lower SB during leisure could help to maintain CVH health factors in the years after pregnancy, including among those who experienced HDP or GDM.

Relationships Between Perinatal Physical Activity and Pain During Labor and Postpartum

Objective: Physical activity (PA) and pain are bidirectionally related during pregnancy. There are limited data on how prenatal changes in PA relate to labor and postpartum pain. The current study examined associations between PA change from the second to third trimester (increasing vs. decreasing) with (1) labor pain, (2) postpartum hospitalization pain, and (3) the likelihood of increasing versus decreasing PA at 6-months postpartum (relative to the third trimester). Methods: A sample of pregnant people with overweight/obesity were enrolled in a longitudinal study between 12- and 20-weeks' gestation (n = 257). A subsample, with at least three pain ratings documented (n = 233), were included in the current analysis. PA change was characterized with the Paffenbarger. Pain was assessed regularly during labor and postpartum hospitalization from 0 (no pain) to 10 (most pain). Labor and postpartum pain were summarized using minimum/maximum pain ratings, percent improvement in pain following analgesia, and overall pain burden. t-Tests compared pain between the PA groups, and chi-square analyses examined the likelihood of increasing versus decreasing PA at 6-months postpartum. Results: The increasing PA group (n = 52; 22%) reported lower minimum pain scores (d = 0.46) during postpartum hospitalization. Most individuals with decreasing PA between trimesters two and three reported increasing PA at 6-months postpartum. Conclusion: Relative to individuals with decreasing PA, individuals with increasing PA experienced less pain during postpartum hospitalization highlighting potential benefits of prenatal PA for postpartum recovery.

Physical Inactivity Among Pregnant Women at High Risk for Gestational Diabetes Mellitus: A Cross-Sectional Study

AIM

To examine the prevalence and predictors of physical inactivity among pregnant women at high risk for gestational diabetes mellitus (GDM) in mainland China.

METHODS

A cross-sectional study was implemented in Zhengzhou, China from October 2021 to February 2022. Two hundred fifty-two pregnant women at high risk for GDM were recruited. Physical inactivity was assessed by the Pregnancy Physical Activity Questionnaire. The Pregnancy Physical Activity Self-Efficacy Scale, Knowledge of Physical Activity Questionnaire, Social Support for Physical Activity Scale, 7-item Generalized Anxiety Disorder Scale, Edinburgh Postnatal Depression Scale and sociodemographic and antenatal characteristics questionnaire were collected and used to predict physical inactivity. Binary logistic regression was applied. Adjusted odds ratios and 95% confidence intervals (CIs) were calculated.

RESULTS

The prevalence of physical inactivity was 53.2%. The risk factors for physical inactivity included low level of physical activity self-efficacy (aOR: 6.05, 95% CI: 1.13-32.31), middle levels of physical activity self-efficacy (aOR: 5.13, 95% CI: 1.45-18.20), no pregnancy physical activity goals (aOR: 3.06, 95% CI: 1.18-8.0), low pregnancy physical activity goals (aOR: 2.64, 95% CI: 1.02-6.8), nulliparity (aOR: 7.17, 95% CI: 3.74-13.75), having a junior college degree or below (aOR: 2.03, 95% CI: 1.10-3.74) and husbands having no habits of regular physical activity (aOR: 2.07, 95% CI: 1.06-4.04).

CONCLUSION

This study revealed that physical inactivity among pregnant women at high risk for GDM was a public health concern in mainland China. Physical activity self-efficacy and pregnancy physical activity goals may be used to develop interventions to enhance physical activity.

Associations of physical activity and sedentary time with aortic stiffness and autonomic function in early pregnancy

Rapid cardiovascular and autonomic adaptations occur during early pregnancy to accommodate augmented cardiac output and placental circulation, with inadequate adaptation associated with hypertensive pregnancy complications. Habitual physical activity (PA) and limiting time in sedentary behavior (SED) may improve pregnancy-related vascular and autonomic function. The objective of this study was to examine the magnitude of the predicted associations between device-measured PA and SED with cardiovascular and autonomic biomarkers including aortic stiffness, blood pressure variability (BPV), and baroreflex sensitivity (BRS) in the first trimester of pregnancy. Pregnant women (N = 92, 21-44 yr of age) free from cardiovascular disease were assessed between 100 and 126 weeks of gestation. Participants wore a thigh-mounted activPAL device for 7 days to assess PA (light intensity and moderate-to-vigorous intensity) and SED. Aortic stiffness was measured by noninvasive applanation tonometry and expressed as carotid-femoral pulse wave velocity (cfPWV). Beat-to-beat blood pressure (BP) and R-R intervals were synchronously recorded for 10 min via finger plethysmography and ECG to derive beat-to-beat BPV and spontaneous cardiovagal BRS (sequence method). In the entire group, neither PA nor SED was related to cfPWV, BPV, or BRS, and this finding was similar in nulliparous and parous pregnant women. In stratified analyses, the association between moderate-to-vigorous-intensity PA and cfPWV differed by gestational age (GA) such that this inverse association was only present in the 12th week of gestation (β = -0.365, P = 0.015). The present study indicates that PA and SED are not associated with aortic stiffness or autonomic function in the first trimester.NEW & NOTEWORTHY Pregnancy is characterized by profound maternal circulatory and autonomic adaptations, but the impact of modifiable factors, such as physical activity and sedentary behavior on vascular and autonomic function during pregnancy, is unclear. We demonstrate that device-measured physical activity and sedentary time are not associated with aortic stiffness, baroreflex sensitivity, and blood pressure variability during the first trimester. The beneficial effect of physical activity on aortic stiffness may become more pronounced with advancing gestational age.

Compliance with 24 h Movement Behavior Guidelines for Pregnant Women in Saudi Arabia: The Role of Trimester and Maternal Characteristics

BACKGROUND

Complying with 24 h movement behavior guidelines for pregnant women may prevent pregnancy complications. This single time point, cross-sectional investigation assessed compliance with the 24 h movement behavior guidelines in pregnant women in Saudi Arabia and examined the role of trimester and maternal characteristics.

METHODS

Pregnant women (n = 935; age = 30 ± 5.6 years; first trimester = 24.1%, second trimester = 33.9%, third trimester = 42.0%) self-reported their characteristics (nationality, region, degree, occupation, smoking status, health status, having children, previous birth). The short-version International Physical Activity Questionnaire, Sedentary Behavior Questionnaire, and Pittsburgh Sleep Quality Index Questionnaire measured moderate physical activity (MPA), sedentary behavior (SB), and sleep duration, respectively. Compliance with the 24 h movement behavior guidelines was reported using frequencies and percentages. Prevalence ratios compared the prevalence of compliance by trimester and maternal characteristics.

RESULTS

Approximately half of the participants did not comply with MPA or sleep duration guidelines (n = 524, [56.0%] and n = 424, [45.5%], respectively). In contrast, about two-thirds of participants (n = 648, [69.3%]) adhered to the SB guideline. Only 154 (16.5%) participants complied with all 3 24 h movement behavior guidelines. Pregnant women in their second trimester, living in Al-Ahsa Governorate, and currently smoking with a bachelor's degree were the most likely to comply with the guidelines.

CONCLUSIONS

These findings underscore the need for tailored efforts to promote healthy 24 h movement behavior guidelines for pregnant women in Saudi Arabia, especially early in pregnancy, while accounting for important maternal characteristics.

Pilot Study of the FitMoms2B Physical Activity Promotion Program Among Black Women With High-Risk Pregnancies

OBJECTIVE

To explore the feasibility of recruitment, adherence, and retention and the acceptability of the FitMoms2B physical activity promotion program and study measures among non-Hispanic Black women with high-risk pregnancies.

DESIGN

One-arm pilot feasibility study.

SETTING

A large regional high-risk prenatal clinic in the southeastern United States.

PARTICIPANTS

Non-Hispanic Black women who had singleton, high-risk pregnancies at 16 to 23 weeks gestation with no contraindications to physical activity (N = 13).

METHOD

We evaluated the feasibility and acceptability of a multicomponent intervention, which included physical activity coaching, support from a workout partner, and an activity tracker. We also assessed the feasibility of study measures for future trials of the program.

RESULTS

Of 179 patients screened, 20 were eligible, and 13 consented and enrolled (65%). Of the 13 participants, 9 completed data collection at Time Point (T) 1 (16-23 weeks gestation) and T2 (24-30 weeks), and 8 completed data collection at T3 (31 or more weeks). Adherence met expectations for coaching (63%), exercise with a workout partner (100%), and use of the activity tracker (92%). Acceptability was high (100%).

CONCLUSION

We found that recruitment, retention, and adherence are feasible for the FitMoms2B physical activity promotion program. The program and study measures were acceptable to participants in our sample. We provide preliminary support for a randomized controlled trial to study physical activity promotion with virtual coaching, workout partner support, and activity tracking among Black pregnant women with high-risk pregnancies without contraindications to physical activity.

Assisted reproductive technology and physical activity among Chinese pregnant women at high risk for gestational diabetes mellitus in early pregnancy: A cross-sectional study

Currently, the number of pregnant women at high risk for gestational diabetes mellitus (GDM) and using assisted reproductive technology (ART) is increasing. The present study aims to explore the relationship between ART and physical activity in Chinese pregnant women at high risk for GDM in early pregnancy. A cross-sectional study was conducted in a regional teaching hospital in Guangzhou, China, between July 2022 and March 2023. Three hundred fifty-five pregnant women at high risk for GDM in early pregnancy completed the Chinese version of the Pregnant Physical Activity Questionnaire (PPAQ), the Pregnancy Physical Activity Knowledge Scale, the Pregnancy Physical Activity Self-Efficacy Scale, the Pregnancy Physical Activity Social Support Scale, and a sociodemographic and obstetric characteristics data sheet. Compared to women who conceived naturally, women who used ART were more likely to be 35 years or older, unemployed, primigravidae, and to have intentionally planned their pregnancies. Women who used ART had significantly lower levels of physical activity and self-efficacy compared to their counterparts who conceived naturally. Over half (55.6%) of women who used ART reported being physically inactive, and those with lower self-efficacy, as well as the unemployed, were significantly more likely to be inactive. Physical inactivity is a critical clinical issue among women who use ART, especially in the context of GDM risk. Future research should develop and test physical activity programs, including enhancing physical activity self-efficacy for women who use ART. Patient or public contribution: In this study, survey questionnaires were completed by participants among Chinese pregnant women at high risk for GDM in early pregnancy.

The sedentary behavior reduction in pregnancy intervention (SPRING) pilot and feasibility randomized trial

Pregnant individuals rarely achieve moderate-to-vigorous intensity physical activity recommendations.Purpose The sedentary behavior reduction in pregnancy intervention (SPRING) pilot and feasibility randomized trial aimed to demonstrate feasibility, acceptability, and initial efficacy of a lower intensity intervention targeting reduced sedentary behavior and increased standing and steps.Methods First trimester pregnant individuals at risk for high sedentary behavior and adverse pregnancy outcomes (APO) were randomized 2:1 to a multi-component sedentary behavior reduction intervention or no-contact control. Intervention components included biweekly remote health coaching, wearable activity monitor, height-adjustable workstation, and a private Facebook group. Evidence-based behavioral targets included sedentary time < 9 h/day, increasing standing by 2-3 h/day, and ≥ 7500 steps/day. Participants completed all-remote assessments (baseline, second trimester, third trimester) of sedentary behavior and activity (thigh-worn activPAL) along with exploratory pregnancy health outcomes abstracted from medical records. Intervention effects vs. control were evaluated using generalized mixed models and an intention-to-treat approach. Intervention participants also provided feedback on perceived benefits and acceptability.Results Participants (34 intervention; 17 control) had mean age 32 years, were 83% White, with mean pre-pregnancy BMI 28 kg/m2. Retention was high (90% and 83% at second and third trimester follow-up visits). Intervention participants decreased sedentary time (-0.84 h/day, p = 0.019) and increased standing (+0.77 h/day, p = 0.003), but did not increase steps/day (+710, p = 0.257) compared to controls. Intervention participants reported many perceived benefits and identified the wearable, height-adjustable workstation, and behavioral lessons as most useful.Conclusion For pregnant individuals at risk for high sedentary behavior and APOs, a sedentary behavior reduction intervention is feasible, acceptable, and may offer a viable alternative to more intense physical activity recommendations during pregnancy. Further testing in a fully powered clinical trial is warranted.Trial registration NCT05093842 on clinicaltrials.gov.

Predictors of physical inactivity among pregnant women

It is recommended that pregnant women be physically active to promote maternal and child health. This study aimed to explore the prevalence of physical inactivity and its modifiable predictors in the three trimesters in Chinese pregnant women. Four hundred forty-four pregnant women completed the Pregnant Physical Activity Questionnaire in the first, second, and third trimesters. The prevalence of physical inactivity reached its highest (66.2%) in the first trimester and lowest (19.4%) in the second trimester. Pregnant women with inadequate physical activity knowledge and low self-efficacy were at higher risk for physical inactivity. Monitoring physical inactivity could be incorporated into antenatal care and start from the first trimester. Prenatal care professionals should take action to increase pregnant women's physical activity self-efficacy and knowledge to enhance their physical activity.

Occupational physical activity as a determinant of daytime activity patterns and pregnancy and infant health

Though physical activity (PA) is recommended during pregnancy, it remains unclear how occupational physical activity (OPA) and sedentary behavior (SB) contribute to activity patterns and health during pregnancy. The purpose of this secondary analysis was to determine if OPA pattern is a determinant of all-day PA and evaluate associations with pregnancy/infant health outcomes. Data was from two prospective cohorts with study visits each trimester: MoM Health (Pittsburgh, PA; n = 120) and PRAMS (Iowa City, Iowa; n = 20). Using employment status/job hours (self-reported in demographic questionnaires) and OPA from the Pregnancy Physical Activity Questionnaire, latent class analysis identified three groups: sitting (n = 61), part-time mixed (n = 9), and active (n = 29). A fourth group included non-working participants (n = 32). Device-based PA (ActiGraph GT3X), SB (activPAL3 micro), and blood pressure were measured each trimester. Glucose screening test, gestational age, gestational weight gain, adverse pregnancy outcomes (APOs: gestational hypertension, preeclampsia, eclampsia, gestational diabetes, intrauterine growth restriction, and preterm birth), and infant outcomes (length, weight, and sex) were abstracted from medical records. Associations between groups with APOs and pregnancy/infant health were calculated using linear/logistic regression with adjustment for age, pre-pregnancy BMI, education, and race. Self-reported participant characteristics were similar across groups, except education which was higher in the sitting versus other groups. All-day device-based PA differed across groups; for example, the sitting group had the highest SB across trimester (all p<0.01) while the active group had the highest steps per day across trimesters (all p<0.01). Pregnancy/infant health did not differ between groups (all p>0.09). Compared to the non-working group, the risk of any APO was non-significantly higher in the sitting (OR = 2.27, 95%CI = 0.63-8.18) and active groups (OR = 2.40, 95%CI = 0.66-9.75), though not the part-time mixed (OR = 0.86, 95%CI = 0.08-9.1). OPA pattern is a determinant of all-day PA during pregnancy. Future studies with larger samples should examine associations between pregnancy OPA patterns and pregnancy/infant health.

A socio-ecological model of factors influencing physical activity in pregnant women: a systematic review

Physical activity (PA) is safe for most pregnant women, improving both maternal fitness and birth outcomes. Despite evidence of benefits, most pregnant women eliminate or reduce PA during pregnancy. This systematic review aimed to analyze the factors affecting maternal PA during pregnancy with reference to a socio-ecological model. A systematic search of relevant published studies between 2001 and 2022 was conducted through PubMed, Scopus, Web of Science, Academic Search Ultimate, Medline, and SPORTDiscus with full text via the EBSCO platform. A total of 32 studies that met the inclusion criteria were reviewed. The findings revealed that various study designs can lead to different outcomes in terms of what is identified as a PA facilitator or barrier. The factors that positively influenced PA in pregnant women were: higher levels of education, knowledge, and skills, as well as access to mass media. Conversely, lower levels of education, lack of knowledge and skills, low income, pregnancy discomforts, limited time, safety concerns, and societal perceptions of PA in pregnancy acted as barriers. Additionally, family, colleagues/friends, and partners could either support or hinder PA. Factors affecting overall maternal PA were somewhat different from those affecting the moderate-to-vigorous intensity of PA. Pregnant women receive little organizational and policy support. There is an urgent need to provide accessible information and resource systems for pregnant women. Since most pregnant women are motivated to engage in PA and susceptible to family advice, interventions should not be limited only to pregnant women, but should involve a family member, especially partners. There is a need to take global, systemic actions to promote an active lifestyle in pregnancy. Addressing safety concerns related to PA during pregnancy should be a significant part of these promotional activities.

Rationale, Design, and Methods for the Sedentary Behavior Reduction in Pregnancy Intervention (SPRING): Protocol for a Pilot and Feasibility Randomized Controlled Trial

BACKGROUND

Adverse pregnancy outcomes (APOs) identify cardiovascular disease risk, but few effective interventions are available. High sedentary behavior (SED) has recently been associated with APOs, but very few randomized controlled trials (RCTs) have tested SED reduction in pregnancy.

OBJECTIVE

The Sedentary Behavior Reduction in Pregnancy Intervention (SPRING) pilot and feasibility RCT addresses this gap by testing the feasibility, acceptability, and preliminary pregnancy health effects of an intervention to reduce SED in pregnant women. The objective of this manuscript is to describe the rationale and design of SPRING.

METHODS

Pregnant participants (n=53) in their first trimester, who are at risk for high SED and APO and without contraindications, are randomized in a 2:1 ratio to an intervention or control group. SED (primary outcome) and standing durations, and steps per day, are measured objectively in each trimester for 1 week with a thigh-mounted activPAL3 accelerometer. SPRING also seeks to demonstrate feasibility and acceptability while estimating preliminary effects on maternal-fetal health outcomes assessed during study visits and abstracted from medical records. The pregnancy-customized intervention promotes daily behavioral targets of less than 9 hours of SED and at least 7500 steps, achieved via increased standing and incorporating light-intensity movement breaks each hour. The multicomponent intervention provides a height-adjustable workstation, a wearable activity monitor, behavioral counseling every 2 weeks (through videoconference), and membership in a private social media group. Herein, we review the rationale, describe recruitment and screening processes, and detail the intervention, assessment protocols, and planned statistical analyses.

RESULTS

This study was funded by the American Heart Association (20TPA3549099), with a funding period of January 1, 2021, and until December 31, 2023. Institutional review board approval was obtained on February 24, 2021. Participants were randomized between October 2021 and September 2022, with final data collection planned for May 2023. Analyses and submission of results are expected for winter of 2023.

CONCLUSIONS

The SPRING RCT will provide initial evidence on the feasibility and acceptability of an SED-reduction intervention to decrease SED in pregnant women. These data will inform the design of a large clinical trial testing SED reduction as a strategy to reduce APO risk.

TRIAL REGISTRATION

ClincialTrials.gov NCT05093842; https://clinicaltrials.gov/ct2/show/NCT05093842.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/48228.

Barriers to physical activity in pregnant women living in Iran and its predictors: a cross sectional study

BACKGROUND AND AIMS

Despite the benefits of physical activity (PA) on maternal and fetal health, the level of PA is low among pregnant women globally. The aim of this study was to determine the barriers to PA and its predictors in Iranian pregnant women specifically.

METHODS

This cross-sectional study included 300 pregnant women referred to the Ilam health centers of Iran. The sampling strategy used stratified random proportional allocation sampling from both comprehensive health centers and health bases. Data were collected from September to December 2018 in relation to individual characteristics. Data collection tools used included the Pregnancy Physical Activity Questionnaire and the Barriers to Physical Activity during Pregnancy Scale. To analyze the data, descriptive statistics and statistical tests of analysis including variance, independent t-test and multiple linear regression were used.

RESULTS

The mean and SD of the total score of PA barriers was 88.55 and 19.28, respectively. The highest and lowest mean scores of the subscale of PA barriers were related to interpersonal and environmental barriers, respectively. Among the intrapersonal barriers related to pregnancy; fear of pregnancy complications, drowsiness, and nausea and vomiting, heaviness or swelling barriers scored higher than other barriers. Lack of regular schedule, insufficient time, and lack of motivation received the highest score in terms of intrapersonal barriers non-related to pregnancy. In the interpersonal subscale; lack of knowledge about how to be physically active during pregnancy, forbiddance of PA by friends and family, as well as lack of advice from physicians and midwives scored higher than other barriers. Lack of adequate facilities and air pollution were identified as barriers to PA in the environmental subscale. PA barriers were significantly associated with pre-pregnancy or early pregnancy body mass index (B = - 14.643), level of education (B = 17.215), and habitual exercise pre-pregnancy (B = - 7.15).

CONCLUSION

Interpersonal barriers were reported to be the most common barriers to PA during pregnancy. Perinatal care providers should encourage, educate and reassure pregnant women, their spouses and their families about the benefits, type and frequency of safe PA in pregnancy. PA interventions focused on women with lower levels of education and income in particular are required.

Physical activity changes among non-Hispanic Black pregnant women

OBJECTIVE

To examine aerobic physical activity (PA) among non-Hispanic Black pregnant women.

DESIGN

Longitudinal prospective cohort study.

SAMPLE

A subset of 161 non-Hispanic Black pregnant women from the Midwestern US participating in a larger study completed questionnaires about aerobic physical activity (PA) before pregnancy (reported at 24.46±2.13 weeks gestation), mid-pregnancy (24.46±2.13 weeks gestation), and late pregnancy (31.78±1.95 weeks gestation).

MEASUREMENTS

Aerobic PA was measured using the Rapid Assessment of Physical Activity (RAPA).

RESULTS

Most participants reported being active prior to pregnancy (n = 101, 63%), with 60 (37%) underactive/sedentary. Aerobic RAPA scores were highest pre-pregnancy (3.29±1.11, median = 4, interquartile range [IQR] = 1) compared with mid-pregnancy (3.05±1.26, median = 4, IQR = 2) and late pregnancy (3.05±1.24, median = 4, IQR = 2). Pre-pregnancy scores were significantly higher than mid-pregnancy scores (Wilcoxon test = 1472, p = .008) and late pregnancy scores (Wilcoxon test = 1854, p = .01).

CONCLUSION

Most Black pregnant participants reported high levels of aerobic PA both before pregnancy and during pregnancy. However, many were underactive or sedentary. Aerobic PA decreased during pregnancy compared with pre-pregnancy, without the drop in third trimester PA found in other populations. Providers should assess PA across pregnancy and promote adequate PA for maternal and infant health, particularly among Black women.

Concurrent Agreement Between ActiGraph and activPAL for Measuring Physical Activity in Pregnant Women and Office Workers

INTRODUCTION

Current best practice for objective measurement of sedentary behavior and moderate-to-vigorous intensity physical activity (MVPA) requires two separate devices. This study assessed concurrent agreement between the ActiGraph GT3X and the activPAL3 micro for measuring MVPA to determine if activPAL can accurately measure MVPA in addition to its known capacity to measure sedentary behavior.

METHODS

Forty participants from two studies, including pregnant women (n = 20) and desk workers (n = 20), provided objective measurement of MVPA from waist-worn ActiGraph GT3X and thigh-worn activPAL micro3. MVPA from the GT3X was compared with MVPA from the activPAL using metabolic equivalents of task (MET)- and step-based data across three epochs. Intraclass correlation coefficient and Bland-Altman analyses, overall and by study sample, compared MVPA minutes per day across methods.

RESULTS

Mean estimates of activPAL MVPA ranged from 22.7 to 35.2 (MET based) and 19.7 to 25.8 (step based) minutes per day, compared with 31.4 min/day (GT3X). MET-based MVPA had high agreement with GT3X, intraclass correlation coefficient ranging from .831 to .875. Bland-Altman analyses revealed minimal bias between 15- and 30-s MET-based MVPA and GT3X MVPA (-3.77 to 8.63 min/day, p > .10) but with wide limits of agreement (greater than ±27 min). Step-based MVPA had moderate to high agreement (intraclass correlation coefficient: .681-.810), but consistently underestimated GT3X MVPA (bias: 5.62-11.74 min/day, p < .02). For all methods, activPAL appears to better estimate GT3X at lower quantities of MVPA. Results were similar when repeated separately by pregnant women and desk workers.

CONCLUSION

activPAL can measure MVPA in addition to sedentary behavior, providing an option for concurrent, single device monitoring. MET-based MVPA using 30-s activPAL epochs provided the best estimate of GT3X MVPA in pregnant women and desk workers.

Pattern and correlates of physical activity and sedentary behaviours of pregnant women in Ibadan, Nigeria: Findings from Ibadan pregnancy cohort study

Globally, physical inactivity is the fourth leading risk factor for premature death. Pregnancy is associated with reduced physical activity because of physiological and anatomical changes and socio-cultural barriers. Even though physical activity provides many benefits, such as improved insulin sensitivity and reduced cardiometabolic risk, it is not emphasized among pregnant women in Nigeria. This study described the pattern of physical activity and sedentary behaviours of pregnant women from the Ibadan Pregnancy Cohort Study in Ibadan, Nigeria. The Ibadan Pregnancy Cohort Study (IbPCS) is a prospective cohort study investigating the associations between maternal obesity, lifestyle factors on glycaemia control, gestational weight gain, pregnancy and postpartum outcomes among pregnant women in Ibadan. The Pregnancy Physical Activity Questionnaire (PPAQ) was used to assess physical activity and sedentary behaviour. Sedentary time was estimated from the time spent watching television, sitting at work and the computer. Bivariate and multivariate logistic regression analyses were done to investigate associations at a 5% level of statistical significance. None of the pregnant women met the WHO recommendation of 150mins of moderate-intensity activity per week. The average time spent engaged in moderate-intensity activity was 26.3 ± 22.9 mins. The mean daily sedentary time was 6.5 ± 4.2 hours. High parity para ≥ 4: [AOR 0.57 95% CI: (0.36-0.89) p = 0.014] and being employed [AOR 0.23 95% CI: (0.15-0.33) p <0.001] reduced the odds of having inadequate physical activity. Correlates of sedentary behavior after adjusting for confounders were high parity: para 1-3 AOR 0.73, 95% CI: (0.58-0.91) p = 0.004], tertiary education: AOR 2.39 95% CI: (1.16-4.91) p = 0.018] and earning a higher income: AOR 1.40: 95% CI: (1.11-1.78) p = 0.005]. Pregnant women's physical activity and sedentary behaviours are emerging public health issues, especially in Nigeria. The level of physical activity was inadequate among pregnant women, while the sedentary time was high. There is a need to implement programmes that promote physical activity and discourage sedentary behaviour among pregnant women in Nigeria.