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Yimer A, Endris S, Wossen A, Abate M. Pregnant women's knowledge, attitude, and practice toward physical exercise during pregnancy and its associated factors at Dessie town health institutions, Ethiopia. AJOG GLOBAL REPORTS 2024; 4:100391. [PMID: 39296603 PMCID: PMC11407080 DOI: 10.1016/j.xagr.2024.100391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2024] Open
Abstract
BACKGROUND Physical exercise consists of planned, repetitive, and intentional movements that reduce the risk of pregnancy-related complications. Worldwide, there is a high rate of physical inactivity during pregnancy, including in Ethiopia, which has detrimental effects on both pregnant women and their developing fetus. OBJECTIVE This study aimed to assess pregnant women's knowledge, attitude, and practice toward physical exercise during pregnancy and its associated factors among antenatal care attendants at health institutions in Dessie, South Wollo Zone, Amhara Region, Ethiopia, in 2023. STUDY DESIGN An institutional-based cross-sectional study was conducted among 614 pregnant women receiving antenatal care between January 18, 2023, and February 25, 2023. The study participants were selected using systematic random sampling technique. Data were collected using a pretested, face-to-face interviewer-administered, and semistructured questionnaire. The data were cleaned, coded, and entered into EpiData (version 4.6; www.epidata.dk) and analyzed using SPSS (version 25; SPSS Inc, Chicago, IL). Bivariate and multivariate binary logistic regression analyses were performed to identify factors associated with knowledge, attitude, and practice toward physical exercise during pregnancy. Variables with a P value of <.2 in the bivariate analysis were transferred to the multivariate analysis. Finally, the adjusted odds ratio and 95% confidence interval with a P value of <.05 in the multivariate analysis were considered statistically significant. RESULTS The study found that 56.3% of participants had good knowledge, 51.5% of participants had a favorable attitude, and 32.2% of participants practiced physical exercise during pregnancy. Age, educational level, and heard about physical exercise during pregnancy were positively associated with pregnant women's knowledge and attitude. In addition, age, antenatal care follow-up, no history of abortion, ever done physical exercise before becoming pregnant, and good knowledge were positively associated with pregnant women's practice of physical exercise during pregnancy. CONCLUSION Our findings indicate that approximately half of the participants had good knowledge and a favorable attitude. However, almost one-third of the participants practiced physical exercise during their pregnancy. It is recommended that antenatal care providers advise pregnant women to strengthen their antenatal care follow-up and offer health education and counseling about the benefits of physical exercise during pregnancy.
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Affiliation(s)
- Abdusellam Yimer
- Department of Midwifery, College of Medicine and Health Sciences, Dire-Dawa University, Dire Dawa, Ethiopia (Yimer)
| | - Seada Endris
- Department of Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia (Endris, Wossen, and Abate)
| | - Alemtsehay Wossen
- Department of Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia (Endris, Wossen, and Abate)
| | - Mengistu Abate
- Department of Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia (Endris, Wossen, and Abate)
- School of Public Health, Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia (Abate)
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Er YT, Chan YM, Mohd Shariff Z, Abdul Hamid H, Mat Daud Z'A, Yong HY. Dietitian-led cluster randomised controlled trial on the effectiveness of mHealth education on health outcomes among pregnant women: a protocol paper. BMJ Open 2023; 13:e075937. [PMID: 37989361 PMCID: PMC10660825 DOI: 10.1136/bmjopen-2023-075937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 10/13/2023] [Indexed: 11/23/2023] Open
Abstract
INTRODUCTION Nutrition education is the cornerstone to maintain optimal pregnancy outcomes including gestational weight gain (GWG). Nevertheless, default for appointments is common and often lead to suboptimal achievement of GWG, accompanied with unfavourable maternal and child health outcomes. While mobile health (mHealth) usage is increasing and helps minimising barriers to clinic appointments among pregnant mothers, its effectiveness on health outcomes has been inconclusive. Therefore, this study aimed to address the gap between current knowledge and clinical care, by exploring the effectiveness of mHealth on GWG as the primary outcome, hoping to serve as a fundamental work to achieve optimal health outcomes with the improvement of secondary outcomes such as physical activity, psychosocial well-being, dietary intake, quality of life and sleep quality among pregnant mothers. METHODS AND ANALYSIS A total of 294 eligible participants will be recruited and allocated into 3 groups comprising of mHealth intervention alone, mHealth intervention integrated with personal medical nutrition therapy and a control group. Pretested structured questionnaires are used to obtain the respondents' personal information, anthropometry data, prenatal knowledge, physical activity, psychosocial well-being, dietary intake, quality of life, sleep quality and GWG. There will be at least three time points of data collection, with all participants recruited during their first or second trimester will be followed up prospectively (after 3 months or/and after 6 months) until delivery. Generalised linear mixed models will be used to compare the mean changes of outcome measures over the entire study period between the three groups. ETHICS AND DISSEMINATION Ethical approvals were obtained from the ethics committee of human subjects research of Universiti Putra Malaysia (JKEUPM-2022-072) and medical research & ethics committee, Ministry of Health Malaysia: NMRR ID-22-00622-EPU(IIR). The results will be disseminated through journals and conferences targeting stakeholders involved in nutrition research. TRIAL REGISTRATION NUMBER Clinicaltrial.gov ID: NCT05377151.
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Affiliation(s)
- Ying Ting Er
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Yoke Mun Chan
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
- Research Centre of Excellence Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Zalilah Mohd Shariff
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Habibah Abdul Hamid
- Department of Obstetrics & Gynaecology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Zulfitri 'Azuan Mat Daud
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
- Research Centre of Excellence Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Heng Yaw Yong
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Wilayah Persekutuan, Malaysia
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Howie EK, Nelson A, McVeigh JA, Andres A. Physical Activity, Sedentary and Sleep Phenotypes in Women During the First Trimester of Pregnancy. Matern Child Health J 2023; 27:1834-1845. [PMID: 37436642 DOI: 10.1007/s10995-023-03745-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 07/13/2023]
Abstract
OBJECTIVES Patterns of physical behaviors including physical activity, sedentary time, and sleep are unknown during pregnancy, but are likely to influence health outcomes. The purpose was to first identify "physical behavior phenotypes" from accelerometer-measured physical behaviors in pregnant women during the first trimester and secondly, to explore the associations between the identified phenotypes with demographic variables and body-mass-index (BMI). METHODS Data were from the Glowing Study (gov ID: NCT01131117), collected between 2011 and 2017 with accelerometer-measured physical behaviors of women in their 12th week of pregnancy. Latent class analysis was used to identify patterns of total physical activity, sleep time, sedentary time, and variation in physical activity. Maternal Body-Mass-Index (BMI). BMI and sociodemographic characteristics were compared between physical behavior phenotypes. RESULTS A total of 212 pregnant women were included in the study (mean age 30.2 years (range 22.1 to 42.4), mean days wear 4.3 (SD 0.7)). Three physical behavior phenotypes were identified from the four physical behavior constructs: low sedentary and stable activity (n = 136, 64%), variable activity (n = 39, 18%), high sedentary and low sleep (n = 37, 17%). BMI, race, and education were significantly different between the three phenotypes, with the low sedentary and stable activity phenotype having the lowest BMI and a higher percentage of white and college educated women. CONCLUSIONS FOR PRACTICE Total physical activity and physical behavior phenotypes during the first trimester were associated with early-pregnancy BMI, race, and education. Future research should examine whether these physical behavior phenotypes are associated with maternal and child health outcomes.
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Affiliation(s)
- Erin K Howie
- Department of Health, Human Performance and Recreation, University of Arkansas, HPER 308I, Fayetteville, AR, 72701, USA.
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia.
| | - Alexander Nelson
- Department of Computer Science and Computer Engineering, University of Arkansas, Fayetteville, AR, USA
| | - Joanne A McVeigh
- Curtin School of Allied Health, Curtin University, Perth, WA, Australia
- Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
| | - Aline Andres
- Arkansas Children's Nutrition Center & Arkansas Children's Research Institute, Little Rock, AR, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Determinants of Suboptimal Gestational Weight Gain among Antenatal Women Residing in the Highest Gross Domestic Product (GDP) Region of Malaysia. Nutrients 2022; 14:nu14071436. [PMID: 35406049 PMCID: PMC9003510 DOI: 10.3390/nu14071436] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 02/04/2023] Open
Abstract
Suboptimal gestational weight gain has been associated with adverse perinatal and maternal outcomes, including increased risk of non-communicable diseases later in life. This study aimed to determine the proportion and determinants of suboptimal GWG. A cross-sectional study was conducted among 475 pregnant women in Selangor between January and March 2020. The study included all pregnant women at their second or third trimester who fulfilled the inclusion and exclusion criteria. A multistage sampling was applied. The GWG adequacy was based on recommendations from the Institute of Medicine (2009). Multinomial logistic regressions were used for data analysis. Out of the 475 respondents, 224 (47.2%) pregnant women had inadequate GWG, 142 (29.9%) had adequate GWG, and 109 (22.9%) had excessive GWG. Multinomial logistic regression showed that having diabetes in pregnancy (AdjOR 2.24, 95% CI: 1.31, 3.83, p = 0.003), middle (M40) monthly household income (AdjOR 2.33, 95% CI: 1.09, 4.96, p = 0.029), low (B40) monthly household income (AdjOR 2.22, 95% CI: 1.07, 4.72, p = 0.039), and an obese pre-pregnancy BMI (AdjOR 2.77, 95% CI: 1.43, 5.35, p = 0.002) were significantly associated with inadequate GWG. Overweight (AdjOR 5.18, 95% CI: 2.52, 10.62, p < 0.001) and obese pre-pregnancy BMIs (AdjOR 17.95, 95% CI: 8.13, 36.95, p < 0.001) were significantly associated with excessive GWG. Improving maternal and perinatal outcomes requires targeted interventions focusing on these modifiable determinants.
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Syed Nor SF, Idris IB, Md Isa Z. Physical inactivity in early pregnancy and the determinants in an urban city setting of Kuala Lumpur, Malaysia. BMC Public Health 2022; 22:93. [PMID: 35027033 PMCID: PMC8758214 DOI: 10.1186/s12889-022-12513-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 01/05/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Physical inactivity in pregnancy has been associated with excessive gestational weight gain, hypertensive disorders, gestational diabetes mellitus and postpartum depression. Despite these risks, physical inactivity level remains high especially in higher income countries. The prevalence of physical inactivity among women in Malaysia aged ≥16 years was 28.2% in 2019 exceeding men by 6.1%. However, little is known regarding the subpopulation of pregnant women especially in Kuala Lumpur which is the most urbanized and highly populated city in Malaysia. Therefore, the aim of this study is to measure the physical inactivity prevalence among first trimester pregnant women in Kuala Lumpur and to identify its determining factors. METHODS This was a cross-sectional study in which 339 first trimester pregnant women were sampled from 13 maternal and child health clinics located in all four parliament districts of Kuala Lumpur. Self-administered questionnaires which contained the Malay version of the pregnancy physical activity questionnaire (PPAQ) were used. Descriptive analysis was conducted to determine the physical inactivity prevalence followed by simple and multiple logistic regression to identify the determinants of physical inactivity with significant level of 5%. RESULTS The prevalence of physical inactivity was 38.3%. The highest activity was seen in the household activity domain, despite only 24.8% of the respondents were housewives/unemployed. There was little to no participation observed in the vigorous intensity category. The determinants of physical inactivity were primigravida (aOR 3.54 95% CI 1.40, 8.97), education level (aOR 3.77 95% CI 1.35, 10.52) and body mass index (aOR 0.88 95% CI 0.80, 0.97) which explained 22.6% variation of physical inactivity in the final adjusted model. CONCLUSION The prevalence of physical inactivity among first trimester pregnant mothers in this study was 38.3%, and the highest activity was seen in the household category. Health education on physical activity in pregnancy should be focused on those who are primigravida and have no tertiary education. The educational content should be updated and tailored to current pandemic situation where self-isolation is the new norm, by advocating for home-based, moderate to vigorous intensity physical activities.
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Affiliation(s)
- Sharifah Fazlinda Syed Nor
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Batu 9 Cheras, 56000, Wilayah Persekutuan Kuala Lumpur, Malaysia
- Training Management Division, Ministry of Health Malaysia, Kompleks E, Pusat Pentadbiran Kerajaan Persekutuan, 62590, Wilayah Persekutuan Putrajaya, Malaysia
| | - Idayu Badilla Idris
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Batu 9 Cheras, 56000, Wilayah Persekutuan Kuala Lumpur, Malaysia.
| | - Zaleha Md Isa
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Batu 9 Cheras, 56000, Wilayah Persekutuan Kuala Lumpur, Malaysia
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Li Q, Zhu Y, Wang J, Zhang Y, Pan Y, Gu R, Guo X, Wei L. Sedentary behaviors and gestational diabetes mellitus: A systematic review. J Obstet Gynaecol Res 2021; 48:285-299. [PMID: 34750937 DOI: 10.1111/jog.15090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 10/07/2021] [Accepted: 10/23/2021] [Indexed: 11/27/2022]
Abstract
AIM Sedentary behaviors are activities that expend less energy than 1.5 metabolic equivalents, such as watching TV, sitting. We aim to systematically review the evidence to determine the association of sedentary behavior (SB) with the risk of gestational diabetes mellitus, and the associations of SB with health outcomes in pregnant women with gestational diabetes mellitus (GDM) and women at high risk of gestational diabetes mellitus. METHODS Two researchers independently performed a literature search using PubMed, Medline, EMBASE, CINAHL, the Cochrane Library, the Rehabilitation and Sports Medicine Source, and the Sedentary Behavior Research Database for studies published up to January 27, 2021. Randomized controlled trials, quasi-experimental studies, and observational studies were screened and selected if SB was assessed in the context of gestational diabetes mellitus. Two reviewers extracted the relevant information and independently assessed the included studies for quality and bias. RESULTS Eighteen studies were included, involving 60 804 patients, and the timeline of the original study included was from 2006 to 2021. Our review showed that SB before pregnancy was not associated with the risk of gestational diabetes mellitus, while SB during pregnancy was uncertain about the risk of gestational diabetes mellitus. In addition, there were significant associations between SB time and metabolic outcomes. In addition, SB may cause some adverse maternal and fetal outcomes. CONCLUSION SB is likely to be the intermediary variable between occurrence of GDM and adverse maternal and infant outcome, rather than a direct influencing factor. Limited by the quantity and quality of included studies, the above conclusions need to be verified by more high-quality studies.
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Affiliation(s)
- Qianqian Li
- Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yuan Zhu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jingyuan Wang
- Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yan Zhang
- Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yueshuai Pan
- Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ruting Gu
- Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xiaojing Guo
- Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lili Wei
- Department of Nursing, The Affiliated Hospital of Qingdao University, Qingdao, China
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Silva-Jose C, Sánchez-Polán M, Diaz-Blanco Á, Coterón J, Barakat R, Refoyo I. Effectiveness of a Virtual Exercise Program During COVID-19 Confinement on Blood Pressure Control in Healthy Pregnant Women. Front Physiol 2021; 12:645136. [PMID: 33776798 PMCID: PMC7988209 DOI: 10.3389/fphys.2021.645136] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 02/17/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The situation caused by COVID-19 has led to movement restrictions for the majority of the population due to the confinement established by the health authorities. This new situation has changed people's habits and significantly affected the pregnant population. Decreased exercise and increased psychophysical stress are associated with excessive weight gain, diabetes, and gestational cardiovascular complications that affect the mother, fetus, and newborn. Recent research shows that the dynamics of maternal blood pressure is one of the most important control factors during pregnancy. Thus, prevention of these type of pathologies through interventions without maternal-fetal risks is important. OBJECTIVES To examine the influence of a virtual exercise program on maternal blood pressure during pregnancy. MATERIALS AND METHODS A randomized clinical trial design was used (NCT04563065). Data from 72 pregnant women without obstetric contraindications under confinement conditions in the Madrid area were collected. Women were randomly assigned to the intervention (IG) or control group (CG). They previously signed informed consent forms. A moderate exercise program was performed as an intervention from 8-10 to 38-39 weeks of pregnancy. Systolic (SBP) and diastolic (DBP) maternal blood pressure were measured during the first, second and third trimesters of pregnancy, as well as before and immediately after delivery in both study groups. RESULTS No differences in systolic and diastolic blood pressure during the first, second and third trimesters were found between groups. Significant differences in SBP were found immediately before delivery (IG = 119.83 ± 10.16 vs. CG = 125.6 ± 10.91; p = 0.047) and immediately after delivery (IG = 115.00 ± 11.18 vs. CG = 122.24 ± 15.71; p = 0.045). CONCLUSIONS Results show lower SBP values for the IG during delivery than CG. A virtual exercise program throughout pregnancy during COVID-19 confinement can help to control systolic blood pressure before and immediately after delivery in healthy pregnant women.
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Affiliation(s)
- Cristina Silva-Jose
- Actividad Físico-Deportiva en Poblaciones Específicas (AFIPE) Research Group, Facultad de Ciencias de la Actividad Física y el Deporte, Universidad Politécnica de Madrid, Madrid, Spain
| | - Miguel Sánchez-Polán
- Actividad Físico-Deportiva en Poblaciones Específicas (AFIPE) Research Group, Facultad de Ciencias de la Actividad Física y el Deporte, Universidad Politécnica de Madrid, Madrid, Spain
| | - Ángeles Diaz-Blanco
- Servicio de Obstetricia y Ginecología, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - Javier Coterón
- Actividad Físico-Deportiva en Poblaciones Específicas (AFIPE) Research Group, Facultad de Ciencias de la Actividad Física y el Deporte, Universidad Politécnica de Madrid, Madrid, Spain
| | - Ruben Barakat
- Actividad Físico-Deportiva en Poblaciones Específicas (AFIPE) Research Group, Facultad de Ciencias de la Actividad Física y el Deporte, Universidad Politécnica de Madrid, Madrid, Spain
| | - Ignacio Refoyo
- Actividad Físico-Deportiva en Poblaciones Específicas (AFIPE) Research Group, Facultad de Ciencias de la Actividad Física y el Deporte, Universidad Politécnica de Madrid, Madrid, Spain
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Rand BG, Johnson TM, Ehrlich SF, Wideman L, Pivarnik JM, Richardson MR, Stone ML, Churilla JR. Diabetes risk status and physical activity in pregnancy: U.S. BRFSS 2011, 2013, 2015, 2017. BMC Pregnancy Childbirth 2020; 20:743. [PMID: 33256646 PMCID: PMC7708155 DOI: 10.1186/s12884-020-03434-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 11/17/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Pregnant women without complications are advised to engage in physical activity (PA) to mitigate adverse outcomes. Differences may exist among pregnant women of diverging diabetes status in meeting national PA recommendations. We sought to examine differences in aerobic activity (AA) and muscle strengthening activity (MSA) by diabetes risk status (DRS) among pregnant women in the United States. METHODS The sample (n = 9,597) included pregnant women, age 18-44 years, who participated in the 2011, 2013, 2015, and 2017 Behavioral Risk Factor Surveillance System. Levels of DRS include: no diabetes (ND), high risk for diabetes (HRD) due to self-reported gestational diabetes or pre-diabetes, and overt diabetes due to self-reported, clinically diagnosed diabetes (DM). Odds ratios (ORs) and 95% confidence intervals (CI) for meeting PA recommendations were obtained. Covariates included age, race, education, household child count, alcohol consumption, and smoking status. RESULTS Findings revealed that on average, DM had 46.5 fewer minutes of weekly AA compared to ND. Furthermore, a significantly lower OR (0.39; CI 0.19-0.82) for meeting both recommendations was observed in DM as compared to ND after adjustment. CONCLUSIONS We observed that pregnant women with overt diabetes had a lower odds of engaging in PA, while those at high risk were similar in their PA engagement to ND. Future studies aimed at assessing determinants of PA behavior may help guide efforts to promote exercise in pregnant women with diabetes.
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Affiliation(s)
| | | | | | - Laurie Wideman
- University of North Carolina at Greensboro, Greensboro, NC, USA
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