Factors Associated with Physical Activity Before and During Pregnancy: Analysis of 2016-2019 PRAM Data

Abstract

Pregnant women are encouraged to engage in 150 minutes of physical activity (PA) each week during pregnancy. However, studies show that a significantly low number of women engage in PA during pregnancy. The current study sought to explore the association between intrapersonal and interpersonal factors and engagement in PA before and during pregnancy among women in Alabama and Rhode Island from 2016 to 2019. A cross-sectional study was completed using the Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2016 to 2019 during the most recent survey phase (Phase 8) for the states of Alabama and Rhode Island. Pregnant women who were told by a healthcare provider that they could not engage in PA were excluded from the analysis. A Chi-Square test of independence, point biserial correlation, and a multivariable logistic regression model were used to determine the association between selected intrapersonal and interpersonal variables and PA three months before and during the third trimester of pregnancy. Only 14.6% of the sample met PA guidelines before pregnancy, and only 8.8% of the total sample met the guidelines during pregnancy. Significant univariate associations were found between race, ethnicity, pre-pregnancy BMI, and state of residence and meeting the PA before pregnancy, and maternal age, education level, pre-pregnancy BMI, source of health insurance, and household income and meeting the PA guidelines during pregnancy. There was no significant relationship between interpersonal factors and meeting the PA guidelines before pregnancy, but WIC participation and marital status were significantly associated with meeting the PA guidelines during pregnancy. In the multivariable regression model, maternal race, maternal ethnicity, pre-pregnancy BMI, and state of residence were all significantly associated with meeting the PA guidelines three months before pregnancy. However, pre-pregnancy BMI was the only variable significantly associated with meeting the PA guidelines during pregnancy in the multivariable logistic regression model. No significant interactions were observed between intrapersonal and interpersonal factors and meeting PA guidelines before or during pregnancy. The study's findings support the need for education, awareness programs, and strategies provided by health education specialists and healthcare providers to encourage engagement in PA before and during pregnancy.