Exercise Outcome Expectations And Change In Self-reported Leisure-time Physical Activity From Pre-pregnancy To Early Pregnancy

PURPOSE: Participating in leisure-time physical activity (LTPA) during pregnancy is recommended for maternal-child health. Research suggests many individuals reduce LTPA after becoming pregnant. We hypothesized that greater perceived benefits of exercise would be associated with maintaining LTPA from before to during pregnancy. METHODS: This is a secondary analysis of the Pregnancy 24/7 cohort study. The Exercise Outcome Expectations and Barriers questionnaire assessed three subscales of perceived benefits of exercise: health-related (HR), body image (BI), and psychological (PSCYH). LTPAs were assessed using the Pregnancy Physical Activity Questionnaire (PPAQ) in the first trimester as during pregnancy (past month) and pre-pregnancy (3 months before becoming pregnant). Reported LTPA volumes were summed for total MET min/week of LTPA; ≥500 MET min/week was used as the cut-off for meeting recommendations. Participants were categorized into four LTPA groups: not meeting recommendations pre- or during pregnancy (maintain low), meeting pre- but not during (decreased), meeting during but not pre- (increased), or meeting pre and during (maintain high). Relative risks of change in LTPA category membership by HR, BI, and PSYCH benefit subscale scores were calculated using separate multinomial logistic regressions. Models additionally adjusted for age, site, and education. RESULTS: Analyses included n = 486 pregnant individuals (mean ± SD age: 30 ± 4.6). Categories of LTPA included n = 95 maintaining low, n = 89 decreasing, n = 27 increasing, and n = 276 maintaining high. Those with higher HR, BI, and PSYCH exercise expectation scores were more likely to be in the maintaining high (RR, 95% CI HR: 1.20, 1.10-1.32; BI: 1.08, 1.01-1.15; PSYCH: 1.19, 1.12-1.27) or decreasing (RR, 95% CI HR: 1.13, 1.02-1.26; BI: 1.12, 1.03-1.22; PSYCH: 1.13, 1.05-1.22) LTPA categories versus maintaining low LTPA. Increasing LTPA was not associated with exercise expectations score. CONCLUSIONS: Those with greater perceived benefits of exercise were more likely to achieve LTPA guidelines before and during pregnancy or before pregnancy but not during. Future research should examine the efficacy of promoting exercise expectations before/during pregnancy, and other factors that may explain LTPA decreases after becoming pregnant. Supported by: 1R01HL164662-01A1