Factors Affecting Physical Activity During Pregnancy: A PRAMSAnalysis

PURPOSE: To evaluate the characteristics of pregnant patients meeting ACSM physical activity (PA) guidelines in 2019 using the Pregnancy Risk Assessment Monitoring System (PRAMS). METHODS: PRAMS is an on-going population-based surveillance system that collects self-reported information on maternal behaviors and experiences before, during, and after the birth of a live infant. We analyzed the characteristics of 7492 Alabama and Rhode Island women that answered questions about PA before and during pregnancy. Participants reported the number of days per week they “participated in any physical activities or exercise for 30 minutes or more” during the 3 months before pregnancy and during the last 3 months of pregnancy (response options, <1 day/week, 1-2 days/week, 3-4 days/week, >5 days/week). We defined “>5 days/week” as meeting the ACSM guidelines and excluded those who were told not to exercise. Respondent characteristics were obtained from the PRAMS questionnaire and children’s birth certificates, including age, race/ethnicity, education level, marital status, insurance at delivery, number of previous live births, smoking, and pre-pregnancy BMI. All analyses were conducted in SAS Enterprise Guide 7.15. RESULTS: In univariate analyses, age < 24, BMI prior to pregnancy of <18.5, marital status (not married), education (less than or only high school), income <$20000, and having Medicaid insurance were all positively correlated with meeting the ACSM guidelines for exercise (p < 0.05). Interestingly, smoking before and during pregnancy was also weakly connected to meeting the PA guidelines. (p < 0.10). Race, diabetes before pregnancy, prior live births, population density, depression and hypertension were not associated with meeting the PA guidelines. In multivariate analysis, only exercise level prior to pregnancy was significantly associated with meeting ACSM guidelines during pregnancy (5 days/week prior to pregnancy vs. <1/day week: OR = 36.7 (95% CI 21.6-62.2). CONCLUSIONS: Overall, the results of this analysis demonstrate a clear trend of younger, less educated and lower-BMI women having a higher likelihood of meeting the ACSM PA guidelines. When adjusting for all factors, only pre-pregnancy activity level was significantly associated with meeting exercise guidelines during pregnancy.