Maternal sedentary behavior and physical activity levels in early to mid-pregnancy and obstetric outcomes: a cohort study

This Swedish cohort study aimed to evaluate if early to mid-pregnancy sedentary behavior and physical activity levels affect the risk of adverse outcomes like gestational hypertension, preeclampsia (including subtypes), gestational diabetes mellitus, labor dystocia, mode of delivery, and severe postpartum hemorrhage. Activity patterns were measured by accelerometers during seven consecutive days in 1405 women between 2016 and 2023. Logistic regression analyses adjusted for BMI, age, smoking, parity, country of birth, pre-pregnancy disease, and year of participation were performed. The accelerometer could not detect light physical activity; why only moderate and vigorous physical activity were included in the analyses. Compared with women being least sedentary, women with the highest proportion of sedentary behavior had higher adjusted odds of any preeclampsia (AOR 3.22, 95% CI 1.44-7.16), with a tendency of higher odds of severe or preterm preeclampsia (AOR 9.84, 95% CI 1.05-92.66 and AOR 5.61, 95% CI 1.04-30.23, respectively). The most physically active women had lower odds of any preeclampsia (AOR 0.22, 95% CI 0.10-0.50) than the least physically active, and the odds seemed lowest for the more severe subtypes. There were no associations with other obstetric outcomes. In conclusion, sedentary behavior and physical activity in early to mid-pregnancy might affect likelihood of preeclampsia, also after adjustment of confounders such as BMI.