Assessment of Physical Activity Domains During Pregnancy and Their Association With Perinatal Outcomes in Women With Psychiatric Disorders

<b>Background:</b> Pregnant women with psychiatric disorders are vulnerable to mental health decline and obstetric complications. Although physical activity (PA) benefits pregnancy, little is known about how its domains-household, occupational, transport, leisure-manifest in this group and relate to outcomes. This study examined PA patterns across domains and their associations with psychiatric symptom severity and obstetric outcomes. <b>Methods:</b> This cross-sectional subanalysis included 64 pregnant women with psychiatric diagnoses at a public maternity hospital in Brazil. PA was measured using the Pregnancy Physical Activity Questionnaire, diagnosis via SCID-5-CV, and symptom severity with the Clinical Global Impression. Obstetric outcomes came from medical records. Only moderate-to-vigorous PA was analyzed. <b>Results:</b> Most participants (84.6%) met WHO recommendations for weekly PA, mainly through household activities (median: 315 min/week). Leisure, transport, and occupational domains showed minimal activity (median: 0 min/week). Higher household PA was linked to adverse obstetric outcomes (<i>P</i> = 0.009). Leisure-time PA was associated with gestational diabetes (<i>P</i> = 0.003). No significant correlations appeared with psychiatric severity. <b>Conclusion:</b> While overall PA volume met health recommendations, it was predominantly in the domestic sphere. These patterns reflect structural and gender-based vulnerabilities and underscore the importance of context and autonomy in evaluating the health impacts of physical activity during pregnancy in this population.