Study on the correlation between physical activity during pregnancy and delivery mode in nulliparous patients: A prospective cohort study

Physical activity during pregnancy is a beneficial behavioral intervention that may enhance pregnancy outcomes. However, the association between prenatal physical activity and mode of delivery remains inconsistent. This study aimed to investigate whether physical activity during pregnancy is associated with delivery mode among nulliparous women. We conducted a prospective cohort study including women with singleton pregnancies and no contraindications to physical activity. Physical activity was assessed using the validated Chinese version of the pregnancy physical activity questionnaire, which categorizes and quantifies activities by type and intensity. The primary outcome was mode of delivery. Univariate and multivariate binary logistic regression models were applied to examine associations between prenatal physical activity and cesarean delivery. A total of 217 women participated in the physical activity survey during pregnancy and subsequently gave birth at our hospital. The median energy expenditure from physical activity during pregnancy was 145.70 (111.92, 181.69) MET-h·wk-1. The mean age of the participants was 30.20 ± 3.71 years. Among the 217 primiparas, 131 experienced vaginal deliveries, while 86 underwent cesarean sections. After comprehensive adjustment for covariates, the risk of cesarean delivery was found to be reduced by 60% in the group that adhered to the recommended levels of physical activity during pregnancy compared to the group that did not (odds ratio (OR): 0.40, 95% confidence interval: 0.20-0.83, P = .0130). Elevated levels of physical activity during pregnancy are associated with a reduced risk of cesarean delivery. Physical activity need not be confined to structured exercise programs; routine activities such as cleaning, shopping, and commuting on foot are effective means of increasing energy expenditure and achieving recommended physical activity levels.