Abstract MP096: Patterns of Physical Activity Across Pregnancy and Their Association With Adverse Pregnancy Outcomes
Background: Cardiovascular disease (CVD) is the leading cause of death among women, and pregnancy complications reveal risk decades before overt CVD. While physical activity is related to CVD, less is known about how the activity patterns during pregnancy may contribute to adverse pregnancy outcomes.
Hypothesis: Increasing activity across pregnancy is related to reduced risk of adverse pregnancy outcomes.
Methods: Nulliparous women were enrolled at 8 centers early in pregnancy (n=10,020). Frequency and duration of up to three leisure activities reported in the first, second and third trimester were analyzed as metabolic equivalents (METs). Growth mixture modeling was used to identify activity patterns in pregnancy. Adverse outcomes (preterm birth [PTB], hypertensive disease of pregnancy [HDP], and gestational diabetes [GDM]) were collected by chart abstraction.
Results: Four patterns of activity across pregnancy were identified: sustained high (3%, n=297); increasing (12%, n=1231); sustained low (77%, n=7717); and decreasing (8%, n=775; Figure). Women with sustained low activity were younger and more likely to be black or Hispanic, obese, or to have smoked prior to pregnancy when compared to those with increasing activity. Women with sustained low vs. increasing activity had higher rates of PTB (9.2 vs. 6.2%), HDP (13.8 vs. 10.5%), and GDM (4.7 vs. 2.5%; all p <0.01). After adjusting for maternal factors (age, race/ethnicity, BMI and smoking), the risk of GDM remained higher in women with sustained low activity compared with those having increasing activity patterns (adjusted OR 1.79 [1.21, 2.66]). Sustained low activity was also associated with higher risk of PTB (adjusted OR 1.36 [1.05, 1.76]).
Conclusion: The majority of women have sustained low activity across pregnancy, and this is independently associated with higher risks of GDM and PTB. These associations raise the possibility that increased activity during pregnancy may improve pregnancy outcomes, and perhaps long-term maternal cardiovascular health.
Author Disclosures: J.M. Catov: None. C.B. Parker: None. B.B. Gibbs: None. C. Bann: None. B. Carper: None. W.A. Grobman: None.
- © 2017 by American Heart Association, Inc.