Prenatal physical activity patterns and determinants in an urban Ecuadorian population
Background & significance. Evidence has accumulated over the past two decades suggesting that healthy pregnant women who engage in regular moderate physical activity (PA) may reduce their risk for certain adverse pregnancy and postnatal health outcomes. The U.S. Department of Health and Human Services (DHHS)/Centers for Disease Control and Prevention (CDC) recently issued the 2008 Physical Activity Guidelines for Americans which recommends at least 150 minutes/week of moderate-intensity aerobic PA for pregnant women. Objectives and hypotheses. The major objectives of the current study were to examine the trimestral PA patterns of urban Ecuadorian women, identify major prenatal PA predictors, and compare reported physical activity with DHHS/CDC (2008) and ACOG (2002) recommendations. It was hypothesized that PA would be similar during 1st and 2nd trimesters but decrease in the 3rd trimester because of increased body mass making movement more difficult. Another a priori hypothesis was that women with more children and those employed outside the home will have higher overall PA but less recreation-derived PA compared to other pregnant women. It was also hypothesized that women will not meet the ACOG (2002) recommendation for moderate-intensity leisure time physical activity but will accumulate an equivalent amount from other activities and will meet the DHSS/CDC (2008) recommendations for pregnant women from the Physical Activity Guidelines for Americans. Methods. The prospective cohort study was conducted in the prenatal clinics of a municipal hospital in Quito, Ecuador. A cohort of 849 apparently healthy women was followed from the 1st through 3rd trimesters. Data on sociodemographic, reproductive/obstetric, lifestyle, common somatic symptoms, and living conditions were collected using a structured questionnaire with open- and closed-ended questions that was administered during the 1st and 2nd trimesters. The intensity or metabolic equivalents (METs) of the different reported activities were obtained from the updated Compendium of Physical Activities which provided an estimate of overall energy expenditure per 24-hour period. Metabolic equivalent hours (MET-hours), a measure of both intensity and duration of specific activities were calculated. Results. Most subjects were aged < 30 years, married, and had completed at least some middle or high school education. Four-tenths were primiparas and only 45% said their current pregnancy was planned. No statistically significant differences were identified for total mean MET’s across trimesters 1-3 (37.4 ± 4 vs. 37.4 ± 3.9 vs. 37.0 ± 4; F=1.1; 3.3). Seventy percent of women’s daily time across all three trimesters was spent in resting/sleeping or in self-care, eating, bathing, dressing, watching TV, reading, and other very low and low intensity activities. Household-related activities (∼16-17%) conducted within the home (e.g., cleaning, cooking), time spent on buses or other transportation (∼6%), household activities performed outside the home such as shopping (2.4%), outside employment (∼2-3%), and caregiving (∼1.1-1.8%) accounted for most of the remainder of time. It was noteworthy that very few women engaged in moderate-vigorous intensity leisure PA during the 1st (8/849), 2nd (3/420), or 3rd trimesters (0/398). Predictors identified for total MET’s for all three trimesters were maternal age, marital status, occupation, and no. of dependents living inside the home. Maternal education, dizziness, and morning sickness were significant predictors of total MET’s only during the first trimester. None of the study women met the ACOG (2002) recommendations for pregnant women due to the reduced recreational opportunities but 40%, 45%, and 44%, respectively met DHHS/CDC (2008) recommendations during the 1st, 2nd, and 3rd trimesters by accumulating moderate intensity PA from other activities. Conclusion. Overall level of PA and activity energy expenditure remained relatively constant over gestation but the amount contributed by different activity categories varied by trimester. Most daily MET expenditures were contributed by lower intensity activities. Only a small handful of women engaged in any recreational PA during the first two trimesters and none during the final trimester. However when contribution of other moderate-intensity activities is taken into account, around 40% of women were able to meet the DHHS/CDC (2008) prenatal PA recommendations. (Abstract shortened by UMI.)
Gonzalez Beltran, Erika, "Prenatal physical activity patterns and determinants in an urban Ecuadorian population" (2009). ETD Collection for University of Texas, El Paso. AAI1473864.