Research articlePredictors of Change in Physical Activity During and After Pregnancy: Project Viva
Introduction
Physical activity during and following pregnancy may have beneficial effects on postpartum weight retention and related health outcomes.1, 2, 3, 4 Few studies have been conducted on the longitudinal changes in physical activity from prepregnancy to the postpartum period. Although physical activity levels appear to decline during pregnancy, the magnitude and persistence of this decline during the postpartum period are unclear.5, 6, 7, 8 Furthermore, the determinants of these changes in physical activity during and following pregnancy have not been identified.
Growing interest in the social ecologic framework as the basis for investigating determinants of physical activity centers on understanding individual, interpersonal, and environmental influences.9, 10, 11, 12, 13 During and after pregnancy, individual factors could include perceived lack of time and energy, physical health, and competing priorities; interpersonal factors could include availability of child care; and environmental factors could include availability of places to exercise.14 Several authors have underscored the paucity of evidence on influences on activity from well-designed, prospective studies11, 15 and there is a particular lack of such data in the postpartum period, a potentially critical period for the development of obesity.16
The purpose of this analysis was to assess the magnitude of changes in physical activity during and after pregnancy, and to identify potential individual, social, and environmental factors that may predict changes in physical activity during and after pregnancy.
Section snippets
Methods
Project Viva is a cohort study of pregnant women and their offspring enrolled in a multisite group medical practice in the area surrounding Boston, Massachusetts, with the goal of examining the roles of prenatal factors in outcomes of pregnancy and infancy.17 This study included all eligible pregnant women in eight selected health centers, unrestricted by age or race. It excluded patients who did not obtain their initial prenatal visit within the first 22 weeks of gestation, those with multiple
Results
Table 1 includes the characteristics of the sample before, during, and after pregnancy. Most women were in their 30s, 34% were overweight or obese before pregnancy, and 24% were nonwhite. The relatively high educational level and household income are reflective of this health-insured population. Approximately 8% to 9% of women were depressed during either time period. The percentage of women working equal to or greater than 35 hours per week was 60% during the second trimester and 30% at 6
Discussion
Declines were observed in total physical activity during pregnancy that persisted to some degree at 6 months postpartum. Self-reported total physical activity declined, on average, by 2.7 hours per week during pregnancy, and remained 1.4 hours per week below prepregnancy levels at 6 months postpartum. An exception to this pattern was time spent walking, as walking at 6 months postpartum was similar to that reported for the prepregnancy period. The decline in physical activity during pregnancy
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