title: Physical activity and hypertensive complications during pregnancy: findings from 2004 to 2006 North Carolina Pregnancy Risk Assessment Monitoring System.
abstract: BACKGROUND
  Hypertensive complications during pregnancy occur in nearly 8 percent of pregnancies and account for 15 percent of all maternal mortalities in the United States. The purpose of this study was to investigate further the association between physical activity and hypertensive complications during pregnancy using data from a population-based surveillance system.
  
  
  METHODS
  This study included 3,348 participants from the 2004 to 2006 North Carolina Pregnancy Risk Assessment Monitoring System. Hypertensive complications during pregnancy were assessed using birth certificate data, and physical activity levels before pregnancy and during pregnancy were self-reported on questionnaires. Multivariate logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) while controlling for confounders.
  
  
  RESULTS
  Although no strong association was found between physical activity before pregnancy and hypertensive complications during pregnancy, a dose-response relationship emerged for the physical activity during pregnancy-hypertensive complications association after adjustment for prepregnancy body mass index (physical activity for 1-4 days per week: OR=0.63, 95% CI: 0.45-0.90; physical activity for 5+ days per week: OR=0.46, 95% CI: 0.20-1.02). When levels of physical activity before and during pregnancy were combined, a statistically significant protective effect was seen only for women who indicated that they were physically active both before and during pregnancy (adjusted OR=0.65, 95% CI: 0.44-0.96).
  
  
  CONCLUSIONS
  In this population-based study, physical activity, particularly during pregnancy, was associated with a lower risk of hypertensive complications during pregnancy. During a healthy pregnancy, health care practitioners may recommend that women engage in physical activity as one way to potentially prevent the development of this critical condition.
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina 27599, USA.
authors.forename: Chantel L
authors.initials: CL
authors.lastname: Martin
authors.forename: Larissa R
authors.initials: LR
authors.lastname: Brunner Huber
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D016001:Confidence Intervals; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology / Q000517:prevention & control; D016015:Logistic Models; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000706:statistics & numerical data; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D011159:Population Surveillance; D011247:Pregnancy; D018570:Risk Assessment / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires