title: Trends in health-related behavioral risk factors among pregnant women in the United States: 2001-2009.
abstract: BACKGROUND
  Unhealthy lifestyle behaviors during pregnancy often predispose women to multiple risks including adverse pregnancy outcomes and impaired health status for mothers. This study assessed the trends in the prevalence of health-related behavioral risk factors over time among U.S. pregnant women.
  
  
  METHODS
  Data from 22,604 pregnant women aged 18-44 years who participated in the 2001-2009 Behavioral Risk Factor Surveillance System were analyzed to assess the trends in the prevalence of behavioral risk factors. Correlates of having individual or clustering healthy behaviors were also assessed among 2295 pregnant women in the 2009 survey.
  
  
  RESULTS
  From 2001 to 2009, among pregnant women, the age-adjusted prevalence of engaging in leisure-time exercise and receiving influenza vaccination increased significantly (p<0.05 for linear trends); the prevalence of any alcohol consumption decreased marginally (p=0.065 for linear trend); and the prevalence of binge drinking, smoking, and consuming fruits and vegetables ≥5 times/day varied little. Over the 9 years, the percentages of pregnant women who reported having all four healthy behaviors (i.e., not currently smoking, no alcohol consumption, engaging in leisure-time exercise, and receiving influenza vaccination) increased linearly from 7.3% in 2001 to 21.2% in 2009 (p<0.001). Sociodemographic characteristics, perceived health status, and health-care availability were differentially associated with certain individual or clustered healthy behaviors.
  
  
  CONCLUSIONS
  Increased efforts emphasizing multiple health-related behavioral risk factors including reducing alcohol use, binge drinking, and smoking and improving fruit and vegetable consumption during pregnancy are needed.
authors: Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. gzhao@cdc.gov
authors: Guixiang
authors: G
authors: Zhao
authors: Earl S
authors: ES
authors: Ford
authors: James
authors: J
authors: Tsai
authors: Chaoyang
authors: C
authors: Li
authors: Indu B
authors: IB
authors: Ahluwalia
authors: William S
authors: WS
authors: Pearson
authors: Lina S
authors: LS
authors: Balluz
authors: Janet B
authors: JB
authors: Croft
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D040343:Behavioral Risk Factor Surveillance System; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006305:Health Status Indicators; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D008019:Life Style; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D015995:Prevalence; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012309:Risk-Taking; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D016387:Women's Health