Physical activity and excess weight in pregnancy have independent and unique effects on delivery and perinatal outcomes.
BACKGROUND
This study examines the effect of low daily physical activity levels and overweight/obesity in pregnancy on delivery and perinatal outcomes.


METHODS
A prospective cohort study combining manually collected postnatal notes with anonymised data linkage. A total of 466 women sampled from the Growing Up in Wales: Environments for Healthy Living study. Women completed a questionnaire and were included in the study if they had an available Body mass index (BMI) (collected at 12 weeks gestation from antenatal records) and/or a physical activity score during pregnancy (7-day Actigraph reading). The full statistical model included the following potential confounding factors: maternal age, parity and smoking status. Main outcome measures included induction rates, duration of labour, mode of delivery, infant health and duration of hospital stay.


RESULTS
Mothers with lower physical activity levels were more likely to have an instrumental delivery (including forceps, ventouse and elective and emergency caesarean) in comparison to mothers with higher activity levels (adjusted OR:1.72(95%CI: 1.05 to 2.9)). Overweight/obese mothers were more likely to require an induction (adjusted OR:1.93 (95%CI 1.14 to 3.26), have a macrosomic baby (adjusted OR:1.96 (95%CI 1.08 to 3.56) and a longer hospital stay after delivery (adjusted OR:2.69 (95%CI 1.11 to 6.47).


CONCLUSIONS
The type of delivery was associated with maternal physical activity level and not BMI. Perinatal outcomes (large for gestational age only) were determined by maternal BMI.
College of Medicine, Swansea University, Swansea, United Kingdom.
Kelly L
KL
Morgan
College of Medicine, Swansea University, Swansea, United Kingdom.
Muhammad A
MA
Rahman
College of Medicine, Swansea University, Swansea, United Kingdom.
Rebecca A
RA
Hill
College of Medicine, Swansea University, Swansea, United Kingdom.
Shang-Ming
SM
Zhou
Department of Physiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Gunnar
G
Bijlsma
College of Medicine, Swansea University, Swansea, United Kingdom.
Ashrafunnesa
A
Khanom
Institute of Life Sciences, Swansea University, Swansea, United Kingdom.
Ronan A
RA
Lyons
College of Medicine, Swansea University, Swansea, United Kingdom.
Sinead T
ST
Brophy
D000328:Adult; D001034:Apgar Score; D015992:Body Mass Index; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007902:Length of Stay; D015233:Models, Statistical; D009043:Motor Activity; D050177:Overweight / Q000503:physiopathology*; D010298:Parity; D011247:Pregnancy; D011446:Prospective Studies; D012907:Smoking; D012923:Social Class; D011795:Surveys and Questionnaires