title: Perceived barriers to leisure-time physical activity during pregnancy: A literature review of quantitative and qualitative evidence.
abstract: OBJECTIVE
  Identify perceived barriers to leisure-time physical activity during pregnancy to inform future interventions aimed at improving physical activity levels in pregnancy.
  
  
  METHODS
  PubMed/Medline and Web of Science databases were systematically searched using a reference period between 1986 and January/2016.
  
  
  METHODS
  A comprehensive search strategy was developed combining the following keywords: (barriers OR constraints OR perceptions OR attitudes) AND (physical activity OR exercise OR motor activity) AND (pregnancy OR pregnant women OR antenatal OR prenatal). Thematic synthesis was conducted to analyze the data. A socioecological model was used to categorize the reported barriers.
  
  
  RESULTS
  Twelve quantitative studies and 14 qualitative studies were included. Barriers belonging to the intrapersonal level of the socioecological model were the most reported in the studies and were categorized in five themes as follows: (1) Pregnancy-related symptoms and limitations; (2) Time constraints; (3) Perceptions of already being active, (4) Lack of motivation and (5) Mother-child safety concerns. At the interpersonal level, barriers were coded into two descriptive themes: (1) Lack of advice and information and (2) Lack of social support. Two other themes were used to summarize Environmental, Organizational and Policy barriers: (1) Adverse weather and (2) Lack of resources.
  
  
  CONCLUSIONS
  A range of relevant barriers to leisure-time physical-activity engagement during pregnancy were identified in this literature review. Pregnancy-related symptoms and limitations barriers were the most reported in studies, regardless of study design. Mother-child safety concerns, lack of advice/information and lack of social support were also important emphasized pregnancy-related barriers to be targeted in future interventions.
authors.affiliation: Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil. Electronic address: carolinavncoll@gmail.com.
authors.forename: Carolina V N
authors.initials: CV
authors.lastname: Coll
authors.affiliation: Postgraduate Program in Physical Education, Federal University of Pelotas, Brazil.
authors.forename: Marlos R
authors.initials: MR
authors.lastname: Domingues
authors.affiliation: Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil.
authors.forename: Helen
authors.initials: H
authors.lastname: Gonçalves
authors.affiliation: Postgraduate Program in Epidemiology, Federal University of Pelotas, Brazil.
authors.forename: Andréa D
authors.initials: AD
authors.lastname: Bertoldi
mesh_terms: D015444:Exercise; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007899:Leisure Activities; D009042:Motivation; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D036301:Qualitative Research; D012944:Social Support; D013997:Time Factors
keywords: Barriers; Literature review; Motor activity; Physical activity; Pregnancy; Socioecological model