Physical activity in pregnant women receiving care in primary
          health care units

Carvalhaes, Maria Antonieta de Barros Leite; Martiniano, Ana Carolina de Almeida; Malta, Maíra Barreto; Takito, Monica Yuri; Benício, Maria Helena D’Aquino

doi:10.1590/S0034-8910.2013047004689

OBJECTIVE

To describe physical-activity patterns of low-risk pregnant women and investigate associated factors.

METHODS

This is a cross-sectional study based on a sample (n = 256) of adult pregnant women in their 2^ndtrimester. The participants were randomly selected among those attending primary health care units in Botucatu in Sao Paulo State in 2010. Physical activities were investigated by using the pregnancy physical activity questionnaire and by analyzing the time and intensity of the following activities: occupational, commuting, household and leisure, expressed in metabolic equivalents/day. The pregnant women were classified according to their level of physical activity and to achieving 150 minutes/week of leisure physical activities, which were the dependent variables in the study. The association between such variables and socioeconomic variables, maternal characteristics, behavioral factors and the care model in the health care unit was evaluated by Poisson regression models with robust variance and by adopting the hierarchical model.

RESULTS

Most pregnant women were insufficiently active (77.7%); 12.5% were moderately active and 9.8% were vigorously active. The highest daily energy expenditure was in carrying out household activities, followed by commuting activities. Only 10.2% of them followed the recommendation, successfully achieving 150 minutes of leisure physical activities per week. Having a job outside of the home reduced the chance of achieving such recommendation (OR = 0.39, 95%CI 0.16;0.93). Having at least one previous delivery (OR = 0.87, 95%CI 0.77;0.99) and being overweight pre-pregnancy (OR = 0.85, 95%CI 0.731;0.99) reduced the chance of being insufficiently active whereas consuming healthy foods less frequently slightly increased it: OR = 1.18, 95%CI 1.02;1.36.

CONCLUSIONS

Pregnant women who were cared for in primary health care units were insufficiently active. Having at least one previous delivery and being overweight pre-pregnancy were identified as protective factors against such condition. Less frequent intake of healthy foods was found to be a risk factor, therefore suggesting a cluster of health risk factors.

Pregnant Women; Motor Activity; Leisure Activities; Sedentary Lifestyle; Risk Factors; Cross-Sectional Studies

Variable	n	%

Per capita household income (minimum wages)
< 0.5	110	43.0
0.5 to 0.9	103	40.2
1.0 and +	43	16.8
Schooling (years completed)
< 8	55	21.5
8 to 11	183	71.5
12 and +	18	7.0
Working outside of the home
Yes	108	42.2
No	148	57.8
Age (years)
18 to 34	232	90.6
35 and +	24	9.4
Previous births
0	101	39.5
1	83	32.4
2 and +	72	28.1
Pre-pregnancy nutritional status
Underweight	24	9.4
Normal weight	145	56.9
Overweight	62	24.3
Obese	24	9.4
Smoker
Yes	32	12.5
No	224	87.5
Consume alcohol
Yes	14	5.5
No	242	94.5
Model of health care in the unit were prenatal care delivered
Family Health Care Strategy	104	40.6
Traditional	152	59.4

Variable	n	%

Walk in leisure time
Yes	69	26.9
No	187	73.1
Walk quickly in leisure time
Yes	26	10.2
No	230	89.8
Other physical activities in leisure time^a
Yes	15	5.9
No	241	94.1
Managing 150 minutes/week of moderate/vigorous physical activities in leisure time
Yes	26	10.2
No	230	89.8
Level of physical activity
Sedentary/not very active	199	77.7
Moderately active	32	12.5
Vigorously active	25	9.8

Type of activity	Median	p25;p75	Mean	(sd)

Total energy expended^a	20.41	15.5;27.92	22.15	9.50
Home based	9.93	6.20;14.28	10.70	6.02
Commuting	7.20	4.13;11.79	8.75	6.68
Occupational^b	3.79	1.25;10.07	6.38	6.42
Leisure	0.00	0.00;0.34	0.31	0.65
Sedentary	3.00	1.50;6.00	3.81	2.70

Variable/Category	n	Insufficiently active (%)	Raw PR	95%CI	Adjusted PR^a	95%CI

Block 1

Per capita income (MW)			p = 0,650
1.0 and +	43	83.7	1		–	–
0.5 a 0.9	103	74.8	0.96	0.82;1.11	–	–
< 0.5	110	78.2	1.07	0.91;1.26	–	–
Schooling (years)			p = 0.217
≥ 8	201	79.6	1	–	–	–
< 8	55	70.9	0.89	0.74;1.07	–	–
Block 2
Age			p = 0.076
18 to 34	232	79.7	1	–	–	–
35 and +	24	58.3	0.73	0.52;1.03	–	–
Previous births			p = 0.008		p = 0.040
None	101	86.1	1	–	1	–
1 or + births	155	71.7	0.84	0.74;0.96	0.88	0.77;0.99
Pre-pregnancy excess weight			p = 0.039		p = 0.047
No	169	82.3	1	–	1	–
Yes	86	69.8	0.85	0.73;0.99	0.85	0.73;0.99
Block 3
Smoker			p = 0.334
No	224	79.3	1	–	–	–
Yes	32	73.0	0.92	0.78;1.09	–	–
Healthy eating score			p = 0.005		p = 0.023
3^rdtercile	108	68.5	1		1	–
1^stor 2^ndtercile	148	84.5	1.23	1.07;1.43	1.18	1.02;1.36
Unhealthy eating score			p = 0.397
1^sttercile	82	74.4	1	–	–	–
2^ndor 3^rdtercile	174	79.3	1.07	0.92;1.24	–	–
Block 4
Health care model			p = 0.722
Family Health Care Strategy	104	77.0	1	–	–	–
Traditional	152	78.8	1.02	0.90;1.17	–	–

Variable/Category	n	150 min/week of PA in leisure time (%)	Raw PR	95%CI	Adjusted PR^a	95%CI

Block 1

Per capita income (MW)			p = 0.362
1.0 and +	43	7.0	1		–	–
0.5 a 0.9	103	9.7	0.82	0.38;1.79	–	–
< 0.5	110	11.8	0.59	0.18;1.97	–	–
Schooling (years)			p = 0.214
≥ 8	201	11.4	1	–	–	–
< 8	55	5.5	0.48	0.15;1.53	–	–
Working outside of the home			p = 0.048		p = 0.034
No	148	13.5	1	–	1
Yes	108	5.6	0.41	0.17;0.99	0.39	0.16;0.93
Block 2
Age			p = 0.260
18 to 34	232	9.5	1	–	–	–
35 and +	24	16.7	1.75	0.66;4.69	–	–
Previous births			p = 0.821
None	101	10.9		–	–	–
v1 or + births	155	10.0	0.92	0.44;1.92	–	–
Pre-pregnancy excess weight			p = 0.237		p = 0.301
No	169	11.8	1	–	1
Yes	86	7.0	0.59	0.25;1.42	0.63	0.27;1.50
Block 3
Smoker			p = 0.441
No	224	9.3	1	–	–	–
Yes	32	12.5	1.36	0.62;2.98	–	–
Healthy eating score			p = 0.666
3º^rdtercile	108	11.1	1	–	–	–
1^stor 2^ndtercile	148	9.5	0.85	0.41;1.77	–	–
Unhealthy eating score			p = 0.560
1^sttercile	82	8.5	1	–	–	–
2^ndor 3^rdtercile	174	10.9	1.28	0.56;2.93	–	–
Block 4
Health care model			p = 0.854
Family Health Care Strategy	104	9.9	1	–	–	–
Traditional	152	10.6	1.07	0.51;2.24	–	–

Brasil

Brasil

Physical activity in pregnant women receiving care in primary health care units

OBJECTIVE

METHODS

RESULTS

CONCLUSIONS