Physical activity and excess weight in pregnancy have independent and unique effects on delivery and perinatal outcomes

• Published in: PloS one Vol. 9; no. 4; p. e94532
• Main Authors: Morgan, Kelly L, Rahman, Muhammad A, Hill, Rebecca A, Zhou, Shang-Ming, Bijlsma, Gunnar, Khanom, Ashrafunnesa, Lyons, Ronan A, Brophy, Sinead T
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01-04-2014; Public Library of Science (PLoS)
• Subjects: Adjustment; Adult; Analysis; Apgar Score; Biology and Life Sciences; Body mass; Body Mass Index; Body size; Body weight; Chronology; Delivery, Obstetric - methods; Delivery, Obstetric - statistics & numerical data; Exercise; Female; Gestation; Gestational age; Health aspects; Humans; Infant, Newborn; Infant, Small for Gestational Age; Length of Stay; Mathematical models; Medical instruments; Medicine and Health Sciences; Models, Statistical; Motor Activity; Obesity; Overweight; Overweight - physiopathology; Parity; Physical activity; Pregnancy; Pregnancy, Complications of; Pregnant women; Prospective Studies; Research and Analysis Methods; Risk factors; Smoking; Social Class; Statistical models; Studies; Surveys and Questionnaires; Womens health; United Kingdom; United Kingdom > UK
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0094532

This study examines the effect of low daily physical activity levels and overweight/obesity in pregnancy on delivery and perinatal outcomes.
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.
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).
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.