Background: Rates of cesarean delivery continue to increase among Hispanics, the largest minority group in the United States. Prior studies of the relationship between physical activity and cesarean delivery have been conflicting, limited by questionnaires not validated for pregnancy, and conducted primarily among non-Hispanic whites. Methods: We evaluated this association among participants (n = 1313) in Proyecto Buena Salud, a prospective cohort of Hispanic women conducted from 2006 to 2011. Physical activity was measured via the Pregnancy Physical Activity Questionnaire. Results: In total, 320 (24.4%) participants delivered via cesarean. In multivariable analyses, increasing levels of sedentary activity in mid/late pregnancy were associated with higher odds of cesarean delivery (odds ratio = 1.54; 95% confidence interval, 1.02–3.33; P trend = .05); however, there were no clear patterns between physical activity and cesarean delivery. When we repeated the analysis excluding planned cesarean deliveries (n = 126), high levels of prepregnancy moderate-intensity physical activity (odds ratio = 0.61; 95% confidence interval, 0.38–0.99) and increasing moderate-intensity physical activity in mid/late pregnancy (P trend = .03) were associated with reduction in odds. Increasing levels of household/caregiving physical activity in pre and mid/late pregnancy were associated with a 50% reduction in odds (P trend < .05). Conclusions: In this prospective cohort of Hispanics, sedentary activity increased odds of cesarean delivery, and moderate-intensity and household/caregiving physical activity reduced odds of unplanned cesarean deliveries.
Lindsey M. Russo, Megan W. Harvey, Penelope Pekow, and Lisa Chasan-Taber
Lisa Chasan-Taber, Marushka Silveira, Bess H. Marcus, Barry Braun, Edward Stanek, and Glenn Markenson
Physical activity during pregnancy is associated with reduced risk of adverse maternal and fetal outcomes. However, the majority of pregnant women are inactive and interventions designed to increase exercise during pregnancy are sparse. We evaluated the feasibility and preliminary efficacy of an exercise intervention among a diverse sample of pregnant women.
The B.A.B.Y. (Behaviors Affecting Baby and You) Study is conducted at a large tertiary care facility in Western Massachusetts. We randomized 110 prenatal care patients (60% Hispanic) to an individually tailored 12-week exercise intervention arm (n = 58) or to a health and wellness control arm (n = 52) at mean = 11.9 weeks gestation. Physical activity was assessed via the Pregnancy Physical Activity Questionnaire (PPAQ).
After the 12-week intervention, the exercise arm experienced a smaller decrease (−1.0 MET-hrs/wk) in total activity vs. the control arm (−10.0 MET-hrs/wk; P = .03), and a higher increase in sports/exercise (0.9 MET-hrs/wk) vs. the control arm (−0.01 MET-hrs/wk; P = .02). Intervention participants (95%) reported being satisfied with the amount of information received and 86% reported finding the study materials interesting and useful.
Findings support the feasibility and preliminary efficacy of a tailored exercise intervention in increasing exercise in a diverse sample of pregnant women.