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

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 2ndtrimester. 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.

【研究目的】本研究旨在描述低危妊娠女性的身体活动模式，并探究其相关影响因素。【研究方法】本研究为横断面研究，研究样本为2010年于巴西圣保罗州博图卡图市基层卫生保健机构就诊的256名孕中期成年妊娠女性，所有受试者均为随机抽取。采用妊娠身体活动问卷对受试者的身体活动情况进行调研，同时分析职业、通勤、家务及休闲四类活动的时长与强度，以代谢当量/日为单位进行量化。本研究的因变量为妊娠女性的身体活动水平，以及是否达到每周150分钟休闲身体活动的推荐标准。采用稳健方差泊松回归模型结合层级模型，评估上述因变量与社会经济变量、产妇特征、行为因素及卫生保健机构照护模式之间的关联。【研究结果】多数妊娠女性身体活动不足（77.7%），12.5%为中等活动水平，9.8%为高强度活动水平。每日能量消耗最高的活动类型为家务活动，其次为通勤活动。仅10.2%的受试者达到每周150分钟休闲身体活动的推荐标准。在外从事工作会降低达到该推荐标准的概率（比值比OR=0.39，95%置信区间CI：0.16;0.93）。有至少1次分娩史（OR=0.87，95%CI：0.77;0.99）及孕前超重（OR=0.85，95%CI：0.731;0.99）会降低身体活动不足的概率；而健康食物摄入频率较低则会小幅提升该风险（OR=1.18，95%CI：1.02;1.36）。【研究结论】在基层卫生保健机构接受照护的妊娠女性普遍存在身体活动不足的情况。有至少1次分娩史及孕前超重被确定为该现象的保护因素；而健康食物摄入频率较低则为风险因素，提示存在一组健康风险因子集群。