Perception and Reality: The Mismatch Between Absolute and Relative Physical Activity Intensity During Pregnancy and Postpartum in United States Women

Overview

Journal Prev Med

Specialty Public Health

Date 2024 Apr 7

PMID 38583604

Authors

Kathryn R Hesketh

Fang Wen

Amy H Herring

Anna Maria Siega-Riz

Kelly R Evenson

Affiliations

Soon will be listed here.

Abstract

Objective: To explore whether a mismatch between absolute physical activity intensity (PAI) and relative self-reported PAI exists during pregnancy and postpartum.

Methods: Women from the PIN3/Postpartum study completed physical activity questionnaires during pregnancy (n = 770; Trimester 2: T2, Trimester 3: T3) and postpartum (n = 181; 3 months: PP3, 12 months PP12) (2001-2005). Activities women engaged in were assigned Metabolic Equivalent (MET) values for absolute intensity; women self-reported perceived exertion (using the Borg scale) for each activity to provide relative intensity. Hierarchical regression models were used to determine whether a mismatch between absolute and relative PAI (for moderate or vigorous physical activity (MPA; VPA)) differed during pregnancy and postpartum. Models were adjusted for socio-demographic factors.

Results: Women commonly overestimated the amount of MPA and VPA they engaged in [T2 MPA mean 60.5 min/week (49.1, 72.0), VPA 3.7 (-1.4, 8.8); T3: MPA 47.7 (38.9, 56.4), 2.9 (-1.7, 7.4); PP3: MPA 69.5 (43.9, 95.1), VPA 15.8 (1.8, 29.7); PP12: MPA 42.20 (26.8, 57.6), VPA 2.75 (-7.8, 12.9)]. Women overestimated both MPA and VPA to a lesser extent at T3 compared to T2 (MPA: β for difference:-12.6 [95%CI: -26.0, -0.9]; VPA: -0.9 [-6.4, 4.6]). Women continued to overestimate their MPA at PP3 and PP12.

Conclusions: Compared to absolute PAI, perceived PAI was greater for MPA compared to VPA and differences persisted from pregnancy through postpartum. Future research should focus on how perceptions relate to women's actual physiological capacity and whether this mismatch influences the amount of physical activity women engage in during the transition to motherhood.

References

Ainsworth B, Haskell W, Herrmann S, Meckes N, Bassett Jr D, Tudor-Locke C . 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011; 43(8):1575-81. DOI: 10.1249/MSS.0b013e31821ece12. View

Marshall M, Montoye A, Conway M, Schlaff R, Pfeiffer K, Pivarnik J . Location, Location, Location: Accelerometer Placement Affects Steps-Based Physical Activity Outcomes During Pregnancy and Postpartum. Am J Lifestyle Med. 2023; 17(1):123-130. PMC: 9830244. DOI: 10.1177/15598276211030472. View

Evenson K, Wen F . Measuring physical activity among pregnant women using a structured one-week recall questionnaire: evidence for validity and reliability. Int J Behav Nutr Phys Act. 2010; 7:21. PMC: 2855515. DOI: 10.1186/1479-5868-7-21. View

Davenport M, Ruchat S, Sobierajski F, Poitras V, Gray C, Yoo C . Impact of prenatal exercise on maternal harms, labour and delivery outcomes: a systematic review and meta-analysis. Br J Sports Med. 2018; 53(2):99-107. DOI: 10.1136/bjsports-2018-099821. View

Meah V, Davies G, Davenport M . Why can't I exercise during pregnancy? Time to revisit medical 'absolute' and 'relative' contraindications: systematic review of evidence of harm and a call to action. Br J Sports Med. 2020; 54(23):1395-1404. DOI: 10.1136/bjsports-2020-102042. View

Borg G . Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982; 14(5):377-81. View

Siega-Riz A, Herring A, Carrier K, Evenson K, Dole N, Deierlein A . Sociodemographic, perinatal, behavioral, and psychosocial predictors of weight retention at 3 and 12 months postpartum. Obesity (Silver Spring). 2009; 18(10):1996-2003. PMC: 2902688. DOI: 10.1038/oby.2009.458. View

Pivarnik J, Lee W, Miller J . Physiological and perceptual responses to cycle and treadmill exercise during pregnancy. Med Sci Sports Exerc. 1991; 23(4):470-5. View

Evenson K, Wen F . National trends in self-reported physical activity and sedentary behaviors among pregnant women: NHANES 1999-2006. Prev Med. 2010; 50(3):123-8. DOI: 10.1016/j.ypmed.2009.12.015. View

10.

Canning K, Brown R, Jamnik V, Salmon A, Ardern C, Kuk J . Individuals underestimate moderate and vigorous intensity physical activity. PLoS One. 2014; 9(5):e97927. PMC: 4024007. DOI: 10.1371/journal.pone.0097927. View

11.

Cohen S, Kamarck T, Mermelstein R . A global measure of perceived stress. J Health Soc Behav. 1983; 24(4):385-96. View

12.

Borodulin K, Evenson K, Herring A . Physical activity patterns during pregnancy through postpartum. BMC Womens Health. 2009; 9:32. PMC: 2784751. DOI: 10.1186/1472-6874-9-32. View

13.

Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A . Physiological changes in pregnancy. Cardiovasc J Afr. 2016; 27(2):89-94. PMC: 4928162. DOI: 10.5830/CVJA-2016-021. View

14.

Hesketh K, Evenson K . Prevalence of U.S. Pregnant Women Meeting 2015 ACOG Physical Activity Guidelines. Am J Prev Med. 2016; 51(3):e87-9. PMC: 4982752. DOI: 10.1016/j.amepre.2016.05.023. View

15.

Lane-Cordova A, Jerome G, Paluch A, Bustamante E, LaMonte M, Pate R . Supporting Physical Activity in Patients and Populations During Life Events and Transitions: A Scientific Statement From the American Heart Association. Circulation. 2021; 145(4):e117-e128. DOI: 10.1161/CIR.0000000000001035. View

16.

Wilcox S, Irwin M, Addy C, Stolarczyk L, Ainsworth B, Whitt M . Agreement between participant-rated and compendium-coded intensity of daily activities in a triethnic sample of women ages 40 years and older. Ann Behav Med. 2002; 23(4):253-62. DOI: 10.1207/S15324796ABM2304_4. View

17.

Evenson K, Goto M, Furberg R . Systematic review of the validity and reliability of consumer-wearable activity trackers. Int J Behav Nutr Phys Act. 2015; 12:159. PMC: 4683756. DOI: 10.1186/s12966-015-0314-1. View

18.

. ACOG Committee Opinion No. 650: Physical Activity and Exercise During Pregnancy and the Postpartum Period. Obstet Gynecol. 2015; 126(6):e135-e142. DOI: 10.1097/AOG.0000000000001214. View

19.

. American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc. 1998; 30(6):975-91. DOI: 10.1097/00005768-199806000-00032. View

20.

Melzer K, Schutz Y, Boulvain M, Kayser B . Physical activity and pregnancy: cardiovascular adaptations, recommendations and pregnancy outcomes. Sports Med. 2010; 40(6):493-507. DOI: 10.2165/11532290-000000000-00000. View