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Maternal daily activity in low risk pregnancy: a longitudinal study
thesis
posted on 2010-12-07, 10:22 authored by Penny E. ClarkeA review of the scientific literature revealed a lack of information regarding the integrated
daily activity levels of low-risk pregnant women in contemporary Western society. A
prospective, longitudinal study was therefore undertaken to (i) assess the impact of low-risk
pregnancy on the daily activity levels of healthy, British primigravid women and (ii) examine
the relationship between total maternal daily activity level and pregnancy outcome. The best
combination of methods to measure daily activity levels during pregnancy was considered to
be a subjective self-report measure used in conjunction with an objective ambulatory activity
monitor. These methods were developed and were demonstrated to be both reliable and valid
in non-pregnant women. However, the study identified some unique problems in using
activity monitors in pregnant women. These problems emanated both from women's
reluctance to wear an activity monitor when pregnant and from a need to measure extremely
low levels of activity in late gestation.
Both data from the ambulatory monitor and the new activity questionnaire demonstrated a
overall decrease in mean maternal daily activity levels between 25 & 38 weeks gestation
(n=51; p<0.01). This decline masked different maternal responses in different activity
domains. The mean occupational activity ratios of women working full-time declined
steadily between 16 & 34 weeks gestation (n=25, p<0.01). Women's working hours and the
more flexible elements of their work were reduced whilst the frequency of work breaks
increased. Between 25 & 38 weeks gestation, mean recreational activity ratios also declined
(n=50, p<0.05). Participation in structured sports and exercise ceased and increasing
amounts of time were spent within the home. In contrast, mean overall domestic activity
ratios were maintained. Between 16 & 38 weeks gestation mean nocturnal activity ratios
increased steadily (n=47; p=0.01) To maintain waking activity during pregnancy, women
actively engaged in a number of different balancing strategies. These strategies comprised
monitoring, prioritising, pacing and forward planning.
Despite the changes that occurred in maternal activity behaviour, one of the strongest and
most consistent predictors of maternal activity behaviour during pregnancy was that of
maternal activity behaviour prior to pregnancy. Occupational activity levels pre-pregnancy
were independently associated with maternal daily activity levels at 12,16 & 25 weeks
gestation (p=0.004-0.020). Self-efficacy was the only significant predictor of the change in
maternal daily activity levels between 25 & 38 weeks gestation (p=0.013). The women who
reduced their activity the most were likely to be those individuals who had more difficulty in
overcoming perceived barriers to physical activity participation. Five main barriers to
physical activity were identified: (i) the physical symptoms of pregnancy (ii) the effect of
outside influences (iii) a lack of motivation (iv) a low maternal body image and (v) a lack of
time and/or appropriate facilities.
Findings suggested that maternal daily activity may impact significantly on pregnancy
outcome. Higher maternal daily activity at 16 weeks gestation was independently associated
with a lower incidence of emergency caesarean section (p<0.05). Higher maternal daily
activity at 38 weeks gestation was independently associated with a higher incidence of an
induction of labour (p<0.05). Total daily activity at 25 & 34 weeks gestation was
independently and negatively associated with infant birthweight (p<0.05).
History
School
- Design and Creative Arts
Department
- Design
Publisher
Loughborough UniversityRights holder
© P.E. ClarkePublication date
2001Notes
A Doctoral Thesis. Submitted in partial fulfillment of the requirements for the award of Doctor of Philosophy of Loughborough University.EThOS Persistent ID
uk.bl.ethos.394879Language
- en
Supervisor(s)
Harriet GrossQualification name
- PhD
Qualification level
- Doctoral
This submission includes a signed certificate in addition to the thesis file(s)
- I have submitted a signed certificate