Measuring physical activity and sedentary behaviors in pregnancy: a comparison of accelerometry and questionnaires
Date
2015
Type:
Article
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Journal Title
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Publisher
Elsevier
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Abstract
Background: Physical activity (PA) during pregnancy may reduce the risk of maternal and fetal
disorders. Few studies have validated questionnaires for use during pregnancy, a time characterized
by different patterns of activity than nonpregnancy.
Purpose: This study compares PA and Sedentary Behaviors (SB) using two questionnaire methods
with objectively recorded physical activity using accelerometry in primary health care, in a
population with low income and low educational level.
Methods: The design was a longitudinal observational study of SB, PA intensity, type and duration
using subjective and objective measurement methods. The women between 18 and 40 years old
were recruited at primary care health. The Global Physical Activity Questionnaire (GPAQ) and
Pregnancy Physical Activity Questionnaire (PPAQ) were used to measure PA and SB. For objectives
measurement, the women wore accelerometer (ActiGraph GT3X plus) for at least 7 days. The
questionnaires (GPAQ-PPAQ) and accelerometry was measured in three times: first trimester
between 8 and 10 weeks, second between 25 and 29 weeks and third trimester between 34 and 38
weeks gestation.
Results: One hundred twelve women participated. The median (P25–P75) for Age = 26 (22–31)
years, level of education = 12 (10–12) years, BMI = 27.4 (24.3–31.7). The 11% reported being
married, and 63.9% have not work. PA by accelerometry and GPAQ:
•According GPAQ by trimesters was median: 1◦ = 162.8 min/day, 2◦ = 107.1 min/day and 3◦ = 117.9
min/day.
•According accelerometry PA level of moderate or vigorous intensity was median = 0 in all
trimesters.
SB by accelerometry and GPAQ:
• According GPAQ by trimesters was median: 1◦= 180 min/day, 2◦= 240 min/day and 3◦= 240
min/day.
• According accelerometry by trimesters was median: 1◦= 604 min/day, 2◦= 594 min/day and 3◦=
575 min/day.
•The correlation between GPAQ and accelerometry was Spearman’s rho = 0.4, p < 0.01.
PA and SB according PPAQ:
•According PPAQ, energy expenditure associated with PA in each trimesters was median: 1 ◦
= 217 METs/hour/week, 2◦= 181 METs/hour/week and 3◦= 130 METs/hour/week.
•The correlation between energy expenditure PPAQ and accelerometry was Spearman’s rho = 0.3
p= 0.03
• For SB, the correlation between PPAQ and accelerometry was Spearman’s rho = 0.3, p= 0.02.
The decrease in PA according GPAQ and PPAQ during pregnancy is statistically significant p < 0.05.
Conclusion(s): The objective measurement of PA shows that this group does not adhere to the
recommendations PA level according American College of Obstetricians and Gynecologists or World
Health Organization.
Pregnant women overestimated the time spent in physical activities and underestimated the time
spent in sedentary behaviours.
Objective methods should be used where possible in studies measuring physical activity in
pregnancy.
Implications: This study indicates a need for more information and motivation for moderate exercise
throughout pregnancy in this group. The physical therapist is the professional who can and should
do health promotion in this area.
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Citation
Physiotherapy 2015; Volume 101, Supplement 1 eS833–eS1237