Device measured physical activity among women with and without adverse pregnancy outcomes: Data from the HUNT study

Abstract

Background Women with a history of adverse pregnancy outcomes (APOs), including gestational diabetes mellitus (GDM), hypertensive disorders of pregnancy (HDP), small for gestational age (SGA) offspring, preterm birth and placental abruption, are at increased risk of cardiovascular disease (CVD) and diabetes mellitus (DM) later in life. Physical inactivity is a risk factor for developing CVD and DM. Thus, for women with a history of APOs, it is particularly important to achieve recommended levels of physical activity (PA). The aim of this study was to investigate differences in PA levels among women with and without a history of APOs, using accelerometers to objectively measure PA levels. Methods This is a population-based cohort study. Women who participated in the fourth survey of Trøndelag health study (HUNT4) and were registered with one or more births in the Medical Birth Registry of Norway (MBRN) before participation, were included in the study. PA levels were objectively measured with two accelerometers worn by the participants for 3–7 consecutive days. Three different paces of walking, running and cycling were measured by the accelerometers and used to calculate our two outcomes: moderate-vigorous physical activity (MVPA) in metabolic equivalent of task (MET)-minutes/week and total PA in min/day. MVPA included moderate and fast walking, running and cycling, and total PA included additionally slow walking. We used linear and logistic regression to examine the associations between history of APOs and PA levels. Results Among 3771 women, 868 (23.0%) had a history of one or more APOs. We found that women with a history of APOs had lower levels of PA. These differences diminished after accounting for postpartum general health and modifiable lifestyle factors. Among women with and without a history of APOs, respectively 17.7% and 15.9% did not achieve recommended levels of PA. Conclusions There were no significant associations between history of APOs and PA levels in the fully adjusted regression analyses. Nevertheless, almost every fifth woman (15.9–17.7%) did not achieve recommended levels of PA, and postpartum follow up of women with APOs aimed at increasing their PA is important to prevent CVD and DM later in life.