Physical activity behaviour in overweight and obese pregnant women

PhD ThesisBackground: Increasing physical activity (PA) may help to reduce the risk of obesity related pregnancy complications. However little is known about the amount, type and intensity of PA obese pregnant women engage in, or the most appropriate measurement method. Previous research suggests that obese pregnant women receive limited advice concerning PA from midwives. Objectives: To investigate the amount of PA carried out by this population and how this changes during pregnancy, to compare measurement methods, and to describe the knowledge, attitudes and practice of midwives surrounding PA. Methods: 1. 130 pregnant women, BMI≥25kg/m2, consented to PA measurement at 2 or 3 time points using the Actigraph accelerometer and Recent Physical Activity Questionnaire. 2. Questionnaires were designed and distributed to midwives within 3 NHS Trusts on Tyneside (n=365) with the aim of identifying barriers to discussing and advising PA with obese pregnant women. The design used the Theoretical Domains Framework approach which uses behavioural determinants to investigate implementation difficulties. Results: 1. At 12-16 weeks gestation over half of the participants achieved 30 minutes of moderate or vigorous PA, decreasing by 36 weeks to 24%. Women who were more active at baseline decreased their PA during pregnancy; those who were less active remained so. Self-reported PA also fell but did not correlate with objectively measured PA. 2. Midwives scored highest on knowledge and social-professional role and lowest on skills, capabilities and environment/context/resources domains. Regression analysis indicated that skills and memory/attention/decision domains had a significant influence on discussing PA. Conclusion: Research is needed to find methods to encourage obese women to increase and maintain PA levels before and during pregnancy, and to find the most appropriate PA measurement methods. Midwives feel knowledgeable and believe giving PA advice to be part of their role, but lack skills, capabilities and resources. Strategies to remove such barriers are needed