Abstract
BackgroundChina had the second largest proportion of preterm birth (PTB) internationally. However, only 11% of pregnant women in China meet international guidelines for maternal physical activity, a significantly lower proportion than that in Western countries. This study aims to examine the association between outdoor physical exercise during pregnancy and PTB among Chinese women in Wuhan, China.MethodsA case-control study was conducted among 6656 pregnant women (2393 cases and 4263 controls) in Wuhan, China from June 2011 to June 2013. Self-reported measures of maternal physical exercise (frequency per week and per day in minutes) were collected. Adjusted odds ratios were estimated using Bayesian hierarchical logistic regression and a generalized additive mixed model (GAMM).ResultsCompared to women not involved in any physical activity, those who participated in physical exercise 1–2 times, 3–4 times, and over five times per week had 20% (aOR: 0.80, 95% credible interval [95% CI]: 0.68–0.92), 30% (aOR: 0.70, 95% CI: 0.60–0.82), and 32% (aOR: 0.68, 95% CI: 0.59–0.78) lower odds of PTB, respectively. The Bayesian GAMM showed that increasing physical exercise per day was associated with lower risk of PTB when exercise was less than 150 min per day; however, this direction of association is reversed when physical exercise was more than 150 min per day.ConclusionMaternal physical exercise, at a moderate amount and intensity, is associated with lower PTB risk. More data from pregnant women with high participation in physical exercise are needed to confirm the reported U-shape association between the physical exercise and risk of preterm birth.
Highlights
Preterm births (PTB), defined as births that occurred at a gestational age of less than 37 weeks, accounted for approximately 35% of deaths among newborn babies globally in 2016 [1,2,3]
Utilizing matched-case control survey data from preterm and fullterm births in Wuhan, China from June 2011 to June 2013, this study aims to examine the association between maternal physical activity and preterm birth (PTB) and to evaluate the potential dose-response shape of the relationship
Compared to those who did not experience PTB, mothers who experienced PTB tended to participate in significantly less physical exercise during pregnancy, be younger, had newborns that were male, have more than one parity, have less weight gain and more maternal comorbidity
Summary
Preterm births (PTB), defined as births that occurred at a gestational age of less than 37 weeks, accounted for approximately 35% of deaths among newborn babies globally in 2016 [1,2,3]. It is generally recommended that pregnant women maintain an adequate level of physical exercise. The United States Department of Health and Human Services advises pregnant women to participate in at least two and a half hours of aerobic activity per week with moderate-intensity [6]. Being physically active is recommended for pregnant women to maintain overall good health, these guidelines do not explicitly claim that physical activity is directly associated with a decreased risk of PTB. Only 11% of pregnant women in China meet international guidelines for maternal physical activity, a significantly lower proportion than that in Western countries. This study aims to examine the association between outdoor physical exercise during pregnancy and PTB among Chinese women in Wuhan, China
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