Correlates of Physical Activity During Pregnancy: A Systematic Review with Implications for Evidence-based Practice.

Abstract

Numerous attempts have been made to improve women's physical activity participation during pregnancy, but activity levels remain low. To examine systematically the associations of physical activity participation during pregnancy with non-modifiable correlates (not subject to change) and modifiable theoretical correlates of physical activity. This systematic review followed PRISMA (preferred reporting items for systematic review and meta-analysis) guidelines. It includes cross-sectional and longitudinal studies that assessed non-modifiable correlates and modifiable theoretical correlates of physical activity. Five electronic databases were searched for studies published in the English language between 2010 and 2017. An author-developed data collection tool was used to examine selected variables; effect sizes were determined; and study bias was assessed. Ten studies were included in the final review. Overall, effect sizes for non-modifiable correlates of physical activity were small to moderate, except for mental health (d=1.35) and prior physical activity (d=0.63). By contrast, modifiable theoretical correlates of physical activity (e.g., self-efficacy [d=0.96-1.42] & intention to be physically active [d=1.62]) had moderate to large effects in the expected direction with physical activity during pregnancy. The findings underscore the importance of developing physical activity interventions for pregnant women that are guided by modifiable theoretical correlates, taking into consideration non-modifiable correlates of physical activity. Clinicians should help pregnant women to increase self-confidence in their ability to be physically active and provide anticipatory guidance to overcome barriers to physical activity.