Impact of prior pregnancy loss or pre-term delivery on attitudes toward exercise in pregnancy

Abstract

Background: Exercise during pregnancy has minimal risks and has been shown to benefit most women, including reduction in cesarean section rates, appropriate maternal and fetal weight gain managing gestational diabetes as well as preventing and treating antenatal depression. There are, however, multiple factors that may influence an expectant mother’s decision to engage in physical activity, including concerns for potentially harming the baby or the pregnancy. We designed a study to determine whether or not a prior pregnancy loss or pre-term delivery would increase an expectant mother’s concern about exercise during a current pregnancy.Methods: Our prospective survey study consisted of 572 obstetric patients, 173 (30.2%) had a history of prior pregnancy loss or pre-term delivery (PPLPT) compared to 399 (69.8%) with no history of a prior pregnancy loss (NPL).Results: Logistic regression modeling was performed, including the following variables: history of abortion, miscarriage, or pregnancy loss, age, pre-pregnancy BMI, typical weekly pre-pregnancy exercise minutes, physical wellbeing and emotional wellbeing. Patients in the PPLPT group were more likely to express a fear of hurting the baby as a barrier to exercise during pregnancy, with an adjusted odds ratio of 2.358 (95% CI 1.111-3.852, p<0.001).Conclusions: Pregnant women who have experienced prior pregnancy loss or pre-term delivery were associated with a significantly higher endorsement of concern that exercise could harm their current pregnancy. This was despite their acknowledgement that exercise is considered safe and encouraged for pregnancies. An awareness of this concern will allow the clinicians who care for these patients to consider additional discussion regarding exercise in pregnancy.