Abstract
BackgroundThis study examines the effect of low daily physical activity levels and overweight/obesity in pregnancy on delivery and perinatal outcomes.MethodsA prospective cohort study combining manually collected postnatal notes with anonymised data linkage. A total of 466 women sampled from the Growing Up in Wales: Environments for Healthy Living study. Women completed a questionnaire and were included in the study if they had an available Body mass index (BMI) (collected at 12 weeks gestation from antenatal records) and/or a physical activity score during pregnancy (7-day Actigraph reading). The full statistical model included the following potential confounding factors: maternal age, parity and smoking status. Main outcome measures included induction rates, duration of labour, mode of delivery, infant health and duration of hospital stay.FindingsMothers with lower physical activity levels were more likely to have an instrumental delivery (including forceps, ventouse and elective and emergency caesarean) in comparison to mothers with higher activity levels (adjusted OR:1.72(95%CI: 1.05 to 2.9)). Overweight/obese mothers were more likely to require an induction (adjusted OR:1.93 (95%CI 1.14 to 3.26), have a macrosomic baby (adjusted OR:1.96 (95%CI 1.08 to 3.56) and a longer hospital stay after delivery (adjusted OR:2.69 (95%CI 1.11 to 6.47).ConclusionsThe type of delivery was associated with maternal physical activity level and not BMI. Perinatal outcomes (large for gestational age only) were determined by maternal BMI.
Highlights
A normal birth, demonstrated by a vaginal delivery without the need for induction or instrumental intervention, promotes minimal intrusion and is often the anticipated mode of delivery amongst healthy expectant mothers [1,2]
The type of delivery was associated with maternal physical activity level and not Body mass index (BMI)
Ventouse deliveries (26 v 12.7%), and elective (21.5 v 15.4%) and emergency (14.9 v 8.7%) caesarean sections (Table 2). This finding remained significant after controlling for maternal age, parity and large for gestational age (LGA) (adjusted odds rations (OR):1.72(95%confidence intervals (CI): 1.05 to 2.9))
Summary
A normal birth, demonstrated by a vaginal delivery without the need for induction or instrumental intervention, promotes minimal intrusion and is often the anticipated mode of delivery amongst healthy expectant mothers [1,2]. An extensive number of studies [11,12,13,14] and reviews [15,16] report the undesirable effects of increasing maternal BMI on the risk of caesarean section and operative vaginal deliveries. This increased risk has been shown to remain constant across women of varying ethnicities and parity [15]. This study examines the effect of low daily physical activity levels and overweight/obesity in pregnancy on delivery and perinatal outcomes
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