Patterns of physical activity, sedentary behavior, and sleep across pregnancy before and during two COVID pandemic years

Andrea C Kozai; Melissa A Jones; Jaclyn D Borrowman; Alisse Hauspurg; Janet M Catov; Christopher E Kline; Kara M Whitaker; Bethany Barone Gibbs

doi:10.1016/j.midw.2024.104268

Patterns of physical activity, sedentary behavior, and sleep across pregnancy before and during two COVID pandemic years

Midwifery. 2024 Dec 18:141:104268. doi: 10.1016/j.midw.2024.104268. Online ahead of print.

Authors

Andrea C Kozai¹, Melissa A Jones², Jaclyn D Borrowman³, Alisse Hauspurg⁴, Janet M Catov⁵, Christopher E Kline⁶, Kara M Whitaker³, Bethany Barone Gibbs⁷

Affiliations

¹ Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: andrea.kozai@pitt.edu.
² Department of Exercise Science, Oakland University, Rochester, MI, USA.
³ Department of Health and Human Physiology, University of Iowa, Iowa City, IA, USA.
⁴ Department of Obstetrics & Gynecology, University of Pittsburgh, Pittsburgh, PA, USA.
⁵ Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA; Department of Obstetrics & Gynecology, University of Pittsburgh, Pittsburgh, PA, USA.
⁶ Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA.
⁷ Department of Epidemiology & Biostatistics, West Virginia University, Morgantown, WV, USA.

PMID: 39721225
DOI: 10.1016/j.midw.2024.104268

Abstract

Background: Physical activity is recommended during pregnancy, and high sedentary behavior and poor sleep may increase the risk of pregnancy complications. Activity patterns and sleep were negatively impacted by the COVID pandemic in many segments of the population, but the impact of the pandemic on pregnant people is understudied. We aimed to compare patterns of physical activity, sedentary time, and sleep during pregnancy between a pre-COVID and a COVID-era cohort.

Methods: Physical activity, sedentary time, and sleep in each trimester of pregnancy were compared between two parallel prospective observational cohorts using identical collection methods. Pre-COVID participants (n=111) were recruited in 2017-2019 and COVID-era participants (n=117) from 2021-2023. Physical activity and sedentary time were measured using the activPAL3 micro accelerometer, and sleep duration was self-reported. Between-cohort comparisons were conducted using linear regression for each behavior in each trimester. Within-COVID-era cohort linear regression analyses assessed whether activity patterns differed as pandemic-era restrictions were eased.

Results: Participant demographics were similar between cohorts except for self-reported income. Adjusted mean moderate-to-vigorous physical activity was 57-77 min/week higher in each trimester in pre-COVID compared to COVID-era participants (p<0.001); adjusted mean sedentary time was 0.77-1.13 hours/day lower in each trimester (p<0.01) and sleep duration was 0.8 hours/day lower in the third trimester in the pre-COVID compared to COVID-era cohort (p<0.05). Within the COVID-era cohort, no significant within-trimester differences were detected across the pandemic years.

Conclusions: Pregnant participants during the COVID pandemic were less active and more sedentary than their pre-pandemic counterparts, and this trend was still detected years after the pandemic began. A more sedentary lifestyle during pregnancy may have health implications, and prenatal care providers should help pregnant people identify strategies to adopt an active lifestyle in the context of pandemic-era barriers.

Keywords: 24-hour movement behaviors; Accelerometry; Maternal health behaviors; Prenatal care.