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Adherence to physical activity guidelines in mid-pregnancy does not reduce sedentary time: an observational study

International Journal of Behavioral Nutrition and Physical Activity volume 12, Article number: 27 (2015) Cite this article

Abstract

Background

Physical activity (PA) interventions designed to prevent prenatal complications have focused on increasing moderate PA yielding conflicting results. Minimal attention has focused on the evaluation of sleep, sedentary behavior (SB), light activity or total daily PA during pregnancy. The purpose of this prospective, longitudinal study was to 1) objectively quantify and compare habitual PA and SB during the 2nd and 3rd trimester; and 2) evaluate differences in activity patterns for women meeting prenatal PA guidelines versus those that did not.

Methods

Forty-six participants wore 2 PA monitors (SenseWear® Mini and activPAL™) during week 18 and week 35 of pregnancy. We compared differences in sleep duration, postural allocation, daily steps, and PA between the 2nd and 3rd trimester and for women who met and did not meet PA guidelines.

Results

During the 2nd trimester, 30% of the women’s day (24-hours) was total sleep; 52% SB; 13% light; 3% moderate; and 0% vigorous PA. Light (P = 0.05), vigorous (P = 0.02), and moderate-vigorous PA (MET-minutes; P = 0.02), decreased with a trend in increased SB (P = 0.07). Activity of other intensities and sleep duration did not significantly change. Only 39% and 37% of participants slept between 7–9 hours/night at week 18 and 35, respectively. Forty-six percent (n = 21) and 28% (n = 13) of participants met prenatal PA guidelines during the 2nd and 3rd trimester, respectively. At week 18, no differences in total sleep, SB, or light PA existed for women who met PA guidelines versus those who did not; total PA was significantly greater for women who met guidelines. At week 35, women that met PA guidelines had significantly less SB (P < 0.005) than women who did not.

Conclusions

This study demonstrates that pregnant women spend the majority of their day in SB. Significant reductions in total activity across pregnancy may be attributed, in part to shifts in light PA and increased SB. Based on the lifestyle of our sample, regardless of meeting PA guidelines in mid-pregnancy, no significant difference exists in time spent in SB, however meeting PA recommendations in late pregnancy may reduce SB. Future interventions should target reducing SB by increasing light and moderate PA beyond volitional exercise.

Background

An infant’s risk of developing chronic disease later in life is influenced by the intrauterine environment established during pregnancy. Similarly, maternal health is an important predictor of an infant’s future risk of developing obesity [1]. Promoting preventative lifestyle strategies in prenatal care may be an effective way to curtail the rise in chronic disease. Physical activity (PA) during pregnancy has been identified as a potential approach to reduce the risk of prenatal complications such as excessive gestational weight gain (GWG) [2,3], abnormal glucose tolerance [4], gestational diabetes mellitus [4], pre-eclampsia [5], pre-term birth [6,7], and large- and small-for-gestational age infants [1,8], which increase the risk for future chronic disease. Although benefits of PA during pregnancy have been extensively documented, only about 25% of women in the United States [9] meet the 2008 Department of Health and Human Services prenatal PA guidelines of at least 150 minutes of moderate PA spread throughout the week [10]. Most PA interventions designed to prevent excessive prenatal weight gain have focused on increasing moderate PA [3,11-13]. However, minimal attention has been given to the evaluation of sleep, sedentary behavior, light activity or total volume of daily activity during pregnancy.

Non-exercise activity thermogenesis (NEAT) represents energy expended from behaviors as part of activities of daily living other than sleeping, eating, or volitional exercise [14]. NEAT, increases metabolic rate and thus, has been shown to be an important factor in the regulation of body weight in non-pregnant adults as a significant contributor to total daily energy expenditure [14]. Minimal attention has been given to the possible impact NEAT may have on perinatal outcomes despite recognition of future research needed in this area [15].

Increases in sedentary behavior (SB) during pregnancy have been associated with adverse perinatal health outcomes including abnormal glucose tolerance and increased risk for gestational diabetes mellitus [4], decreased insulin sensitivity and increased insulin secretion [16], excessive GWG [2], and lower birth weight [6]. Increasing time spent in light activity (i.e. NEAT) could have important health implications during pregnancy by directly reducing time spent in SB. Some studies have used self-report measures to quantify SB during pregnancy [4,6] but these may not have sufficient precision to distinguish SB from light PA [17]. Other studies have used objective devices but these have not separated nighttime sleep from total SB [2,18]. To advance work on the contributions of light or NEAT activity during pregnancy it is important to utilize objective methods that can distinguish sleep from total daily SB.

The present study advances research in this area by employing two state-of-the-art objective activity monitors for multiple, consecutive 24-hour periods to assess free-living PA and SB during pregnancy. The specific purpose of this prospective, longitudinal study was 1) to objectively quantify and compare habitual PA and SB during the 2nd and 3rd trimester; and 2) to evaluate differences in activity patterns for women meeting prenatal PA guidelines versus those that did not. The study will help to characterize patterns of SB and light PA during pregnancy to inform the best design of future prenatal interventions that aim to improve maternal and fetal outcomes.

Methods

Participants

Healthy pregnant women were recruited from local obstetric clinics, campus-wide emails, advertisements, and a partnership with a large hospital in a nearby city. Fifty-six women were enrolled in the prospective, longitudinal study at week 18 (±1 week) of gestation; 8 of these women did not complete the study for the following reasons: time constraints (n = 6), skin irritation from an activity monitor (n = 1), and pre-term delivery (n = 1). Inclusion criteria included 18–45 years of age and singleton pregnancy whereas the exclusion criteria included smoking during pregnancy or a history of chronic disease. Qualification criteria were confirmed by each participant’s medical provider. All participants provided written informed consent (approved by Iowa State University Institutional Review Board).

Data collection

Data collection occurred for 7-consecutive days at week 18 (±1 week; 2nd trimester) and week 35 (±1 week; 3rd trimester) of gestation. No advice was provided during the study regarding prenatal exercise. At enrollment, height (Ayrton 226 Hite-Rite Precision Mechanical Stadiometer, quick Medical GS, Snoqualmie, WA) and weight without shoes or bulky clothing (Detecto Model 6855 Cardinal Scale, Manufacturing Co., Webb City, MO) were measured to the nearest 0.1 cm and 0.01 kg, respectively. Each participant was instructed to record PA in a 7-day record (PAR) and to wear 2 PA monitors (SenseWear® Mini armband (SWA), and activPAL™ for 7 days, 24 hours a day during each data collection period except when showering or swimming. To control for differences in the time of day participants began wearing the monitors, the data was standardized to represent 6, 24 hour periods and involved removal of data on the first and last day of the 7-day monitoring periods, as those provided partial days of data. Therefore we analyzed data from the 7-day period starting at midnight on the 1st day of data collection and ending at midnight on the 6th day of data collection for each participant.

Activity monitors

SenseWear® Mini Activity Monitor (SWA)

The SWA (BodyMedia, Pittsburgh, PA) is a multi-sensor, pattern-recognition monitor that is worn on the left arm over the triceps muscle. It has unique potential for evaluation of pregnant women since it is worn on the arm, providing a more comfortable location than waist placement which has been shown to result in decreased compliance across pregnancy [19-21]. Good agreement between SWA estimates of energy expenditure and measured energy expenditure using an indirect calorimeter has been previously reported at mid-pregnancy using an earlier algorithm (version 5.2e; r = 0.93) [22]. These analyses have been repeated to show improved agreement and no systematic bias using the most currently available algorithm (version 5.2 h, unpublished observations from C. Campbell). Data were downloaded using version 8.0 of the BodyMedia software (algorithm v5.2 h). An excel code was written to categorize minute epochs into sleep, sedentary (≤1.5 METs; independent of nighttime sleep), light (1.6-2.9 METs), moderate (3-5.9 METs), vigorous (≥6 METs) PA, and PA volume (total MET-minutes per day and daily moderate-vigorous PA (MVPA) MET-minutes) [23,24].

An advantage of the SWA is that the monitor automatically detects when the monitor is not worn, also known as off-body time (OBT; e.g. due to showering or swimming). A “valid” day was defined as less than 72 minutes of OBT and at least four valid days were required [25]. OBT in excess of 72 minutes was evaluated using the PARs (Figure 1). If OBT included water exercise (e.g. water aerobics: 5.5 MET, code 18355), a MET was assigned from the 2011 Compendium of Physical Activities [24] and time spent in these activities supplemented the objective PA data (n = 10 participants). The SWA has been shown to reliably quantify sleep when compared to polysomnography [26], the gold standard for objective sleep measurement. Nighttime sleep was identified from the SWA and defined as sleep between 10 pm and 7 am. Sleep extending beyond the timeframe of 10 pm – 7 am was only counted as nighttime sleep if sleep was uninterrupted for more than two hours (e.g. sleep from 11 pm-6 am, and 7-8 am was counted as 8 hours of nighttime sleep). None of the participants worked overnight shifts that would result in abnormal sleep patterns.

Figure 1
figure 1

Number of participants included in the analysis for each physical activity monitor. SWA, SenseWear® Mini Armband. Physical activity data was evaluated at each time point using criteria for valid data to determine inclusion in the analysis of SWA or activPAL™ files.

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Data from the SWA was used to assess adherence to PA recommendations. This was done in two ways to account for various interpretations of the 2008 Department of Health and Human Services prenatal PA recommendations: 1) ≥ 150 minutes of accumulated MVPA per week and 2) ≥ 150 minutes of MVPA per week completed in at least 10-minute bouts [22]. A 10-minute bout consisted of at least 8 moderate-vigorous minutes within 10-consecutive minutes thereby allowing for up to 2 minutes below the moderate intensity threshold as previously reported [18]. Vigorous activity was counted as two minutes of moderate PA [10].

activPAL™

The activPAL™ (PAL Technologies, Ltd, Glasgow, Scotland) is an innovative accelerometer designed to evaluate postural allocation [27], offering considerable potential for understanding SB. Unlike the SWA, a key feature of the activPAL™ is the ability to differentiate time spent lying down/sitting versus standing or walking. However, sedentary time reported by the activPAL™ includes sleep (nighttime sleep plus naps) as this monitor is not able to discern between sleep and wake time spent sitting or lying. As such, data from the activPAL™ are presented as sit/lie and upright (standing and stepping). The term sedentary was not used because sleep is included in sit/lie time and is a biologically necessary sedentary behavior. To summarize the differences between these two monitors, the activPAL™ identifies SB based on posture alone (e.g. sit versus stand), whereas the SWA defines SB according to METs (e.g. ≤ 1.5 METs).

The activPAL™ is worn on the right leg over the quadriceps muscle with an adhesive provided by the manufacturer. This monitor has been used successfully in various populations [27-31] and has been validated to quantify postural allocation and step counts [27]. activPAL™ data were analyzed according to previously published methodology [28] and variables of interest included daily totals of steps, sit/lie, upright, standing, and stepping time, and number and length of sit/lie and upright bouts (Note: a bout is operationalized as any period of time greater than one second during which a posture was maintained). The same days used to assess SWA data were used to analyze the activPAL™ data. Three participants with valid SWA data did not have activPAL™ data; these participants’ SWA data was retained in the analysis. Additionally, two women had inadequate SWA wear time (see SenseWear® Activity Monitor) and were excluded from analyses at both time points for both monitors; activPAL™ cannot distinguish non-wear time from sit/lie time therefore it was assumed if the SWA was not worn, the activPAL™ was also not worn. Thus, 46 complete data sets were assessed for the SWA (Figure 1). Since six participants did not have any activPAL™ data at week 18 and/or week 35, 40 complete data sets were assessed for the activPAL™ (Figure 1).

Data analyses

Descriptive statistics were used to assess participant characteristics. The Shapiro-Wilk test for normality revealed the majority of the data from the SWA was normally distributed while the data from the activPAL™ was not; therefore values were reported in means and standard deviations or medians and interquartile ranges (IQRs), respectively. PA and SB variables across pregnancy were compared using either paired t-tests (SWA) or Wilcoxon rank-sum test (activPAL™). Independent t-tests with a Bonferroni adjustment for multiple comparisons were used to analyze any differences in PA variables between participants meeting PA guidelines versus those that did not. Significance was set at P < 0.05 and analyses were conducted with NCSS 2007 (Number Cruncher Statistical System; version 07.1.20, NCSS, LLC., Kaysville, Utah).

Results

Participant characteristics

Participants were young adults (mean age = 29.0 ± 3.5 years old), predominantly married (93%) and Caucasian (93%). All had some college education, and 54% were nulliparous. Overall, participants had an average pre-pregnancy body mass index (BMI) of 24.9 ± 5.0 kg/m2 (underweight (<18.5 kg/m2) BMI: n = 1; normal (18.5-24.9 kg/m2): n = 30; overweight (25–29.9 kg/m2): n = 9; obese (>30 kg/m2): n = 6).

Physical activity and sedentary behavior patterns

According to the SWA, the percentages of a day spent in SB, light PA, moderate PA, vigorous PA, and total sleep, at week 18 and 35 are depicted in Figure 2A and B, respectively. Light and vigorous PA significantly decreased from week 18 to week 35 (P = 0.05 and P = 0.02, respectively) while naps, accumulated moderate PA, and MVPA in bouts of at least 10 minutes did not significantly change between time points. For all participants combined, there was a trend for sedentary time (including napping) to increase from week 18 to week 35 (P = 0.07). Total MET-minutes per day and MVPA MET-minutes in at least 10-minute bouts significantly decreased from week 18 to 35 (Table 1).

Figure 2
figure 2

Daily profile of activity per the SWA during A) 2 nd trimester and B) 3 rd trimester. PA, physical activity; OBT, off-body time.

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Table 1 Sedentary behavior and physical activity during the 2 nd and 3 rd trimester (n = 46)
Full size table

Thirty-nine percent (n = 18) of participants at week 18 and 37% (n = 17) at week 35 averaged between the recommended 7–9 hours of sleep per night [32]. Time spent sleeping at night did not significantly change (Table 1). None of the participants slept less than an average of 5 hours per night or greater than 9 hours at either time point yet 62% of women slept less than 7 hours per night at both time points.

Utilizing the activPAL™, no significant differences in sit/lie and upright time were observed between week 18 and 35; however, total stepping time, total steps per day, and the length of sit/lie and upright bouts all significantly decreased (P < 0.001, P < 0.001, P = 0.003, P < 0.001, respectively) (Table 2). In addition, the number of sit/lie and upright bouts per day, and the number of sit to stand transitions significantly increased across pregnancy (P < 0.005 for all variables).

Table 2 Daily activity profile including sit/lie and upright time during the 2 nd and 3 rd trimester (n = 40)
Full size table

Adherence to physical activity guidelines

Using the definition of ≥ 150 minutes of accumulated MVPA, 65% and 61% of women met the guideline at week 18 and 35, respectively. With the definition of ≥ 150 minutes of MVPA in a bout of at least 10 minutes, 46% and 28% of women met the guideline at week 18 and 35, respectively. Those who met the guideline at week 18 spent an average of 344 ± 279 minutes in at least 10-minute bouts per week. After correcting for multiple comparisons, no differences in time spent in SB, light PA, or total sleep at week 18 were identified for women who met PA guidelines versus those that did not (Table 3). At week 35, no differences for total sleep and light PA persisted, yet those women that met PA guidelines had significantly less SB. However, those who met guidelines during either the second or third trimester spent about 70% of their time awake in sedentary behavior compared to 80% for women that did not meet guidelines. Similarly, women who met guidelines at week 18 and 35 had significantly greater daily MET-minutes (P < 0.001).

Table 3 Women who met versus did not meet physical activity guidelines a during 2 nd and 3 rd trimester
Full size table

Discussion

The current study demonstrates that the sampled group of healthy women with a low-risk pregnancy spent more than half their total day and at least 70% of their time awake in sedentary behaviors regardless of meeting current 2008 Department of Health and Human Services prenatal PA guidelines. In comparison, the general adult population has been reported to spend about 55-60% of time awake in sedentary behavior [29,30]. Contrary to previous findings of activity patterns during pregnancy [9,20,33], moderate PA did not change over time, however vigorous and total PA volume, represented by total MET-minutes and steps declined. Nighttime sleep remained inadequate with over 60% of the women sleeping less than seven hours per night.

Although research has targeted prenatal MVPA and volitional exercise as a means to minimize adverse prenatal outcomes, little attention has been given to behaviors during the rest of the day. Pregnant women placed on activity restriction (i.e. bed rest) represent a highly sedentary population. Bed rest is associated with maternal muscle atrophy [34], weight gain [34,35], bone loss [35], and low birth weight [36]. Thus, the considerable time spent in SB as demonstrated in the current study may be of great concern - reinforcing previous studies [2,4,6,16] relating increased SB to adverse pregnancy outcomes. Collectively, time spent in SB may be a crucial component of daily behavior that should be targeted in future interventions.

Both total PA and moderate PA have been show to decrease during the 3rd trimester [9,33,37,38]. A previous report demonstrates a decrease in moderate PA across pregnancy via objective monitoring (ActiGraph accelerometer, model #AM7164) [33] while the current study demonstrates the change in total PA is possibly due to a reduction in light and vigorous PA rather than a decrease in moderate PA. One distinct difference between the opposing findings is the amount of time participants wore the activity monitors. In the current study, the participants wore the monitors 24-hours a day (except when submerged in water) yielding an average wear time of 23.6 hours per day compared to 12.3 hours per day in the comparative study [33]. If our sample is representative of pregnant women’s typical sleep patterns, approximately 17 hours of awake time (24 total hours – 7 sleep hours = 17 awake hours) exists each day outside of nighttime sleep, leaving over 5 hours a day not accounted for in partial-day monitoring. To best understand total PA, including SB, objective monitoring of the majority of day- and nighttime activities is imperative.

Two useful indicators of total PA are MET-minutes per day and steps per day which reflect the total volume of daily activity encompassing sedentary, light, moderate and vigorous PA. Higher levels of total daily activity have been associated with the prevention of excessive GWG such that women with > 8.5 MET-hours per week of activity of all intensities were less likely to gain excessive weight [39]. The current study provides support for future efforts to prevent prenatal complications by decreasing SB through increasing overall activity (emphasizing a reduction in SB, an increase of light PA or NEAT in addition to volitional exercise). A previous report from Gradmark et al. supports this idea since total activity, rather than subcomponents of PA, were determined to be most strongly associated with insulin sensitivity during pregnancy [16].

The 24-hour monitoring period was particularly valuable to capture and account for nighttime sleep, independent of daytime SB. Nighttime sleep should be assessed when considering optimal behaviors during pregnancy as disrupted sleep patterns have been reported to start in the first trimester and continue throughout pregnancy [40,41]. Sleep has been reported to be of poor quality, decreased duration, decreased efficiency, and more fragmented towards the end of pregnancy [40]. Borodulin et al. used a measure of self-report to determine that 61.3% of women (n = 1259) during their 2nd trimester were sleeping between 7–9 hours per night, the recommended amount for adults [42]. Comparatively, in the current study using an objective assessment of sleep only 39% and 37% of participants met these recommendations during the 2nd and 3rd trimester, respectively. Sleep deprivation could lead to daytime napping, which may not fully compensate for inadequate nighttime sleep [43]. Additionally, regular daytime sleep could increase the risk for still birth [43] and maternal hyperglycemia [44]. Given the prenatal health concerns associated with inadequate sleep, it is important to assess behavior over a 24-hour period so that sleep and daytime PA can be evaluated in relation to health outcomes.

Sedentary time described by the activPAL™ includes all time spent lying or sitting, including sleep, whereas the SWA defines sedentary time based on energy expenditure. Therefore, these definitions explain the observed differences in sedentary time between the SWA and activPAL™. Occupation was not assessed and could influence changes in activity patterns across pregnancy. For example, early in pregnancy, an elementary school teacher may stand for longer bouts whereas later in pregnancy, she may opt to sit while teaching. Future studies could evaluate occupation as a possible covariate to explain changes in PA across pregnancy. Finally, it is important to note that the sample of pregnant women in the current study was small, highly educated, mostly Caucasian and married. Thus, the sample may not be representative of populations with more diversity in race and socioeconomic status.

Conclusions

This study demonstrates that after accounting for total sleep, pregnant women spend more than half of the 24 hour day, or at least 70% of time awake, in sedentary behaviors. Additionally, women meeting prenatal PA guidelines did not have significantly less SB at mid-pregnancy. Throughout pregnancy, SB remained the most predominant daily behavior; while vigorous PA, steps, and MET-minutes significantly decreased in the 3rd trimester. Significant reductions in total activity across pregnancy may be attributed in part to shifts in decreased light PA, increased SB, and a reduction in vigorous PA. Attention to maintaining an active lifestyle during pregnancy has focused on increasing MVPA; however, promotion of reducing sedentary time and increasing light and moderate activity beyond volitional exercise may be additional strategies to target in future interventions to promote optimal maternal and fetal health outcomes.

Abbreviations

AP:

ActivPAL™

GWG:

Gestational weight gain

MET:

Metabolic equivalents of task

MVPA:

Moderate-vigorous physical activity

NEAT:

Non-exercise activity thermogenesis

PA:

Physical activity

PAR:

Physical activity record

SB:

Sedentary behavior

SWA:

SenseWear® Mini armband

References

  1. Phelan S, Hart C, Phipps M, Abrams B, Schaffner A, Adams A, et al. Maternal behaviors during pregnancy impact offspring obesity risk. Exp Diabetes Res. 2011;2011(Suppl p1):985139.

    Google Scholar 

  2. Jiang H, Qian X, Li M, Lynn H, Fan Y, Jiang H, et al. Can physical activity reduce excessive gestational weight gain? Findings from a Chinese urban pregnant women cohort study. Int J Behav Nutr Phys Act. 2012;9:12.

    Article  CAS  Google Scholar 

  3. Mottola MF, Giroux I, Gratton R, Hammond JA, Hanley A, Harris S, et al. Nutrition and exercise prevent excess weight gain in overweight pregnant women. Med Sci Sports Exerc. 2010;42:265–72.

    Article  CAS  Google Scholar 

  4. Oken E, Ning Y, Rifas-Shiman SL, Radesky JS, Rich-Edwards JW, Gillman MW. Associations of physical activity and inactivity before and during pregnancy with glucose tolerance. Obstet Gynecol. 2006;108:1200–7.

    Article  Google Scholar 

  5. Deierlein AL, Siega-Riz AM, Evenson KR. Physical activity during pregnancy and risk of hyperglycemia. J Womens Health. 2012;21:769–75.

    Article  Google Scholar 

  6. Both MI, Overvest MA, Wildhagen MF, Golding J, Wildschut HI. The association of daily physical activity and birth outcome: a population-based cohort study. Eur J Epidemiol. 2010;25:421–9.

    Article  Google Scholar 

  7. Juhl M, Andersen PK, Olsen J, Madsen M, Jørgensen T, Nøhr EA, et al. Physical exercise during pregnancy and the risk of preterm birth: a study within the Danish National Birth Cohort. Am J Epidemol. 2008;167:859–66.

    Article  Google Scholar 

  8. Juhl M, Olsen J, Andersen PK, Nøhr EA, Andersen AM. Physical exercise during pregnancy and fetal growth measures: a study within the Danish National Birth Cohort. Am J Obstet Gynecol. 2010;202:63. e1-63.e8.

    Article  Google Scholar 

  9. Evenson KR, Wen F. National trends in self-reported physical activity and sedentary behaviors among pregnant women: NHANES 1999–2006. Prev Med. 2010;50:123–8.

    Article  Google Scholar 

  10. U.S. Department of Health and Human Services: Physical Activity Guidelines for Americans [http://www.health.gov/paguidelines/guidelines/chapter7.aspx]

  11. Price BB, Amini SB, Kappeler K. Exercise in pregnancy: effect on fitness and obstetric outcomes-a randomized trial. Med Sci Sports Exerc. 2012;44:2263–9.

    Article  Google Scholar 

  12. Skouteris H, Hartley-Clark L, McCabe M, Milgrom J, Kent B, Herring SJ, et al. Preventing excessive gestational weight gain: a systematic review of interventions. Obes Rev. 2010;11:757–68.

    Article  CAS  Google Scholar 

  13. Muktabhant B, Lumbiganon P, Ngamjarus C, Dowswell T. Interventions for preventing excessive weight gain during pregnancy. Cochrane Database Syst Rev. 2012;4:CD007145.

    Google Scholar 

  14. Levine JA. Non-exercise activity thermogenesis (NEAT). Nutr Rev. 2004;62:S82–97.

    Article  Google Scholar 

  15. Downs DS, Chasan-Taber L, Evenson KR, Leiferman J, Yeo S. Physical activity and pregnancy: past and present evidence and future recommendations. Res Q Exerc Sport. 2012;83:485–502.

    Google Scholar 

  16. Gradmark A, Pomeroy J, Renström F, Steiginga S, Persson M, Wright A, et al. Physical activity, sedentary behaviors, and estimated insulin sensitivity and secretion in pregnant and non-pregnant women. BMC Pregnancy Childbirth. 2011;11:44.

    Article  Google Scholar 

  17. Evenson KR, Chasan-Taber L, Symons Downs D, Pearce EE. Review of self-reported physical activity assessments for pregnancy: summary of the evidence for validity and reliability. Paediatr Perinat Epidemiol. 2012;26:479–94.

    Article  Google Scholar 

  18. Gennuso KP, Gangnon RE, Matthews CE, Thraen-Borowski KM, Colbert LH. Sedentary Behavior, Physical Activity, and Markers of Health in Older Adults. Med Sci Sports Exerc. 2013;45:1493–500.

    Article  Google Scholar 

  19. Harrison CL, Thompson RG, Teede HJ, Lombard CB. Measuring physical activity during pregnancy. Int J Behav Nutr Phys Act. 2011;8:19.

    Article  Google Scholar 

  20. McParlin C, Robson SC, Tennant PW, Besson H, Rankin J, Adamson AJ, et al. Objectively measured physical activity during pregnancy: a study in obese and overweight women. BMC Pregnancy Childbirth. 2010;10:76.

    Google Scholar 

  21. DiNallo JM, Downs DS, Le Masurier G. Objectively assessing treadmill walking during the second and third pregnancy trimesters. J Phys Act Health. 2012;9:21–8.

    Google Scholar 

  22. Smith KM, Campbell CG, Physical activity during pregnancy. Impact of applying different physical activity guidelines. J Pregnancy. 2013;2013:165617.

    Article  Google Scholar 

  23. Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett Jr DR, Tudor-Locke C, et al. Compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011;2011(43):1575–81.

    Article  Google Scholar 

  24. Pate RR, O’Neill JR, Lobelo F. The evolving definition of “sedentary”. Exerc Sport Sci Rev. 2008;36:173–8.

    Article  Google Scholar 

  25. Scheers T, Philippaerts R, Lefevre J. Variability in physical activity patterns as measured by the SenseWear Armband: how many days are needed? Eur J Appl Physiol. 2012;112:1653–62.

    Article  Google Scholar 

  26. Sharif MM, Bahammam AS. Sleep estimation using BodyMedia’s SenseWear™ armband in patients with obstructive sleep apnea. Ann Thorac Med. 2013;8:53–7.

    Article  Google Scholar 

  27. Dowd KP, Harrington DM, Donnelly AE. Criterion and concurrent validity of the activPAL™ professional physical activity monitor in adolescent females. PLoS ONE. 2012;7:e47633.

    Article  CAS  Google Scholar 

  28. Fitzsimons CF, Kirk A, Baker G, Michie F, Kane C, Mutrie N. Using an individualised consultation and activPAL™ feedback to reduce sedentary time in older Scottish adults: results of a feasibility and pilot study. Prev Med. 2013;57:718–20.

    Article  Google Scholar 

  29. Matthews CE, Chen KY, Freedson PS, Buchowski MS, Beech BM, Pate RR, et al. Amount of time spent in sedentary behaviors in the United States, 2003–2004. Am J Epidemol. 2008;167:875–81.

    Article  Google Scholar 

  30. Spittaels H, Van Cauwenberghe E, Verbestel V, De Meester F, Van Dyck D, Verloigne M, et al. Objectively measured sedentary time and physical activity time across the lifespan: a cross-sectional study in four age groups. Int J Behav Nutr Phys Act. 2012;9:149.

    Article  Google Scholar 

  31. Matthews CE, Keadle SK, Sampson J, Lyden K, Bowles HR, Moore SC, et al. Validation of a previous-day recall measure of active and sedentary behaviors. Med Sci Sports Exerc. 2013;45:1629–38.

    Article  Google Scholar 

  32. Centers for Disease Control and Prevention, Division of Adult and Community Health: Sleep and Sleep Disorders [http://www.cdc.gov/features/sleep/]

  33. Evenson KR, Wen F. Prevelance and correlates of objectively measured physical activity and sedentary behavior among US pregnant women. Prev Med. 2011;53:39–43.

    Article  Google Scholar 

  34. Brun CR, Shoemaker JK, Bocking A, Hammond JA, Poole M, Mottola MF. Bed-rest exercise, activity restriction, and high-risk pregnancies: a feasibility study. Appl Physiol Nutr Metab. 2011;36:577–82.

    Article  Google Scholar 

  35. Bigelow C, Stone J. Bed rest in pregnancy. Mt Sinai J of Med. 2011;78:291–302.

    Article  Google Scholar 

  36. Maloni JA, Alexander GR, Schluchter MD, Shah DM, Seunghee P. Antepartum bed rest: maternal weight change and infant birth weight. Biol Res Nurs. 2004;5:177–86.

    Article  Google Scholar 

  37. Rousham EK, Clarke PE, Gross H. Significant changes in physical activity among pregnant women in the UK as assessed by accelerometry and self-reported activity. Eur J Clin Nutr. 2006;60:393–400.

    Article  CAS  Google Scholar 

  38. Borodulin KM, Evenson KR, Wen F, Herring AH, Benson AM. Physical activity patterns during pregnancy. Med Sci Sports Exerc. 2008;40:1901–8.

    Article  Google Scholar 

  39. Cohen TR, Plourde H, Koski KG. Are Canadian women achieving a fit pregnancy? A pilot study. Can J Public Health. 2010;101:87–91.

    Google Scholar 

  40. Hedman C, Pohjasvaara T, Tolonen U, Suhonen-Malm AS, Myllylä VV. Effects of pregnancy on mothers’ sleep. Sleep Med. 2002;3:37–42.

    Article  CAS  Google Scholar 

  41. Lee KA, Zaffke ME, McEnany G. Parity and sleep patterns during and after pregnancy. Obstet Gynecol. 2000;95:14–8.

    Article  CAS  Google Scholar 

  42. Borodulin K, Evenson KR, Monda K, Wen F, Herring AH, Dole N. Physical activity and sleep among pregnant women. Paediatr Perinat Epidemiol. 2010;24:45–52.

    Article  Google Scholar 

  43. Stacey T, Thompson JM, Mitchell EA, Ekeroma AJ, Zuccollo JM, McCowan LM. Association between maternal sleep practices and risk of late stillbirth: a case–control study. BMJ. 2011;342:d3403.

    Article  Google Scholar 

  44. Izci Balserak B, Jackson N, Ratcliffe SA, Pack AI, Pien GW. Sleep-disordered breathing and daytime napping are associated with maternal hyperglycemia. Sleep Breath. 2013;342:d3403.

    Google Scholar 

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Acknowledgements

The authors would like to extend a sincere thank you to all of the women that participated in this study as well as individuals in Dr. Christina Campbell’s laboratory that assisted with data collection. Additionally, we thank Anna Peterson for her contributions to the statistical analysis of this study. This work was funded by the Uelner Professorship awarded to CG Campbell in 2011. BodyMedia, Inc. processed SWA files for the version 5.2 h algorithm but did not provide any funding for the current study.

Author information

Authors and Affiliations

  1. Department of Food Science and Human Nutrition, Iowa State University, 220 MacKay Hall, Ames, Iowa, 50011, USA

    Diana R Di Fabio, Courtney K Blomme, Katie M Smith & Christina G Campbell

  2. Department of Kinesiology, Iowa State University, 235 Forker Building, Ames, Iowa, 50011, USA

    Gregory J Welk

  3. Interdepartmental Graduate Program in Nutritional Sciences, Iowa State University, Ames, Iowa, 50011, USA

    Diana R Di Fabio, Katie M Smith, Gregory J Welk & Christina G Campbell

  4. Sandy S. and Roy W. Uelner Professor of Food Science and Human Nutrition, Ames, Iowa, 50011, USA

    Christina G Campbell

Authors
  1. Diana R Di Fabio
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  2. Courtney K Blomme
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  3. Katie M Smith
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  4. Gregory J Welk
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  5. Christina G Campbell
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Corresponding author

Correspondence to Christina G Campbell.

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Competing interests

Although GJ Welk has previously collaborated with BodyMedia, Inc., no financial support for this study was provided by BodyMedia, Inc. None of the other authors report any conflict of interest.

Authors’ contributions

CC and KS designed the study. DD, CB, and KS participated in the collection and analysis of data. DD, KS, and CC drafted the manuscript. DD performed the statistical analysis. GW provided guidance on the study protocol and use of the physical activity monitors. All authors read and approved the final manuscript.

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Di Fabio, D.R., Blomme, C.K., Smith, K.M. et al. Adherence to physical activity guidelines in mid-pregnancy does not reduce sedentary time: an observational study. Int J Behav Nutr Phys Act 12, 27 (2015). https://doi.org/10.1186/s12966-015-0191-7

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  • DOI: https://doi.org/10.1186/s12966-015-0191-7

Keywords

International Journal of Behavioral Nutrition and Physical Activity

ISSN: 1479-5868

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