Socio-ecological exploration of antenatal exercise among pregnant Saudi women

Saudi women are physically inactive but little is known about their activity during pregnancy and related factors. The Saudi health care transformation strategy aims to improve the well-being of individuals by increasing physical activity levels, including the health of childbearing women. The current study employed a socio-ecological model to identify factors associated with adherence to the American College of Obstetricians and Gynecologists antenatal exercise guidelines among pregnant Saudi women and their correlations at intrapersonal, interpersonal, environmental, organizational, and policy levels.

A cross-sectional, descriptive study was conducted based on 254 participants with normal pregnancy, aged between 18 and 45 years, and with a single, living fetus, by responding to a self-reported questionnaire. A convenience sampling method was employed to recruit participants who attended antenatal care in the eastern province between April and August 2023, with a response rate of 94.4 %.

Adherence to exercise guidelines among Saudi women decreased by 59.8 % during pregnancy compared with pre-pregnancy levels. The most commonly reported barriers were intrapersonal factors, especially tiredness, pregnancy discomforts, and fear of exercise. By contrast, interpersonal factors, particularly social support and health education, were the most widely reported facilitators, as well as organizational and policy factors, particularly access to exercise facilities. Regression analysis suggested that intrapersonal (engagement in exercise pre-pregnancy) and organizational and policy factors (reported lack of pregnancy-specific exercise programs as a barrier to exercise) positively influenced adherence to the guidelines among pregnant Saudi women.

Adherence to exercise guidelines declined significantly during pregnancy. Saudi women reported intrapersonal factors as barriers and interpersonal factors as facilitators.