Exploring Factors Influencing Physical Inactivity During the First Trimester of Pregnancy: A Convergent Mixed-Methods...

This study aims to investigate physical inactivity levels in early pregnancy and explore the associated factors among Chinese pregnant women.

A convergent mixed-methods study was employed, comprising a cross-sectional survey (n = 802) and in-depth semi-structured interviews (n = 18).

First trimester pregnant women were recruited through convenience sampling method between August 2022 and March 2023. Sociodemographic, obstetric, social support, and lifestyle characteristics were obtained using a structured questionnaire. Physical inactivity levels were assessed using the International Physical Activity Questionnaire. Quantitative data were analysed using logistic regression, while qualitative data underwent thematic analysis. The results were integrated through a side-by-side comparison approach.

The prevalence of physical inactivity in early pregnancy was 51.2%, with walking being the predominant activity. Logistic regression analysis indicated that women under the age of 25 were more likely to engage in physical activity during early pregnancy than those aged 25-29 (adjusted odds ratio [aOR] = 2.213, 95% confidence interval [CI]: 1.063-4.605) and 30-34 years (aOR = 2.320, 95% CI: 1.107-4.866). Compared to women with a high school education or lower, those with a college degree (aOR = 2.158, 95% CI: 1.153-4.039) or a postgraduate education or higher (aOR = 2.116, 95% CI: 1.058-4.231) were more likely to be physically inactive during early pregnancy. Factors associated with higher inactivity included not engaging in regular exercise before pregnancy (aOR = 0.671, 95% CI: 0.500-0.900), experiencing vaginal bleeding in early pregnancy (aOR = 1.504, 95% CI: 1.097-2.063), and reporting poor sleep quality in early pregnancy (aOR = 1.529, 95% CI: 1.133-2.063). Thematic analysis identified four key themes: individual, interpersonal, social, and environmental factors. The main barriers included time constraints, pregnancy-related discomfort, fears and anxieties, lack of confidence, limited resources and conflicting advice. Key facilitators were spousal support and policies that encouraged or enabled exercise during pregnancy.

Pregnant women participated in surveys and interviews, while Dr. Hu, Nurse Director Zhu, and Shen were involved in participant recruitment.