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Activity Restriction in Pregnancy and the Risk of Early Delivery: The AWARE Study
Anthony C Sciscione1, Whitney A Booker, Rebecca G Clifton
1Columbia University, New York, New York; Ochsner Health, New Orleans, Louisiana; the University of Alabama at Birmingham, Birmingham, Alabama; the Hospital of the University of Pennsylvania, Philadelphia, and the University of Pittsburgh, Pittsburgh, Pennsylvania; The Ohio State University, Columbus, and Case Western Reserve University, Cleveland, Ohio; Northwestern University, Chicago, Illinois; the University of Texas Medical Branch at Galveston, Galveston, and the University of Texas at Austin, Austin, Texas; the University of Utah Health Sciences Center, Salt Lake City, Utah; Brown University, Providence, Rhode Island; the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; the George Washington University Biostatistics Center, Washington, DC; the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland; and Christiana Hospital, Newark, Delaware.
Activity restriction in pregnancy lacks evidence. Sedentary behavior (under 3,500 steps/day) in high-risk pregnancies was linked to earlier delivery and increased preterm birth risk before 34 weeks.
Area of Science:
- Obstetrics and Gynecology
- Maternal-Fetal Medicine
- Perinatal Research
Background:
- Activity restriction is frequently advised for high-risk pregnancies, yet scientific evidence supporting its benefits is limited.
- This study investigates the relationship between physical activity levels and pregnancy outcomes in individuals at risk for preterm birth.
Purpose of the Study:
- To assess the impact of physical activity levels on pregnancy latency and the incidence of preterm birth.
- To determine if a threshold of daily steps influences these outcomes in high-risk pregnancies.
Main Methods:
- An ancillary study involving 117 participants with short cervical length, monitored using wrist accelerometers for daily steps.
- Participants were categorized based on median daily steps: fewer than 3,500 (sedentary) versus 3,500 or more.
- Primary outcome was latency to delivery; secondary outcomes included preterm birth at 32, 34, and 37 weeks gestation.
Main Results:
- No significant difference in latency to delivery was observed between activity groups.
- Participants with fewer than 3,500 median steps per day delivered earlier (34.9 weeks) compared to those with 3,500+ steps (37.7 weeks).
- The sedentary group showed a significantly higher likelihood of preterm birth before 34 weeks (47.3%) versus the active group (17.7%).
Conclusions:
- Activity restriction did not significantly alter pregnancy latency in this cohort.
- Sedentary activity (fewer than 3,500 steps/day) in the second trimester among individuals with a short cervix is associated with earlier delivery and increased risk of preterm birth before 34 weeks.
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