Related Experiment Video
Updated: Feb 21, 2026
A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
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.
Objective:
Activity restriction is commonly recommended in pregnancy despite lacking evidence of benefit. We sought to evaluate the amount of physical activity in patients at high risk for preterm birth and pregnancy latency and preterm birth.
Methods:
This is an ancillary study of two randomized trials of preterm birth prevention in people with a short cervical length. People were enrolled from 16 0/7 to 23 6/7 weeks of gestation and instructed to wear a wrist accelerometer, which calculated physical activity data (steps per day) until delivery. The number of steps per day was calculated for each participant. The primary outcome was latency from time of enrollment to delivery. Sedentary activity was defined as a median of fewer than 3,500 steps per day. We compared outcomes between those with fewer than 3,500 median steps per day and those with 3,500 or more median steps per day. Secondary outcomes included preterm birth before 32, 34, and 37 weeks of gestation.
Results:
Of the 120 participants enrolled in the ancillary study, 117 (97.5%) had complete accelerometer data. At enrollment, the median gestational age was 22.8 weeks (interquartile range 21.3, 23.7), and a quarter of participants (25.8%) had been placed on activity restriction by their practitioner. The primary outcome, latency from time of enrollment to delivery, was not different between the groups (hazard ratio 0.95, 95% CI, 0.88-1.03). Steps per day did not differ by median cervical length at baseline between the groups. However, participants with fewer than 3,500 median steps per day delivered at an earlier gestational age (34.9 weeks vs 37.7 weeks, P =.04) and were more likely to deliver before 34 weeks (47.3% vs 17.7%, P =.03).
Conclusion:
There was no statistically significant difference in latency from time of enrollment to delivery between those with and those without activity restriction. However, among individuals with a short cervix in the second trimester, sedentary activity (fewer than 3,500 steps per day) was associated with an increased risk of preterm birth before 34 weeks of gestation and delivery at an earlier gestational age.
Related Concept Videos
01:52Regression Toward the Mean
01:22Diabetes Mellitus: Type 2 and Gestational
01:07Teratogenicity
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
01:20Pathophysiology of Diabetes
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...