Determinants of Incidental Physical Activity During Pregnancy in Urban South India: Evidence of Volume Without...

Background It is recommended that women engage in physical activity (PA) during pregnancy, as it is important for both maternal and fetal health; however, in urban Indian settings, this is mostly in the form of everyday domestic and transport-related tasks rather than planned exercise. The factors underlying this pattern (sufficient activity volume but a lack of structured exercise) are not well known. Methodology A cross-sectional study was conducted in the community among pregnant women (second/third trimester) from six urban field practice areas of Chettinad Hospital in Chengalpattu district, Tamil Nadu, India. Multistage sampling was used. The Pregnancy Physical Activity Questionnaire (PPAQ), which is validated and classifies participants as active (≥150 minutes/week, as recommended by the WHO), was used to measure PA. Activity domains were further categorized as structured (exercise/sports) and incidental (household/transport-related) activity. A validated Physical Activity Knowledge questionnaire consisting of 20 items was used to assess knowledge about PA. The chi-square test was used to analyze associations, and binary logistic regression was used to identify independent determinants. Results The average age of the subjects was 26.5 ± 3.8 years. The majority (n = 186, 92.5%) reported meeting the activity threshold recommended by the WHO, but all the activity reported was incidental, with no structured fitness practices. The mean total PA was 303.9 ± 102.1 minutes/week, most of which was from household and transport-related activities. Levels of knowledge were low (n = 96, 47.8%) and moderate (n = 101, 50.2%), with very low awareness of danger signs and contraindications to exercise. Multivariable analysis revealed that higher educational status (adjusted odds ratio (AOR) = 3.41; 95% confidence interval (CI) 1.24-9.38) and better knowledge (AOR = 4.12; 95% CI 1.18-14.37) were significant factors associated with being physically active. There were positive trends in the case of prior exercise, and no significant association was seen for counseling. Conclusions Most women had adequate levels of PA during pregnancy, but there was a lack of structured exercise, suggesting an issue with the quality of PA. Increasing awareness, promoting structured exercise practices, and strengthening antenatal counseling with specific instructions could help address this gap.