Physical activity patterns in third trimester of pregnancy – use of pregnancy physical activity questionnaire in Poland
More details
Hide details
European Observatory of Health Inequalities, State University of Applied Sciences, Kalisz, Poland
Department of Oncological Gynecology and Obstetrics, Centre of Postgraduate Medical Education, Warsaw, Poland
Second Department of Obstetrics and Gynecology, Center of Postgraduate Medical Education, Warsaw, Poland
Faculty of Medicine, State University of Applied Sciences, Kalisz, Poland
Department of Physiolgy, University of Medical Sciences, Poznan, Poland
Cezary Wojtyła   

European Observatory of Health Inequalities, State University of Applied Sciences, Kaszubska 13, 62-800, Kalisz, Poland
Adverse pregnancy outcomes are less common among physically active women, and children born to such mothers are less likely to be at risk for macrosomia, obesity and metabolic diseases in the future.

The aims of the study were to establish physical activity (PA) patterns among pregnant women in the third trimester, and to determine the attitudes of prenatal care providers to maternal PA during pregnancy.

Material and methods:
The study was conducted in 2017 using surveys from the Polish Pregnancy-related Assessment Monitoring System program (Pol-PrAMS). The study included 3,451 postpartum women. The Pregnancy Physical Activity Questionnaire was used to investigate their PA. This part of Pol-PrAMS study was completed by 2,744 postpartum women who were subjected to statistical analysis.

Sedentary or light physical activity comprised 75% of the overall PA in the third trimester of pregnancy (mean values of energy expenditure: 67 and 93.3 MET-h/week, respectively). Household or caregiving activities accounted for almost 50% of all activities and were the most common PA types (mean energy expenditure: 105 MET-h/week). Restriction of PA in pregnancy was reported by over 60% of the women, most often due to concerns over proper foetal development. Over 85% of prenatal care providers either did not address the issue of PA with the future mothers at all, or recommended PA restriction.

Aune D, Saugstad OD, Henriksen T, Tonstad S. Physical activity and the risk of preeclampsia: a systematic review and meta-analysis. Epidemiology. 2014; 25(3):331-343. doi: 10.1097/EDE.0000000000000036.
Aune D, Sen A, Henriksen T, Saugstad OD, Tonstad S. Physical activity and the risk of gestational diabetes mellitus: a systematic review and dose-response meta-analysis of epidemiological studies. Eur J Epidemiol. 2016; 31(10): 967-997.
ACOG Committee Opinion No. 650: Physical Activity and Exercise During Pregnancy and the Postpartum Period. Obstet Gynecol. 2015; 126(6): e135-42. doi: 10.1097/AOG.0000000000001214.
Currie LM, Woolcott CG, Fell DB, Armson BA, Dodds L. The association between physical activity and maternal and neonatal outcomes: a prospective cohort. Matern Child Health J. 2014; 18(8): 1823-30. doi: 10.1007/s10995-013-1426-3.
Wang Y, Gao E, Wu J, Zhou J, Yang Q, Walker MC, et al. Fetal macrosomia and adolescence obesity: results from a longitudinal cohort study. Int J Obes (Lond). 2009; 33(8): 923-8. doi: 10.1038/ijo.2009.131.
Bell RJ, Palma SM, Lumley JM. The effect of vigorous exercise during pregnancy on birth-weight. Aust N Z J Obstet Gynaecol. 1995; 35(1): 46-51.
Clapp JF 3rd. The effects of maternal exercise on fetal oxygenation and feto-placental growth. Eur J Obstet Gynecol Reprod Biol. 2003; 110 Suppl 1: S80-5.
Clapp JF 3rd, Kim H, Burciu B, Lopez B. Beginning regular exercise in early pregnancy: effect on fetoplacental growth. Am J Obstet Gynecol, 2000; 183: 1484-1488.
Webb KA, Wolfe LA, McGrath MJ. Effects of acute and chronic maternal exercise on fetal heart rate. J Appl Physiol (1985). 1994; 77(5): 2207-13.
Erkkola RU, Pirhonen JP, Kivijärvi AK. Flow velocity waveforms in uterine and umbilical arteries during submaximal bicycle exercise in normal pregnancy. Obstet Gynecol. 1992; 79(4): 611-5.
Clapp JF. Effects of Diet and Exercise on Insulin Resistance during Pregnancy. Metab Syndr Relat Disord. 2006; 4(2): 84-90. doi: 10.1089/met.2006.4.84.
Wojtyła A, Kapka-Skrzypczak L, Biliński P, Paprzycki P. Physical activity among women at reproductive age and during pregnancy (Youth Behavioural Polish Survey - YBPS and Pregnancy-related Assessment Monitoring Survay - PrAMS) - epidemiological population studies in Poland during the period 2010-2011. Ann Agric Environ Med. 2011; 18(2): 365-74.
Borodulin K, Evenson KR, Herring AH. Physical activity patterns during pregnancy through postpartum. BMC Womens Health. 2009; 9:32. doi: 10.1186/1472-6874-9-32.
Santos PC, Abreu S, Moreira C, Santos R, Ferreira M, Alves O, et al. Physical Activity Patterns During Pregnancy in a Sample of Portuguese Women: A Longitudinal Prospective Study. Iran Red Crescent Med J. 2016; 18(3): e22455. doi: 10.5812/ircmj.22455.
Hegaard HK, Damm P, Hedegaard M, Henriksen TB, Ottesen B, Dykes AK, et al. Sports and leisure time physical activity during pregnancy in nulliparous women. Matern Child Health J. 2011; 15(6): 806-13. doi: 10.1007/s10995-010-0647-y.
Domingues MR, Barros AJ. Leisure-time physical activity during pregnancy in the 2004 Pelotas Birth Cohort Study. Rev Saude Publica. 2007; 41(2): 173-80. Erratum in: Rev Saude Publica. 2007 Jun;41(3):493.
Liu J, Blair SN, Teng Y, Ness AR, Lawlor DA, Riddoch C. Physical activity during pregnancy in a prospective cohort of British women: results from the Avon longitudinal study of parents and children. Eur J Epidemiol. 2011; 26(3): 237-47. doi: 10.1007/s10654-010-9538-1.
Juhl M, Olsen J, Andersen PK, Nøhr EA, Andersen AM. Physical exercise during pregnancy and fetal growth measures: a study within the Danish National Birth Cohort. Am J Obstet Gynecol. 2010; 202(1): 63.e1-8. doi: 10.1016/j.ajog.2009.07.033.
Misra DP, Strobino DM, Stashinko EE, Nagey DA, Nanda J. Effects of physical activity on preterm birth. Am J Epidemiol. 1998; 147(7): 628-35.
Lynch KE, Landsbaugh JR, Whitcomb BW, Pekow P, Markenson G, Chasan-Taber L. Physical activity of pregnant Hispanic women. Am J Prev Med. 2012; 43(4): 434-9.
Wojtyła C, Wojtyła – Buciora P. Cigarette smoking among pregnant women in Poland. J Health Inequal 2017; 3(1): 47–5. doi:
Wojtyła C, Wojtyła A. Alcohol consumption by pregnant women in Poland. J Health Inequal. 2017; 3: 51–57. doi:
Stelmach M, Janik-Koncewicz K, Herbeć A, Wijatkowska K, Wojtyła A, Zatoński WA. Give it up! – a new mobile app and campaign supporting women to quit smoking in Poland – project rationale and app description. J Health Inequal. 2018; 4(1): 23–26 doi:
CDC. Pregnancy Risk Assessment Monitoring System. Accessed October 29, 2018.
Wojtyla C, Wojtyla-Buciora P. Polish Pregnancy-related Assessment Monitoring System (Pol-PrAMS): research on lifestyle health behaviours of Polish women during gestation – study design. J Health Inequal. 2016; 2: 185-191.
Pregnancy Physical Activity Questionnaire. Instruction. Accessed April 20, 2018.
Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000; 32(9 Suppl): S498-504.
Chasan-Taber L, Schmidt MD, Roberts DE, Hosmer D, Markenson G, Freedson PS. Development and validation of a Pregnancy Physical Activity Questionnaire. Med Sci Sports Exerc. 2004 Oct; 36(10): 1750-60. Erratum in: Med Sci Sports Exerc. 2011; 43(1):195.
Harrison CL, Thompson RG, Teede HJ, Lombard CB. Measuring physical activity during pregnancy. Int J Behav Nutr Phys Act. 2011; 8:19. doi: 10.1186/1479-5868-8-19.
Schmidt MD, Freedson PS, Pekow P, Roberts D, Sternfeld B, Chasan-Taber L. Validation of the Kaiser Physical Activity Survey in pregnant women. Med Sci Sports Exerc. 2006; 38(1): 42-50.
American College of Obstetricians and Gynecologists. ACOG Committee opinion. 549: obesity in pregnancy. Obstet Gynecol. 2013; 121: 213-217.
Artal R. The role of exercise in reducing the risks of gestational diabetes mellitus in obese women. Best Pract Res Clin Obstet Gynaecol. 2015; 29(1): 123-32. doi: 10.1016/j.bpobgyn.2014.05.013.
Bergier J, Kapka-Skrzypczak L, Biliński P, Paprzycki P, Wojtyła A. Physical activity of Polish adolescents and young adults according to IPAQ: a population based study. Ann Agric Environ Med. 2012; 19(1): 109-15.
Chandonnet N, Saey D, Alméras N, Marc I. French Pregnancy Physical Activity Questionnaire compared with an accelerometer cut point to classify physical activity among pregnant obese women. PLoS One. 2012; 7(6): e38818. doi: 10.1371/journal.pone.0038818.
Schmidt T, Heilmann T, Savelsberg L, Maass N, Weisser B, Eckmann-Scholz C. Physical Exercise During Pregnancy - How Active Are Pregnant Women in Germany and How Well Informed? Geburtshilfe Frauenheilkd. 2017; 77(5): 508-15. doi: 10.1055/s-0043-107785.
Cohen TR, Plourde H, Koski KG. Use of the Pregnancy Physical Activity Questionnaire (PPAQ) to identify behaviours associated with appropriate gestational weight gain during pregnancy. J Phys Act Health. 2013; 10(7): 1000-7.
Wojtyła A, Kapka-Skrzypczak L, Paprzycki P, Skrzypczak M, Biliński P. Epidemiological studies in Poland on effect of physical activity of pregnant women on the health of offspring and future generations - adaptation of the hypothesis development origin of health and diseases. Ann Agric Environ Med. 2012; 19(2): 315-26.