Abstract
Objectives Cigarette smoking, low physical activity, and sedentary behavior are modifiable risk factors for adverse pregnancy outcomes. However, only one study has evaluated predictors of these health risk behaviors among women at high risk for gestational diabetes mellitus (GDM). Therefore, our goal was to examine predictors of smoking, low physical activity, and sedentary behavior during pregnancy in an ethnically diverse high risk cohort. Methods This cross-sectional analysis utilized baseline data from the Behaviors Affecting Baby and You (B.A.B.Y.) study conducted among prenatal care patients at high risk for GDM (personal history of GDM or family history of diabetes and body mass index [BMI] ≥ 25 kg/m2). Smoking was assessed using questions from the Pregnancy Risk Assessment Monitoring System questionnaire and sedentary behavior (top vs. lower quartiles) and moderate/vigorous physical activity (bottom vs. upper quartile) via the Pregnancy Physical Activity Questionnaire. Results Participants (n = 400) enrolled at a mean of 12.4 (SD 3.6) weeks gestation. A total of 150 (44.1%) engaged in one, 37 (10.9%) in two, and 4 (1.2%) in three risk behaviors. Lower household income and not having children at home were each associated with a 2–6 fold increased odds of smoking, high sedentary behavior, and engaging in at least one risk behavior. Being married, Hispanic or of younger age was associated with a 2–6 fold reduced odds of smoking. BMI and personal history of GDM were not associated with risk behaviors. Conclusions for Practice Findings help characterize high risk groups and inform prenatal interventions targeting these health risk behaviors.
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Ainsworth, B. E., Haskell, W. L., Herrmann, S. D., Meckes, N., Bassett, D. R., Jr, Tudor-Locke, C., … Leon, A. S. (2011). 2011 compendium of physical activities: A second update of codes and MET values. Medicine and Science in Sports and Exercise, 43(8), 1575–1581. https://doi.org/10.1249/MSS.0b013e31821ece12.
Ainsworth, B. E., Haskell, W. L., Leon, A. S., Jacobs, D. R., Montoye, H. J., Jr., Sallis, J. F., & Paffenbarger, R. S. (1993). Compendium of physical activities: Classification of energy costs of human physical activities. Medicine and Science in Sports and Exercise, 25(1), 71–80.
Artal, R., & O’Toole, M. (2003). Guidelines of the american college of obstetricians and gynecologists for exercise during pregnancy and the postpartum period. British Journal of Sports Medicine, 37(1), 6–12 (discussion 12).
Chasan-Taber, L., Freedson, P. S., Roberts, D. E., Schmidt, M. D., & Fragala, M. S. (2007). Energy expenditure of selected household activities during pregnancy. Research Quarterly for Exercise and Sport, 78(2), 133–137.
Chasan-Taber, L., Schmidt, M. D., Roberts, D. E., Hosmer, D., Markenson, G., & Freedson, P. S. (2004). Development and validation of a pregnancy physical activity questionnaire. Medicine and Science in Sports and Exercise, 36(10), 1750–1760.
Chasan-Taber, L., Silveira, M., Lynch, K. E., Pekow, P., Braun, B., Manson, J. E., Solomon, C. G., & Markenson, G. (2014). Physical activity before and during pregnancy and risk of abnormal glucose tolerance among Hispanic women. Diabetes & Metabolism, 41(1), 67–75.
Chasan-Taber, L., Silveira, M., Marcus, B. H., Braun, B., Stanek, E., & Markenson, G. (2011). Feasibility and efficacy of a physical activity intervention among pregnant women: The behaviors affecting baby and you (B.A.B.Y.) study. Journal of Physical Activity & Health, 8(Suppl 2), S228–S238.
Edmonds, J. K., Hawkins, S. S., & Cohen, B. B. (2014). The influence of detailed maternal ethnicity on cesarean delivery: Findings from the U.S. birth certificate in the state of massachusetts. Birth, 41(3), 290–298. https://doi.org/10.1111/birt.12108.
Evenson, K. R., & Wen, F. (2010). National trends in self-reported physical activity and sedentary behaviors among pregnant women: NHANES 1999–2006. Preventive Medicine, 50(3), 123–128. https://doi.org/10.1016/j.ypmed.2009.12.015.
Gollenberg, A., Pekow, P., Markenson, G., Tucker, K. L., & Chasan-Taber, L. (2008). Dietary behaviors, physical activity, and cigarette smoking among pregnant puerto rican women. The American Journal of Clinical Nutrition, 87(6), 1844–1851.
Hammoud, A. O., Bujold, E., Sorokin, Y., Schild, C., Krapp, M., & Baumann, P. (2005). Smoking in pregnancy revisited: Findings from a large population-based study. American Journal of Obstetrics and Gynecology, 192(6), 1856–1862. https://doi.org/10.1016/j.ajog.2004.12.057 (discussion 1862–3).
Harrod, C. S., Chasan-Taber, L., Reynolds, R. M., Fingerlin, T. E., Glueck, D. H., Brinton, J. T., & Dabelea, D. (2014). Physical activity in pregnancy and neonatal body composition: The healthy start study. Obstetrics and Gynecology, 124(2 Pt 1), 257–264. https://doi.org/10.1097/AOG.0000000000000373.
Hunt, K. J., & Schuller, K. L. (2007). The increasing prevalence of diabetes in pregnancy. Obstetrics and Gynecology Clinics of North America, 34(2), 173–199. https://doi.org/10.1016/j.ogc.2007.03.002.
Kahn, R. S., Certain, L., & Whitaker, R. C. (2002). A reexamination of smoking before, during, and after pregnancy. American Journal of Public Health, 92(11), 1801–1808.
Kvalvik, L. G., Nilsen, R. M., Skjaerven, R., Vollset, S. E., Midttun, O., Ueland, P. M., & Haug, K. (2012). Self-reported smoking status and plasma cotinine concentrations among pregnant women in the norwegian mother and child cohort study. Pediatric Research, 72(1), 101–107. https://doi.org/10.1038/pr.2012.36.
Leppanen, M., Aittasalo, M., Raitanen, J., Kinnunen, T. I., Kujala, U. M., & Luoto, R. (2014). Physical activity during pregnancy: Predictors of change, perceived support and barriers among women at increased risk of gestational diabetes. Maternal and Child Health Journal. https://doi.org/10.1007/s10995-014-1464-5.
Martell, B. N., Garrett, B. E., & Caraballo, R. S. (2016). Disparities in adult cigarette smoking: United States, 2002–2005 and 2010–2013. Morbidity and Mortality Weekly Report, 65(30), 753–758.
Martin, L. T., McNamara, M., Milot, A., Bloch, M., Hair, E. C., & Halle, T. (2008).Correlates of smoking before, during, and after pregnancy. American Journal of Health Behavior, 32(3), 272–282.
Ning, Y., Williams, M. A., Dempsey, J. C., Sorensen, T.K., Frederick, I. O., & Luthy, D. A. (2003). Correlates of recreational physical activity in early pregnancy. The Journal of Maternal-Fetal & Neonatal Medicine: The Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians, 13(6), 385–393. https://doi.org/10.1080/jmf.13.6.385.393.
Office of Data Management and Outcomes Assessment, Massachusetts Department of Public Health (2014). Massachusetts Births 2013. Resource document. Accessed January 20, 2017, from http://www.mass.gov/eohhs/docs/dph/research-epi/birth-report-2013.pdf.
Petersen, A. M., Leet, T. L., & Brownson, R. C. (2005). Correlates of physical activity among pregnant women in the united states. Medicine and Science in Sports and Exercise, 37(10), 1748–1753.
Poyatos-Leon, R., Garcia-Hermoso, A., Sanabria-Martinez, G., Alvarez-Bueno, C., Sanchez-Lopez, M., & Martinez-Vizcaino, V. (2015). Effects of exercise during pregnancy on mode of delivery: A meta-analysis. Acta Obstetricia Et Gynecologica Scandinavica, 94(10), 1039–1047. https://doi.org/10.1111/aogs.12675.
R Core Team. R: A language and environment for statistical computing.
Rossen, L. M., & Schoendorf, K. C. (2014). Trends in racial and ethnic disparities in infant mortality rates in the united states, 1989–2006. American Journal of Public Health, 104(8), 1549–1556. https://doi.org/10.2105/AJPH.2013.301272.
Savitz, D. A., & Murnane, P. (2010). Behavioral influences on preterm birth: A review. Epidemiology, 21(3), 291–299. https://doi.org/10.1097/EDE.0b013e3181d3ca63.
Tobias, D. K., Zhang, C., van Dam, R. M., Bowers, K., & Hu, F. B. (2011). Physical activity before and during pregnancy and risk of gestational diabetes mellitus: A meta-analysis. Diabetes Care, 34(1), 223–229.
Tong, V. T., Dietz, P. M., Morrow, B., D’Angelo, D. V., Farr, S. L., Rockhill, K. M., … Centers for Disease Control and Prevention (CDC). (2013). Trends in smoking before, during, and after pregnancy–pregnancy risk assessment monitoring system, United States, 40 sites, 2000–2010. Morbidity and Mortality Weekly Report: Surveillance Summaries, 62(6), 1–19.
Zhang, C., Solomon, C. G., Manson, J. E., & Hu, F. B. (2006). A prospective study of pregravid physical activity and sedentary behaviors in relation to the risk for gestational diabetes mellitus. Archives of Internal Medicine, 166(5), 543–548. https://doi.org/10.1001/archinte.166.5.543.
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This study was funded by National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases Grant R01DK074876.
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Nobles, C.J., Marcus, B.H., Stanek, E.J. et al. The Health Behaviors of Ethnically Diverse Women at Increased Risk of Gestational Diabetes: The Behaviors Affecting Baby and You (B.A.B.Y.) Study. Matern Child Health J 22, 735–744 (2018). https://doi.org/10.1007/s10995-018-2442-0
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DOI: https://doi.org/10.1007/s10995-018-2442-0