Department of Psychology, University of Memphis, Memphis, Tennessee, USA.
Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
BMC Public Health. 2022 Nov 7;22(1):2029. doi: 10.1186/s12889-022-14457-2.
Physical activity is recommended for all pregnant individuals and can prevent excessive gestational weight gain. However, physical activity has not been assessed among military personnel and other TRICARE beneficiaries, who experience unique military lifestyles. The current study assessed physical activity among pregnant TRICARE beneficiaries, both active duty and non-active duty, as measured by accelerometry and self-report data to examine potential predictors of physical activity engagement in the third trimester, and if self-report data was consistent with accelerometry data. We expected having a lower BMI, being active-duty, and having higher baseline physical activity engagement to be associated with higher physical activity at 32-weeks. We also hypothesized that accelerometry data would show lower physical activity levels than the self-reported measure.
Participants were 430 TRICARE adult beneficiaries (204 Active Duty; 226 non-Active Duty) in San Antonio, TX who were part of a randomized controlled parent study that implemented a stepped-care behavioral intervention. Participants were recruited if they were less than 12-weeks gestation and did not have health conditions precluding dietary or physical activity changes (e.g., uncontrolled cardiovascular conditions) or would contribute to weight changes. Participants completed self-report measures and wore an Actical Activity Monitor accelerometer on their wrist to collect physical activity data at baseline and 32-weeks gestation.
Based on the accelerometer data, 99% of participants were meeting moderate physical activity guidelines recommending 150 min of moderate activity per week at baseline, and 96% were meeting this recommendation at 32-weeks. Based on self-report data, 88% of participants at baseline and 92% at 32-weeks met moderate physical activity recommendations. Linear regression and zero-inflated negative binomial models indicated that baseline physical activity engagement predicted moderate physical activity later in pregnancy above and beyond BMI and military status. Surprisingly, self-reported data, but not accelerometer data, showed that higher baseline activity was associated with decreased vigorous activity at 32-weeks gestation. Additionally, self-report and accelerometry data had small correlations at baseline, but not at 32-weeks.
Future intervention efforts may benefit from intervening with individuals with lower pre-pregnancy activity levels, as those who are active seem to continue this habit.
The trial is registered on clinicaltrials.gov (NCT03057808).
体力活动被推荐给所有孕妇，可以防止妊娠体重过度增加。然而，在经历独特的军事生活方式的军人和其他特里卡雷（TRICARE）受益人群中，还没有对体力活动进行评估。本研究通过加速度计和自我报告数据评估了怀孕特里卡雷受益人群（现役和非现役）的体力活动，以检查第三孕期体力活动参与的潜在预测因素，以及自我报告数据是否与加速度计数据一致。我们预计较低的 BMI、现役和较高的基线体力活动参与度与 32 周时较高的体力活动相关。我们还假设加速度计数据显示的体力活动水平低于自我报告测量值。
参与者是德克萨斯州圣安东尼奥的 430 名特里卡雷成年受益人群（204 名现役；226 名非现役），他们是一项随机对照父母研究的一部分，该研究实施了阶梯式护理行为干预。参与者如果处于妊娠不到 12 周，并且没有健康状况排除饮食或体力活动改变（例如，不受控制的心血管状况）或会导致体重变化，则符合入组条件。参与者完成自我报告测量，并在基线和妊娠 32 周时在手腕上佩戴 Actical 活动监测器加速度计收集体力活动数据。
基于加速度计数据，99%的参与者在基线时符合每周 150 分钟中等强度体力活动的推荐指南，96%的参与者在 32 周时符合这一建议。基于自我报告数据，88%的参与者在基线时和 92%的参与者在 32 周时符合中等强度体力活动建议。线性回归和零膨胀负二项式模型表明，基线体力活动参与度预测了妊娠后期的中等强度体力活动，超出了 BMI 和军事地位的预测。令人惊讶的是，自我报告数据，但不是加速度计数据，表明较高的基线活动与妊娠 32 周时剧烈活动的减少相关。此外，自我报告和加速度计数据在基线时有较小的相关性，但在 32 周时没有。
未来的干预措施可能受益于对基线活动水平较低的个体进行干预，因为那些活跃的个体似乎会继续保持这种习惯。
该试验在 clinicaltrials.gov 注册（NCT03057808）。
