Study on the Correlation Between Physical Activity During Pregnancy and Delivery Mode in Nulliparous Patients：A prospective cohort study

BACKGROUND: Physical activity during pregnancy is a beneficial behavioral intervention aimed at enhancing pregnancy outcomes. Nevertheless, the association between prenatal physical activity and mode of delivery remains contentious. This study seeks to investigate whether physical activity during pregnancy correlates with the mode of delivery, with the ultimate objective of bolstering pregnant women's self-efficacy regarding physical activity and ameliorating pregnancy outcomes. OBJECTIVE: This study aims to test the hypothesis that physical activity during pregnancy is associated with a reduced risk of cesarean delivery. STUDY DESIGN: This prospective cohort study surveyed women with singleton pregnancies, free from contraindications to physical activity, utilizing the Chinese version of the Pregnancy Physical Activity Questionnaire. This instrument categorizes and quantifies physical activity by type and intensity. The primary outcome of interest is the mode of delivery. Univariate and multivariate binary logistic regression models were employed to ascertain the relationship between prenatal physical activity and mode of delivery. RESULTS: A total of 217 women participated in the physical activity survey during pregnancy and subsequently gave birth at our hospital. The median energy expenditure from physical activity during pregnancy was 145.70 (111.92, 181.69) MET-h·wk⁻¹. The mean age of the participants was 30.20±3.71 years. Among the 217 primiparas, 131 experienced vaginal deliveries, while 86 underwent cesarean sections. After comprehensive adjustment for covariates, the risk of cesarean delivery was found to be reduced by 60% in the group that adhered to the recommended levels of physical activity during pregnancy compared to the group that did not (OR: 0.40, 95% CI: 0.20 to 0.83, P=0.0130). CONCLUSION: Elevated levels of physical activity during pregnancy are associated with a reduced risk of cesarean delivery. Physical activity need not be confined to structured exercise programs; routine activities such as cleaning, shopping, and commuting on foot are effective means of increasing energy expenditure and achieving recommended physical activity levels.