Association of Prepregnancy Nutritional Status and Physical Activity Levels with Birth Size Outcomes among West Sumatran Pregnant Women: Results from the Vitamin D Pregnant Mothers Cohort Study in Indonesia

Arif Sabta Aji; Yusrawati Yusrawati; Safarina G. Malik; Chahya Kusuma; Nurindrawaty Lipoeto

doi:10.3889/oamjms.2021.6898

Authors

Arif Sabta Aji Department of Nutrition, Faculty of Health Sciences, Universitas Alma Ata, Yogyakarta, Indonesia; Department of Public Health, Alma Ata Graduate School of Public Health, Faculty of Health Sciences, Universitas Alma Ata, Yogyakarta, Indonesia https://orcid.org/0000-0001-6952-0010
Yusrawati Yusrawati Department of Obstetry and Gynaecology, Faculty of Medicine, Universitas Andalas, Padang, Indonesia
Safarina G. Malik Department of Eijkman, Institute for Molecular Biology, Jakarta, Indonesia https://orcid.org/0000-0002-7258-2586
Chahya Kusuma Department of Public Health, Alma Ata Graduate School of Public Health, Faculty of Health Sciences, Universitas Alma Ata, Yogyakarta, Indonesia
Nurindrawaty Lipoeto Department of Nutrition, Faculty of Medicine, Andalas University, Padang, Indonesia https://orcid.org/0000-0003-4119-3593

DOI:

https://doi.org/10.3889/oamjms.2021.6898

Keywords:

Pregnancy, Physical activity, Body mass index, Birth size, Indonesia

Abstract

Background: Maternal and neonatal morbidity is still high in developing countries like in Indonesia. There are several factors may affect maternal health during pregnancy such as physical activity level (PAL) and pre-pregnancy nutritional status.

Aim: To analyze the association between maternal physical activity status (PAL) and pre-pregnancy body mass index (PP BMI) with birth size outcomes.

Methods: A prospective birth cohort study, Vitamin D Pregnant Mothers (VDPM) Study, to 183 healthy singleton pregnant women. Pre-pregnancy body mass index was classified according to WHO guidelines for Asian Population. Women PAL was measured at the first trimester (T1) and third trimester (T3) during pregnancy using the Global Physical Activity Questionnaire (GPAQ). Birth size outcomes were measured immediately after birth such as birth weight, birth length, and head circumference.

Results: Pregnant women at T3 had two times lower physical activity than T1 of pregnancy (OR, 2.18; CI, 1.044-4.57; p = 0.045). Maternal PAL at T1 and T3 were mostly in sedentary level (74.3% and 77.1%, respectively). There was no association between PP BMI, PAL, and birth size outcomes (p > 0.05 for all comparisons). However, the physical activity at T1 had a significant association with birth weight outcomes [MD (95%CI): 155.3 (13.8 – 296.8), p = 0.032]. There was a significant interaction between maternal PAL and PP BMI on birth weight (p interaction = 0.011) and head circumference (p interaction = 0.034).

Conclusions: Our study reveals that pre-maternal nutritional status and physical activity behavior during the pregnancy associated with the head circumference and birth weight outcomes. Further large studies are needed to confirm our findings.

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References

Smith KM, Campbell CG. Physical activity during pregnancy: Impact of applying different physical activity guidelines. J Pregnancy. 2013;2013:165617. https://doi.org/10.1155/2013/165617 DOI: https://doi.org/10.1155/2013/165617

Nascimento SL, Surita FG, Godoy AC, Kasawara KT, Morais SS. Physical activity patterns and factors related to exercise during pregnancy: A cross sectional study. PLoS One. 2015;10(7):e0133564. https://doi.org/10.1371/journal.pone.0133564 PMid:26083416 DOI: https://doi.org/10.1371/journal.pone.0133564

Aji AS, Desmawati D, Yerizel E, Lipoeto NI. The association between lifestyle and maternal vitamin D during pregnancy in West Sumatra, Indonesia. Asia Pac J Clin Nutr. 2018;27(6):1286. PMid:30485928

Roland MC, Friis CM, Godang K, Bollerslev J, Haugen G, Henriksen T. Maternal factors associated with fetal growth and birthweight are independent determinants of placental weight and exhibit differential effects by fetal sex. PLoS One. 2014;9:e87303. https://doi.org/10.1371/journal.pone.0087303 DOI: https://doi.org/10.1371/journal.pone.0087303

Ferraro ZM, Gaudet L, Adamo KB. The potential impact of physical activity during pregnancy on maternal and neonatal outcomes. Obstet Gynecol Surv. 2012;67(2):99-110. https://doi.org/10.1097/ogx.0b013e318242030e PMid:22325300 DOI: https://doi.org/10.1097/OGX.0b013e318242030e

Muktabhant B, Lumbiganon P, Ngamjarus C, Dowswell T. Interventions for preventing excessive weight gain during pregnancy. Cochrane Database Syst Rev. 2012;4:CD007145. https://doi.org/10.1002/14651858.cd007145.pub2 PMid:22513947 DOI: https://doi.org/10.1002/14651858.CD007145.pub2

Tremblay MS, Shields M, Laviolette M, Craig CL, Janssen I, Connor Gorber S. Fitness of Canadian children and youth: Results from the 2007-2009 Canadian health measures survey. Health Rep. 2010;21(1):7-20. PMid:20426223

Aji AS, Erwinda E, Yusrawati Y, Malik SG, Lipoeto NI. Vitamin D deficiency status and its related risk factors during early pregnancy: A cross-sectional study of pregnant Minangkabau women, Indonesia. BMC Pregnancy Childbirth. 2019;19(1):183. https://doi.org/10.1186/s12884-019-2341-4 PMid:31117971 DOI: https://doi.org/10.1186/s12884-019-2341-4

Aji AS, Yerizel E, Desmawati D, Lipoeto NI. Low maternal Vitamin D and calcium food intake during pregnancy associated with place of residence: A cross-sectional study in West sumatran women, Indonesia. Open Access Maced J Med Sci. 2019;7(17):2879-85. https://doi.org/10.3889/oamjms.2019.659 PMid:31844453 DOI: https://doi.org/10.3889/oamjms.2019.659

Lim JU, Lee JH, Kim JS, Hwang YI, Kim TH, Lim SY, et al. Comparison of World Health Organization and Asia-Pacific body mass index classifications in COPD patients. Int J Chron Obstruct Pulmon Dis. 2017;12:2465-75. https://doi.org/10.2147/copd.s141295 PMid:28860741 DOI: https://doi.org/10.2147/COPD.S141295

Sattler MC, Jaunig J, Watson ED, van Poppel MN, Mokkink LB, Terwee CB, et al. Physical activity questionnaires for pregnancy: A systematic review of measurement properties. Sports Med. 2018;48(10):2317-46. https://doi.org/10.1007/s40279-018-0961-x PMid:30094797 DOI: https://doi.org/10.1007/s40279-018-0961-x

Bisson M, Croteau J, Guinhouya BC, Bujold E, Audibert F, Fraser WD, et al. Physical activity during pregnancy and infant’s birth weight: Results from the 3D birth cohort. BMJ Open Sport Exerc Med. 2017;3(1):e000242. https://doi.org/10.1136/bmjsem-2017-000242 PMid:28761717 DOI: https://doi.org/10.1136/bmjsem-2017-000242

Rêgo AS, Batista RF, Ribeiro CC, Bettiol H, Cardoso VC, Barbieri MA, et al. Physical activity in pregnancy and adverse birth outcomes. Cad Saúde Pública. 2016;32(11):e00086915 PMid:27925023 DOI: https://doi.org/10.1590/0102-311x00086915

Xi C, Luo M, Wang T, Wang Y, Wang S, Guo L, et al. Association between maternal lifestyle factors and low birth weight in preterm and term births: A case-control study. Reprod Health. 2020;17(1):93. https://doi.org/10.1186/s12978-020-00932-9 PMid:32527333 DOI: https://doi.org/10.1186/s12978-020-00932-9

Kasawara KT, do Nascimento SL, Costa ML, Surita FG, Silva JL. Exercise and physical activity in the prevention of pre‐eclampsia: Systematic review. Acta Obstet Gynecol Scand. 2012;91(10):1147-57. https://doi.org/10.1111/j.1600-0412.2012.01483.x PMid:22708966 DOI: https://doi.org/10.1111/j.1600-0412.2012.01483.x

Vamos CA, Flory S, Sun H, DeBate R, Bleck J, Thompson E, et al. Do physical activity patterns across the Lifecourse impact birth outcomes? Matern Child Health J. 2015;19(8):1775-82. https://doi.org/10.1007/s10995-015-1691-4 PMid:25874877 DOI: https://doi.org/10.1007/s10995-015-1691-4

Evenson KR, Barakat R, Brown WJ, Dargent-Molina P, Haruna M, Mikkelsen EM, et al. Guidelines for physical activity during pregnancy: Comparisons from around the world. Am J Lifestyle Med. 2014;8(2):102-21. https://doi.org/10.1177/1559827613498204 PMid:25346651 DOI: https://doi.org/10.1177/1559827613498204

Bauer I, Hartkopf J, Kullmann S, Schleger F, Hallschmid M, Pauluschke-Fröhlich J, et al. Spotlight on the fetus: How physical activity during pregnancy influences fetal health: A narrative review. BMJ Open Sport Exerc Med. 2020;6(1):e000658. https://doi.org/10.1136/bmjsem-2019-000658 PMid:32206341 DOI: https://doi.org/10.1136/bmjsem-2019-000658

Bahadoran P, Mohamadirizi S. Relationship between physical activity and quality of life in pregnant women. Iran J Nurs Midwifery. 2015;20:282.

Pathirathna ML, Sekijima K, Sadakata M, Fujiwara N, Muramatsu Y, Wimalasiri KM. Effects of physical activity during pregnancy on neonatal birth weight. Sci Rep. 2019;9:6000. https://doi.org/10.1038/s41598-019-42473-7 DOI: https://doi.org/10.1038/s41598-019-42473-7

Newton ER, May L. Adaptation of maternal-fetal physiology to exercise in pregnancy: The basis of guidelines for physical activity in pregnancy. Clin Med Insights Womens Health. 2017;10:1179562X17693224. https://doi.org/10.1177/1179562x17693224 PMid:28579865 DOI: https://doi.org/10.1177/1179562X17693224

Badon SE, Wander PL, Qiu C, Miller RS, Williams MA, Enquobahrie DA. Maternal leisure time physical activity and infant birth size. Epidemiology. 2016;27(1):74-81. https://doi.org/10.1097/ede.0000000000000399 PMid:26427724 DOI: https://doi.org/10.1097/EDE.0000000000000399

Gondwe A, Ashorn P, Ashorn U, Dewey KG, Maleta K, Nkhoma M, et al. Pre-pregnancy body mass index (BMI) and maternal gestational weight gain are positively associated with birth outcomes in rural Malawi. PLoS One. 2018;13:e0206035. https://doi.org/10.1371/journal.pone.0206035 PMid:30352100 DOI: https://doi.org/10.1371/journal.pone.0206035

Wise LA, Palmer JR, Heffner LJ, Rosenberg L. Prepregnancy body size, gestational weight gain, and risk of preterm birth in African-American women. Epidemiology. 2010;21(2):243-52. https://doi.org/10.1097/ede.0b013e3181cb61a9 PMid:20124904 DOI: https://doi.org/10.1097/EDE.0b013e3181cb61a9

Stamnes Koepp UM, Frost Andersen L, Dahl-Joergensen K, Stigum H, Nass O, Nystad W. Maternal pre-pregnant body mass index, maternal weight change and offspring birthweight. Acta Obstet Gynecol Scand. 2012;91:243-9. https://doi.org/10.1111/j.1600-0412.2011.01321.x PMid:22077818 DOI: https://doi.org/10.1111/j.1600-0412.2011.01321.x

Hinkle SN, Schieve LA, Stein AD, Swan DW, Ramakrishnan U, Sharma AJ. Associations between maternal prepregnancy body mass index and child neurodevelopment at 2 years of age. Int J Obes (Lond) 2012;36(10):1312-9. https://doi.org/10.1038/ijo.2012.143 PMid:22964791 DOI: https://doi.org/10.1038/ijo.2012.143

Watson ED, Micklesfield LK, van Poppel MN, Norris SA, Sattler MC, Dietz P, et al. Validity and responsiveness of the global physical activity questionnaire (GPAQ) in assessing physical activity during pregnancy. PLoS One. 2017;12(5):e0177996. https://doi.org/10.1371/journal.pone.0177996 PMid:28552977 DOI: https://doi.org/10.1371/journal.pone.0177996