Walking promotion in healthy pregnant women and perinatal outcomes: a multivariate analysis comparing active and sedentary mothers

Abstract

BACKGROUND: Regular physical activity during pregnancy is associated with important maternal health benefits, yet the specific impact of walking on labour and neonatal outcomes remains unclear. Although walking is the most common form of exercise among pregnant women, evidence linking walking levels to obstetric and neonatal results is still limited. We aim to explore the relationship between walking activity level in the third trimester of pregnancy (T3) and obstetric and neonatal outcomes. METHODS: This was a secondary analysis of the Walking_Preg Project (WPP) randomised clinical trial registered in the U.S. National Library of Medicine Trials registry (https://clinicaltrials.gov/study/NCT03735381). Participants were healthy, low-risk pregnant women who were not previously physically active. They were given pedometers and physical activity recommendations. The sample was classified at T3 as physically active (?7,500 steps/day) or sedentary (<7,500 steps/day) according to Tudor-Locke and Bassett's index to classify pedometer-determined physical activity in healthy adults. Multivariate analyses were conducted to compare obstetric and neonatal outcomes between active and sedentary women. RESULTS: 41 pregnant women walked at least 7,500 steps per day in T3, while 137 did not reach that activity level. The crude and adjusted multivariate models showed an inverse relationship between walking ?7,500 steps/day in T3 and unplanned caesarean delivery (adjusted OR 0.27, 95% CI 0.05-1.47) as well as a positive relationship with induction of labour (adjusted OR 1.10, 95% CI 0.46-2.61) and neonatal weight (adjusted B coef = 97.55, 95% CI -64.03-259.14; p = 0.23). However, statistical significance was not reached. CONCLUSIONS: In this secondary analysis, no statistically significant associations were observed between walking activity during the third trimester and obstetric or neonatal outcomes. Given the low adherence to the walking program and the exploratory nature of the analysis, these findings should be interpreted with caution and require confirmation in larger, adequately powered studies.