Date of Award


Document Type

Campus Access Thesis


Epidemiology and Biostatistics



First Advisor

Jihong Liu


Purpose: Inadequate or excessive weight gain during pregnancy can increase the risk for adverse maternal and fetal outcomes. Physical activity (PA) during pregnancy has been suggested as a lifestyle intervention to help mothers achieve their target weight gain recommendations. PA during pregnancy has been encouraged, but the knowledge about exercise and its association with weight gain during pregnancy is very limited. Thus, the primary objective of this study is to investigate the association between PA during pregnancy and gestational weight gain (GWG). Specifically, this study focused on two questions: 1) Is PA during pregnancy higher among non-Hispanic white women than women of non-Hispanic black or Other race/ethnicity; and 2) Do women who exercise during pregnancy have an increased odds of gaining weight within the recommended range.

Methods: Data came from the 2009 South Carolina Pregnancy Risk Assessment Monitoring System (PRAMS) (n=883). PA status was assessed in the following ways: 1) PA during pregnancy (yes vs. no); 2) patterns of PA before and during pregnancy; 3) total months of being physically active during pregnancy (0, 1-5, 6-9 months); and 4) physical activity index (PAI) (0, < 19, ¡Ý19). Using prepregnancy weight, women were categorized as underweight (body mass index (BMI) <18.5 kg/m2), normal weight (18.5-24.9), overweight (25.0-29.9), and obese (¡Ý30.0). The Institute of Medicine¡¯s 2009 GWG guidelines was used to determine the status of gestational weight gain (inadequate, adequate, and excessive). Multinomial logistic regression models were used to adjust for potential confounders.

Findings: We found 32.1% of the women reported PA during pregnancy. Our sample included 46% of women who were normal weight before entering pregnancy (BMI¡Ü25), with an additional 28.1% of the women being overweight, and 25.8% of the women being obese before pregnancy. We also found PA during pregnancy, PA before and during pregnancy, PAI, and PA months were all significantly associated with a lower odds of gaining excessive GWG during pregnancy. Women who reported exercise during pregnancy (AOR: 0.44, 95% CI: 0.23-0.88) or exercise both before and during pregnancy (AOR: 0.46, 95% CI: 0.23-0.90) had a lower odds of excessive GWG when compared to those who did not perform any exercise during pregnancy. Also women who had a PAI ¡Ý19 or those who reported being physically active for 6-9 months during pregnancy had about 70% lower odds of gaining excessive weight during pregnancy than their counterparts. Obese women had a lower odds of PA during pregnancy (AOR: 0.37; 95% CI: 0.19-0.72) compared to normal weight women. Overall, the results indicated that there is an association between prepregnancy BMI (p=0.0109) and PA.

Conclusions: Women who are physically active during pregnancy were more likely to meet GWG recommendations than women who were inactive during pregnancy. Our findings provide evidence to support the need to promote or increase PA during pregnancy to reduce the higher proportion of women who are gaining excessive GWG.