The following is a summary of “Activity Restriction and Risk of adverse pregnancy outcomes,” published in the August 2024 issue of Obstetrics and Gynecology by Ha et al.
Activity restriction (AR) is commonly recommended during pregnancy for various conditions despite a lack of conclusive evidence demonstrating its effectiveness in improving pregnancy outcomes. This study aimed to assess whether AR is associated with a reduced likelihood of adverse pregnancy outcomes (APOs).
Researchers conducted a secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b) cohort, which followed nulliparous singletons across eight sites from October 2010 to September 2013. Data on demographics and clinical factors were collected at four time points, with AR recommendations recorded between 22 and 29 weeks gestation and at delivery. Participants who had missing data on AR or age were excluded. Investigators analyzed the association between AR and various APOs, including gestational hypertension (gHTN), preeclampsia/eclampsia, preterm birth (PTB), and small for gestational age (SGA) neonate, using uni- and multivariable logistic regression models adjusted for identified risk factors. Of 10,038 participants, 9,312 met the inclusion criteria, with 1,386 (14.9%) receiving AR recommendations. Notably, Black [adjusted odds ratio (aOR) 0.81, 95% CI 0.68-0.98] and Hispanic [aOR 0.73, 95% CI 0.61-0.87] participants were less likely to receive AR compared to White participants.
Overall, 3,197 (34.3%) participants experienced at least one APO, with 51.7% of those recommended AR compared to 31.3% without AR. After adjusting for baseline differences, AR was associated with increased odds of gHTN [aOR 1.61, 95% CI 1.35-1.92], preeclampsia/eclampsia [aOR 2.52, 95% CI 2.06-3.09], and both iatrogenic and spontaneous PTB [aOR 2.98, 95% CI 2.41-3.69], but not in neonates with SGA.
These findings suggest that AR is linked to higher odds of hypertensive disorders and PTB. Future research is needed to explore potential causative relationships and assess the influence of racial and ethnic disparities in AR recommendations.
Source: sciencedirect.com/science/article/abs/pii/S2589933324001964
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