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Prematurity

Poster Session 1

(315) Activity in women at risk for early delivery: A prospective observational study

Tuesday, February 13, 2024
10:30 AM – 12:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

    Primary & Presenting Author(s)

  • Anthony C. Sciscione, DO

    Program Director
    Delaware Center for Maternal & Fetal Medicine of Christiana Care, Inc.
    Newark, DE, United States

Objective:

Activity restriction is commonly employed in pregnancy without evidence that it prolongs pregnancy or improves outcomes. We sought to evaluate whether physical activity in patients at high risk for preterm birth was associated with pregnancy prolongation. 

Study Design:

An ancillary study of preterm birth prevention in patients with a short cervical length. Participants were enrolled from 16.0 to 25.6 weeks and were instructed to wear a wrist accelerometer (Fitbit Flex 2) until delivery. Physical activity data (steps per day) were reviewed weekly by research nurses along with a monthly interview. Sedentary activity is commonly defined as < 3,500 or < 5,000 steps per day (SPD). We compared outcomes between < 3500 median SPD vs ≥ 3500 median SPD; and < 5000 median SPD vs. ≥ 5000 median SPD. The primary outcome was time from enrollment to delivery.

Results:

Overall 120 patients were enrolled and 117 (97.5%) had accelerometer data. Median gestational age at entry was 22.5 weeks (IQR 21.3, 23.7). At enrollment, a quarter of patients (25.8%) were placed on activity restriction (AR) by their provider. Median cervical length at baseline did not differ by SPD. Time from enrollment to delivery did not differ by SPD group. However, participants with < 3500 median SPD delivered earlier and were more likely to deliver at < 34 weeks vs.  ≥ 3500 median SPD (Table). Of 104 patients with accelerometer and study visit data, 39 (37.5 %) were ultimately placed on AR. Of patients prescribed AR, 51.3% reported modifying their work schedule vs. 27.7% who were not prescribed on AR.

Conclusion: Among individuals with a short cervix in the second trimester, physical activity level was not associated with time to delivery. However, the risk of preterm delivery at < 34 weeks was significantly higher with less activity (< 3500 steps per day). Patients are still being placed on AR and even when not placed on AR patients are still modifying their work schedules.