Effects of structured education and a physical activity prescription during prenatal care on maternal and fetal outcomes: A quasi-experimental study

Abstract Background: Physical activity (PA) during pregnancy is associated with healthy gestational weight gain (GWG) and a reduction in risk of developing gestational diabetes (GD), hypertension (GHT) and fetal macrosomia. However, less than 20% of pregnant women meet the PA recommendations in Canada. We tested the effects of PA education and a PA prescription by prenatal nurses and physicians on fetal and maternal outcomes.Methods: Administrative data from two periods with distinct prenatal care offering were used. In the first period, 394 pregnant women followed at the obstetrics clinic of a university hospital received standard care whereas 422 women followed in the second period received standard care supplemented with education on the relevance of PA during pregnancy and a prescription for PA. Logistic regressions were used to compare odds of excessive GWG, GD, GHT, and fetal macrosomia between the two study groups.Results: The addition of PA education and PA prescription to prenatal care was associated with a 29% reduction in odds of excessive GWG (adjusted OR 0.71, 95% CI 0.51-0.99), 73% reduction in odds of GHT (0.27, 0.14-0.53) and 44% reduction in odds of fetal macrosomia (0.56, 0.34-0.93). The intervention was not associated with different odds of GD (0.48, 0.12-1.94). Conclusions: The inclusion of education and prescription of PA as part of routine prenatal care can lead to significant improvements in maternal and fetal health outcomes.