Barriers to physical activity profile and related factors during pregnancy: a latent profile analysis

Barriers to physical activity profile and related factors during pregnancy: a latent profile analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Barriers to physical activity profile and related factors during pregnancy: a latent profile analysis Ting Shen, Yan Jiang, Wei Han, Qunfeng Lu, Cuiqin Huang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7462013/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Physical activity is a modifiable factor that contributes to maternal and fetal health. The percentage of pregnant women who did not meet World Health Organization recommendations was high. Recent studies have found that there are some barriers to PA during pregnancy and influencing factors; however, little is known about the exploration of population heterogeneity. Thus, this study emphasizes the distinct profiles of barriers to physical activity during pregnancy and the relevant factors, which are essential for screening potential groups with high levels of barriers to PA during pregnancy, quickly, and exhibiting a novel perspective for the management of barriers to physical activity among pregnant women. Methods A descriptive cross-sectional survey was carried out at one general hospital in Shanghai, China from December 1, 2024, to May 31, 2025. 300 pregnant women completed the demographic characteristics questionnaire, social support rating scale, generalized anxiety disorder-7 (GAD-7) questionnaires, the barriers to physical activity during pregnancy scale during pregnancy. Latent profile analysis(LPA) was used to identify groups showing different levels of barriers to physical activity during pregnancy. Additionally, univariate analysis and multinominal logistic regression analysis were used to reveal the factors influencing different groups. Results Three profiles of barriers to PA during pregnancy emerged: “Low physical activity barrier-worry about pregnancy complication group”(10.3%), “Moderate physical activity barrier- pregnancy-related discomfort symptom group”(54.3%), and “High physical activity barrier group”(35.3%). Multinomial logistic regression analysis revealed that the frequency of pre-pregnancy exercise and social support were significant factors affecting barriers to physical activity profiles. Conclusion We categorized barriers to PA during pregnancy and identified risk factors. Healthcare providers can provide targeted interventions for pregnant women according to the factors influencing different profiles to reduce the level of PA barriers in pregnant women. physical activity barriers pregnant women latent profile analysis Figures Figure 1 Introduction Physical activity(PA) refers to any bodily movement resulting from the contraction of skeletal muscles that causes energy expenditure and is essential for health maintenance of health[ 1 ]. Evidence shows that regular PA during pregnancy benefits the fetus and the mothers[ 2 ]. Appropriate physical activity without complications in pregnant women can significantly reduce the incidence of gestational hypertension and gestational diabetes mellitus, prevent excessive weight gain during pregnancy, relieve perinatal depression and lower back pain, reduce the occurrence of neonatal complications or the risk of emergency caesarean section[ 3 – 5 ], improve muscle strength, reduce labor pain, promote postpartum weight loss, and increase the significance of fetal oxygen supply[ 6 ].More importantly, PA is a modifiable factor contributing to maternal and fetal health[ 5 ]. In recent years, the concept of considering physical activity as a vital sign during pregnancy has been proposed and it has become a key element in prenatal care, fundamentally changing the way maternity healthcare is handled[ 7 ]. The World Health Organization (WHO) recommends at least 150 minutes of moderate-intensity physical activity per week during pregnancy in women with no pregnancy-related contraindications or complications[ 2 ]. A survey conducted in Shanghai, China, showed that 47.5% of pregnant women experienced physical inactivity, and only 2.8% achieved the recommended duration of 150 minutes per week[ 8 ]. Another study found that the prevalence of physical inactivity was highest(66.2%) in the first trimesters[ 9 ]. The percentages of pregnant women in Jordan and Zimbabwe who met WHO recommendations were 28.9% and 11%, respectively[ 10 , 11 ]. Barriers to physical activity refer to those that individuals face in carrying out, maintaining, or increasing physical activity[ 12 ]. Basic PA barriers include intrapersonal barriers, such as bad feelings of tiredness, illness, morning sickness, low energy, lack of interest or motivation, and high body weight; interpersonal barriers, such as being advised to avoid PA from others; unclear advice or lack of advice from healthcare workers; and environmental factors such as weather conditions[ 13 , 14 ]. Amiri-Farahani et al[ 15 ] developed the barriers to Physical Activity during Pregnancy Scale (BPAPS) based on relevant literature, and quantitative and qualitative studies revealed that the barriers to PA during pregnancy mostly included intrapersonal barriers related to pregnancy, intrapersonal barriers unrelated to pregnancy, interpersonal barriers, and environmental barriers. This study investigated the level of physical activity barriers during pregnancy using the BPAPS and found that the mean BPAPS scores of pregnant women living in Iran and Ibadan were 88.55 and 85.35, respectively[ 16 , 17 ]. Pre-pregnancy or early pregnancy body mass index, maternal education, antenatal admission, level of education, parity, attitudes toward exercise, ethnicity, income, and habitual exercise pre-pregnancy were factors of PA barriers[ 14 , 16 – 18 ]. In summary, previous studies have investigated the current status of physical activity barriers and analyzed these factors. However, heterogeneity within pregnant women has not been fully considered. Latent profile analysis (LPA) is an individual-centered method that identifies distinct subgroups within a population based on participants’ responses to individual items, allowing for the exploration of population heterogeneity[ 19 ]. To date, nearly all relevant studies have been conducted on latent profile analysis of barriers to physical activity during pregnancy. This study used LPA to explore the latent profiles of barriers to PA and further analyzed the factors with the aim of providing references for reducing barriers to PA during pregnancy. Research Questions What is the level of barriers to physical activity during pregnancy, and is there heterogeneity? If heterogeneity exists, which factors influencing barriers to physical activity across different potential profiles? Methods Study population This study used a descriptive cross-sectional design. This study followed the Reporting of Observational Studies (STROBE) checklist[ 20 ]. The participants were recruited from a grade 3A hospital in one city. The inclusion criteria were as follows: (1)informed consent and voluntary participation in this study, (2) adequate cognitive and behavioral abilities, and (3) age 18 years or older. The exclusion criteria were as follows: (1)women with absolute contraindications for PA (e.g., preeclampsia, cervical insufficiency, or unexplained persistent vaginal bleeding) during pregnancy. To ensure reliable and precise subgroup results in LPA, a minimum of 300 participants were necessary according to the recommendation[ 21 ]. The following formula was used to estimate the sample size: N = [max (number of items)] (5–10). After considering 10% of the invalid samples, the total required sample size ranged from 160 to 319 on a 29-item scale. A total of 320 questionnaires were distributed (by the author) to pregnant women from December 1, 2024, to May 31, 2025, by convenience sampling. We received 300 valid responses, resulting in an effective response rate of 93.8%. Measures General Information Questionnaire The demographic characteristic questionnaire included age, gestational age, current employment status, education level, personal monthly income, frequency of pre-pregnancy exercise, duration of each pre-pregnancy exercise session, and exercise guidance. All demographic information was a potential confounder based on the existing literature and clinical expert experience. Barriers to physical activity during pregnancy scale(BPAPS) Barriers to physical activity during pregnancy were measured using the 29-item self-reporting designed barriers to physical activity during pregnancy scale by Amiri-Farahani[ 15 ]. BPAPS includes four dimensions: intrapersonal barriers related to pregnancy, intrapersonal barriers unrelated to pregnancy, interpersonal barriers, and environmental barriers. The BPAPS was scored on a Likert 5-point scale: 5 = strong agreement, 4 = agreement, 3 = neutral, 2 = disagree, and 1 = strong disagreement. The scale demonstrated good internal consistency; the Cronbach’s α coefficient of the overall scale was 0.824, and the Cronbach’s α coefficient of the dimensions was 0.722–0.815. The Chinese version of BPAPS was developed by Yang et al[ 22 ]. The Cronbach’s α for this study was 0.946. Social Support Rating Scale The level of social support was measured using ten-item self-reporting designed social support rating scale by Xiao[ 23 ]. The scale includes three subscales: objective support, subjective support, and support utilization. The total score on the scale ranges from 12 to 83. The Cronbach’s α for this study was 0.769. Generalized Anxiety Disorder-7 (GAD-7) Questionnaires Anxiety was measured using the generalized anxiety disorder-7 (GAD-7) questionnaire, which was developed to measure the level of anxiety and has been validated in primary care settings[ 24 ] and is widely used in different populations[ 25 ]. The scale consists of seven items, each with four options, and scores range from (not at all) 0 to 3 (almost every day), with higher scores indicating more severe anxiety symptoms in the study participants. The Cronbach’s α for this study was 0.925. Data collection Data were collected online and the questionnaire was distributed using a web-based questionnaire through the “Questionnaire Star” network platform ( www.wjx.cn ), a popular online data-gathering tool in China used for conducting web surveys. One researcher met with the participants face-to-face to explain the purpose of the questionnaire. After obtaining permission from the participants, a quick response code was provided to them to scan and fill out the questionnaire. After completing the questionnaire, the participants successfully completed it, ensuring its integrity. The same account set in the background can be filled only once, to avoid repeated filling. The quality of the questionnaires was checked by two researchers and questionnaires that violated the requirements were deleted. Ethical considerations The questionnaires were completed anonymously to ensure confidentiality. To ensure the authenticity and reliability of the questionnaire and reduce participants’ concerns. An online version of the informed consent form was provided to all participants before they completed the questionnaire. The right to withdraw from the study at any time has been guaranteed, all information will be used only for this study, and we will keep it strictly confidential. This study was approved by the Ethics Committee (2025-KY-148 [K] ). Data analysis Mplus 8.0 statistical software was applied for latent profile analysis based on 29 barriers to physical activity during pregnancy. The model fit was assessed using several indices, including the Akaike information criterion(AIC), Bayesian information criterion(BIC), adjusted Bayesian information criterion(aBIC), bootstrap likelihood ratio test (BLRT), Lo-Mendell-Rubin likelihood ratio test (LMRT), and entropy. The smaller the values of AIC, BIC, aBIC, the better fits of the model[ 26 , 27 ]. Additionally, the Entropy value ranges from 0 to 1; the closer it is to 1, the more accurate is the classification. BLRT and LMRT were used to compare the fit of different class models. If the P-values corresponding to LMRT and BLRT reached a significant level, the K-class model was deemed superior to the K-1 class model0[ 28 , 29 ]. The above evaluation indices only provide a reference for profile decision making, and the interpretability of various categories should also be considered when determining the best model. SPSS 26.0 was used for descriptive analysis(means and standard deviation were used for measurement data, and frequencies or percentages (%) were used for count data). Univariate and multinomial logistic regression analyses were performed to evaluate the influence of various factors on organizational silence among the participants. Statistical significance was set at P 35 years old. The majority of the participants had a gestational age of 28 weeks or more(88.3%) and were on duty(84.3). Seventy% of participants had a high school education or less, 64% had a personal monthly income of more than 10 000 yuan; 23.3% had never exercised before pregnancy, 63.7% exercised less than 30 minutes per session before pregnancy, and up to 86.7% had never received physical activity guidance. The mean scores for social support and GAD-7 were 41.01 and 4.42, respectively. Detailed information is provided in Table 1. LPA results of barriers to physical activity during pregnancy scale The average score of each item of BPAPS for the 300 participants are 2.51±0.60, the average scores of each item of intrapersonal barriers related to pregnancy dimension of BPAPS, intrapersonal barriers non-related to pregnancy dimension of BPAPS, interpersonal barriers dimension of BPAPS and environmental barriers of BPAPS were 2.87±0.73, 2.47±0.78, 2.14±0.70, 2.34±0.67, respectively. Four profiles were fitted to the model and the results are presented in Table 2. The results show that as the number of categories gradually increased, the AIC, BIC, and BIC for models 1-4 gradually decreased. However, in the four-category model, the LMRT value (0.6141) is not significant. In the three-category model, the entropy value(0.964) was higher and the LMRT and BLRT values were significant. In addition, the value of the diagonal in the average probability matrix of the latent categories was significantly higher than 0.70, indicating that the results of the three-category latent classification model were reliable(Table 3). Therefore, three profiles were selected as best-fit models. Latent category and characteristics of barriers to physical activity during pregnancy among the participants Based on the latent classification results, the researchers plotted the scores of the three latent profiles for each topic of BPAPS. See Fig.1. The total score for Profile1 was 39.23±7.329, and the average score for all items was approximately 1.35 points, indicating a low level of barriers to physical activity during pregnancy. However, the average score of item 9 “I am concerned with possible pregnancy complications such as miscarriages and premature labor” was 2.246. Therefore, this category was named the “Low physical activity barrier-worry about pregnancy complications group”. There were 31 participants in this group(10.3%) were included in this group. The total score for Profile 2 was 68.11±7.053, and the average score for all items was approximately 2.35 points, showing a moderate level of barriers to physical activity during pregnancy. And the scores of each item of intrapersonal barriers related to pregnancy dimension were between 2.404 and 3.163, So the Profile2 was named the “Moderate physical activity barrier-pregnancy-related discomfort symptom group.” There were 163 participants in Profile2(54.3%). The total score for Profile 3 was 90.02±9.876, and the average score for all items was approximately 3.10 points, indicating a high level of barriers to physical activity during pregnancy. So, Profile3 was named the “High physical activity barrier group” and comprised 106 participants in Profile3(35.3%). Univariate analysis and multivariate logistic regression analysis of the factors influencing the latent categories of the barriers to physical activity during pregnancy among participants In the univariate analysis, educational level, personal monthly income, frequency of pre-pregnancy exercise, receiving exercise guidance or not, social support, and GAD-7 were factors that influenced the three latent profiles(P < 0.05). The results were presented in Table1. In the disordered multi-classification logistic regression, using Profile1 as the reference group, the results indicated that the statistically influencing factors were the frequency of pre-pregnancy exercise and social support. See Table4. The comparison between Profile3 and Profile1 reveled the following findings: (1)participants who had no exercise habits before pregnancy were 20.855 times more likely to belonging to Profile3 compared to other participants(P < 0.05). (2) The likelihood of participants belonging to Profile3 decreased by 8.8% with increasing social support scores (P < 0.05). TABLE 1. Demographic information four profile latent profiles among the participants(n,%) Item Total number Profile1（n=31） Profile2 （n=163） Profile3 （n=106） Value P Age 0.094 a 0.955 ≤35 246(82) 26（83.9） 133(81.6) 87(82.0) ＞35 54(18) 5（16.1） 30(18.4) 19(17.9) Gestational Age 3.334 a 0.189 ＜28 weeks 35(11.7) 2（6.5） 24（14.7） 9（8.5） ≥28 weeks 265(88.3) 29（93.5） 139（85.3） 97（91.5） Current employment status 0.253 a 0.881 Does not work 47(15.7) 5（16.1） 24（14.7） 18（17.0） On duty 253(84.3) 26（83.9） 139（85.3） 88（83.0） Education level 7.339 a 0.025 High school or less 210(70) 17（54.8） 110（67.5） 83（78.3） College or more 90(30) 14（45.2） 53（32.5） 23（21.7） Personal monthly income 7.412 a 0.025 ≤10,000 108(36) 10（32.3） 49（30.1） 49（46.2） ＞10,000 192(64) 21（67.7） 114（69.6） 57（53.8） Frequency of pre-pregnancy exercise 26.463 a ＜0.001 No 70(23.3) 1（3.2） 29（17.8） 40(37.7） 1~2 times weekly 113(37.7) 11（35.5） 67（41.1） 35（33.0） 3~6 times weekly 61(20.3) 10（32.3） 34（20.9） 17（16.0） Every day 56(18.7) 9（29.0） 33（20.2） 14（13.2） Duration of each exercise session of pre-pregnancy 8.454 a 0.076 ≤30 minutes 191(63.7) 15（48.4） 99（60.7） 77（72.6） 30~60 minutes 88(29.3) 14（45.2） 50（30.7） 24（22.6） ＞60 minutes 21(7) 2（6.5） 14（8.6） 5（4.7） Receiving exercise guidance 6.233 a 0.044 No 260(86.7) 28（90.3） 134（82.2） 98（86.7） Yes 40(13.3) 3（9.7） 29（17.8） 8（7.5） Social support score 41.01±6.87% 44.23±6.46 41.66±6.67 39.08±6.80 8.779 b ＜0.001 The score of GAD-7 4.42±2.07 3.61±1.34 3.85±1.45 5.54±1.65 6.403 b 0.002 a x 2 test, b ANOVA Note: Profile1: Low physical activity barrier-worry about pregnancy complication group; Profile 2: Moderate physical activity barrier- pregnancy-related discomfort symptom group; Profile 3: High physical activity barrier group. TABLE 2. Fitting index of latent profile analysis about the participants’ barriers to physical activity during pregnancy scale Model AIC BIC aBIC Entropy LMRT BLRT Class Probability 1 23637.361 23852.180 23668.238 —— —— —— —— 2 21584.593 21910.526 21631.442 0.941 0.0007 ＜0.001 155/145（0.52/0.48） 3 20707.097 21144.143 21144.143 0.964 0.0163 ＜0.001 31/163/106（0.10/0.54/0.35） 4 20267.819 20815.979 20346.610 0.957 0.6141 ＜0.001 33/119/66/82（0.11/0.39/0.22/0.28） Abbreviations: AIC = Akaike information criterion; BIC = Bayesian information criterion; aBIC = sample size-adjusted Bayesian information criterion; BLRT = bootstrap likelihood ratio test; LMR = Lo-Mendell-Rubin adjusted likelihood ratio test TABLE 3. Average attribution probability matrix for each potential profile Potential Profile 1 2 3 1 0.976 0.024 0.000 2 0.000 0.989 0.011 3 0.000 0.024 0.976 TABLE 4. Multivariate Logistic regressions for predicting in four profile latent classes among the participants Variables Profile 2 VS Profile 1 Profile 3 VS Profile 1 βValue P value OR value 95%CI βValue P value OR value 95%CI Education level High school or less 0.505 0.231 1.657 0.726~3.783 0.880 0.061 2.411 0.961~6.052 College or more(refer) Personal monthly income ≤10,000 -0.360 0.425 0.698 0.288~1.689 0.265 0.579 1.304 0.511~3.328 ＞10,000（refer） frequency of pre-pregnancy exercise No 1.936 0.077 6.982 0.813~59.012 0.038 0.006 20.855 2.342~185.747 1~2 times weekly 0.294 0.572 1.341 0.485~3.712 0.568 0.335 1.765 0.556~5.607 3~6 times weekly -0.133 0.805 0.876 0.306~2.508 0.253 0.682 1.288 0.384~4.316 Every day(refer) Receiving exercise guidance No -0.802 0.219 0.448 0.125~1.613 0.209 0.780 1.232 0.285~5.334 Yes(refer) Social support -0.051 0.105 0.950 0.894~1.011 -0.092 0.007 0.912 0.856~0.975 GAD-7 0.006 0.923 1.006 0.898~1.126 0.089 0.139 1.094 0.971~1.231 OR: Odds ratio; 95%CI: 95% Confidence interval Discussion The level of barriers to PA during pregnancy In this study, the scores for each item of the BPAPS were (2.51 ± 0.60). And the score for the intrapersonal barrier related to the pregnancy subscale of BPAPS was the highest, at 2.87 ± 0.73, followed by the intrapersonal barrier not related to pregnancy subscale of BPAPS, the environmental barriers subscale of BPAPS, and the interpersonal barriers subscale of BPAPS, with scores of 2.47 ± 0.78, 2.34 ± 0.67, and 2.14 ± 0.70, respectively. These results were consistent with Shang et al[14]. However, inconsistent with studies conducted by [16], the mean score of each item was 3.05, which was higher than that in our study. Contrary to this study, the highest mean scores on the BPAPS subscale were related to interpersonal barriers among pregnant Iranian women. Intrapersonal barriers related to pregnancy usually include drowsiness, lethargy, heavy feelings, abdominal size, pain, shortness of breath, concerns about pregnancy-related complications, and gastrointestinal problems. These barriers occur during different trimesters and display dynamic trend[30]. For example, Sytsma et al. found that nausea or fatigue was a greater barrier for non-exercisers than exercisers in the first trimester of pregnancy[31]. Therefore, individualized and targeted intervention measures should be formulated and implemented based on the different patterns of physical change. LPA of barriers to PA during pregnancy This study identified three profiles of barriers to PA during pregnancy through LPA, namely “Low physical activity barrier-worry about pregnancy complication group”(10.3%), “Moderate physical activity barrier- pregnancy-related discomfort symptom group”(54.3%), and “High physical activity barrier group”(35.3%). It also proved that pregnant women exhibit group heterogeneity in their levels of barriers to PA during pregnancy. The pregnant women in “Low physical activity barrier-worry about pregnancy complication group” were mainly characterized by a higher frequency of pre-pregnancy exercise. This finding was consistent with that reported by Suberu et al[17]. and Dolatabadi et al [16]. Habits gradually form in later stages of life. Once formed, although not permanent, they cannot be not easily changed either[32]. Habit formation interventions or habit-based intervention might be good approaches, which are effective in fostering physical activity habit[33, 34]. The pregnant women in “Moderate physical activity barrier- pregnancy-related discomfort symptom group” were mainly characterized by receiving exercise guidance. Receiving exercise guidance or counselling may help pregnant women overcome the barriers to PA, but some qualitative studies have revealed that women often experience inadequate and insufficient PA counselling from the perspectives of pregnant women[35] and counselling about PA from healthcare providers is perceived as ineffective and minimal[36]. As a result, although they received guidance on physical activity, they still faced moderate barriers. Additionally, midwives regard counselling on PA during pregnancy as a challenge, walking on thin ice, and opportunity; therefore, further training should be performed to improve their counselling[37]. As we all know, exercise is a subset of PA. The Exercise is Medicine(EIM) initiative has played a compelling call for action during pregnancy, advocating the inclusion of PA in routine care[38]. The EIM emphasized the importance of PA prescription, a safe and effective intervention based on evidence guidelines and recommendations tailored to individual needs and capabilities, empowering expectant mothers to take and maintain PA or positive lifestyles[39]. Pregnant women in the high physical activity barrier group” were mainly characterized by low education levels, low-income levels, no exercise habits before pregnancy, low social support levels, and high anxiety levels. The results reported by Dolatabadi et al. demonstrated that women with secondary education had higher barrier scores than women with diploma or university education[16]. However, no significant impact of educational level was found in the study by Shang et al[14]. There is still no consensus on the influence of different income levels on barriers to PA during pregnancy. Dolatabadi et al. reported that women with medium-income levels had the highest mean scores[16]. Therefore, further studies are required to ensure that all pregnant women, regardless of their income and educational level, have the opportunity to engage in PA during pregnancy. Correlates of barriers to PA during pregnancy In the current study, pregnant women who did not exercise before pregnancy were more likely to belong to profile 3. Previous studies have found that pre-pregnancy PA[17] and habitual exercise pre-pregnancy[16] are associated with lower levels of barriers to PA. Based on this finding, we can quickly identify the population with high levels of PA barriers by simply asking pregnant women about their pre-pregnancy PA habits. At the same time, we can combine these simple questions with relevant scales, such as the Get Active Questionnaire for Pregnancy and the Health Care Provider Consultation Form for Prenatal Physical Activity[40] to identify high-risk populations and determine whether physical activity counselling is needed. We can then formulate targeted intervention measures to reduce barrier levels and increase physical activity levels, thereby promoting the health of both the mother and fetus. Social support influenced barriers to PA during pregnancy among pregnant women in Profile 3. Specifically, women with lower levels of social support were more likely to exhibit higher levels of barriers to PA during pregnancy. Social support for pregnant women is important for maternal and infant health and well-being[41]. Previous studies have found that lack of social support or family support is a barrier to participating in or increasing PA during pregnancy[42, 43], and it is commonly reported as an enabler of PA[44]. Social support from various sources may reduce these obstacles by minimizing the risk of falls or anxiety associated with PA [45]. Additionally, supporters’ knowledge, beliefs, social support, and PA levels were considered predictors of PA levels in pregnant women. Thus, the role of social support may be critical in regular PA during pregnancy, and we may focus on different conditions for pregnant women’s PA. Limitations Despite the meaningful findings of our study, it has several limitations. First, the respondents in our study came from one medical institution; therefore, the results may not apply to other places. Multi-center and large samples are needed to conducted in the future to confirm the results. Second, this study only investigated the impact of one psychological state (anxiety) on PA. The results of multinomial logistic regression analysis showed no statistical significance. Further research is needed to explore the influence of psychological states on PA. Conclusion Barriers to PA among pregnant women are heterogeneous. Our findings revealed three distinct latent profiles of berries to PA, and the frequency of pre-pregnancy exercise and social support were significant factors affecting the barriers to physical activity profiles. Healthcare workers should be aware of these distinctive features to screen potential groups with high levels of barriers to PA during pregnancy and provide targeted PA counselling and support. Relevance for clinical practice Although the country has gradually placed a greater emphasis on physical exercise and physical activities for the entire population, physical activity remains a serious issue among pregnant women. Releasing barriers to PA during pregnancy is crucial for maternal and fetal health and well-being [2]. Ruart et al. found that the main indicators of PA showed no significant differences between groups after performing regular PA counselling, whether measured or reported, and they suggested focusing on interventions for perceived barriers to limit PA decline[46]. Thus, it is imperative to identify barriers to PA during pregnancy. In this study, we identified different categories of barriers to PA during pregnancy using a person-centered approach and identified the demographic characteristics of the different groups. The results of this study can help relevant personnel, such as exercise consultants, quickly identify people with physical activity disorders and, through simple questions such as the frequency of exercise before pregnancy, quickly screen pregnant women with physical activity disorders and implement targeted stratified management models. Abbreviations PA Physical activity GAD-7 Generalized anxiety disorder-7 LPA Latent profile analysis WHO World Health Organization BPAPS Barriers to physical activity during pregnancy scale Declarations Ethics approval and consent to participate This study was approved by Ethics Committee of Shanghai Sixth People’s Hospital[2025-KY-148(K)]. This study followed the principles of the Declaration of Helsinki. The questionnaires were completed anonymously to ensure confidentiality. To ensure the authenticity and reliability of the questionnaire and reduce participants’ concerns. An online version of the informed consent form was provided to all participants before the start of completing the questionnaires. The right to withdraw from the study at any time has been guaranteed. Consent for publication Not applicable. Competing interests The authors declare no competing interests. Funding This work was supported by the Nursing Project of Shanghai Sixth People’s Hospital[grant numbers YJHLKT2024-30]. Author Contribution T.S. contributed to conceptualization, methodology, investigation, formal analysis, writing-original draft. Y.J. contributed to conceptualization, methodology, writing-original draft, project administration. W.H. contributed to investigation, supervision. Q.F.L. contributed to methodology, writing-review and editing. C.Q.H. contributed to conceptualization, methodology, writing-review and editing, supervision. All authors reviewed the manuscript. Acknowledgements This study was grateful to the pregnant women who participated in the survey. The authors acknowledge the team members of Shanghai Sixth People's Hospital for their support and contributions. Data availability The data supporting the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions. 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Development of a habit-based intervention to support healthy eating and physical activity behaviours for pregnant women with overweight or obesity: Healthy Habits in Pregnancy and Beyond (HHIPBe). BMC Pregnancy Childbirth. 2024;24(1):760. Braendstrup N, Roland CB, Knudsen SD, Bendix JM, Clausen TD, Molsted S, Stallknecht B, Lokkegaard E, Jespersen AP. Counselling on physical activity in Danish antenatal care: A qualitative study of experiences from both the pregnant woman's and the care provider's perspective. Sex REPRODUCTIVE Healthc 2023, 38. Grenier LN, Atkinson SA, Mottola MF, Wahoush O, Thabane L, Xie F, Vickers-Manzin J, Moore C, Hutton EK, Murray-Davis B. Be Healthy in Pregnancy: Exploring factors that impact pregnant women's nutrition and exercise behaviours. Matern Child Nutr. 2021;17(1):e13068. Lindqvist M, Mogren I, Eurenius E, Edvardsson K, Persson M. An on-going individual adjustment: a qualitative study of midwives' experiences counselling pregnant women on physical activity in Sweden. BMC Pregnancy Childbirth 2014, 14. Santos-Rocha R, Pajaujiene S, Szumilewicz A. ACTIVE PREGNANCY: Workshop on Promotion of Physical Activity in Pregnancy for Exercise Professionals. J Multidiscip Healthc. 2022;15:2077–89. Sparks JR, Ruiz-Ramie JJ, Kishman EE, Wang XW. A Call for the Implementation of Physical Activity as a Vital Sign (PAVS) During Pregnancy. Am J Lifestyle Med. 2025;19(4):548–60. Davenport MH, Neil-Sztramko S, Lett B, Duggan M, Mottola MF, Ruchat SM, Adamo KB, Andrews K, Artal R, Beamish N, et al. Development of the Get Active Questionnaire for Pregnancy: breaking down barriers to prenatal exercise. Appl Physiol Nutr Metab. 2022;47(7):787–803. Collins NL, Dunkel-Schetter C, Lobel M, Scrimshaw SC. Social support in pregnancy: psychosocial correlates of birth outcomes and postpartum depression. J Pers Soc Psychol. 1993;65(6):1243–58. Chang MW, Nitzke S, Buist D, Cain D, Horning S, Eghtedary K. I am pregnant and want to do better but i can't: focus groups with low-income overweight and obese pregnant women. Matern Child Health J. 2015;19(5):1060–70. Da Costa D, Ireland K. Perceived benefits and barriers to leisure-time physical activity during pregnancy in previously inactive and active women. Women Health. 2013;53(2):185–202. McKeough R, Blanchard C, Piccinini-Vallis H. Pregnant and Postpartum Women's Perceptions of Barriers to and Enablers of Physical Activity During Pregnancy: A Qualitative Systematic Review. J Midwifery Womens Health. 2022;67(4):448–62. Wang Y, Zhang R, Feng S. Social Support and Physical Activity in Pregnant Women With Gestational Diabetes Mellitus: Exploring the Mediating Role of Fear of Falling. Nurs Open. 2025;12(3):e70174. Ruart S, Sinnapah S, Hue O, Janky E, Antoine-Jonville S. Prenatal Counseling throughout Pregnancy: Effects on Physical Activity Level, Perceived Barriers, and Perinatal Health Outcomes: A Quasi-Experimental Study. Int J Environ Res Public Health 2020, 17(23). Additional Declarations No competing interests reported. Supplementary Files STROBEchecklistcrosssectionalPA.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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1","display":"","copyAsset":false,"role":"figure","size":148855,"visible":true,"origin":"","legend":"\u003cp\u003eLatent profile of the barriers of PA among pregnant women.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7462013/v1/6fe3a5c68d3c9164db6a8b68.png"},{"id":108779754,"identity":"609f65c4-aed1-461a-a543-092a2b9cb544","added_by":"auto","created_at":"2026-05-08 09:58:24","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":478586,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7462013/v1/07619fb3-4b90-4070-8272-572f4137b2ed.pdf"},{"id":93173594,"identity":"b1137709-8bce-4d02-85ee-2f7ff3b270a8","added_by":"auto","created_at":"2025-10-09 20:09:32","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":31390,"visible":true,"origin":"","legend":"","description":"","filename":"STROBEchecklistcrosssectionalPA.docx","url":"https://assets-eu.researchsquare.com/files/rs-7462013/v1/825553253caa6d59bfa49e04.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Barriers to physical activity profile and related factors during pregnancy: a latent profile analysis","fulltext":[{"header":"Introduction","content":"\u003cp\u003ePhysical activity(PA) refers to any bodily movement resulting from the contraction of skeletal muscles that causes energy expenditure and is essential for health maintenance of health[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Evidence shows that regular PA during pregnancy benefits the fetus and the mothers[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Appropriate physical activity without complications in pregnant women can significantly reduce the incidence of gestational hypertension and gestational diabetes mellitus, prevent excessive weight gain during pregnancy, relieve perinatal depression and lower back pain, reduce the occurrence of neonatal complications or the risk of emergency caesarean section[\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], improve muscle strength, reduce labor pain, promote postpartum weight loss, and increase the significance of fetal oxygen supply[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].More importantly, PA is a modifiable factor contributing to maternal and fetal health[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn recent years, the concept of considering physical activity as a vital sign during pregnancy has been proposed and it has become a key element in prenatal care, fundamentally changing the way maternity healthcare is handled[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The World Health Organization (WHO) recommends at least 150 minutes of moderate-intensity physical activity per week during pregnancy in women with no pregnancy-related contraindications or complications[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. A survey conducted in Shanghai, China, showed that 47.5% of pregnant women experienced physical inactivity, and only 2.8% achieved the recommended duration of 150 minutes per week[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Another study found that the prevalence of physical inactivity was highest(66.2%) in the first trimesters[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The percentages of pregnant women in Jordan and Zimbabwe who met WHO recommendations were 28.9% and 11%, respectively[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eBarriers to physical activity refer to those that individuals face in carrying out, maintaining, or increasing physical activity[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Basic PA barriers include intrapersonal barriers, such as bad feelings of tiredness, illness, morning sickness, low energy, lack of interest or motivation, and high body weight; interpersonal barriers, such as being advised to avoid PA from others; unclear advice or lack of advice from healthcare workers; and environmental factors such as weather conditions[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Amiri-Farahani et al[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e] developed the barriers to Physical Activity during Pregnancy Scale (BPAPS) based on relevant literature, and quantitative and qualitative studies revealed that the barriers to PA during pregnancy mostly included intrapersonal barriers related to pregnancy, intrapersonal barriers unrelated to pregnancy, interpersonal barriers, and environmental barriers. This study investigated the level of physical activity barriers during pregnancy using the BPAPS and found that the mean BPAPS scores of pregnant women living in Iran and Ibadan were 88.55 and 85.35, respectively[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. Pre-pregnancy or early pregnancy body mass index, maternal education, antenatal admission, level of education, parity, attitudes toward exercise, ethnicity, income, and habitual exercise pre-pregnancy were factors of PA barriers[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn summary, previous studies have investigated the current status of physical activity barriers and analyzed these factors. However, heterogeneity within pregnant women has not been fully considered. Latent profile analysis (LPA) is an individual-centered method that identifies distinct subgroups within a population based on participants\u0026rsquo; responses to individual items, allowing for the exploration of population heterogeneity[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. To date, nearly all relevant studies have been conducted on latent profile analysis of barriers to physical activity during pregnancy. This study used LPA to explore the latent profiles of barriers to PA and further analyzed the factors with the aim of providing references for reducing barriers to PA during pregnancy.\u003c/p\u003e\u003cp\u003eResearch Questions\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eWhat is the level of barriers to physical activity during pregnancy, and is there heterogeneity?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eIf heterogeneity exists, which factors influencing barriers to physical activity across different potential profiles?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eStudy population\u003c/p\u003e\u003cp\u003eThis study used a descriptive cross-sectional design. This study followed the Reporting of Observational Studies (STROBE) checklist[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. The participants were recruited from a grade 3A hospital in one city. The inclusion criteria were as follows: (1)informed consent and voluntary participation in this study, (2) adequate cognitive and behavioral abilities, and (3) age 18 years or older. The exclusion criteria were as follows: (1)women with absolute contraindications for PA (e.g., preeclampsia, cervical insufficiency, or unexplained persistent vaginal bleeding) during pregnancy. To ensure reliable and precise subgroup results in LPA, a minimum of 300 participants were necessary according to the recommendation[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. The following formula was used to estimate the sample size: \u003cem\u003eN\u003c/em\u003e = [max (number of items)] (5\u0026ndash;10). After considering 10% of the invalid samples, the total required sample size ranged from 160 to 319 on a 29-item scale. A total of 320 questionnaires were distributed (by the author) to pregnant women from December 1, 2024, to May 31, 2025, by convenience sampling. We received 300 valid responses, resulting in an effective response rate of 93.8%.\u003c/p\u003e\u003cp\u003eMeasures\u003c/p\u003e\u003cp\u003eGeneral Information Questionnaire\u003c/p\u003e\u003cp\u003eThe demographic characteristic questionnaire included age, gestational age, current employment status, education level, personal monthly income, frequency of pre-pregnancy exercise, duration of each pre-pregnancy exercise session, and exercise guidance. All demographic information was a potential confounder based on the existing literature and clinical expert experience.\u003c/p\u003e\u003cp\u003eBarriers to physical activity during pregnancy scale(BPAPS)\u003c/p\u003e\u003cp\u003eBarriers to physical activity during pregnancy were measured using the 29-item self-reporting designed barriers to physical activity during pregnancy scale by Amiri-Farahani[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. BPAPS includes four dimensions: intrapersonal barriers related to pregnancy, intrapersonal barriers unrelated to pregnancy, interpersonal barriers, and environmental barriers. The BPAPS was scored on a Likert 5-point scale: 5\u0026thinsp;=\u0026thinsp;strong agreement, 4\u0026thinsp;=\u0026thinsp;agreement, 3\u0026thinsp;=\u0026thinsp;neutral, 2\u0026thinsp;=\u0026thinsp;disagree, and 1\u0026thinsp;=\u0026thinsp;strong disagreement. The scale demonstrated good internal consistency; the Cronbach\u0026rsquo;s α coefficient of the overall scale was 0.824, and the Cronbach\u0026rsquo;s α coefficient of the dimensions was 0.722\u0026ndash;0.815. The Chinese version of BPAPS was developed by Yang et al[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. The Cronbach\u0026rsquo;s α for this study was 0.946.\u003c/p\u003e\u003cp\u003eSocial Support Rating Scale\u003c/p\u003e\u003cp\u003eThe level of social support was measured using ten-item self-reporting designed social support rating scale by Xiao[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The scale includes three subscales: objective support, subjective support, and support utilization. The total score on the scale ranges from 12 to 83. The Cronbach\u0026rsquo;s α for this study was 0.769.\u003c/p\u003e\u003cp\u003eGeneralized Anxiety Disorder-7 (GAD-7) Questionnaires\u003c/p\u003e\u003cp\u003eAnxiety was measured using the generalized anxiety disorder-7 (GAD-7) questionnaire, which was developed to measure the level of anxiety and has been validated in primary care settings[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] and is widely used in different populations[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. The scale consists of seven items, each with four options, and scores range from (not at all) 0 to 3 (almost every day), with higher scores indicating more severe anxiety symptoms in the study participants. The Cronbach\u0026rsquo;s α for this study was 0.925.\u003c/p\u003e\u003cp\u003eData collection\u003c/p\u003e\u003cp\u003eData were collected online and the questionnaire was distributed using a web-based questionnaire through the \u0026ldquo;Questionnaire Star\u0026rdquo; network platform (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e\u003ca href=\"http://www.wjx.cn\" target=\"_blank\"\u003ewww.wjx.cn\u003c/a\u003e\u003c/span\u003e\u003cspan address=\"http://www.wjx.cn\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e), a popular online data-gathering tool in China used for conducting web surveys. One researcher met with the participants face-to-face to explain the purpose of the questionnaire. After obtaining permission from the participants, a quick response code was provided to them to scan and fill out the questionnaire. After completing the questionnaire, the participants successfully completed it, ensuring its integrity. The same account set in the background can be filled only once, to avoid repeated filling. The quality of the questionnaires was checked by two researchers and questionnaires that violated the requirements were deleted.\u003c/p\u003e\u003cp\u003eEthical considerations\u003c/p\u003e\u003cp\u003eThe questionnaires were completed anonymously to ensure confidentiality. To ensure the authenticity and reliability of the questionnaire and reduce participants\u0026rsquo; concerns. An online version of the informed consent form was provided to all participants before they completed the questionnaire. The right to withdraw from the study at any time has been guaranteed, all information will be used only for this study, and we will keep it strictly confidential. This study was approved by the Ethics Committee (2025-KY-148 [K] ).\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eData analysis\u003c/h2\u003e\u003cp\u003eMplus 8.0 statistical software was applied for latent profile analysis based on 29 barriers to physical activity during pregnancy. The model fit was assessed using several indices, including the Akaike information criterion(AIC), Bayesian information criterion(BIC), adjusted Bayesian information criterion(aBIC), bootstrap likelihood ratio test (BLRT), Lo-Mendell-Rubin likelihood ratio test (LMRT), and entropy. The smaller the values of AIC, BIC, aBIC, the better fits of the model[\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Additionally, the Entropy value ranges from 0 to 1; the closer it is to 1, the more accurate is the classification. BLRT and LMRT were used to compare the fit of different class models. If the P-values corresponding to LMRT and BLRT reached a significant level, the K-class model was deemed superior to the K-1 class model0[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. The above evaluation indices only provide a reference for profile decision making, and the interpretability of various categories should also be considered when determining the best model. SPSS 26.0 was used for descriptive analysis(means and standard deviation were used for measurement data, and frequencies or percentages (%) were used for count data). Univariate and multinomial logistic regression analyses were performed to evaluate the influence of various factors on organizational silence among the participants. Statistical significance was set at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003eParticipants characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter excluding questionnaires that violated the requirements, \u0026nbsp; 300 were assessed and analyzed. Among the included participants, 18% were aged \u0026gt; 35 years old. The majority of the participants had a gestational age of 28 weeks or more(88.3%) and were on duty(84.3). Seventy% of participants had a high school education or less, 64% had a personal monthly income of more than 10 000 yuan; 23.3% had never exercised before pregnancy, 63.7% exercised less than 30 minutes per session before pregnancy, and up to 86.7% had never received physical activity guidance. The mean scores for social support and GAD-7 were 41.01 and 4.42, respectively. Detailed information is provided in Table 1.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLPA results of barriers to physical activity during pregnancy scale\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe average score of each item of BPAPS for the 300 participants are 2.51±0.60, the average scores of each item of intrapersonal barriers related to pregnancy dimension of BPAPS, intrapersonal barriers non-related to pregnancy dimension of BPAPS, interpersonal barriers dimension of BPAPS and environmental barriers of BPAPS were 2.87±0.73, 2.47±0.78, 2.14±0.70, 2.34±0.67, respectively. Four profiles were fitted to the model and the results are presented in Table 2. The results show that as the number of categories gradually increased, the AIC, BIC, and BIC for models 1-4 gradually decreased. However, in the four-category model, the LMRT value (0.6141) is not significant. In the three-category model, the entropy value(0.964) was higher and the LMRT and BLRT values were significant. In addition, the value of the diagonal in the average probability matrix of the latent categories was significantly higher than 0.70, indicating that the results of the three-category latent classification model were reliable(Table 3). Therefore, three profiles were selected as best-fit models.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLatent category and characteristics of barriers to physical activity during pregnancy among the participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBased on the latent classification results, the researchers plotted the scores of the three latent profiles for each topic of BPAPS. See Fig.1. The total score for Profile1 was 39.23±7.329, and the average score for all items was approximately 1.35 points, indicating a low level of barriers to physical activity during pregnancy. However, the average score of item 9 “I am concerned with possible pregnancy complications such as miscarriages and premature labor” was 2.246. Therefore, this category was named the “Low physical activity barrier-worry about pregnancy complications group”. There were 31 participants in this group(10.3%) were included in this group. The total score for Profile 2 was 68.11±7.053, and the average score for all items was approximately 2.35 points, showing a moderate level of barriers to physical activity during pregnancy. And the scores of each item of \u0026nbsp; intrapersonal barriers related to pregnancy dimension were between 2.404 and 3.163, So the Profile2 was named the “Moderate physical activity barrier-pregnancy-related discomfort symptom group.” There were 163 participants in Profile2(54.3%). The total score for Profile 3 was 90.02±9.876, and the average score for all items was approximately 3.10 points, indicating a high level of barriers to physical activity during pregnancy. So, Profile3 was named the “High physical activity barrier group” and comprised 106 participants in Profile3(35.3%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eUnivariate analysis and multivariate logistic regression analysis of the factors influencing the latent categories of the barriers to physical activity during pregnancy \u0026nbsp;among participants\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the univariate analysis, educational level, personal monthly income, frequency of pre-pregnancy exercise, receiving exercise guidance or not, social support, and GAD-7 \u0026nbsp;were factors that influenced the three latent profiles(P \u0026lt; 0.05). The results were presented in Table1.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn the disordered multi-classification logistic regression, using Profile1 as the reference group, the results indicated that the statistically influencing factors were the frequency of pre-pregnancy exercise and social support. See Table4.\u003c/p\u003e\n\u003cp\u003eThe comparison between Profile3 and Profile1 reveled the following findings: (1)participants who had no exercise habits before pregnancy were 20.855 times more likely to belonging to Profile3 compared to other participants(P \u0026lt; 0.05). (2) The likelihood of participants belonging to Profile3 decreased by 8.8% with increasing social support scores (P \u0026lt; 0.05).\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" valign=\"top\"\u003e\n \u003cp\u003eTABLE 1. Demographic information four profile latent profiles among the participants(n,%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eItem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTotal number\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eProfile1（n=31）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eProfile2\u003c/p\u003e\n \u003cp\u003e（n=163）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eProfile3\u003c/p\u003e\n \u003cp\u003e（n=106）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eValue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.094\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.955\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e≤35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e246(82)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26（83.9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e133(81.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e87(82.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e＞35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e54(18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5（16.1）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30(18.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e19(17.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eGestational Age\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.334\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.189\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e＜28 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35(11.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2（6.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24（14.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9（8.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e≥28 weeks\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e265(88.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e29（93.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e139（85.3）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e97（91.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eCurrent employment status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.253\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.881\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eDoes not work\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e47(15.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5（16.1）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24（14.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18（17.0）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eOn duty\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e253(84.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26（83.9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e139（85.3）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e88（83.0）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eEducation level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.339\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eHigh school or less\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e210(70)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17（54.8）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e110（67.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e83（78.3）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eCollege or more\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e90(30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14（45.2）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e53（32.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23（21.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003ePersonal monthly income\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.412\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e≤10,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e108(36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10（32.3）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e49（30.1）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e49（46.2）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e＞10,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e192(64)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21（67.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e114（69.6）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e57（53.8）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eFrequency of pre-pregnancy exercise\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26.463\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e70(23.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1（3.2）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e29（17.8）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e40(37.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e1~2 times weekly\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e113(37.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11（35.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e67（41.1）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35（33.0）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e3~6 times weekly\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e61(20.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10（32.3）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34（20.9）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e17（16.0）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eEvery day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e56(18.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9（29.0）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e33（20.2）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14（13.2）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eDuration of each exercise session of pre-pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.454\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.076\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e≤30 minutes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e191(63.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15（48.4）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e99（60.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e77（72.6）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e30~60 minutes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e88(29.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14（45.2）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e50（30.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24（22.6）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e＞60 minutes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21(7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2（6.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14（8.6）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5（4.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003eReceiving exercise guidance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.233\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.044\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e260(86.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28（90.3）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e134（82.2）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e98（86.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e40(13.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3（9.7）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e29（17.8）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8（7.5）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSocial support score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e41.01±6.87%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e44.23±6.46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e41.66±6.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e39.08±6.80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.779\u003csup\u003e\u0026nbsp;b\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eThe score of GAD-7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e4.42±2.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.61±1.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3.85±1.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5.54±1.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.403\u003csup\u003e\u0026nbsp;b\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e\u003cbr\u003e\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003csup\u003ea\u003c/sup\u003ex\u003csup\u003e2\u003c/sup\u003e test,\u003csup\u003e\u0026nbsp;b\u003c/sup\u003eANOVA\u003c/p\u003e\n\u003cp\u003eNote: Profile1: Low physical activity barrier-worry about pregnancy complication group; Profile 2: Moderate physical activity barrier- pregnancy-related discomfort symptom group; Profile 3: High physical activity barrier group.\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"662\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"8\" valign=\"top\"\u003e\n \u003cp\u003eTABLE 2. Fitting index of latent profile analysis about the participants’ barriers to physical activity during pregnancy scale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eModel\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eaBIC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eEntropy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLMRT\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eBLRT\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eClass Probability\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23637.361\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23852.180\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23668.238\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e——\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e——\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e——\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e——\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21584.593\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21910.526\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21631.442\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;0.941\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e155/145（0.52/0.48）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20707.097\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21144.143\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21144.143\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.964\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;0.0163\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e31/163/106（0.10/0.54/0.35）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20267.819\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20815.979\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20346.610\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.957\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.6141\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e＜0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e33/119/66/82（0.11/0.39/0.22/0.28）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eAbbreviations: AIC = Akaike information criterion; BIC = Bayesian information criterion; aBIC = sample size-adjusted Bayesian information criterion; BLRT = bootstrap likelihood ratio test; LMR = Lo-Mendell-Rubin adjusted likelihood ratio test\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"557\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eTABLE 3. Average attribution probability matrix for each potential profile\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePotential Profile\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.976\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.989\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.024\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.976\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\"\u003e\n \u003cp\u003eTABLE 4. Multivariate Logistic regressions for predicting in four profile latent classes among the participants\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eProfile 2 VS Profile 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eProfile 3 VS Profile 1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eβValue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOR value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eβValue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eP value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eOR value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e95%CI\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHigh school or less\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.505\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.231\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.657\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.726~3.783\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.880\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.061\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.411\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.961~6.052\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eCollege or more(refer)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePersonal monthly income\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e≤10,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.360\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.425\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.698\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.288~1.689\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.265\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.579\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.304\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.511~3.328\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e＞10,000（refer）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003efrequency of pre-pregnancy exercise\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.936\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.077\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.982\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.813~59.012\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.038\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20.855\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2.342~185.747\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1~2 times weekly\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.294\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.572\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.341\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.485~3.712\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.568\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.335\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.765\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.556~5.607\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3~6 times weekly\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.805\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.876\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.306~2.508\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.253\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.682\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.288\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.384~4.316\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\"\u003e\n \u003cp\u003eEvery day(refer)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"9\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eReceiving exercise guidance\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.802\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.219\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.448\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.125~1.613\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.780\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.232\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.285~5.334\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003eYes(refer)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSocial support\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.105\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.950\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.894~1.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e-0.092\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.912\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.856~0.975\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGAD-7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.923\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.898~1.126\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.089\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1.094\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.971~1.231\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eOR: Odds ratio; 95%CI: 95% Confidence interval\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003e\u003cstrong\u003eThe level of barriers to PA during pregnancy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn this study, the scores for each item of the BPAPS were (2.51 ± 0.60). And the score for the intrapersonal barrier related to the pregnancy subscale of BPAPS was the highest, at 2.87 ± 0.73, followed by the intrapersonal barrier not related to pregnancy subscale of BPAPS, the environmental barriers subscale of BPAPS, and the interpersonal barriers subscale of BPAPS, with scores of 2.47 ± 0.78, 2.34 ± 0.67, and 2.14 ± 0.70, respectively. These results were consistent with Shang et al[14]. However, inconsistent with studies conducted by [16], the mean score of each item was 3.05, which was higher than that in our study. Contrary to this study, the highest mean scores on the BPAPS subscale were related to interpersonal barriers among pregnant Iranian women. Intrapersonal barriers related to pregnancy usually include drowsiness, lethargy, heavy feelings, abdominal size, pain, shortness of breath, concerns about pregnancy-related complications, and gastrointestinal problems. These barriers occur during different trimesters and display dynamic trend[30]. For example, Sytsma et al. found that nausea or fatigue was a greater barrier for non-exercisers than exercisers in the first trimester of pregnancy[31]. Therefore, individualized and targeted intervention measures should be formulated and implemented based on the different patterns of physical change.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLPA of barriers to PA during pregnancy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study identified three profiles of barriers to PA during pregnancy through LPA, namely “Low physical activity barrier-worry about pregnancy complication group”(10.3%), “Moderate physical activity barrier- pregnancy-related discomfort symptom group”(54.3%), and “High physical activity barrier group”(35.3%). It also proved that pregnant women exhibit group heterogeneity in their levels of barriers to PA during pregnancy.\u003c/p\u003e\n\u003cp\u003eThe pregnant women in “Low physical activity barrier-worry about pregnancy complication group” were mainly characterized by a higher frequency of pre-pregnancy exercise. This finding was consistent with that reported by Suberu et al[17]. and Dolatabadi et al [16]. Habits gradually form in later stages of life. Once formed, although not permanent, they cannot be not easily changed either[32]. Habit formation interventions or habit-based intervention might be good approaches, which are effective in fostering physical activity habit[33, 34].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe pregnant women in “Moderate physical activity barrier- pregnancy-related discomfort symptom group” were mainly characterized by receiving exercise guidance. Receiving exercise guidance or counselling may help pregnant women overcome the barriers to PA, but some qualitative studies have revealed that women often experience inadequate and insufficient PA counselling from the perspectives of pregnant women[35] and counselling about PA from healthcare providers is perceived as ineffective and minimal[36]. As a result, although they received guidance on physical activity, they still faced moderate barriers. Additionally, midwives regard counselling on PA during pregnancy as a challenge, walking on thin ice, and opportunity; therefore, further training should be performed to improve their counselling[37]. As we all know, exercise is a subset of PA. The Exercise is Medicine(EIM) initiative has played a compelling call for action during pregnancy, advocating the inclusion of PA in routine care[38]. The EIM emphasized the importance of PA prescription, a safe and effective intervention based on evidence guidelines and recommendations tailored to individual needs and capabilities, empowering expectant mothers to take and maintain PA or positive lifestyles[39].\u003c/p\u003e\n\u003cp\u003ePregnant women in the high physical activity barrier group” were mainly characterized by low education levels, low-income levels, no exercise habits before pregnancy, low social support levels, and high anxiety levels. The results reported by \u0026nbsp;Dolatabadi et al. demonstrated that women with secondary education had higher barrier scores than women with diploma or university education[16]. However, no significant impact of educational level was found in the study by Shang et al[14]. There is still no consensus on the influence of different income levels on barriers to PA during pregnancy. Dolatabadi et al. reported that women with medium-income levels had the highest mean scores[16]. Therefore, further studies are required to ensure that all pregnant women, regardless of their income and educational level, have the opportunity to engage in PA during pregnancy.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorrelates of barriers to PA during pregnancy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIn the current study, pregnant women who did not exercise before pregnancy were more likely to belong to profile 3. Previous studies have found that pre-pregnancy PA[17] and habitual exercise pre-pregnancy[16] are associated with lower levels of barriers to PA. Based on this finding, we can quickly identify the population with high levels of PA barriers by simply asking pregnant women about their pre-pregnancy PA habits. At the same time, we can combine these simple questions with relevant scales, such as the Get Active Questionnaire for Pregnancy and the Health Care Provider Consultation Form for Prenatal Physical Activity[40] to identify high-risk populations and determine whether physical activity counselling is needed. We can then formulate targeted intervention measures to reduce barrier levels and increase physical activity levels, thereby promoting the health of both the mother and fetus.\u003c/p\u003e\n\u003cp\u003eSocial support influenced barriers to PA during pregnancy among pregnant women in Profile 3. Specifically, women with lower levels of social support were more likely to exhibit higher levels of barriers to PA during pregnancy. Social support for pregnant women is important for maternal and infant health and well-being[41]. Previous studies have found that lack of social support or family support is a barrier to participating in or increasing PA during pregnancy[42, 43], and it is commonly reported as an enabler of PA[44]. \u0026nbsp;Social support from various sources may reduce these obstacles by minimizing the risk of falls or anxiety associated with PA [45]. Additionally, supporters’ knowledge, beliefs, social support, and PA levels were considered predictors of PA levels in pregnant women. Thus, the role of social support may be critical in regular PA during pregnancy, and we may focus on different conditions for pregnant women’s PA.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDespite the meaningful findings of our study, it has several limitations. First, the respondents in our study came from one medical institution; therefore, the results may not apply to other places. Multi-center and large samples are needed to conducted in the future to confirm the results. Second, this study only investigated the impact of one psychological state (anxiety) on PA. The results of multinomial logistic regression analysis showed no statistical significance. Further research is needed to explore the influence of psychological states on PA.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eBarriers to PA among pregnant women are heterogeneous. Our findings revealed three distinct latent profiles of berries to PA, and the frequency of pre-pregnancy exercise and social support were significant factors affecting the barriers to physical activity profiles. Healthcare workers should be aware of these distinctive features to screen potential groups with high levels of barriers to PA during pregnancy and provide targeted PA counselling and support.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eRelevance for clinical practice\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAlthough the country has gradually placed a greater emphasis on physical exercise and physical activities for the entire population, physical activity remains a serious issue among pregnant women. Releasing barriers to PA during pregnancy is crucial for maternal and fetal health and well-being [2]. Ruart et al. found that the main indicators of PA showed no significant differences between groups after performing regular PA counselling, whether measured or reported, and they suggested focusing on interventions for perceived barriers to limit PA decline[46]. Thus, it is imperative to identify barriers to PA during pregnancy. In this study, we identified different categories of barriers to PA during pregnancy using a person-centered approach and identified the demographic characteristics of the different groups. The results of this study can help relevant personnel, such as exercise consultants, quickly identify people with physical activity disorders and, through simple questions such as the frequency of exercise before pregnancy, quickly screen pregnant women with physical activity disorders and implement targeted stratified management models.\u0026nbsp;\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003ePA \u0026nbsp; \u0026nbsp; \u0026nbsp; Physical activity\u003c/p\u003e\n\u003cp\u003eGAD-7 \u0026nbsp; Generalized anxiety disorder-7\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eLPA \u0026nbsp; \u0026nbsp; \u0026nbsp;Latent profile analysis\u003c/p\u003e\n\u003cp\u003eWHO \u0026nbsp; \u0026nbsp;World Health Organization\u003c/p\u003e\n\u003cp\u003eBPAPS \u0026nbsp; Barriers to physical activity during pregnancy scale\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003cp\u003e This study was approved by Ethics Committee of Shanghai Sixth People\u0026rsquo;s Hospital[2025-KY-148(K)]. This study followed the principles of the Declaration of Helsinki. The questionnaires were completed anonymously to ensure confidentiality. To ensure the authenticity and reliability of the questionnaire and reduce participants\u0026rsquo; concerns. An online version of the informed consent form was provided to all participants before the start of completing the questionnaires. The right to withdraw from the study at any time has been guaranteed.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003cp\u003eNot applicable.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e\u003cp\u003eThis work was supported by the Nursing Project of Shanghai Sixth People\u0026rsquo;s Hospital[grant numbers YJHLKT2024-30].\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eT.S. contributed to conceptualization, methodology, investigation, formal analysis, writing-original draft. Y.J. contributed to conceptualization, methodology, writing-original draft, project administration. W.H. contributed to investigation, supervision. Q.F.L. contributed to methodology, writing-review and editing. C.Q.H. contributed to conceptualization, methodology, writing-review and editing, supervision. All authors reviewed the manuscript.\u003c/p\u003e\u003ch2\u003eAcknowledgements\u003c/h2\u003e\u003cp\u003eThis study was grateful to the pregnant women who participated in the survey. The authors acknowledge the team members of Shanghai Sixth People's Hospital for their support and contributions.\u003c/p\u003e\u003ch2\u003eData availability\u003c/h2\u003e\u003cp\u003eThe data supporting the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eCaspersen CJ, Powell KE, Christenson GM. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research. Public Health Rep. 1985;100(2):126\u0026ndash;31.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBull FC, Al-Ansari SS, Biddle S, Borodulin K, Buman MP, Cardon G, Carty C, Chaput JP, Chastin S, Chou R, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451\u0026ndash;62.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMelzer K, Schutz Y, Boulvain M, Kayser B. Physical activity and pregnancy: cardiovascular adaptations, recommendations and pregnancy outcomes. Sports Med. 2010;40(6):493\u0026ndash;507.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLaredo-Aguilera JA, Gallardo-Bravo M, Rabanales-Sotos JA, Cobo-Cuenca AI, Carmona-Torres JM. Physical Activity Programs during Pregnancy Are Effective for the Control of Gestational Diabetes Mellitus. Int J Environ Res Public Health 2020, 17(17).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMeander L, Lindqvist M, Mogren I, Sandlund J, West CE, Domell\u0026ouml;f M. Physical activity and sedentary time during pregnancy and associations with maternal and fetal health outcomes: an epidemiological study. BMC Pregnancy Childbirth. 2021;21(1):166.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDowns DS, Chasan-Taber L, Evenson KR, Leiferman J, Yeo S. Physical activity and pregnancy: past and present evidence and future recommendations. Res Q Exerc Sport. 2012;83(4):485\u0026ndash;502.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSallis RE, Baggish AL, Franklin BA, Whitehead JR. The Call for a Physical Activity Vital Sign in Clinical Practice. Am J Med. 2016;129(9):903\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhou T, Lin Y, Xu F, Ma X, Wang N, Ding Y. 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PLOS Glob Public Health. 2025;5(1):e0003470.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZaragoza J, Generelo E, Juli\u0026aacute;n JA, Abarca-Sos A. Barriers to adolescent girls' participation in physical activity defined by physical activity levels. J Sports Med Phys Fit. 2011;51(1):128\u0026ndash;35.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMay LE, Moss SJ, Szumilewicz A, Santos-Rocha R, Shojaeian NA. Barriers and Facilitators of Physical Activity in Pregnancy and Postpartum Among Iranian Women: A Scoping Review. Healthc (Basel) 2024, 12(23).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShang X, Ye L, Gu X, Zhou A, Xu Y, Zhang Y, Liao Y, Li L. Attitudes and Barriers to Physical Activity and Exercise Self-Efficacy Among Chinese Pregnant Women: A Cross-Sectional Study. 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Int J Environ Res Public Health 2020, 17(23).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"physical activity, barriers, pregnant women, latent profile analysis","lastPublishedDoi":"10.21203/rs.3.rs-7462013/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7462013/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003ePhysical activity is a modifiable factor that contributes to maternal and fetal health. The percentage of pregnant women who did not meet World Health Organization recommendations was high. Recent studies have found that there are some barriers to PA during pregnancy and influencing factors; however, little is known about the exploration of population heterogeneity. Thus, this study emphasizes the distinct profiles of barriers to physical activity during pregnancy and the relevant factors, which are essential for screening potential groups with high levels of barriers to PA during pregnancy, quickly, and exhibiting a novel perspective for the management of barriers to physical activity among pregnant women.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA descriptive cross-sectional survey was carried out at one general hospital in Shanghai, China from December 1, 2024, to May 31, 2025. 300 pregnant women completed the demographic characteristics questionnaire, social support rating scale, generalized anxiety disorder-7 (GAD-7) questionnaires, the barriers to physical activity during pregnancy scale during pregnancy. Latent profile analysis(LPA) was used to identify groups showing different levels of barriers to physical activity during pregnancy. Additionally, univariate analysis and multinominal logistic regression analysis were used to reveal the factors influencing different groups.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThree profiles of barriers to PA during pregnancy emerged: \u0026ldquo;Low physical activity barrier-worry about pregnancy complication group\u0026rdquo;(10.3%), \u0026ldquo;Moderate physical activity barrier- pregnancy-related discomfort symptom group\u0026rdquo;(54.3%), and \u0026ldquo;High physical activity barrier group\u0026rdquo;(35.3%). Multinomial logistic regression analysis revealed that the frequency of pre-pregnancy exercise and social support were significant factors affecting barriers to physical activity profiles.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eWe categorized barriers to PA during pregnancy and identified risk factors. Healthcare providers can provide targeted interventions for pregnant women according to the factors influencing different profiles to reduce the level of PA barriers in pregnant women.\u003c/p\u003e","manuscriptTitle":"Barriers to physical activity profile and related factors during pregnancy: a latent profile analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-09 19:53:20","doi":"10.21203/rs.3.rs-7462013/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5f657578-9a49-458d-952d-12fb56a45a42","owner":[],"postedDate":"October 9th, 2025","published":true,"recentEditorialEvents":[{"type":"decision","content":"Rejected","date":"2026-05-08T09:43:35+00:00","index":"","fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-05-08T09:58:09+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-09 19:53:20","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7462013","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7462013","identity":"rs-7462013","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}