Degree of Physical activity during pregnancy and pregnancy related complication

Degree of Physical activity during pregnancy and pregnancy related complication | 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 Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Degree of Physical activity during pregnancy and pregnancy related complication Molla Hailu, Natnael Amare, Abayneh Tunta, Dr Zeru Seyoum This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4173404/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: Even though motherhood is a positive and enjoyable experience, it is also a vulnerable period that can be accompanied by various complications. Hypertensive disorder of pregnancy and gestational diabetes mellitus are of the most significant contributors to these complications. Therefore, the main objective of this study is to assess if the of degree of physical activities during pregnancy has impact on the development of hypertensive disorder of pregnancy and gestational diabetes mellitus. Methods: A cross-sectional study was conducted in 150 women who gave birth from November 2021 to February 2022 at MTUTH, Ethiopia. Data was collected through face-to-face interviews using a structured questionnaire. Descriptive statistics, linear regression, chi-square, and t-test were conducted to check the presence of any association between the dependent and independent variables. A p-value of < 0.05 was considered statistically significant. Result: Among the total study participant, 65(43.3%) and 85(56.7%) of them were engaged in vigorous physical activities and light physical activities during pregnancy, respectively. From these study participants 62 (41.3%) of them had pregnancy related complication. It was found that women who engaged in vigorous physical activity had a lower proportion of complications (17.74%) compared to those who engaged in light physical activity (82.26%). This difference was statistically significant (p=0.001). Conclusion: The finding of this study showed that pregnancy related complication, specifically HDP and GDM, was low in women who had vigorous physical activities during pregnancy as compared to those that have sedentary life style or engaged in light physical activities. Obstetrics & Gynecology Intensity of physical activity Hypertensive disorder of pregnancy Gestational diabetes mellitus Pregnancy related complication Introduction Pregnancy is a period of time during which a fertilized egg develops into a fetus inside a woman's uterus. It is a complex process that involves various physiological changes in a woman's body. These changes are necessary to support the growth and development of the fetus. The most notable changes and adaptations that take place during pregnancy include elevated resting heart rate, elevated cardiac output, and decreased peripheral vascular resistance ( 1 , 2 ). An increase in endothelium-dependent vasodilation appears to be a major moderator of these modifications and adaptations. Nitric oxide (NO) released by endothelial cells has been suggested to be the primary cause of the reduced systemic vascular resistance seen during pregnancy. Sustaining appropriate placental blood perfusion requires the uterine arteries' high exhaustion and low resistance ( 3 ). However, as the pregnancy progresses, the resistance of uterine spiral artery blood flow will be decreased gradually, the V-shaped notch in early diastole tends to be flat and even disappear in late pregnancy ( 4 ). This in turn results in a decreased production or an increased inactivation of NO that would be linked to the endothelial dysfunction and reduced placental perfusion. If the endothelial and placental function becomes impaired, it will cause various obstetric disorders such as intrauterine growth restriction, hypertensive disorder of pregnancy, gestational diabetes mellitus, spiral arterial embolism, decidual necrosis, placental abruption, preterm labor; leading to adverse pregnancy outcomes such as perinatal morbidity and mortality globally ( 5 , 6 ). Therefore, even though motherhood is a positive and enjoyable experience, it is also a vulnerable period that can be accompanied by various complications in which many women are experiencing suffering, illness, and death. Hypertensive disorders of pregnancy (HDP) are one of the most significant contributors to these complications and sufferings. Maternal hypertensive disorder is a group of high blood pressure disorders that include gestational hypertension, preeclampsia, eclampsia, preeclampsia superimposed on chronic hypertension, and chronic hypertension ( 7 ). The development of hypertensive disorders is thought to be due to various factors, including genetic predisposition, immunological factors, and abnormalities in the placenta. The exact mechanism is not fully understood, but some of commonly observed factors are placental imbalance, abnormal immune response, genetic factors, and endothelial dysfunction. HDP is mainly manifested as hypertension and damage to important organs such as heart, kidney, liver and nervous system. The previous study has proven 16% of maternal deaths can be attributed to HDP, so it has become an urgent obstetric crisis ( 8 ). Hypertension in pregnancy is associated with potentially lethal complications including abruption placentae, disseminated intravascular coagulation, cerebral hemorrhage, hepatic failure, and acute renal failure ( 9 ). Worldwide, hypertensive disorders remain the leading causes of pregnancy- related maternal mortality, stillbirth, and neonatal death ( 10 ). In addition to hemodynamic adaptive changes, pregnancy is also characterized by endocrine and metabolism changes thereby forming a pseudo-diabetic state of progressive insulin resistance. In the early stages of pregnancy, there is an increase in insulin sensitivity. This is because the body needs to provide adequate energy and nutrients to support the growing fetus. Insulin sensitivity is enhanced to ensure that glucose from the mother's blood can be transported to the placenta and reach the developing baby. However, as pregnancy progresses, especially during the second and third trimesters, there is a natural decrease in insulin sensitivity. This is primarily due to the presence of hormones like estrogen, progesterone, and human placental lactogen, which can interfere with insulin action ( 11 , 12 ). The decrease in insulin sensitivity during pregnancy is a normal physiological response. It allows for the efficient utilization of glucose by the developing fetus, as it ensures that glucose is available for fetal growth and development. However, if the mother failed to manage this change appropriately the decrease in insulin sensitivity can become too significant, resulting in the development of gestational diabetes mellitus (GDM) which is one of the most common complications related to pregnancy. GDM is a condition characterized by high blood sugar levels during pregnancy. This condition affects approximately 14% worldwide ( 13 ), leading to adverse maternal and neonatal outcomes. It typically resolves after delivery, but it can have both short- and long-term potential risks for both the mother and the baby if not managed properly. Jaundice, birth trauma, erythremia, hypoglycemia, macrosomia, and hypocalcemia are examples of unfavourable newborn outcomes. Comparing the children of euglycemic women to those of gestational diabetic moms, the latter group is more likely to experience obesity, impaired glucose tolerance, and diabetes in adolescence or early adulthood. Moreover, mother with GDM have a higher chance of developing overt diabetes following childbirth and a higher risk of developing other pregnancy problems such preeclampsia, infection, and postpartum hemorrhage ( 14 – 16 ). Therefore, GDM and HDP are common complications that can significantly impact the health of the mother and the unborn baby, in which their incidence become rise in recent years, making them a significant public health concern. In order to prevent these and other life threating complication of pregnancy and their subsequent deadly consequence many scholars recommend different medical and non-medical preventive strategies. Among these strategies some of them are community engagement and mobilization, food security for girls and pregnant women, delayed marriage and delayed first pregnancy, birth spacing, health human resources, screening for HDP and GDM risk, provision of antenatal care, time-of-disease maternal risk assessment, time-of-disease fetal risk assessment, well-resourced settings, and physical activities ( 10 ). So, as researches indicated physical activity during pregnancy may have a positive effect in reducing the risk of developing GDM and HDP. Physical activity is any bodily movement produced by skeletal muscles that require energy expenditure. It is all types of movement include walking, cycling, wheeling, sports, and active recreation and play, and can be done at any level of skill and for enjoyment by everybody. Engaging in regular physical activity offers numerous benefits for both physical and mental health. The benefits of physical activity among men and non-pregnant women on health, such as reducing the risk of essential hypertension, coronary atherosclerotic heart disease, and type 2 diabetes are well documented, but there is a gap on the effect of physical activity during pregnancy on pregnancy related complication ( 17 ). There has been a controversy about exercising during pregnancy. On one side, there are those who argue that exercise during pregnancy can have numerous benefits for both the mother and the baby. They suggest that staying physically active can help reduce the risks of gestational diabetes, preeclampsia, excessive weight gain, and other complications during pregnancy. Additionally, regular exercise is believed to boost mood, improve energy levels, and promote better sleep for expectant mothers. It is worth noting that the American College of Obstetricians and Gynecologists (ACOG) recommends moderate-intensity physical activity for most pregnant women, provided they have no medical or obstetric complications. They emphasize that exercises like walking, swimming, and low-impact aerobics are generally safe during pregnancy, but it is crucial for expectant mothers to consult with their healthcare providers before starting or modifying an exercise routine. WHO is also recommended that pregnant women engage in at least 150 minutes of moderate-intensity aerobic activity spread throughout the week ( 18 – 20 ). On the other side, some experts assert that pregnant women should limit their physical activity and avoid excessive exertion. They express concerns about potential risks to the developing fetus, such as an increased likelihood of preterm labor, reduced blood flow to the uterus, and overheating. Critics of exercise during pregnancy argue that caution should be taken, especially if there are underlying health conditions or pregnancy complications present. For this reason, many pregnant women are physically inactive, increasing this inactivity during the last trimester of pregnancy ( 13 , 21 ). Therefore, this study would provide additional knowledge in order to decide whether or not exercising during pregnancy. The main objective of this study is to assess the effect of level of physical activities during pregnancy on the development of HDP and GDM. This study is not only significant for the field of obstetrics and gynecology but also for pregnant women and health professionals involved in antenatal care and public health policymakers. It aims to address a critical research gap and provide evidence-based recommendations that can inform clinical practice and prenatal care guidelines. The findings of this research have the potential to impact the lives of pregnant women and their unborn babies by promoting a healthy lifestyle and reducing the risk of complications during pregnancy. Method and Materials Institution based cross-sectional study was conducted at the MizanTepi University Teaching Hospital (MTUTH) from November 2021 to February 2022. The study population was pregnant women who gave birth, and fulfilled the inclusion criteria during the study period, and volunteered to take part in the study. Eligibility criteria Inclusion criteria All volunteer pregnant women who gave birth during the study period Exclusion criteria Previous history of diabetes mellitus, hypertension, seizure, heart diseases Women with multiple pregnancy and intrauterine fetal death (IUFD) Operational definition Vigorous activities : are described as activities that require a large amount of physical effort and largely increase breathing or heart rate. These include carrying wood, manual grinding, weeding, drawing water from the well or river and bringing water from another house, Ploughing or digging, washing clothes, sweeping floors, gardening, and any fitness or recreational activities that cause large increases in breathing or heart rate, like running for at least 10 minutes continuously (22)(23). Light activities : are described as activities that require small physical effort and mildly increase breathing or heart rate. These include, mopping the floor, cooking, shopping, child care, tailoring, walking for no more than 10 minutes, etc. Sedentary behavior : is defined as sitting or reclining at work or at home; while getting to and from places; travelling in a car, bus, motor, or cart; reading; or watching television. Measurement and data collection procedure Sample size determination We calculated the sample size using the single population proportion formula by taking physical activity prevalence during pregnancy of 10.2% from a previous study (24) based on the assumption of a 95% confidence interval (CI) with a margin of error of 5%. Using this formula, we got a total sample size of 150. Sampling method All eligible pregnant women who gave birth at Mizan Tepi University Teaching Hospital were selected until the total sample size was attained. Data collection tools and procedure Data was collected through face-to-face interviews using a structured questionnaire that was adapted from the Ethiopia demographic survey (25) and other peer reviewed articles (26,27). The questionnaire contains socio-demographic, obstetric, physical activity characteristics, and the Pregnancy Physical Activity Questionnaire (PPAQ), which was developed by Chasan-Taber L, et al (27). A questionnaire was translated into Amharic language. This questionnaire was pretested on 5% of pregnant women who gave birth but were not part of the study participants from similar health settings, and based on pretesting feedback, modifications were made to the survey prior to administration. For each activity, respondents were asked in their local language to select the type of physical activity and the amount of time spent on that activity per day or week during the current pregnancy. The types of Physical activity at work, travel, and sports or leisure time activities were assessed. The level was then classified as vigorous physical activities and light physical activities. The primary outcomes studied were degree of physical activity during pregnancy and the development of HDP and GDM. Secondary outcomes included maternal age, occupation, educational status, number of parities, and residence of the study participant. Data management and analysis The data obtained from the questionnaire was entered, checked and cleaned by epidata software version 3.1, and then exported to SPSS(Statistical Package for Social science) version 25 software for analysis. Descriptive statistics were computed using frequencies with percentages for categorical variables and the mean and standard deviation for continuous variables. Linear regression, Chi-square, and t-test were conducted to check the presence of any association between the dependent and independent variables. A p-value of < 0.05 was considered statistically significant. Ethical considerations This study was conducted after obtaining ethical clearance from the Research Ethics Review Committee of the College of Health Sciences, Mizan Tepi University. The study was conducted with written and oral consent, which assures the willingness of each participant to participate in the study. Each participant signed an informed consent form. The confidentiality and privacy of the pregnant woman were also protected. Results This study, which was conducted to assess the effect of degree of physical activity during pregnancy on pregnancy related complication, includes a total of 150 women who gave birth during the study period. Among the total study participant, 65(43.3%) and 85(56.7%) of them were engaged in vigorous physical activities and light physical activities during pregnancy, respectively. From these study participants 62 (41.3%) of them had pregnancy related complication. Of this, 31, 21, 19, 13 of the complication was gestational diabetes mellitus, gestational hypertension, preeclampsia and eclampsia, respectively, in which some of the women had more than one complication during the study period. As shown in the table 1 below, the mean age of the study participants in both groups was found to be relatively similar, with pregnant women experiencing complications having a mean age of 28.53±3.63 years, and those without complications having a mean age of 28.04±3.77 years. The difference in maternal age between the two groups was not statistically significant (p=0.431). In terms of place of residence, a significant association was observed between place of residence and the occurrence of pregnancy-related complications. Among women with complications, 80.64% resided in urban areas, while only 19.36% were from rural areas. In contrast, pregnant women without complications relatively had a more balanced distribution, with 23.3% residing in urban areas and 35.3% residing in rural areas. This difference in distribution was found to be statistically significant (p=0.001). Regarding physical activity during pregnancy, it was found that women who engaged in vigorous physical activity had a lower proportion of complications (17.74%) compared to those who engaged in light physical activity (82.26%). This difference was statistically significant (p=0.001). Among women who develop HDP, 43 (81.13%) had light physical activity while the remaining 10 (18.87%) of the women with HDP were had vigorous physical activities. Similarly, from the study participants who develop GDM 26 (83.87%) of them had light physical activities, and 5 (16.13%) of the women with GDM were engaged in vigorous physical activities. Table 1 : Association of study participant’s characteristics and degree of physical activity during pregnancy with pregnancy related complication. Characteristics of the study participants Pregnant women with Pregnancy related complication Pregnant women without complication n=88 (58.7%) P-value Gestational Diabetes mellitus n=31(20.7%) Gestational hypertension n=21 (14%) Pre-eclampsia n=19(12.7%) Eclampsia n=13(8.7%) Total n=62 (41.3%) Maternal age in year (mean±S.D) 28.54±3.56 28.63±3.52 28.63±3.52 28.88±3.4 28.53±3.63 28.04±3.77 0.431 Place of Residence Rural 5 (16.1%) 3 (14.3%) 4 (21.1%) 4 (30.8%) 12 (8%) 53 (35.3%) 0.001 Urban 26 (83.9%) 18 (85.7%) 15 (78.9%) 9 (69.2%) 50 (33.3%) 35 (23.3%) Gravida Primigravida 11 (35.5%) 9 (42.9%) 11 (57.9%) 9 (69.2%) 31 (20.7%) 41 (27.3%) 0.681 Multigravida 20 (64.5 %) 12 (57.1%) 8 (42.1%) 4 (30.8%) 31 (20.7%) 47 (31.3%) Educational status Illetrate 2 (6.5%) 0 0 1 (7.7%) 2 (1.3%) 23 (15.3%) 0.001 Read and write 6 (19.4%) 5 (23.8%) 4 (21.1%) 2 (15.4%) 13 (8.7%) 22 (14.7%) Primary 4 (12.9%) 3 (14.3%) 3 (15.8%) 3 (23.1%) 11 (7.3%) 15 (10%) Secondary 4 (12.9%) 6 (28.6%) 3 (15.8%) 1 (7.7%) 9 (6%) 14 (9.3%) Higher education 15 (48.4%) 7 (33.4%) 9 (47.4%) 6 (46.2%) 27 (18%) 14 (9.3%) Occupation House wife 12 (38.7%) 9(42.9%) 7 (36.8%) 7 (53.8%) 23 (15.3%) 31 (20.7) 0.001 Farmer 2 (6.5%) 2 (9.5%) 0 1 (7.7%) 4 (2.7%) 30 (20%) Merchant 6 (19.4%) 5 (23.8%) 3 (15.8%) 1 (7.7%) 12 (8%) 8 (5.3%) Governmental/ private employer 8 (25.8%) 4 (19%) 6 (31.6%) 4 (30.8%) 18 (12%) 11 (7.3%) Daily laborer 1 (3.2%) 1 (4.8%) 1 (5.3%) 0 3 (2%) 5 (3.3%) Student 2 (6.5%) 0 2 (10.5%) 0 2 (1.3%) 3 (2%) Physical activity during pregnancy Vigorous Physical activity 5 (16.1%) 3 (14.3%) 3 (15.8%) 4 (30.8%) 11 (7.3%) 54 (36%) 0.001 Light Physical activity 26 (83.9%) 18 (85.7%) 16 (84.2%) 9 (69.2%) 51 (34%) 34 (22.7%) Discussion The findings from this study reveal certain associations between participant characteristics, physical activity during pregnancy, and pregnancy-related complications. These associations are consistent with some previous research studies, while differing from others. Firstly, the non-significant difference in maternal age between women with and without complications suggests that age may not be a significant factor in the development of gestational diabetes mellitus or hypertensive disorders of pregnancy. This finding aligns with the results of a study conducted by Belayhun Y. et al. ( 28 ), which also found no significant association between maternal age and pregnancy complications. But a study conducted by Khalil A. et al. in United Kingdom found a significant association between maternal age and pregnancy related complication such as HDP and GDM in which women with advanced maternal age has a higher risk of developing these complication ( 29 ). In terms of place of residence, our study found that rural residence was associated with a lower proportion of pregnancy complications compared to urban residence. This finding is in line with previous studies such as the research conducted by Kilembe F. et al. and Middendorp D. et al. ( 30 , 31 ), which reported a lower prevalence of pregnancy related complication such as HDP among women living in rural areas. Contradicting to this study other studies found that pregnancy related complication such as HDP and GDM is highly prevalent in women reside in rural area as compared to women lived in urban area ( 28 , 32 ). This difference could be attributed to disparities in healthcare access and lifestyle factors specific to rural and urban areas. Furthermore, the association between educational status and pregnancy complications is supported by several studies. Our study found that illiterate women had a lower proportion of complications compared to women with higher levels of education. This finding is consistent with the research conducted by Sole K. et al. in Norway which reported a lower risk of hypertensive disorders of pregnancy among women with lower educational attainment ( 33 ). Lastly, our study assesses the effect level of physical activities during pregnancy on the development of HDP and GDM, which is the main objective of this study and found a significant negative relationship between degree of physical activities during pregnancy and the risk of HDP and GDM. Importantly, women who engaged in vigorous physical activity during pregnancy was associated with lower proportion of developing HDP (gestational hypertension, pre-eclampsia, and eclampsia) as compared to women who have sedentary life style or engaged in light physical activities. From the pregnant women with HDP, only 18.87% were women engaged vigorous physical activities as compared 81.13% of women that had light physical activities. This is in line with a study conducted by Sorensen T. et al. ( 34 ), which reported engaging in physical activity during pregnancy is associated with a 34% reduced risk of HDP compared to being inactive. The study found that the risk of HDP decreases with increasing time spent on physical activity during pregnancy, as well as with increasing intensity of physical activity. In their study they showed that in addition to physical activity during pregnancy, participating in vigorous physical activities before pregnancy was associated with a 60% reduction in the risk of HDP. Another study done by Física A. et al. ( 35 ), also showed that physical activity during pregnancy serve as a positive effect on preventing HDP. The proposed mechanism behind this protective effect revolves around various physiological changes that occur during vigorous exercise. When engaging in vigorous physical activities, several factors come into play: improved Cardiovascular Conditioning, enhanced endothelial function, improved insulin sensitivity (helps maintain healthy blood sugar levels, which is essential for maintaining overall vascular health), and reduced inflammatory response ( 36 ). In line with this proposed mechanism, a study conducted by Pahlavani H. et al. found that regular exercise during pregnancy has potential benefits in preventing complications such as gestational diabetes and preeclampsia by modulating the levels of placentokines and exerkines, leading to improved metabolism, insulin sensitivity, and vascular function ( 37 ). In addition, physical activity during pregnancy can increase the expression of eNOS production and decrease the generation of reactive oxygen species in human placenta. NO generated by NOS has been demonstrated to contribute to the regulation of vascular tone by counteracting the actions of vasoconstrictors. This adaptation may contribute to the beneficial effects of physical activity during pregnancy on the vascular and antioxidant system, enhance endothelium-dependent vasodilation and reduce oxidative stress in the placenta, and then reduce the risk of HDP and GDM. Physical activities during pregnancy increases villous vascular development and cell proliferation, and increased villous vascular volume improves placental growth by enhancing placental transfer of oxygen and diffusible substrates; all these have role in the reduction of the development of hypertensive disorder during pregnancy ( 3 ). Different from this, a prospective cohort study conducted on Hispanic women by Chasan-taber L. et al. ( 38 ), found that higher levels of physical activity during pregnancy were not associated with significant reductions in risk of HDP. In our study women who engaged in vigorous physical activity during pregnancy also have less chance to develop GDM as compared to women who engaged in light physical activities. From the pregnant women with GDM who participated in our study, 83.87% of them had light physical activities and 16.13% of the women were engaged in vigorous physical activities during their pregnancy. This indicates how the level of physical activities during pregnancy is negatively related with the development of GDM. This is in line with a study conducted by Cordero Y. et al. ( 39 ), found that a physical exercise program performed during pregnancy can effectively reduce the prevalence of gestational diabetes mellitus (GDM) and preserve glucose tolerance. The study found that the intervention group, which followed a program of on-land and aquatic aerobic and muscular conditioning exercises, had a significantly lower prevalence of GDM (1%) compared to the control group (8.8%). A prospective case control study conducted by Mishra and Kishore among 100 cases of GDM and 273 controls to examine the relationship between physical activity during pregnancy and the risk of gestational diabetes mellitus (GDM) found that higher levels of physical activity are associated with a lower risk of GDM, while low-to-moderate physical activity levels increase the odds of developing GDM. Prolonged sitting and lower levels of moderate activity are identified as significant risk factors for GDM ( 40 ). Another study also showed that vigorous physical activity during pregnancy plays a crucial role in preventing and managing gestational diabetes mellitus (GDM) by controlling inflammation markers, reducing oxidative stress, and improving insulin sensitivity. Regular physical activity during pregnancy can compensate for defects in the insulin signaling pathway, change adipokine profiles, and reduce inflammation, all of which contribute to better glucose control in pregnant women with GDM. Physical activity during pregnancy with appropriate level and duration can improve insulin sensitivity, glucose control, lipid utilization in skeletal muscle, antioxidant activity, and reduce inflammation, ultimately reducing the risk of GDM ( 41 ). The results of this study provide valuable insights into the factors that may influence the occurrence of pregnancy-related complications, specifically HDP and GDM. However, it is important to note that this study has certain limitations, such as a relatively small sample size and potential confounding factors that were not accounted for in the analysis. Conclusion Overall, the finding of our study showed that pregnancy related complication, specifically HDP and GDM, was low in women who had vigorous physical activities during pregnancy as compared to those that have sedentary life style or engaged in light physical activities. So, incorporating regular physical activity into a healthy lifestyle during pregnancy may have protective benefits in reducing the risk of these pregnancy related complication. However, it is important to note that each pregnancy is unique, and factors such as maternal health, gestational age, and previous exercise habits should be taken into account. Therefore, it is recommended to consult with a healthcare professional before starting or continuing any exercise routine during pregnancy. They can provide personalized guidance based on an individual's health status and provide appropriate exercise recommendations. Lastly, the author recommends further research with larger sample sizes and control for potential confounders to validate and expand upon these findings. Abbreviations IUGR Intra-uterine growth retardation IUFD Intra-uterine fetal death MDG Millennium development goal MOH Ministry of Health MTUTH Mizan-Tepi University Teaching Hospital NGO Non-governmental organization:SD:Standard deviation SPSS Statistical package for social science WHO World Health Organization. Declarations Acknowledgment I would like to express my gratitude to Mizan-Tepi University Teaching Hospital gynecology and obstetrics ward Doctors and Midwives for their time and effort in helping me during data collection. References Vinturache A, Khalil A G libr. women’s med. Maternal Physiological Changes in Pregnancy. 2021; Available from: issn: 1756-2228; DOI 10.3843/GLOWM.411323 Hailu M, Abebe Y, Amsalu H. Evaluation of Platelet Count’s Role in the Prediction of Pregnancy-Induced Hypertension. SN Compr Clin Med [Internet]. 2023;5(1):157. Available from: https://doi.org/10.1007/s42399-023-01481-5 Ramírez-Vélez R, Bustamante J, Czerniczyniec A, Aguilar De Plata AC, Lores-Arnaiz S. Effect of exercise training on enos expression, NO production and oxygen metabolism in human placenta. PLoS One. 2013;8(11). Asnafi N, Hajian K. Mid-trimester uterine artery Doppler ultrasound as a predictor of adverse obstetric outcome in high-risk pregnancy. Taiwan J Obstet Gynecol. 2011 Mar 1;50(1):29–32. Heimrath J, Paprocka M, Czekanski A, Ledwozyw A, Kantor A, Dus D. Pregnancy-induced hypertension is accompanied by decreased number of circulating endothelial cells and circulating endothelial progenitor cells. Arch Immunol Ther Exp (Warsz) [Internet]. 2014/02/23. 2014 Aug;62(4):353–6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24563102 Wu J, Ren Y, Zhu C, Peng T, Zhang B, Li M. Abnormal placental perfusion and the risk of stillbirth : a hospital-based retrospective cohort study. 2021;1–10. Brown M, Magee L, Kenny L, Karumanchi S, McCarthy F, Saito S, et al. The hypertensive disorders of pregnancy: ISSHP classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens. 2018 May 1;13. E. Jimmy et al. ACOG Practice Bulletin No. 202: Gestational Hypertension and Preeclampsia. Obstet Gynecol [Internet]. 2019;133(1). Available from: https://journals.lww.com/greenjournal/Fulltext/2019/01000/ACOG_Practice_Bulletin_No__202__Gestational.49.aspx Poon LC, Shennan A, Hyett JA, Kapur A, Hadar E, Divakar H, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet. 2019 May;145 Suppl:1–33. von Dadelszen P, Magee LA. Preventing deaths due to the hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol. 2016 Oct;36:83–102. Alex NS, Khan HR, Ramachandra SG, Medhamurthy R. Pregnancy-associated Steroid Effects on Insulin Sensitivity , Adipogenesis , and Lipogenesis : Role of Wnt / β -Catenin Pathway. J Endocr Soc [Internet]. 2023;7(8):1–24. Available from: https://doi.org/10.1210/jendso/bvad076 Masuyama H, Hiramatsu Y. Potential role of estradiol and progesterone in insulin resistance through constitutive androstane receptor. 1999;229–39. Laredo-Aguilera J, Gallardo-Bravo M, Rabanales-Sotos J, Cobo-Cuenca A, Journal - International, 2020 U. Physical activity programs during pregnancy are effective for the control of gestational diabetes mellitus. mdpi.com [Internet]. [cited 2023 Feb 26]; Available from: https://www.mdpi.com/1660-4601/17/17/6151 Perämäki R, Gissler M, Ollila MM, Hukkanen J, Vääräsmäki M, Uotila J, et al. The risk of developing type 2 diabetes after gestational diabetes: A registry study from Finland. Diabetes Epidemiol Manag. 2023 Apr 1;10:100124. Dempsey JC, Butler CL, Williams MA. No Need for a Pregnant Pause : Physical Activity May Reduce the Occurrence of Gestational Diabetes Mellitus and Preeclampsia. 2005;141–9. of gestational diabetes. 2008;179(3):229–34. Gao Y, Ren S, Zhou H, Xuan R. Impact of physical activity during pregnancy on gestational hypertension. Phys Act Heal. 2020;4(1):32–9. Activity P, Pregnancy ED. Physical Activity and Exercise during Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstet Gynecol. 2020;135(4):E178–88. Evenson KR, Barakat R, Brown WJ, Dargent-Molina P, Haruna M, Mikkelsen EM, et al. Guidelines for Physical Activity During Pregnancy: Comparisons From Around the World. Am J Lifestyle Med. 2014;8(2):102–21. WHO. Physical activity. 2024;(October 2022):1–9. Available from: https://www.who.int/news Catov JM, Parker CB, Gibbs BB, Bann CM, Carper B, Silver RM, et al. Patterns of leisure-time physical activity across pregnancy and adverse pregnancy outcomes. Int J Behav Nutr Phys Act. 2018;15(1):1–10. WHO. Global Physical Activity Questionnaire (GPAQ) Analysis Guide. Geneva World Heal Organ [Internet]. 2012;1–22. Available from: http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Global+Physical+Activity+Questionnaire+(GPAQ)+Analysis+Guide#1 Id TP, Osta N El, Hout H, Chammas D El, Helou N El, Younes H, et al. PLOS ONE Pregnancy physical activity questionnaire ( PPAQ ): Translation and cross cultural adaption of an Arabic version. 2020;1–14. Available from: http://dx.doi.org/10.1371/journal.pone.0230420 Ussery E, Hyde E, Bombard J, Juhl A, Kim S, Carlson S. Physical Activity Before and During Pregnancy, Colorado Pregnancy Risk Assessment Monitoring System, 2012–2015. Prev Chronic Dis. 2020 Jul 9;17. Kaewkiattikun K. Effects of immediate postpartum contraceptive counseling on long-acting reversible contraceptive use in adolescents. Vol. Volume 8, Adolescent Health, Medicine and Therapeutics. 2017. 115–123 p. Legesse M, Ali JH, Manzar MD, Salahuddin M, Hassen HY. Level of physical activity and other maternal characteristics during the third trimester of pregnancy and its association with birthweight at term in South Ethiopia: A prospective cohort study. PLoS One [Internet]. 2020;15(7):1–15. Available from: http://dx.doi.org/10.1371/journal.pone.0236136 Chasan-Taber L, Schmidt MD, Roberts DE, Hosmer D, Markenson G, Freedson PS. Development and validation of a pregnancy physical activity questionnaire. Med Sci Sports Exerc. 2004;36(10):1750–60. Belayhun Y, Kassa Y, Mekonnen N, Binu W, Tenga M, Duko B. Determinants of Pregnancy-Induced Hypertension among Mothers Attending Public Hospitals in Wolaita Zone , South Ethiopia : Findings from Unmatched Case-Control Study. 2021;2021. Khalil A, Syngelaki A, Maiz N, Zinevich Y, Nicolaides KH. Maternal age and adverse pregnancy outcome : a cohort study. 2013;(March):634–43. Middendorp D Van, Asbroek A, Bio FY, Edusei A, Meijjer L, Newton S, et al. Rural and urban differences in blood pressure and pregnancy-induced hypertension among pregnant women in Ghana. 2013;1–8. Kilembe FD, Hussain A, Stray-pedersen B. Hypertensive Disorders of Pregnancy : Prevalence , Maternal Complications and Perinatal Outcomes at Lilongwe Central Hospital , Malawi By : Franklin David Kilembe As partial fulfillment for the award of the Master of Philosophy Degree in International Com. 2004;(June). Venkatesh KK, Huang X, Cameron NA, Petito LC, Joseph J, Landon MB, et al. Rural – ­ urban disparities in pregestational and gestational diabetes in pregnancy : Serial , cross- ­ sectional analysis of over 12 million pregnancies. 2024;(June 2023):26–35. Sole KB, Staff AC, Katariina Laine. The association of maternal country of birth and education with hypertensive disorders of pregnancy : A population- ­ based study of 960 516 deliveries in Norway. 2018;(February):1237–47. Sorensen TK, Williams MA, Lee I, Dashow EE, Thompson M Lou, Luthy DA. Recreational Physical Activity During Pregnancy and Risk of Preeclampsia. 2003; Física A, Gestantes EM, Prevenção C, Síndrome DA. INTEGRATIVE REVIEW ARTICLE PHYSICAL ACTIVITY IN PREGNANT WOMEN AS PREVENTION OF GESTATIONAL HYPERTENSIVE SYNDROME. 2018;12(4):1017–26. Ferrari N, Joisten C. Impact of physical activity on course and outcome of pregnancy from pre- to postnatal. Eur J Clin Nutr [Internet]. 2021; Available from: http://dx.doi.org/10.1038/s41430-021-00904-7 Pahlavani HA, Laher I, Weiss K, Knechtle B, Zouhal H. Physical exercise for a healthy pregnancy : the role of placentokines and exerkines. J Physiol Sci [Internet]. 2023;1–15. Available from: https://doi.org/10.1186/s12576-023-00885-1 Chasan-taber L, Silveira M, Pekow P, Braun B, Manson JE, Solomon CG, et al. Physical activity , sedentary behavior and risk of hypertensive disorders of pregnancy in Hispanic women. 2014;1–16. Cordero Y, Mottola MF, Vargas J, Blanco M, Activity P, Faculty SS, et al. Exercise Is Associated with a Reduction in Gestational Diabetes Mellitus ´. 2015;1328–33. Mishra S, Shetty A, Rao C, … SN-IJ of, 2018 U. Erratum: Effect of physical activity during pregnancy on gestational diabetes mellitus. ncbi.nlm.nih.gov [Internet]. [cited 2023 Feb 26]; Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6330856/ Wang C, Janese K, Yang H. ScienceDirect Exercise and its role in gestational diabetes mellitus. Chronic Dis Transl Med [Internet]. 2016;2(4):208–14. Available from: http://dx.doi.org/10.1016/j.cdtm.2016.11.006 Additional Declarations The authors declare no competing interests. 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. Also discoverable on Platform About Our Team In Review Editorial Policies Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4173404","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":284342908,"identity":"23c43a0f-c71d-4489-8847-8ab8c16fbcbf","order_by":0,"name":"Molla Hailu","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAw0lEQVRIiWNgGAWjYFAC5sYHiQ0SciDmgQfEaWFsNnjYIGEM1pJApJY2yYcNDIkNIDZRWnTbGxskEndYpM8PO/wQaIudnG4DAS1mZw42GCSekcjdeDvNAKgl2djsACEtNxIbEhLbgFpmJ4C0HEjcRoyWA0At6Yaz0z8QraWxAaglQV46h1hbzhxsZgBqMdwgnVNwIMGAGL8cbz7+82dbnbz87PTNHz5U2MkR1AIHBmCVBsQqBwH5BlJUj4JRMApGwYgCAEcwTEOLfqKLAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0001-8793-0080","institution":"Woldia University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Molla","middleName":"","lastName":"Hailu","suffix":""},{"id":284343093,"identity":"7cdc3dbc-00b8-4ec1-bb12-f3a64cbab416","order_by":1,"name":"Natnael Amare","email":"","orcid":"","institution":"Woldia University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Natnael","middleName":"","lastName":"Amare","suffix":""},{"id":284343094,"identity":"8b05cbe0-4b97-4b5c-9201-5d1778e6d7f7","order_by":2,"name":"Abayneh Tunta","email":"","orcid":"","institution":"Woldia University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Abayneh","middleName":"","lastName":"Tunta","suffix":""},{"id":284343095,"identity":"479817fe-5f40-49f9-aa67-8a6a49b29758","order_by":3,"name":"Dr Zeru Seyoum","email":"","orcid":"","institution":"","correspondingAuthor":false,"submittingAuthor":false,"prefix":"Dr","firstName":"Zeru","middleName":"","lastName":"Seyoum","suffix":""}],"badges":[],"createdAt":"2024-03-27 04:37:31","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false,"coiExplicitlySet":false},"doi":"10.21203/rs.3.rs-4173404/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4173404/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":53606142,"identity":"3c607a97-8c69-449a-a11e-ad35ffaeaca4","added_by":"auto","created_at":"2024-03-28 03:44:38","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":271332,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4173404/v1/61d9ed84-dbe5-4bb3-8d86-c0e345132e67.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eDegree of Physical activity during pregnancy and pregnancy related complication\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003ePregnancy is a period of time during which a fertilized egg develops into a fetus inside a woman's uterus. It is a complex process that involves various physiological changes in a woman's body. These changes are necessary to support the growth and development of the fetus. The most notable changes and adaptations that take place during pregnancy include elevated resting heart rate, elevated cardiac output, and decreased peripheral vascular resistance (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). An increase in endothelium-dependent vasodilation appears to be a major moderator of these modifications and adaptations. Nitric oxide (NO) released by endothelial cells has been suggested to be the primary cause of the reduced systemic vascular resistance seen during pregnancy. Sustaining appropriate placental blood perfusion requires the uterine arteries' high exhaustion and low resistance (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). However, as the pregnancy progresses, the resistance of uterine spiral artery blood flow will be decreased gradually, the V-shaped notch in early diastole tends to be flat and even disappear in late pregnancy (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). This in turn results in a decreased production or an increased inactivation of NO that would be linked to the endothelial dysfunction and reduced placental perfusion. If the endothelial and placental function becomes impaired, it will cause various obstetric disorders such as intrauterine growth restriction, hypertensive disorder of pregnancy, gestational diabetes mellitus, spiral arterial embolism, decidual necrosis, placental abruption, preterm labor; leading to adverse pregnancy outcomes such as perinatal morbidity and mortality globally (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTherefore, even though motherhood is a positive and enjoyable experience, it is also a vulnerable period that can be accompanied by various complications in which many women are experiencing suffering, illness, and death. Hypertensive disorders of pregnancy (HDP) are one of the most significant contributors to these complications and sufferings. Maternal hypertensive disorder is a group of high blood pressure disorders that include gestational hypertension, preeclampsia, eclampsia, preeclampsia superimposed on chronic hypertension, and chronic hypertension (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). The development of hypertensive disorders is thought to be due to various factors, including genetic predisposition, immunological factors, and abnormalities in the placenta. The exact mechanism is not fully understood, but some of commonly observed factors are placental imbalance, abnormal immune response, genetic factors, and endothelial dysfunction.\u003c/p\u003e \u003cp\u003eHDP is mainly manifested as hypertension and damage to important organs such as heart, kidney, liver and nervous system. The previous study has proven 16% of maternal deaths can be attributed to HDP, so it has become an urgent obstetric crisis (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Hypertension in pregnancy is associated with potentially lethal complications including abruption placentae, disseminated intravascular coagulation, cerebral hemorrhage, hepatic failure, and acute renal failure (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Worldwide, hypertensive disorders remain the leading causes of pregnancy- related maternal mortality, stillbirth, and neonatal death (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn addition to hemodynamic adaptive changes, pregnancy is also characterized by endocrine and metabolism changes thereby forming a pseudo-diabetic state of progressive insulin resistance. In the early stages of pregnancy, there is an increase in insulin sensitivity. This is because the body needs to provide adequate energy and nutrients to support the growing fetus. Insulin sensitivity is enhanced to ensure that glucose from the mother's blood can be transported to the placenta and reach the developing baby. However, as pregnancy progresses, especially during the second and third trimesters, there is a natural decrease in insulin sensitivity. This is primarily due to the presence of hormones like estrogen, progesterone, and human placental lactogen, which can interfere with insulin action (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). The decrease in insulin sensitivity during pregnancy is a normal physiological response. It allows for the efficient utilization of glucose by the developing fetus, as it ensures that glucose is available for fetal growth and development. However, if the mother failed to manage this change appropriately the decrease in insulin sensitivity can become too significant, resulting in the development of gestational diabetes mellitus (GDM) which is one of the most common complications related to pregnancy.\u003c/p\u003e \u003cp\u003eGDM is a condition characterized by high blood sugar levels during pregnancy. This condition affects approximately 14% worldwide (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e), leading to adverse maternal and neonatal outcomes. It typically resolves after delivery, but it can have both short- and long-term potential risks for both the mother and the baby if not managed properly. Jaundice, birth trauma, erythremia, hypoglycemia, macrosomia, and hypocalcemia are examples of unfavourable newborn outcomes. Comparing the children of euglycemic women to those of gestational diabetic moms, the latter group is more likely to experience obesity, impaired glucose tolerance, and diabetes in adolescence or early adulthood. Moreover, mother with GDM have a higher chance of developing overt diabetes following childbirth and a higher risk of developing other pregnancy problems such preeclampsia, infection, and postpartum hemorrhage (\u003cspan additionalcitationids=\"CR15\" citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eTherefore, GDM and HDP are common complications that can significantly impact the health of the mother and the unborn baby, in which their incidence become rise in recent years, making them a significant public health concern. In order to prevent these and other life threating complication of pregnancy and their subsequent deadly consequence many scholars recommend different medical and non-medical preventive strategies. Among these strategies some of them are community engagement and mobilization, food security for girls and pregnant women, delayed marriage and delayed first pregnancy, birth spacing, health human resources, screening for HDP and GDM risk, provision of antenatal care, time-of-disease maternal risk assessment, time-of-disease fetal risk assessment, well-resourced settings, and physical activities (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). So, as researches indicated physical activity during pregnancy may have a positive effect in reducing the risk of developing GDM and HDP.\u003c/p\u003e \u003cp\u003ePhysical activity is any bodily movement produced by skeletal muscles that require energy expenditure. It is all types of movement include walking, cycling, wheeling, sports, and active recreation and play, and can be done at any level of skill and for enjoyment by everybody. Engaging in regular physical activity offers numerous benefits for both physical and mental health. The benefits of physical activity among men and non-pregnant women on health, such as reducing the risk of essential hypertension, coronary atherosclerotic heart disease, and type 2 diabetes are well documented, but there is a gap on the effect of physical activity during pregnancy on pregnancy related complication (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThere has been a controversy about exercising during pregnancy. On one side, there are those who argue that exercise during pregnancy can have numerous benefits for both the mother and the baby. They suggest that staying physically active can help reduce the risks of gestational diabetes, preeclampsia, excessive weight gain, and other complications during pregnancy. Additionally, regular exercise is believed to boost mood, improve energy levels, and promote better sleep for expectant mothers. It is worth noting that the American College of Obstetricians and Gynecologists (ACOG) recommends moderate-intensity physical activity for most pregnant women, provided they have no medical or obstetric complications. They emphasize that exercises like walking, swimming, and low-impact aerobics are generally safe during pregnancy, but it is crucial for expectant mothers to consult with their healthcare providers before starting or modifying an exercise routine. WHO is also recommended that pregnant women engage in at least 150 minutes of moderate-intensity aerobic activity spread throughout the week (\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOn the other side, some experts assert that pregnant women should limit their physical activity and avoid excessive exertion. They express concerns about potential risks to the developing fetus, such as an increased likelihood of preterm labor, reduced blood flow to the uterus, and overheating. Critics of exercise during pregnancy argue that caution should be taken, especially if there are underlying health conditions or pregnancy complications present. For this reason, many pregnant women are physically inactive, increasing this inactivity during the last trimester of pregnancy (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Therefore, this study would provide additional knowledge in order to decide whether or not exercising during pregnancy.\u003c/p\u003e \u003cp\u003eThe main objective of this study is to assess the effect of level of physical activities during pregnancy on the development of HDP and GDM. This study is not only significant for the field of obstetrics and gynecology but also for pregnant women and health professionals involved in antenatal care and public health policymakers. It aims to address a critical research gap and provide evidence-based recommendations that can inform clinical practice and prenatal care guidelines. The findings of this research have the potential to impact the lives of pregnant women and their unborn babies by promoting a healthy lifestyle and reducing the risk of complications during pregnancy.\u003c/p\u003e"},{"header":"Method and Materials","content":"\u003cp\u003eInstitution based cross-sectional study was conducted at the MizanTepi University Teaching Hospital (MTUTH) from November 2021 to February 2022.\u0026nbsp;The study population was pregnant women who gave birth, and fulfilled the inclusion criteria during the study period, and volunteered to take part in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEligibility criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll volunteer pregnant women who gave birth during the study period\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eExclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePrevious history of diabetes mellitus, hypertension, seizure, heart diseases\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWomen with multiple pregnancy and intrauterine fetal death (IUFD)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOperational definition\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eVigorous activities\u003c/strong\u003e: are described as activities that require a large amount of physical effort and largely increase breathing or heart rate. These include carrying wood, manual grinding, weeding, drawing water from the well or river \u0026nbsp; \u0026nbsp; and bringing water from another house, Ploughing or digging, washing clothes, sweeping floors, gardening, and any fitness or recreational activities that cause large increases in breathing or heart rate, like running for at least 10 minutes continuously (22)(23).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLight activities\u003c/strong\u003e: are described as activities that require small physical effort and mildly increase breathing or heart rate. These include, mopping the floor, cooking, shopping, child care, tailoring, walking for no more than 10 minutes, etc.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSedentary behavior\u003c/strong\u003e: is defined as sitting or reclining at work or at home; while getting to and from places; travelling in a car, bus, motor, or cart; reading; or watching television.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMeasurement and data collection procedure\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSample size determination\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe calculated the sample size using the single population proportion formula by taking physical activity prevalence during pregnancy of 10.2% from a previous study (24) based on the assumption of a 95% confidence interval (CI) with a margin of error of 5%.\u003c/p\u003e\n\u003cp\u003e\u003cimg src=\"data:image/png;base64,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\"\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:10.0pt;margin-left:0in;line-height:150%;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:justify;'\u003eUsing this formula, we got a total sample size of 150.\u003c/p\u003e\n\u003ch3\u003eSampling method\u003c/h3\u003e\n\u003cp\u003eAll eligible pregnant women who gave birth at Mizan Tepi University Teaching Hospital were selected until the total sample size was attained.\u003c/p\u003e\n\u003ch2\u003eData collection tools and procedure\u003c/h2\u003e\n\u003cp\u003eData was collected through face-to-face interviews using a structured questionnaire that was adapted from the Ethiopia demographic survey\u0026nbsp;(25)\u0026nbsp;and other peer reviewed articles\u0026nbsp;(26,27). The questionnaire contains socio-demographic, obstetric, physical activity characteristics, and the Pregnancy Physical Activity Questionnaire (PPAQ), which was developed by Chasan-Taber L, et al\u0026nbsp;(27).\u003c/p\u003e\n\u003cp\u003eA questionnaire was translated into Amharic language. \u0026nbsp;This questionnaire was pretested on 5% of pregnant women who gave birth but were not part of the study participants from similar health settings, and based on pretesting feedback, modifications were made to the survey prior to administration. For each activity, respondents were asked in their local language to select the type of physical activity and the amount of time spent on that activity per day or week during the current pregnancy. The types of Physical activity at work, travel, and sports or leisure time activities were assessed. The level was then classified as vigorous physical activities and light physical activities.\u003c/p\u003e\n\u003cp\u003eThe primary outcomes studied were degree of physical activity during pregnancy and the development of HDP and GDM. Secondary outcomes included maternal age, occupation, educational status, number of parities, and residence of the study participant.\u003c/p\u003e\n\u003ch2\u003eData management and analysis\u003c/h2\u003e\n\u003cp\u003eThe data obtained from the questionnaire was entered, checked and cleaned by epidata \u0026nbsp;software \u0026nbsp;version \u0026nbsp; 3.1, \u0026nbsp;and \u0026nbsp;then \u0026nbsp; exported \u0026nbsp;to \u0026nbsp;SPSS(Statistical \u0026nbsp;Package \u0026nbsp; for \u0026nbsp;Social \u0026nbsp;science) \u0026nbsp; version 25 software \u0026nbsp;for \u0026nbsp;analysis.\u003c/p\u003e\n\u003cp\u003eDescriptive statistics were computed using frequencies with percentages for categorical variables and the mean and standard deviation for continuous variables. Linear regression, Chi-square, and t-test were conducted to check the presence of any association between the dependent and independent variables. A p-value of \u0026lt; 0.05 was considered statistically significant.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eEthical considerations\u003c/h2\u003e\n\u003cp\u003eThis study was conducted after obtaining ethical clearance from the Research Ethics Review Committee of the College of Health Sciences, Mizan Tepi University. The study was conducted with written and oral consent, which assures the willingness of each participant to participate in the study. Each participant signed an informed consent form. The confidentiality and privacy of the pregnant woman were also protected.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThis study, which was conducted to assess the effect of degree of physical activity during pregnancy on pregnancy related complication, includes a total of 150 women who gave birth during the study period. Among the total study participant, 65(43.3%) and 85(56.7%) of them were engaged in vigorous physical activities and light physical activities during pregnancy, respectively. From these study participants 62 (41.3%) of them had pregnancy related complication. Of this, 31, 21, 19, 13 of the complication was gestational diabetes mellitus, gestational hypertension, preeclampsia and eclampsia, respectively, in which some of the women had more than one complication during the study period.\u003c/p\u003e\n\u003cp\u003eAs shown in the table \u003cstrong\u003e1\u003c/strong\u003e below, the mean age of the study participants in both groups was found to be relatively similar, with pregnant women experiencing complications having a mean age of 28.53\u0026plusmn;3.63 years, and those without complications having a mean age of 28.04\u0026plusmn;3.77 years. The difference in maternal age between the two groups was not statistically significant (p=0.431).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn terms of place of residence, a significant association was observed between place of residence and the occurrence of pregnancy-related complications. Among women with complications, 80.64% resided in urban areas, while only 19.36% were from rural areas. In contrast, pregnant women without complications relatively had a more balanced distribution, with 23.3% residing in urban areas and 35.3% residing in rural areas. This difference in distribution was found to be statistically significant (p=0.001).\u003c/p\u003e\n\u003cp\u003eRegarding physical activity during pregnancy, it was found that women who engaged in vigorous physical activity had a lower proportion of complications (17.74%) compared to those who engaged in light physical activity (82.26%). This difference was statistically significant (p=0.001).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAmong women who develop HDP, 43 (81.13%) had light physical activity while the remaining 10 (18.87%) of the women with HDP were had vigorous physical activities. Similarly, from the study participants who develop GDM 26 (83.87%) of them had light physical activities, and 5 (16.13%) of the women with GDM were engaged in vigorous physical activities.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1\u003c/strong\u003e: Association of study participant\u0026rsquo;s characteristics and degree of physical activity during pregnancy with pregnancy related complication.\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eCharacteristics of the study participants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003ePregnant women with Pregnancy related complication\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003ePregnant women without complication\u003c/p\u003e\n \u003cp\u003en=88 (58.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eP-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGestational Diabetes mellitus \u0026nbsp; n=31(20.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGestational hypertension\u003c/p\u003e\n \u003cp\u003en=21 (14%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; Pre-eclampsia\u003c/p\u003e\n \u003cp\u003en=19(12.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eEclampsia\u003c/p\u003e\n \u003cp\u003en=13(8.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003cp\u003en=62 (41.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eMaternal age in year (mean\u0026plusmn;S.D)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.54\u0026plusmn;3.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.63\u0026plusmn;3.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.63\u0026plusmn;3.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.88\u0026plusmn;3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.53\u0026plusmn;3.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28.04\u0026plusmn;3.77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.431\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003ePlace of Residence\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRural\u0026nbsp;\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\u003e3 (14.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (21.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (30.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e53 (35.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e26 (83.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e18 (85.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e15 (78.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e9 (69.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e50 (33.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e35 (23.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eGravida\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePrimigravida\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\u003e9 (42.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11 (57.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9 (69.2%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e31 (20.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e41 (27.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;0.681\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMultigravida\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20 (64.5 %)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (57.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 (42.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (30.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e31 (20.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e47 (31.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eEducational status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eIlletrate\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\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (7.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23 (15.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRead and write\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6 (19.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5 (23.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (21.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (15.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e13 (8.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e22 (14.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (12.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (14.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (15.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (23.1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11 (7.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15 (10%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (12.9%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6 (28.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (15.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (7.7%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9 (6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14 (9.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHigher education\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\u003e7 (33.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9 (47.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6 (46.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27 (18%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14 (9.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eOccupation\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHouse wife\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (38.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9(42.9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7 (36.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7 (53.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e23 (15.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e31 (20.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"6\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;0.001\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eFarmer\u0026nbsp;\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\u003e2 (9.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (7.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (2.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e30 (20%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMerchant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6 (19.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5 (23.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (15.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (7.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e12 (8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 (5.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eGovernmental/ private employer\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 (25.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (19%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6 (31.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (30.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18 (12%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11 (7.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDaily laborer\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\u003e1 (4.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e1 (5.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e5 (3.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStudent\u0026nbsp;\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\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (10.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e2 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003ePhysical activity during pregnancy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eVigorous Physical activity\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\u003e3 (14.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e3 (15.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e4 (30.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e11 (7.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e54 (36%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e0.001\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLight Physical activity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26 (83.9%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e18 (85.7%)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16 (84.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9 (69.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e51 (34%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34 (22.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe findings from this study reveal certain associations between participant characteristics, physical activity during pregnancy, and pregnancy-related complications. These associations are consistent with some previous research studies, while differing from others. Firstly, the non-significant difference in maternal age between women with and without complications suggests that age may not be a significant factor in the development of gestational diabetes mellitus or hypertensive disorders of pregnancy. This finding aligns with the results of a study conducted by Belayhun Y. et al. (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e), which also found no significant association between maternal age and pregnancy complications. But a study conducted by Khalil A. et al. in United Kingdom found a significant association between maternal age and pregnancy related complication such as HDP and GDM in which women with advanced maternal age has a higher risk of developing these complication (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn terms of place of residence, our study found that rural residence was associated with a lower proportion of pregnancy complications compared to urban residence. This finding is in line with previous studies such as the research conducted by Kilembe F. et al. and Middendorp D. et al. (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e), which reported a lower prevalence of pregnancy related complication such as HDP among women living in rural areas. Contradicting to this study other studies found that pregnancy related complication such as HDP and GDM is highly prevalent in women reside in rural area as compared to women lived in urban area (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). This difference could be attributed to disparities in healthcare access and lifestyle factors specific to rural and urban areas.\u003c/p\u003e \u003cp\u003eFurthermore, the association between educational status and pregnancy complications is supported by several studies. Our study found that illiterate women had a lower proportion of complications compared to women with higher levels of education. This finding is consistent with the research conducted by Sole K. et al. in Norway which reported a lower risk of hypertensive disorders of pregnancy among women with lower educational attainment (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eLastly, our study assesses the effect level of physical activities during pregnancy on the development of HDP and GDM, which is the main objective of this study and found a significant negative relationship between degree of physical activities during pregnancy and the risk of HDP and GDM. Importantly, women who engaged in vigorous physical activity during pregnancy was associated with lower proportion of developing HDP (gestational hypertension, pre-eclampsia, and eclampsia) as compared to women who have sedentary life style or engaged in light physical activities. From the pregnant women with HDP, only 18.87% were women engaged vigorous physical activities as compared 81.13% of women that had light physical activities.\u003c/p\u003e \u003cp\u003eThis is in line with a study conducted by Sorensen T. et al. (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e), which reported engaging in physical activity during pregnancy is associated with a 34% reduced risk of HDP compared to being inactive. The study found that the risk of HDP decreases with increasing time spent on physical activity during pregnancy, as well as with increasing intensity of physical activity. In their study they showed that in addition to physical activity during pregnancy, participating in vigorous physical activities before pregnancy was associated with a 60% reduction in the risk of HDP. Another study done by F\u0026iacute;sica A. et al. (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e), also showed that physical activity during pregnancy serve as a positive effect on preventing HDP.\u003c/p\u003e \u003cp\u003eThe proposed mechanism behind this protective effect revolves around various physiological changes that occur during vigorous exercise. When engaging in vigorous physical activities, several factors come into play: improved Cardiovascular Conditioning, enhanced endothelial function, improved insulin sensitivity (helps maintain healthy blood sugar levels, which is essential for maintaining overall vascular health), and reduced inflammatory response (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). In line with this proposed mechanism, a study conducted by Pahlavani H. et al. found that regular exercise during pregnancy has potential benefits in preventing complications such as gestational diabetes and preeclampsia by modulating the levels of placentokines and exerkines, leading to improved metabolism, insulin sensitivity, and vascular function (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn addition, physical activity during pregnancy can increase the expression of eNOS production and decrease the generation of reactive oxygen species in human placenta. NO generated by NOS has been demonstrated to contribute to the regulation of vascular tone by counteracting the actions of vasoconstrictors. This adaptation may contribute to the beneficial effects of physical activity during pregnancy on the vascular and antioxidant system, enhance endothelium-dependent vasodilation and reduce oxidative stress in the placenta, and then reduce the risk of HDP and GDM. Physical activities during pregnancy increases villous vascular development and cell proliferation, and increased villous vascular volume improves placental growth by enhancing placental transfer of oxygen and diffusible substrates; all these have role in the reduction of the development of hypertensive disorder during pregnancy (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDifferent from this, a prospective cohort study conducted on Hispanic women by Chasan-taber L. et al. (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e), found that higher levels of physical activity during pregnancy were not associated with significant reductions in risk of HDP.\u003c/p\u003e \u003cp\u003eIn our study women who engaged in vigorous physical activity during pregnancy also have less chance to develop GDM as compared to women who engaged in light physical activities. From the pregnant women with GDM who participated in our study, 83.87% of them had light physical activities and 16.13% of the women were engaged in vigorous physical activities during their pregnancy. This indicates how the level of physical activities during pregnancy is negatively related with the development of GDM.\u003c/p\u003e \u003cp\u003eThis is in line with a study conducted by Cordero Y. et al. (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e), found that a physical exercise program performed during pregnancy can effectively reduce the prevalence of gestational diabetes mellitus (GDM) and preserve glucose tolerance. The study found that the intervention group, which followed a program of on-land and aquatic aerobic and muscular conditioning exercises, had a significantly lower prevalence of GDM (1%) compared to the control group (8.8%).\u003c/p\u003e \u003cp\u003eA prospective case control study conducted by Mishra and Kishore among 100 cases of GDM and 273 controls to examine the relationship between physical activity during pregnancy and the risk of gestational diabetes mellitus (GDM) found that higher levels of physical activity are associated with a lower risk of GDM, while low-to-moderate physical activity levels increase the odds of developing GDM. Prolonged sitting and lower levels of moderate activity are identified as significant risk factors for GDM (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAnother study also showed that vigorous physical activity during pregnancy plays a crucial role in preventing and managing gestational diabetes mellitus (GDM) by controlling inflammation markers, reducing oxidative stress, and improving insulin sensitivity. Regular physical activity during pregnancy can compensate for defects in the insulin signaling pathway, change adipokine profiles, and reduce inflammation, all of which contribute to better glucose control in pregnant women with GDM. Physical activity during pregnancy with appropriate level and duration can improve insulin sensitivity, glucose control, lipid utilization in skeletal muscle, antioxidant activity, and reduce inflammation, ultimately reducing the risk of GDM (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe results of this study provide valuable insights into the factors that may influence the occurrence of pregnancy-related complications, specifically HDP and GDM. However, it is important to note that this study has certain limitations, such as a relatively small sample size and potential confounding factors that were not accounted for in the analysis.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eOverall, the finding of our study showed that pregnancy related complication, specifically HDP and GDM, was low in women who had vigorous physical activities during pregnancy as compared to those that have sedentary life style or engaged in light physical activities. So, incorporating regular physical activity into a healthy lifestyle during pregnancy may have protective benefits in reducing the risk of these pregnancy related complication. However, it is important to note that each pregnancy is unique, and factors such as maternal health, gestational age, and previous exercise habits should be taken into account. Therefore, it is recommended to consult with a healthcare professional before starting or continuing any exercise routine during pregnancy. They can provide personalized guidance based on an individual's health status and provide appropriate exercise recommendations. Lastly, the author recommends further research with larger sample sizes and control for potential confounders to validate and expand upon these findings.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIUGR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eIntra-uterine growth retardation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIUFD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eIntra-uterine fetal death\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMDG\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMillennium development goal\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMOH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMinistry of Health\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMTUTH\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eMizan-Tepi University Teaching Hospital\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eNGO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eNon-governmental organization:SD:Standard deviation\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSPSS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eStatistical package for social science\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eWHO\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eWorld Health Organization.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAcknowledgment\u003c/h2\u003e \u003cp\u003eI would like to express my gratitude to Mizan-Tepi University Teaching Hospital gynecology and obstetrics ward Doctors and Midwives for their time and effort in helping me during data collection.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eVinturache A, Khalil A G libr. women\u0026rsquo;s med. Maternal Physiological Changes in Pregnancy. 2021; Available from: issn: 1756-2228; DOI 10.3843/GLOWM.411323\u003c/li\u003e\n\u003cli\u003eHailu M, Abebe Y, Amsalu H. Evaluation of Platelet Count\u0026rsquo;s Role in the Prediction of Pregnancy-Induced Hypertension. SN Compr Clin Med [Internet]. 2023;5(1):157. Available from: https://doi.org/10.1007/s42399-023-01481-5\u003c/li\u003e\n\u003cli\u003eRam\u0026iacute;rez-V\u0026eacute;lez R, Bustamante J, Czerniczyniec A, Aguilar De Plata AC, Lores-Arnaiz S. Effect of exercise training on enos expression, NO production and oxygen metabolism in human placenta. PLoS One. 2013;8(11). \u003c/li\u003e\n\u003cli\u003eAsnafi N, Hajian K. Mid-trimester uterine artery Doppler ultrasound as a predictor of adverse obstetric outcome in high-risk pregnancy. Taiwan J Obstet Gynecol. 2011 Mar 1;50(1):29\u0026ndash;32. \u003c/li\u003e\n\u003cli\u003eHeimrath J, Paprocka M, Czekanski A, Ledwozyw A, Kantor A, Dus D. Pregnancy-induced hypertension is accompanied by decreased number of circulating endothelial cells and circulating endothelial progenitor cells. Arch Immunol Ther Exp (Warsz) [Internet]. 2014/02/23. 2014 Aug;62(4):353\u0026ndash;6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24563102\u003c/li\u003e\n\u003cli\u003eWu J, Ren Y, Zhu C, Peng T, Zhang B, Li M. Abnormal placental perfusion and the risk of stillbirth : a hospital-based retrospective cohort study. 2021;1\u0026ndash;10. \u003c/li\u003e\n\u003cli\u003eBrown M, Magee L, Kenny L, Karumanchi S, McCarthy F, Saito S, et al. The hypertensive disorders of pregnancy: ISSHP classification, diagnosis \u0026amp; management recommendations for international practice. Pregnancy Hypertens. 2018 May 1;13. \u003c/li\u003e\n\u003cli\u003eE. Jimmy et al. ACOG Practice Bulletin No. 202: Gestational Hypertension and Preeclampsia. Obstet Gynecol [Internet]. 2019;133(1). Available from: https://journals.lww.com/greenjournal/Fulltext/2019/01000/ACOG_Practice_Bulletin_No__202__Gestational.49.aspx\u003c/li\u003e\n\u003cli\u003ePoon LC, Shennan A, Hyett JA, Kapur A, Hadar E, Divakar H, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: A pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet. 2019 May;145 Suppl:1\u0026ndash;33. \u003c/li\u003e\n\u003cli\u003evon Dadelszen P, Magee LA. Preventing deaths due to the hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol. 2016 Oct;36:83\u0026ndash;102. \u003c/li\u003e\n\u003cli\u003eAlex NS, Khan HR, Ramachandra SG, Medhamurthy R. Pregnancy-associated Steroid Effects on Insulin Sensitivity , Adipogenesis , and Lipogenesis : Role of Wnt / \u0026beta; -Catenin Pathway. J Endocr Soc [Internet]. 2023;7(8):1\u0026ndash;24. Available from: https://doi.org/10.1210/jendso/bvad076\u003c/li\u003e\n\u003cli\u003eMasuyama H, Hiramatsu Y. Potential role of estradiol and progesterone in insulin resistance through constitutive androstane receptor. 1999;229\u0026ndash;39. \u003c/li\u003e\n\u003cli\u003eLaredo-Aguilera J, Gallardo-Bravo M, Rabanales-Sotos J, Cobo-Cuenca A, Journal - International, 2020 U. Physical activity programs during pregnancy are effective for the control of gestational diabetes mellitus. mdpi.com [Internet]. [cited 2023 Feb 26]; Available from: https://www.mdpi.com/1660-4601/17/17/6151\u003c/li\u003e\n\u003cli\u003ePer\u0026auml;m\u0026auml;ki R, Gissler M, Ollila MM, Hukkanen J, V\u0026auml;\u0026auml;r\u0026auml;sm\u0026auml;ki M, Uotila J, et al. The risk of developing type 2 diabetes after gestational diabetes: A registry study from Finland. Diabetes Epidemiol Manag. 2023 Apr 1;10:100124. \u003c/li\u003e\n\u003cli\u003eDempsey JC, Butler CL, Williams MA. No Need for a Pregnant Pause : Physical Activity May Reduce the Occurrence of Gestational Diabetes Mellitus and Preeclampsia. 2005;141\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eof gestational diabetes. 2008;179(3):229\u0026ndash;34. \u003c/li\u003e\n\u003cli\u003eGao Y, Ren S, Zhou H, Xuan R. Impact of physical activity during pregnancy on gestational hypertension. Phys Act Heal. 2020;4(1):32\u0026ndash;9. \u003c/li\u003e\n\u003cli\u003eActivity P, Pregnancy ED. Physical Activity and Exercise during Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstet Gynecol. 2020;135(4):E178\u0026ndash;88. \u003c/li\u003e\n\u003cli\u003eEvenson KR, Barakat R, Brown WJ, Dargent-Molina P, Haruna M, Mikkelsen EM, et al. Guidelines for Physical Activity During Pregnancy: Comparisons From Around the World. Am J Lifestyle Med. 2014;8(2):102\u0026ndash;21. \u003c/li\u003e\n\u003cli\u003eWHO. Physical activity. 2024;(October 2022):1\u0026ndash;9. Available from: https://www.who.int/news\u003c/li\u003e\n\u003cli\u003eCatov JM, Parker CB, Gibbs BB, Bann CM, Carper B, Silver RM, et al. Patterns of leisure-time physical activity across pregnancy and adverse pregnancy outcomes. Int J Behav Nutr Phys Act. 2018;15(1):1\u0026ndash;10. \u003c/li\u003e\n\u003cli\u003eWHO. Global Physical Activity Questionnaire (GPAQ) Analysis Guide. Geneva World Heal Organ [Internet]. 2012;1\u0026ndash;22. Available from: http://scholar.google.com/scholar?hl=en\u0026amp;btnG=Search\u0026amp;q=intitle:Global+Physical+Activity+Questionnaire+(GPAQ)+Analysis+Guide#1\u003c/li\u003e\n\u003cli\u003eId TP, Osta N El, Hout H, Chammas D El, Helou N El, Younes H, et al. PLOS ONE Pregnancy physical activity questionnaire ( PPAQ ): Translation and cross cultural adaption of an Arabic version. 2020;1\u0026ndash;14. Available from: http://dx.doi.org/10.1371/journal.pone.0230420\u003c/li\u003e\n\u003cli\u003eUssery E, Hyde E, Bombard J, Juhl A, Kim S, Carlson S. Physical Activity Before and During Pregnancy, Colorado Pregnancy Risk Assessment Monitoring System, 2012\u0026ndash;2015. Prev Chronic Dis. 2020 Jul 9;17. \u003c/li\u003e\n\u003cli\u003eKaewkiattikun K. Effects of immediate postpartum contraceptive counseling on long-acting reversible contraceptive use in adolescents. Vol. Volume 8, Adolescent Health, Medicine and Therapeutics. 2017. 115\u0026ndash;123 p. \u003c/li\u003e\n\u003cli\u003eLegesse M, Ali JH, Manzar MD, Salahuddin M, Hassen HY. Level of physical activity and other maternal characteristics during the third trimester of pregnancy and its association with birthweight at term in South Ethiopia: A prospective cohort study. PLoS One [Internet]. 2020;15(7):1\u0026ndash;15. Available from: http://dx.doi.org/10.1371/journal.pone.0236136\u003c/li\u003e\n\u003cli\u003eChasan-Taber L, Schmidt MD, Roberts DE, Hosmer D, Markenson G, Freedson PS. Development and validation of a pregnancy physical activity questionnaire. Med Sci Sports Exerc. 2004;36(10):1750\u0026ndash;60. \u003c/li\u003e\n\u003cli\u003eBelayhun Y, Kassa Y, Mekonnen N, Binu W, Tenga M, Duko B. Determinants of Pregnancy-Induced Hypertension among Mothers Attending Public Hospitals in Wolaita Zone , South Ethiopia : Findings from Unmatched Case-Control Study. 2021;2021. \u003c/li\u003e\n\u003cli\u003eKhalil A, Syngelaki A, Maiz N, Zinevich Y, Nicolaides KH. Maternal age and adverse pregnancy outcome : a cohort study. 2013;(March):634\u0026ndash;43. \u003c/li\u003e\n\u003cli\u003eMiddendorp D Van, Asbroek A, Bio FY, Edusei A, Meijjer L, Newton S, et al. Rural and urban differences in blood pressure and pregnancy-induced hypertension among pregnant women in Ghana. 2013;1\u0026ndash;8. \u003c/li\u003e\n\u003cli\u003eKilembe FD, Hussain A, Stray-pedersen B. Hypertensive Disorders of Pregnancy : Prevalence , Maternal Complications and Perinatal Outcomes at Lilongwe Central Hospital , Malawi By : Franklin David Kilembe As partial fulfillment for the award of the Master of Philosophy Degree in International Com. 2004;(June). \u003c/li\u003e\n\u003cli\u003eVenkatesh KK, Huang X, Cameron NA, Petito LC, Joseph J, Landon MB, et al. Rural \u0026ndash; \u0026shy; urban disparities in pregestational and gestational diabetes in pregnancy : Serial , cross- \u0026shy; sectional analysis of over 12 million pregnancies. 2024;(June 2023):26\u0026ndash;35. \u003c/li\u003e\n\u003cli\u003eSole KB, Staff AC, Katariina Laine. The association of maternal country of birth and education with hypertensive disorders of pregnancy : A population- \u0026shy; based study of 960 516 deliveries in Norway. 2018;(February):1237\u0026ndash;47. \u003c/li\u003e\n\u003cli\u003eSorensen TK, Williams MA, Lee I, Dashow EE, Thompson M Lou, Luthy DA. Recreational Physical Activity During Pregnancy and Risk of Preeclampsia. 2003; \u003c/li\u003e\n\u003cli\u003eF\u0026iacute;sica A, Gestantes EM, Preven\u0026ccedil;\u0026atilde;o C, S\u0026iacute;ndrome DA. INTEGRATIVE REVIEW ARTICLE PHYSICAL ACTIVITY IN PREGNANT WOMEN AS PREVENTION OF GESTATIONAL HYPERTENSIVE SYNDROME. 2018;12(4):1017\u0026ndash;26. \u003c/li\u003e\n\u003cli\u003eFerrari N, Joisten C. Impact of physical activity on course and outcome of pregnancy from pre- to postnatal. Eur J Clin Nutr [Internet]. 2021; Available from: http://dx.doi.org/10.1038/s41430-021-00904-7\u003c/li\u003e\n\u003cli\u003ePahlavani HA, Laher I, Weiss K, Knechtle B, Zouhal H. Physical exercise for a healthy pregnancy : the role of placentokines and exerkines. J Physiol Sci [Internet]. 2023;1\u0026ndash;15. Available from: https://doi.org/10.1186/s12576-023-00885-1\u003c/li\u003e\n\u003cli\u003eChasan-taber L, Silveira M, Pekow P, Braun B, Manson JE, Solomon CG, et al. Physical activity , sedentary behavior and risk of hypertensive disorders of pregnancy in Hispanic women. 2014;1\u0026ndash;16. \u003c/li\u003e\n\u003cli\u003eCordero Y, Mottola MF, Vargas J, Blanco M, Activity P, Faculty SS, et al. Exercise Is Associated with a Reduction in Gestational Diabetes Mellitus \u0026acute;. 2015;1328\u0026ndash;33. \u003c/li\u003e\n\u003cli\u003eMishra S, Shetty A, Rao C, \u0026hellip; SN-IJ of, 2018 U. Erratum: Effect of physical activity during pregnancy on gestational diabetes mellitus. ncbi.nlm.nih.gov [Internet]. [cited 2023 Feb 26]; Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6330856/\u003c/li\u003e\n\u003cli\u003eWang C, Janese K, Yang H. ScienceDirect Exercise and its role in gestational diabetes mellitus. Chronic Dis Transl Med [Internet]. 2016;2(4):208\u0026ndash;14. Available from: http://dx.doi.org/10.1016/j.cdtm.2016.11.006\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"no funder","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"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":"Intensity of physical activity, Hypertensive disorder of pregnancy, Gestational diabetes mellitus, Pregnancy related complication","lastPublishedDoi":"10.21203/rs.3.rs-4173404/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4173404/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eEven though motherhood is a positive and enjoyable experience, it is also a vulnerable period that can be accompanied by various complications. Hypertensive disorder of pregnancy and gestational diabetes mellitus are of the most significant contributors to these complications. Therefore, the main objective of this study is to assess if the of degree of physical activities during pregnancy has impact on the development of hypertensive disorder of pregnancy and gestational diabetes mellitus.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA cross-sectional study was conducted in 150 women who gave birth from November 2021 to February 2022 at MTUTH, Ethiopia. Data was collected through face-to-face interviews using a structured questionnaire. Descriptive statistics, linear regression, chi-square, and t-test were conducted to check the presence of any association between the dependent and independent variables. A p-value of \u0026lt; 0.05 was considered statistically significant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResult: \u003c/strong\u003eAmong the total study participant, 65(43.3%) and 85(56.7%) of them were engaged in vigorous physical activities and light physical activities during pregnancy, respectively. From these study participants 62 (41.3%) of them had pregnancy related complication. It was found that women who engaged in vigorous physical activity had a lower proportion of complications (17.74%) compared to those who engaged in light physical activity (82.26%). This difference was statistically significant (p=0.001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e The finding of this study showed that pregnancy related complication, specifically HDP and GDM, was low in women who had vigorous physical activities during pregnancy as compared to those that have sedentary life style or engaged in light physical activities.\u003c/p\u003e","manuscriptTitle":"Degree of Physical activity during pregnancy and pregnancy related complication","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-28 03:44:15","doi":"10.21203/rs.3.rs-4173404/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":"3c201671-2d3c-46ec-ba0c-c2333f070011","owner":[],"postedDate":"March 28th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":29933083,"name":"Obstetrics \u0026 Gynecology"}],"tags":[],"updatedAt":"2024-03-28T03:44:15+00:00","versionOfRecord":[],"versionCreatedAt":"2024-03-28 03:44:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4173404","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4173404","identity":"rs-4173404","version":["v1"]},"buildId":"wLkW0s4AflPzk-lpfg-fK","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}