Physical inactivity in early pregnancy and the determinants in an urban city setting of Kuala Lumpur, Malaysia

BACKGROUND: Physical inactivity in pregnancy has been associated with excessive gestational weight gain, hypertensive disorders, gestational diabetes mellitus and postpartum depression. Despite these risks, physical inactivity level remains high especially in higher income countries. The prevalence of physical inactivity among women in Malaysia aged ≥16 years was 28.2% in 2019 exceeding men by 6.1%. However, little is known regarding the subpopulation of pregnant women especially in Kuala Lumpur which is the most urbanized and highly populated city in Malaysia. Therefore, the aim of this study is to measure the physical inactivity prevalence among first trimester pregnant women in Kuala Lumpur and to identify its determining factors. METHODS: This was a cross-sectional study in which 339 first trimester pregnant women were sampled from 13 maternal and child health clinics located in all four parliament districts of Kuala Lumpur. Self-administered questionnaires which contained the Malay version of the pregnancy physical activity questionnaire (PPAQ) were used. Descriptive analysis was conducted to determine the physical inactivity prevalence followed by simple and multiple logistic regression to identify the determinants of physical inactivity with significant level of 5%. RESULTS: The prevalence of physical inactivity was 38.3%. The highest activity was seen in the household activity domain, despite only 24.8% of the respondents were housewives/unemployed. There was little to no participation observed in the vigorous intensity category. The determinants of physical inactivity were primigravida (aOR 3.54 95% CI 1.40, 8.97), education level (aOR 3.77 95% CI 1.35, 10.52) and body mass index (aOR 0.88 95% CI 0.80, 0.97) which explained 22.6% variation of physical inactivity in the final adjusted model. CONCLUSION: The prevalence of physical inactivity among first trimester pregnant mothers in this study was 38.3%, and the highest activity was seen in the household category. Health education on physical activity in pregnancy should be focused on those who are primigravida and have no tertiary education. The educational content should be updated and tailored to current pandemic situation where self-isolation is the new norm, by advocating for home-based, moderate to vigorous intensity physical activities.