Development and Validation of a Pregnancy Physical Activity Questionnaire

TLDR

Physical activity during pregnancy has uncertain effects on maternal and fetal health, and the optimal dose for favorable outcomes is not yet established. This study aimed to develop and validate a pregnancy physical activity questionnaire (PPAQ). The authors identified activities via 24‑hour recalls from 235 diverse pregnant women, created a 32‑item self‑administered PPAQ, and validated it by having 54 women complete the questionnaire and wear an actigraph for seven days, repeating the PPAQ afterward. The PPAQ showed good reproducibility (ICC 0.78–0.93) and moderate correlations with actigraph data (Spearman 0.08–0.43), especially for sports/exercise and occupational activities, indicating it is a reliable and reasonably accurate tool for measuring pregnancy physical activity.

Abstract

Purpose: The effect of physical activity during pregnancy on maternal and fetal health remains controversial and studies have yet to identify the optimal dose of physical activity associated with favorable pregnancy outcomes. The aim of this study was to develop and validate a pregnancy physical activity questionnaire (PPAQ). Methods: To ascertain the type, duration, and frequency of physical activities performed by pregnant women, three 24-h physical activity recalls were administered to 235 ethnically diverse prenatal care patients at a large tertiary care facility in western Massachusetts. The relative contribution of each activity to between-person variance in energy expenditure was used to establish the list of activities for the PPAQ. The PPAQ is self-administered and asks respondents to report the time spent participating in 32 activities including household/caregiving, occupational, sports/exercise, transportation, and inactivity. To validate the PPAQ, 54 pregnant women completed the PPAQ and then wore a Manufacturing Technology, Inc. actigraph for the following 7 d. At the end of the 7-d period, the PPAQ was repeated. Results: Intraclass correlation coefficients used to measure reproducibility of the PPAQ were 0.78 for total activity, 0.82 for moderate activity, 0.81 for vigorous activity, and ranged from 0.83 for sports/exercise to 0.93 for occupational activity. Spearman correlations between the PPAQ and three published cut points used to classify actigraph data ranged from 0.08 to 0.43 for total activity, 0.25 to 0.34 for vigorous activity, 0.20 to 0.49 for moderate activity, and −0.08 to 0.22 for light-intensity activity. Correlations were higher for sports/exercise and occupational activities as compared to household/caregiving activities. Conclusions: The PPAQ is a reliable instrument and a reasonably accurate measure of a broad range of physical activities during pregnancy.