Structural influences of women's preconception physical activity status

Background: Preconception health is recognized as a critical component during the reproductive years and influences optimal pregnancy and birth outcomes. Specifically, a Healthy People 2020 objective is to increase the proportion of women who had a healthy weight prior to pregnancy. While intrapersonal barriers to preconception physical activity among women have been studied, the structural and macro-level influences are unknown. This study examines the structural influences of preconception physical activity among women.

Methods: Data from the National Longitudinal Study of Adolescent Health were limited to women (Wave III; age 18-28; n=5,798) and excluded respondents who were pregnant, physically disabled, and missing data. The outcome variable was having at least 5 instances of moderate-vigorous physical activity in one week. Structural predictor variables focused on respondents' neighborhoods (e.g., crime; vehicle availability; racial/ethnic diversity). Survey-weighted logistic regression was used.

Results: Few women (26.6%) reported having a high level of physical activity. Women were less likely to report high levels of physical activity if they lived in areas that had more crime (OR=0.72), homes without a vehicle (OR=0.71), higher proportions of persons without a high school education (OR=0.54), and non-White residents (OR=0.66). Adjusted analysis revealed only lack of a high school education (AOR=0.57) was a significant predictor of high levels of physical activity among preconception women.

Discussion: Findings suggest that neighborhood composition may have an impact on preconception physical activity status. Subsequently, efforts should be targeted locally to improve the structural conditions that facilitate physical activity among preconception women, thus ultimately improving pregnancy/birth outcomes.