Recommendations of physical activity and rest in a Colombian prenatal control program

Ruiz-Rodríguez, Myriam; Sánchez-Martínez, Yuri; Ramírez-Muñoz, Paula Camila; Camargo-Lemos, Diana Marina

doi:10.11606/S1518-8787.2019053000934

Brasil

home Sumário navigate_before Anterior Atual Seguinte navigate_next

home Sumário

Original Article • Rev. Saúde Pública 53 • 2019 • https://doi.org/10.11606/S1518-8787.2019053000934 linkcopy

Recommendations of physical activity and rest in a Colombian prenatal control program

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE To determine the frequency of the registry of physical activity and rest recommendations made to pregnant women and to explore their associated factors in a prenatal care program of primary care public institutions in Bucaramanga, Colombia.

METHODS An observational study was conducted. The sampling frame consisted of the medical records of the pregnant women who attended at least one prenatal care program between January 1 and December 31, 2012 (n = 2.932), in 21 primary care health centers. We analyzed sociodemographic variables, prenatal and clinical antecedents, and information related to health personnel and the organization of health centers as possible factors associated with the recommendations of physical activity and rest recorded in the clinical history. Logistic regression models were applied to explore associations with α = 0.10.

RESULTS There was a frequency of 26.1% of PA recommendations and 3.6% of rest recommendation on record, issued by nutrition (97.3%) and medical (86.7%) professionals, respectively. The factors associated with the registration of physical activity recommendations were: being nulliparous pregnant (OR = 1.7), attending more than four Prenatal Care Attention Programs (OR = 2.2), having high or medium obstetric risk in the first prenatal care program (OR = 0.6), and being attended in the western (OR = 0.5) and eastern (OR = 0.2) administrative areas health centers.

CONCLUSIONS The low frequency of physical activity recommendations found in the records makes it necessary to reinforce the management strategies of health centers and strengthen the monitoring and accompaniment to comply with the care protocols. In addition, it is necessary to train health teams on the benefits of physical activity and their proper prescription, considering the multiple benefits derived from their practice on the maternal-fetal health.

Pregnant Women; Exercise; Rest; Prenatal Care

Characteristics	n	%
Sociodemographic

Age (years old) Median (RIC)	22	19–27
Education (years) Median (RIC)	9	6–11
Paid occupation	270	32.3
Live with partner	637	77.6
Socioeconomic stratum
1	329	39.7
2	309	37.3
> 3	190	22.9

Anthropometry

BMI (first PNC)
Under Weight	65	8.0
Normal weight	476	58.3
Overweight	275	33.7

Background

Nulliparous	505	60.5
Obstetric history^a	353	42.2

Related to the PNCP

Gestational trimester (first PNC)
1	465	59.5
2	227	29.0
3	90	11.5
Obstetric risk (first PNC)^b	427	56.6
More than 4 PNCs made	457	54.5
Diagnostics during PNC^a,c	128	15.3

Administrative area of the care center

North	250	29.8
West	229	27.3
East	166	19.8
South	193	23.0

Characteristic	Registry of PA recommendations				p	Registry of rest recommendations				p

	Yes (n = 219)		No (n = 619)			Yes (n = 30)		No (n = 808)

	n	%	n	%		n	%	n	%
Characteristics

Age (years old) Median (RIC)	22	18–26	23	19–27	0.037	25	21–27	22	19–27	0.051
Education (years) Median (RIC)	10	6–11	9	6–11	0.507	7.5	5–11	9	6–11	0.160
Paid occupation	66	30.1	204	33.1	0.426	8	26.7	262	32.5	0.502
Live with partner	171	79.5	466	76.9	0.426	26	92.9	611	77.0	0.049
Socioeconomic stratum
1	97	44.7	232	38.0	0.004	14	46.7	315	39.5	0.095
2	88	40.5	221	36.2		14	46.7	295	37.0
> 3	32	14.7	158	25.9		2	6.7	188	23.6

Anthropometry

BMI (first PNC)
Under Weight	14	6.4	51	8.5	0.020	2	6.7	63	8.0	0.850
Normal weight	144	66.4	332	55.4		19	63.3	457	58.1
Overweight	59	27.2	216	36.1		9	30.0	266	33.8
Medical History
Nulliparous	148	67.6	357	57.9	0.012	10	33.3	495	61.5	0.002
Obstetric history^a	89	40.6	264	42.8	0.580	13	43.3	340	42.2	0.900

Related to the PNCP

Gestational trimester (first PNC)
1	135	66.2	330	57.1	0.032	25	86.2	440	58.4	0.009
2	54	26.5	173	29.9		4	13.8	223	29.6
3	15	7.3	75	13.0		0	0	90	11.9
Obstetric risk (first PNC)^b	78	40.4	349	62.1	< 0.001	15	62.5	412	56.4	0.551
More than 4 PNCs made	157	71.7	300	48.5	< 0.001	24	80.0	433	53.6	0.004
Diagnostics during PNC^c	33	15.1	95	15.3	0.921	3	10.0	125	15.5	0.413

Administrative area of the care center

North	100	45.7	150	24.2	< 0.001	11	36.7	239	29.6	0.491
West	51	23.3	178	28.8		6	20.0	223	27.6
East	13	5.9	153	24,7		4	13.3	162	20.0
South	55	25.1	138	22.3		9	30.0	184	22.8

Characteristic	Not Adjusted			Adjusted

	OR	95%CI	p	OR	95%CI	p
BMI (first PNC)
Under Weight	0.6	0.3–1.2	0.15	0.6	0.3–1.2	0.138
Normal weight	Ref.			Ref.
Overweight	0.6	0.4–0.9	0.009	0.7	0.5–1.1	0.103
Nulliparous
No	Ref.			Ref.
Yes	1.5	1.1–2.1	0.013	1.7	1.1–2.4	0.007
Obstetric risk (first PNC)ᵇ
No	Ref.			Ref.
Yes	0.4	0.3–0.6	< 0.001	0.6	0.4–0.9	0.010
PNC number
1–4	Ref.			Ref.
> 4	2.7	1.9–3.7	< 0.001	2.2	1.5–3.2	< 0.001
Administrative area of the care center
North	Ref.			Ref.
West	0.4	0.3–0.6	< 0.001	0.5	0.3–0.8	0.008
East	0.1	0.1–0.2	< 0.001	0.2	0.1–0.3	< 0.001
South	0.6	0.4–0.9	0.012	0.8	0.5–1.3	0.459

vertical_align_top file_download show_chart

more_horizclose
- image
- translate
- link
- article
- vertical_align_top
- file_download
- show_chart
- image
- translate
- link
- article

location_on

Faculdade de Saúde Pública da Universidade de São Paulo Avenida Dr. Arnaldo, 715, 01246-904 São Paulo SP Brazil, Tel./Fax: +55 11 3061-7985 - São Paulo - SP - Brazil
E-mail: revsp@usp.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS

Acessibilidade / Reportar erro

[TFN1] RIC: interquartile range; BMI: body mass index; PNC: prenatal control; PNCP: Prenatal Control Program

[TFN2] ^a Includes diagnosis of diabetes, pregnancy-induced hypertension, preeclampsia, eclampsia or kidney disease in previous pregnancies.

[TFN3] ^b Includes high and medium obstetric risk.

[TFN4] ^c Includes diagnoses of anemia, threatened abortion, placenta previa or intrauterine growth restriction in at least one prenatal check-up.