Title : Knowledge, social support, anxiety, depression, and moderate physical activity among pregnant women with high risk for gestational diabetes mellitus: The Mediating role of physical activity self-efficacy
Background: Gestational diabetes mellitus (GDM) is one of the most common medical complications in pregnancy. Moderate physical activity during pregnancy may prevent the risk of GDM. However, most pregnant women in the world did not meet the recommended level of physical activity. In mainland China, the “three-child policy” is likely to predict a further increase in the incidence of GDM, as pregnant women with elder age, pre-pregnancy overweight, or obese have risen dramatically since the “two-child policy”. Moreover, women with high risk for GDM prefer to perform sedentary behaviors and have low total physical activity. However, the mechanism among the complex factors of moderate physical activity during pregnancy is unknown.
Aim: To examine the mechanism and mediators of moderate physical activity among pregnant women with high risk for GDM in mainland China.
Methods: A cross-sectional study was conducted. Pregnant women (n = 252) completed the Pregnancy Physical Activity Questionnaire, Pregnancy Physical Activity Self-efficacy Scale, Edinburgh Postnatal Depression Scale, 7- item Generalized Anxiety Disorder scale, Physical Activity Social Support Scale, Physical Activity Knowledge Questionnaire, and a socio-demographic data sheet. Structural equation modeling (SEM) was used to explore the direct and indirect associations between study variables.
Results: Above half of the pregnant women did not achieve the recommended level of physical activity during pregnancy. The correlation analysis revealed that only physical activity self-efficacy was significantly correlated with moderate physical activity. Physical activity self-efficacy played a mediating role in the relationship between knowledge on physical activity and moderate physical activity, social support for physical activity and moderate physical activity, and anxiety symptoms and moderate physical activity. Furthermore, knowledge on physical activity also could improve moderate physical activity by reducing anxiety symptoms and enhancing physical activity self- efficacy.
Conclusion: Our study revealed a high prevalence of physical inactivity among pregnant women with high risk for GDM in mainland China. Physical activity self-efficacy played an important mediating role among the complex influencing factors of moderate physical activity. Future studies focused on enhancing physical activity self-efficacy should develop to improve physical activity for pregnant women with high risk for GDM.
- This study indicates that there is a high priority to take strategies to prevent the occurrence of GDM focused on pregnant women with high risk for GDM by improving moderated physical activity.
- Among the complex predictors of physical inactivity, physical activity self-efficacy was found to be the key modifiable element by both direct and indirect effects on moderate physical activity.
- The findings offer evidence for researchers or healthcare providers to develop physical activity interventions focused on self-efficacy-enhancing strategies in pregnant women, such as providing updated knowledge on physical activity, social support for physical activity, and emotional management methods.