Next Steps for Measures of Physical Activity During Pregnancy
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LETTER TO THE EDITOR
Next Steps for Measures of Physical Activity During Pregnancy Lisa Chasan‑Taber1 · Kelly R. Evenson2
© Springer Science+Business Media, LLC, part of Springer Nature 2019
We appreciate the recent Commentary by Guérin et al. (2018) which was designed to stimulate academic discussion among women’s health researchers regarding how best to measure physical activity (PA) during pregnancy. This topic is particularly important in light of the recent 2018 Physical Activity Guidelines Advisory Committee Scientific Report (2018). In brief, while the committee found strong evidence that moderate-intensity PA reduces excessive gestational weight gain, gestational diabetes, and symptoms of postpartum depression, questions remain regarding the impact of PA on preeclampsia, gestational hypertension, and postpartum weight loss as well as quality of sleep, quality of life, and symptoms of anxiety and depression both during pregnancy and postpartum. The committee highlighted the importance of future studies designed to elucidate the impact of varying types (e.g., leisure-time, occupational, household, transportation), intensities, and doses of PA on maternal and fetal outcomes as critical in informing clinical and public health practice. In their Commentary, Guérin et al. note discrepancies between PA estimates derived from self-report versus objective measures (Guérin et al. 2018). They argue that a more systematic use of accelerometry is necessary to improve validity and reliability of PA measurement and thereby ensure evidence-based recommendations for pregnant women. The authors premise their argument upon two motivating factors: (1) findings that many people inaccurately self-report their PA levels, and (2) the increasing availability of accelerometry.
* Lisa Chasan‑Taber [email protected] 1
Department of Biostatistics & Epidemiology, School of Public Health & Health Sciences, University of Massachusetts, 401 Arnold House, 715 North Pleasant Street, Amherst, MA 01003‑9304, USA
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina – Chapel Hill, Chapel Hill, NC, USA
2
In terms of their first point, the authors do not acknowledge that one of the highest priorities in designing a selfreport PA questionnaire for epidemiologic practice is the ability of the questionnaire to rank individuals (i.e., to discriminate among individuals) according to their PA rather than to estimate their absolute energy expenditure. Therefore, in the development of questionnaires such as the Pregnancy Physical Activity Questionnaire (PPAQ) (ChasanTaber et al. 2004), activities that were the most important contributors to between-person variation in pregnancy PA were selected for inclusion. This approach maximizes the ability of this questionnaire to correctly classify individuals into PA rankings thereby facilitating the ability of the questionnaire to predict maternal and fetal health outcomes. Such an approach is robust against systematic overestimation of PA by respond
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