Physical activity in both the preconception period and during pregnancy may enhance the probability of getting pregnant and reduce the risks of complications during pregnancy. Adults, including pregnant women without complications, are recommended to be physically active for at least 30 minutes per day to maintain physical and mental health. Nonetheless, many women reduce their level of exercise during early pregnancy.
With this project, we will test the effectiveness of receiving motivational counseling on physical activity (PA) among women trying to conceive and during the first trimester of the pregnancy if they conceive. We will further investigate whether PA is associated with fecundability, spontaneous abortion (SAB) and other birth outcomes, i.e., gestational diabetes, preeclampsia, and birth weight.
Female
18-49 years
In a relationship with a male partner
Trying to conceive
Using birth control
Receiving fertility treatment
Have been trying to conceive for more than six months
Parallel
Use of activity trackers and motivational conversations to enhance focus on physical activity among women trying to conceive.
BehavioralAll participants will receive a wrist-worn activity tracker (Garmin VívoSmart 5) which will be connected with an application, Fitrockr. Data from the devices will be linked to data from the Snartforældre-questionnaires. The participants are asked to wear the tracker 24/7 during preconception and during the first trimester of their pregnancy if they conceive within 12 months. Participants will receive information material and be asked to set goals for their PA level. To follow-up on the goal setting, they will receive two phone calls, where the conversations will be inspired by motivational interviewing.
Physical activity
Physical activity will be objectively measured continuously (24/7) using wrist-worn activity trackers with triaxial accelerometry.
Time to pregnancy (TTP)
TTP will be estimated by using variables from baseline and follow-up questionnaires. In each follow-up questionnaire, women report the date of the first day of their last menstrual period (LMP), whether they are currently pregnant, and whether they experienced any other pregnancies (SAB, induced abortion, or ectopic pregnancy) since their last questionnaire. For irregularly cycling women, we estimate cycle length based on baseline LMP date, expected date of next menses, and LMP recorded during follow-up.
Spontaneous abortion
Spontaneous abortion (SAB), defined as an intrauterine pregnancy loss before week 22 of gestation, will be identified from both bimonthly follow-up questionnaires and registries. In follow-up questionnaires, women report if they have had a pregnancy loss since the date of the most recent completed questionnaire as well as the date of loss and the gestational age at loss. Using the civil registration number (CPR), we will retrieve data from the Danish National Patient Registry (DNPR) and the Danish Medical Birth Registry (DMBR) to identify SABs and induced abortions occurring after the baseline enrollment date. For SABs identified from both registry and questionnaire data, we will use data from the DNPR (based on early ultrasound fetometry or LMP) to ascertain the time of SAB.
A process evaluation assessing the implementation and mechanisms of impact of the SnartForældre.dk/Activity intervention
A mixed methods process evaluation using the UK Medical Research Council's process evaluation framework to assess implementation (reach, fidelity, and dose) and mechanisms of impact of the intervention. We will collect data through motivational conversations and activity trackers, which provide both qualitative and quantitative insights. Through motivational conversations with participants, we will capture their experiences, challenges, and suggestions regarding the intervention. This qualitative feedback helps us understand context-specific issues. Data from activity trackers will offer objective measures of participant behavior and engagement with the intervention, allowing us to identify trends, such as compliance and changes in activity levels, that may indicate whether the intervention is being followed as intended.
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