Changed pattern of physical activity and energy expenditure among mid-pregnancy women during China's COVID-19 lockdown: A cross-sectional study

Background: This study examines the physical activity (PA) patterns and energy expenditure of Chinese pregnant women during the COVID-19 lockdown, their influencing factors, and explores potential improvement strategies. Methods: A survey using the Chinese version of the Pregnancy Physical Activity Questionnaire (PPAQ) was conducted among 610 women in their second trimester. It compared their PA patterns and energy expenditure during the lockdown with pre-pandemic levels. Factors influencing PA were analyzed using one-way ANOVA and regression. Results: Although aware of PA benefits, respondents overestimated their PA levels during lockdown, showing significantly lower PA and energy expenditure than before pregnancy, primarily in housework and caregiving activities. Average energy expenditure was 34.3 MET-hrs/wk. Influential factors included concerns about miscarriage/preterm birth, parity, pre-pregnancy exercise habits, and family opposition. Conclusions: The lockdown notably decreased PA patterns and energy expenditure in midpregnancy, highlighting a gap between perception and practice. Activities were mainly sedentary to light-intensity. Influencing factors suggest the need for targeted health education and support. Implementing adaptive strategies, personalized antenatal care, effective health education, family engagement, and digital health tools could enhance PA during restrictive periods like lockdowns.