Relationship between social determinants of health, health-related quality of life, health perceptions, and physical activity during pregnancy

Background: Physical activity is essential to maintain the health of the mother and fetus during pregnancy; however, most pregnant women do not achieve the recommended amount. Studies have identified that social determinants of health (SDOH) may play a role in a woman’s ability to participate in physical activity throughout pregnancy; however, there is little exploration of pregnant women from diverse backgrounds. Differences across SDOH influence health-related quality of life (HRQOL) and health perception, and each variable’s relationship to physical activity during pregnancy requires further investigation. Objectives: Our first objective was to examine the relationship between SDOH and HRQOL variables in pregnant women. Our second objective was to compare participant physical activity levels by HRQOL, health perception, and SDOH categories in pregnant women. Design: Secondary analysis. Methods: Survey data from the National Institute of Health All of Us Research Program were utilized for this study. Demographics, SDOH, and HRQOL variables were extracted for analyses along with digital Fitbit data. HRQOL variables were analyzed for association with SDOH and demographic variables using separate one-way ANOVA. SDOH, demographic variables, and HRQOL variables were then analyzed for association with participant Fitbit data using separate one-way ANOVA. For significant associations, Tukey pairwise comparisons were performed. Results: We found significant differences in health perception and quality of life across groups of SDOH and demographic variables including supportive relationships, income level, education level, and marital status. Women who reported higher HRQOL perceptions had significantly higher step counts and more very active minutes than those who reported lower HRQOL perceptions. Conclusions: SDOH are related to how pregnant women perceive their health and quality of life. Pregnant women with better health and quality-of-life perceptions are more likely to participate in more very active physical activity.