Activity restriction during pregnancy recommended less often for Black, Hispanic women
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Key takeaways:
- Among 9,000 participants, 14.9% received a recommendation for activity restriction during pregnancy.
- Black and Hispanic patients were less likely to be recommended to restrict their activity during pregnancy.
BALTIMORE — Black and Hispanic women may be less likely to receive a recommendation to restrict activity during pregnancy compared with white women, according to research presented at the ACOG Annual Clinical & Scientific Meeting.
The Society for Maternal-Fetal Medicine does not recommend activity restriction in pregnancy, but it is commonly prescribed, Laura Ha, MD, a maternal-fetal medicine fellow at Cedars-Sinai Medical Center, and colleagues reported in a poster.
The researchers performed a secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be prospective cohort, in which 9,312 participants responded to survey questions regarding recommendations for activity restriction from 2010 to 2013.
Overall, 14.9% of women were recommended activity restriction during pregnancy. Those with obesity, chronic hypertension, renal disease and a short cervix had a higher likelihood of receiving a recommendation to restrict their activity.
The most common types of activity restriction recommended were decreased work hours (17%), no walking (21%), no housework (24%), no working (31%), no exercise (42%) and no heavy lifting (56%).
Hirsch said the most surprising finding is that 21% of participants who were recommended activity restriction were advised not to walk during their pregnancy, which is essentially “old-school bedrest.” This puts women at risk for deconditioning, venous thromboembolism and other adverse outcomes.
Compared with white participants, Black (aOR = 0.81; 95% CI, 0.68-0.98) and Hispanic (aOR = 0.73; 95% CI, 0.61-0.87) women had a lower likelihood of being recommended activity restriction by their provider, even after adjusting for confounding factors such as chronic medical conditions.
The researchers concluded that “implicit bias may impact which patients receive advice to limit activity in pregnancy.”
“We think the reasons why this is happening are probably complex. The thing to remember is that activity restriction is not thought to be helpful in modern pregnancy care,” Anna M. Hirsch, MD, a resident obstetrician/gynecologist at Cedars-Sinai Medical Center, told Healio during the poster presentation. “The takeaway is for OB/GYN physicians to stop recommending activity restriction in pregnancy without evidence to do so, especially since we know it's not being applied universally.”