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  • Population Study Article
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Maternal physical activity, sitting, and risk of non-cardiac birth defects

Pediatric Research volume 95, pages 334–341 (2024)Cite this article

Abstract

Background

The relationship between maternal physical activity (PA)/sitting and birth defects is largely unexplored. We examined whether pre-pregnancy PA/sitting were associated with having a pregnancy affected by a birth defect.

Methods

We used data from two United States population-based case–control studies: 2008–2011 deliveries from the National Birth Defects Prevention Study (NBDPS; 9 states) and 2014–2018 deliveries from the Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS; 7 states). Cases with one of 12 non-cardiac birth defects (n = 3798) were identified through population-based registries. Controls (n = 2682) were live-born infants without major birth defects randomly sampled using vital/hospital records. Mothers self-reported pre-pregnancy PA/sitting. Unconditional logistic regression models estimated associations between PA/sitting categories and the 12 birth defects.

Results

Mothers engaging in pre-pregnancy PA was associated with a reduced odds of five (spina bifida, cleft palate, anorectal atresia, hypospadias, transverse limb deficiency) and a higher odds of two (anencephaly, gastroschisis) birth defects. Mothers spending less time sitting in pre-pregnancy was associated with a reduced odds of two (anorectal atresia, hypospadias) and a higher odds of one (cleft lip with or without cleft palate) birth defect.

Conclusions

Reasonable next steps include replication of these findings, improved exposure assessment, and elucidation of biologic mechanisms.

Impact

  • Using data from two population-based case–control studies, we found that mothers engaging in different types of physical activity in the 3 months before pregnancy had an infant with a reduced odds of five and a higher odds of two birth defects.

  • Mothers spending less time sitting in the 3 months before pregnancy had an infant with a reduced odds of two and a higher odds of one birth defect.

  • Clarification and confirmation from additional studies are needed using more precise exposure measures, distinguishing occupational from leisure-time physical activity, and elucidation of mechanisms supporting these associations.

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Fig. 1: Adjusted odds ratios and 95% confidence intervals of the association of mother’s physical activity three months before pregnancy with birth defects; NBDPS (2008–2011) and BD-STEPS (2014–2018).
Fig. 2: Adjusted odds ratios and 95% confidence intervals of the association of mother’s sitting three months before pregnancy with birth defects; NBDPS (2008–2011) and BD-STEPS (2014–2018).

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Data availability

The study questionnaires and the process for accessing the data used in this study are described at https://www.cdc.gov/ncbddd/birthdefects/nbdps-public-access-procedures.html.

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Acknowledgements

The authors thank Sarah Tinker and Kathy Wisniewski for their contributions to the writing and analysis, the California Department of Public Health Maternal Child and Adolescent Health Division for providing data for these analyses, and the reviewers for their helpful comments.

Funding

This project was supported through funding from the Centers for Disease Control and Prevention (CDC) to the North Carolina Center for Birth Defects Research and Prevention at the University of North Carolina at Chapel Hill (grant number U01DD001231), and CDC cooperative agreements under PA #96043, PA #02081, FOA #DD09–001, FOA #DD13–003, and NOFO #DD18–001 to the Centers for Birth Defects Research and Prevention participating in the National Birth Defects Prevention Study (NBDPS) and/or the Birth Defects Study To Evaluate Pregnancy exposureS (BD-STEPS). S.M. was supported by the National Institutes of Health (NIH), National Institute of Child Health Development #T32 HD52468. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC, the NIH, or the California Department of Public Health.

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Authors and Affiliations

  1. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina – Chapel Hill, Chapel Hill, NC, USA

    Kelly R. Evenson, Sanjida Mowla, Andrew F. Olshan & Tania A. Desrosiers

  2. Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA

    Gary M. Shaw

  3. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Elizabeth C. Ailes & Jennita Reefhuis

  4. Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina – Chapel Hill, Chapel Hill, NC, USA

    Neha Joshi

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the National Birth Defects Prevention Study and Birth Defects Study To Evaluate Pregnancy exposureS

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All authors provided (1) substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; (2) drafting the article or revising it critically for important intellectual content; and (3) final approval of the version to be published.

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Correspondence to Kelly R. Evenson.

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Evenson, K.R., Mowla, S., Olshan, A.F. et al. Maternal physical activity, sitting, and risk of non-cardiac birth defects. Pediatr Res 95, 334–341 (2024). https://doi.org/10.1038/s41390-023-02768-y

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