The effect of physical activity and sleepi̇ng during pregnancy of pregnant women on fatigue symptoms and birth results

Objective: The aim of this study was to determine the effects of insomnia and physical activity on fatigue and birth outcomes in pregnant women. Method: The study was designed as a prospective cohort research. The research was carried out with the 18 years old and older pregnant women who were in the first 12 weeks of their pregnancy period between the dates of 01.03.2017 and 01.06.2017; and were observed by 6 Education Family Health Units of Department of Family Medicine, Faculty of Medicine, Dokuz Eylül University until the end of their pregnancy. A total of 5 interviews were conducted with people who volunteered to participate in the study. Pregnant Information Form including the personal characteristics of the pregnant woman, pregnancy and birth history, Risk Assessment Form, Multidimensional Assessment Scale of Fatigue, Short Form of International Physical Activity Questionnaire, Pittsburgh Sleep Quality Scale, Hospital Anxiety and Depression Scale was applied to volunteers in first 4 face to face interviews by researcher. In addition to these, in the fifth interview, the birth week, birth weight and delivery type of the baby were examined in terms of birth results. Statistical analyses were done with SPSS 22.00 software. First, the mean, standard deviation of continuous descriptive variables and frequency and percentages of categorical descriptive variables were given. Chi Square test was applied to compare categorical independent variable and dependent variable. Then, T-Test and ANOVA were used to compare means. P Value was stated as <0,05 for significant results. Results: The mean age of participants in this study was 28,08±5,18 years. It was the first pregnancy for 43.5% of the participants and 67.9% of them were unemployed. The highest mean of the sleep quality was detected in fourth observation (p=0.000). There was not any significant difference between the averages of physical activity points. Fatigue was most severe in the fourth observation of the pregnancy (p=0,000). The relationship between general sleep point average and pregnancy week was significant (p=0,004). The type of birth was significantly affected by the education level, pre-operation status, being relative with husband, having child under 5 years old and the last birth type (p<0,005). The point average of fatigue in the fourth observation was the higher among the women who have natural child birth (p=0,039). The physical activity point average of C-Section birth women was significantly higher than the others (p=0,030). Low-weight birth rate was significantly related to the relativeness with husband and last birth type (p<0,005). Although the average point of sleep was under sleep quality category, it was lower among women who had low-weight babies. Having pre-pregnancy operation (p=0.008), unplanned pregnancy (p=0.023), total pregnancy, total birth, alive birth, alive child and rate of miscarry were significantly related (p<0,005). Conclusion: Although it has been studied in a limited population, monitoring of pregnancies from beginning to end and investigating the most likely effects on birth outcomes and fatigue differentiates our study from other similar studies. The society studied is a closed society. In our study, pregnant women working out of home were few. There are many mothers who have other children at home and are responsible for taking care of them. Therefore, pregnancies who are not interested in physical activity and have high fatigue scores and sleep conditions are common. More studies are needed in order to obtain more accurate results in terms of birth duration and quality of sleep and to evaluate the sample of larger sleep objectively. In the evaluation of physical activity, the results will be clearer with studies with pre-pregnancy fitness levels, different exercise types and control groups with known intensity. Key Words: Pregnancy, fatigue, physical activity, sleep, birth.