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Assessment of Knowledge and Belief of Pregnant Women Attending Maternal and Child Care Unit in Primary Health Center of Sulaimani City Regarding Exercise During Pregnancy

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Background: given the positive physical and mental health outcomes associated with
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Kirkuk University Journal /Scientific Studies (KUJSS)
Volume 10, Issue 1, June 2015 , p.p(158-172)
ISSN 1992 - 0849
Web Site: www.kujss.com Email: kirkukjoursci@yahoo.com,
kirkukjoursci@gmail.com

Assessment of Knowledge and Belief of Pregnant Women
Attending Maternal and Child Care Unit in Primary
Health Center of Sulaimani City Regarding Exercise
During Pregnancy
Atiya K Muhammad1, Muhammad R Amen2
1Dean of School of Nursing / Faculty of Medical Science / University of Sulaimani.
1atiyakareem@yahoo.com
2Head of Adult Nursing Branch / School of Nursing / Faculty of Medical Science / University
of Sulaimani.
2
muhammadamen1@gmail.com
Received date: 6 / 4 / 2014 Accepted date: 22 / 9 / 2014
ABSTRACT
Background: given the positive physical and mental health outcomes associated with
participating in regular exercise, promoting exercise during pregnancy needs to remain a
crucial objective among health promoters.
Objectives: to determine the knowledge level and document self-reported beliefs about
physical exercise during pregnancy.
Method: a descriptive study was carried out on 197 pregnant women who attended the
maternal and child care units in two primary health care centers of Sulaimani city.The
study was carried out for the period of (April, 2013 February, 2014 ). Data was analyzed
with SPSS (16.0) program. Chi-Square (Fishers' Exact) test was used in the statistical
assessment and the figure of p<0.05 was considered as the statistically significant.
Results: majority 81.2 % of participants had inadequate knowledge regarding effect of
exercise during pregnancy and only 13.7% of participants believed that exercises had
positive effect on pregnancy. Level of knowledge and belief increase with increasing level
of education, employment, better financial status, extended family type, and women who
had no abortion while age, gestational age, pregnancy and delivery number were not
associated with knowledge and belief level.
Kirkuk University Journal /Scientific Studies (KUJSS)
Volume 10, Issue 1, June 2015 , p.p(158-172)
ISSN 1992 - 0849
Web Site: www.kujss.com Email: kirkukjoursci@yahoo.com,
kirkukjoursci@gmail.com

Conclusions: researchers conclude that the knowledge of pregnant women in Sulaimani
regarding exercise during pregnancy is inadequate. Women's education, occupation, family
type, financial status and pervious abortion had a positive effect on pregnant women's
knowledge and beliefs.
Keywords : Knowledge, Belief, Exercise, Pregnancy
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1atiyakareem@yahoo.com
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muhammadamen1@gmail.com
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Kirkuk University Journal /Scientific Studies (KUJSS)
Volume 10, Issue 1, June 2015 , p.p(158-172)
ISSN 1992 - 0849
Web Site: www.kujss.com Email: kirkukjoursci@yahoo.com,
kirkukjoursci@gmail.com

1.INTRODUCTION
Exercise is a safe and effective way to gain many physical and mental health benefits,
pregnancy is a good time to develop healthy lifestyle habits including regular exercise and
good nutrition [1].Improving the quantity and quality of information related to physical
exercise has the potential to correct inaccurate perceptions and confer several benefits on
maternal and fetal health. Effective intervention strategies should focus not only on the
pregnant woman but also extend to her family, friends and exercise provider [2].
The American Congress of Obstetricians and Gynecologists (ACOG 2002)[3] and the
American College of Sports Medicine (ACSM)[4]recommend 30 minutes or more of
moderate to vigorous exercise a day on most of the week during pregnancy. More recently,the
United States Department of Health and Human Services (USDHH)[5] released exercise
guidelines for pregnant women. According to the guidelines, at least 150 minutes of
moderate-intensity aerobic activity per week is advised for those who have not been engaged
in regular exercise before pregnancy. Further, under a health-care provider’s
recommendations and adjustments, healthy women who have been engaged in regular
exercise may continue to do so throughout the pregnancy and postpartum [6].
Research indicates that the exercise during pregnancy is determined by several belief
factors, the safety issue is an important belief factor for exercising during pregnancy. In a
study of British pregnant women [7], one third of the participants chose the risk of health to
an unborn baby as a primary reason for not being active during pregnancy.
Guszkowskaexamined pregnant women’s belief about the safety of exercise during pregnancy
and stated that the majority of pregnant women had safety concerns about their own and
baby’s health, regardless of the intensity and frequency of exercise, and normseems to be a
prominent determinant of women’s exercise participation during pregnancy [8].
Given the positive physical and mental health outcomes associated with participating in
regular exercise, promoting exercise during pregnancy needs to remain a crucial objective
among health promoters [9]. Now a day, information about the physical exercise and activity
level of the community is inadequate, adopted an increasingly sedentary lifestyle, in particular
the low level of awareness about exercise during pregnancy is observed. This study provides
information to create more successful interventions to help women get correct information
and understand concepts regarding the safety and benefits of physical activity during
pregnancy.
Kirkuk University Journal /Scientific Studies (KUJSS)
Volume 10, Issue 1, June 2015 , p.p(158-172)
ISSN 1992 - 0849
Web Site: www.kujss.com Email: kirkukjoursci@yahoo.com,
kirkukjoursci@gmail.com

Objective of the study
The objectives of this study were to determine the knowledge level, to document self-
reported beliefs about physical exercise among pregnant women, and to explore association
between some socio-demographic and obstetric characteristics with knowledge and belief
levels.
Methodology
A cross-sectional study was carried out during the period of (April, 2013 to February,
2014).A purposive "non-probability" sample of (197) pregnant women who have been
attending Maternal Ante Natal Care (MANC) units in Ibrahim-Pasha and Ali-Kamal Primary
Health Centers (PHC) in the Sulaimani city has been chosen. For the purpose of data
collection, an assessment tool was constructed by researchers. Questionnaire consisted of
socio-demographic which includes participants' age, levels of education, type of family,
occupations , other item is financial status whish consisted of sufficient that means the family
income is enough with ability to save some money, barely sufficient means it is enough ,
while insufficient means is not enough and obstetric characteristics, (13) questions regarding
knowledge and 10 questions on beliefs regarding exercise during pregnancy.
Knowledge: notions about physical exercise during pregnancy were classified
as adequate (had heard about it and knew what kinds of exercise are indicated and which
should not be performed; in accordance with the ACOG definition (ACGO) appropriate
exercises for pregnant women are low-impact, moderate-intensity activities such as walking,
water aerobics, stretching, yoga and swimming, while high-impact forms of exercise such as
strength training and running should not be performed); or inadequate (had heard about
physical exercise during pregnancy but did not know what kind of exercise is indicated or
contraindicated, or had never heard of physical exercise during pregnancy) [1].
Beliefs: classified as Believe which means women had a broad definition of what types of
activities constituted exercise during pregnancy; women believed exercise was generally
beneficial during pregnancy and women believed certain types of activities or movements
could cause problems with pregnancy) according to ACOG 2002 guidelines and Don't
Believe which means women has no a broad definition of what types of activities
constituted exercise during pregnancy; women believed exercise generally cause problems
Kirkuk University Journal /Scientific Studies (KUJSS)
Volume 10, Issue 1, June 2015 , p.p(158-172)
ISSN 1992 - 0849
Web Site: www.kujss.com Email: kirkukjoursci@yahoo.com,
kirkukjoursci@gmail.com

with pregnancy and could not determine certain types of activities or movements could cause
problems with pregnancy according to (ACOG 2002) guidelines [10].
This study was approved by ethical committee of the School of Nursing at University of
Sulaimani. A pilot study was conducted for the determination of the reliability and a panel of
experts for the content validity of the assessment tool. The data were collected through the
interview techniques. A score of (1) was given to all "agree" answers, while a score of zero
given to all "disagree" answer for a positive statement and vice-versa. Regarding knowledge
for the women who answered questions correctly considered as (adequate knowledge), for
whom did not answered considered as (inadequate knowledge) and the same applied for
belief. Statistical analyses were performed using SPSS (16.0) with the significance level set at
(0.05). Factors associated with levels of knowledge and belief examined by chi-square and
Fishers' Exact tests.
2.RESULT & DISCUSSION
The population consisted of young women, nearly one third (23-27 years) and (29.4%) of
them (28-32 years). Nearly half (42.7%) had at least some high school education such as
institute or college certificate. More than half of them were housewives, and (58.4%) were
barely financially sufficient as presented in Table.(1) . These characteristics are similar to
those found in regional study in Iran by [11], who evaluated knowledge and performance of
pregnant women referring to a hospital on exercises during pregnancy and postpartum
periods. As for obstetric characteristics (44.7%) were in (29-38 weeks) of gestations, more
than half were prime pregnancy with nulliparas, and more than two third of them had no
abortion.
Kirkuk University Journal /Scientific Studies (KUJSS)
Volume 10, Issue 1, June 2015 , p.p(158-172)
ISSN 1992 - 0849
Web Site: www.kujss.com Email: kirkukjoursci@yahoo.com,
kirkukjoursci@gmail.com

Table.(1): Distribution of the women in accordance with their socio-demographic and
obstetric characteristics.
Variables
n
%
Variables
n
%
Age (years)
18 22
33
16.8
Illiterate
4
2.0
23 27
63
32.0
Primary
26
13.2
28 - 32
58
29.4
Secondary
84
42.7
33 37
31
15.7
Institute &
College
83
42.1
38 42
12
6.1
Type of Family
Extended Family
92
46.7
1
99
50.3
Nuclear Family
105
53.3
≥ 2
98
49.7
Table.(1): continuo
Occupation
Number of Para
House Wife
110
55.8
0
99
50.3 %
Paid Employment
76
38.6
1 2
84
42.6 %
Self employed
11
5.6
≥ 3
14
7.1 %
Income
Sufficient
45
22.8
0
153
77.7
Barely Sufficient
115
58.4
≥ 1
44
22.3
Insufficient
37
18.8
Total
197
100
Total
197
100
Majority (81.2 %) of participant in present study has inadequate knowledge regarding
effect of exercise during pregnancy, which means less than one fifth (18.8 %) of them has
adequate knowledge as illustrated in Figure.(1) . Therefore there is no big difference for
participants belief regarding effect of exercises on pregnant women, (86.3%) of participant do
Kirkuk University Journal /Scientific Studies (KUJSS)
Volume 10, Issue 1, June 2015 , p.p(158-172)
ISSN 1992 - 0849
Web Site: www.kujss.com Email: kirkukjoursci@yahoo.com,
kirkukjoursci@gmail.com

not believe, and only (13.7%) of participant believes that exercises have positive effect on
pregnancy, Figure.(2) .
Figure.(1): Distribution Levels of Knowledge Figure.(2): Distribution Levels of Belief
The women in this study were shown to be inadequately knowledgeable concerning the
physical exercise in pregnancy. Evaluation of the knowledge of these women with respect to
physical exercise during pregnancy showed findings (81.2 %) of participant had inadequate
knowledge regarding effect of exercise during pregnancy, which means less than one fifth
(18.8 %) of them had adequate knowledge as presented in Figure.(1) .These findings are in
agreement with the results that reported in other regional countries study by others [11]who
found that the (22%) of women in their study had good knowledge regarding exercise during
pregnancy. More recent study in Turkey [12] researchers found majority of the pregnant
women heard about the exercises performed during pregnancy but they do not have sufficient
and true knowledge about the exercises performed in pregnancy.
Based on the findings, only (13.7%) of participant believes that exercises have positive
effect on pregnancy, and the rest do not believe or believe that exercise has negative effect on
pregnant women, fetus and pregnancy outcome, Figure.(2) .While Evenson & Braddly [13]
found different result in their study on belief about exercise and physical activity among
pregnant women and they reported that the (68%) of women agreed that most women who
never exercised could begin an exercise program during pregnancy. Most (89%) agreed that
regular exercise was better than irregular exercise during pregnancy. While almost all women
agreed with the benefits of light activity (98. A study that evaluated factors associated with
women's perceptions of the safety of physical activity in pregnancy found that women
Kirkuk University Journal /Scientific Studies (KUJSS)
Volume 10, Issue 1, June 2015 , p.p(158-172)
ISSN 1992 - 0849
Web Site: www.kujss.com Email: kirkukjoursci@yahoo.com,
kirkukjoursci@gmail.com

perceive physical exercise as beneficial because they believe it helps control blood glucose
levels, minimizes weight gain, improves energy efficiency and mood, makes childbirth easier
and contributes towards fetal health [14]. Nevertheless, although these women recognized
these advantages, they believed that it was more important to rest and relax during pregnancy
than to exercise.
These findings of previous study that mentioned before are not in agreement with the
results of the present study, a lack of knowledge and belief concerning the benefits of exercise
during pregnancy was main finding of present study results .The difference may have resulted
from different factors such as; culture difference, most studies regarding belief in exercise in
pregnancy carried out western society, according to our knowledge there is no regional study
to evaluate women belief regarding exercise during pregnancy, Krans & Chang [15] found
that the culture as a major contributing factor in knowledge and belief in exercise and
concluded that the health care provider should be aware of cultural myth that prevent women
from believing and performing some activities during pregnancy. Maternity and child health
care and follow up system also may influence in the levels of knowledge and belief of
pregnant women, information of benefit of exercises are absence in the program that apply in
the maternity and child health care in the primary health care centers, shortage of health
knowledge generally may be other factors affected women knowledge and belief.
Except age group the association was significant between all others socio-demographic
variables and each of knowledge and belief levels, (p) value is (> 0.05). Level of knowledge
and belief increase with increasing level of education, employment, good financial status, and
extended family type while they decrease in housewife, poor financial and nuclear family
type, as demonstrated in Table.(2) .
Kirkuk University Journal /Scientific Studies (KUJSS)
Volume 10, Issue 1, June 2015 , p.p(158-172)
ISSN 1992 - 0849
Web Site: www.kujss.com Email: kirkukjoursci@yahoo.com,
kirkukjoursci@gmail.com

Table.(2): Distribution of association between level of knowledge and belief levels with (age
group; level of education; occupations; type of family and financial status)
Age Group
Knowledge Levels
Belief Levels
Total
N (%)
Adequate
N (%)
Inadequate
N (%)
Belief
N (%)
Don't Belief
N (%)
18 - 22
6 (18.2%)
27 (81.8%)
3 (9.1%)
30 (90.9%)
33 (100 %)
23 - 27
14 (22.2%)
49 (77.8%)
9 (14.3%)
54 (85.7%)
63 (100 %)
28 32
10 (17.2%)
48 (82.8%)
8 (13.8%)
50 (86.2%)
58 (100 %)
33 - 37
6 (19.4%)
25 (80.6%)
5 (16.1%)
26 (83.9%)
31 (100 %)
38 - 42
1 (8.3%)
11 (91.7%)
2 (16.7%)
10 (83.3%)
12 (100 %)
X2 = 1.45
P = 0.84
No Sign.
Fis E = 0.855
P = 0.93
No Sign.
Levels of Education
Illiterate
0 (0 %)
4 (100 %)
0 (0 %)
4 (100 %)
4 (100 %)
Primary
2 (7.7 %)
24 (92.3 %)
1 (3.8%)
25 (96.2%)
26 (100 %)
Secondary
8 (9.5 %)
76 (90.5 %)
8 (9.5%)
76 (90.5%)
84 (100 %)
Institute &
College
27 (32.5 %)
56 (67.5 %)
18 (21.7%)
65 (78.3%)
83 (100 %)
Fis E = 18.03
P = 0.0001
Highly Sign.
Fis E = 8.48
P = 0.037
Sign.
Occupations
Paid
Employment
22 (28.9%)
54 (71.1%)
16 (21.1%)
60 (78.9%)
76 (100 %)
Housewife
11 (10 %)
99 (90%)
6 (5.5%)
104 (94.5%)
110 ( 100 %)
Self Employed
43 (6.4%)
76 (3.6%)
5 (45.5%)
6 (54.5%)
11 (100 %)
X2 =12.94
P = 0.002
Sign.
X2 = 19.18
P = 0.0001
Highly Sign.
Type of Family
Extended
Family
25 (27.2%)
67 (72.8%)
18 (19.6%)
74 (80.4%)
92 (100 %)
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Age Group
Knowledge Levels
Belief Levels
Total
N (%)
Adequate
N (%)
Inadequate
N (%)
Belief
N (%)
Don't Belief
N (%)
18 - 22
6 (18.2%)
27 (81.8%)
3 (9.1%)
30 (90.9%)
33 (100 %)
23 - 27
14 (22.2%)
49 (77.8%)
9 (14.3%)
54 (85.7%)
63 (100 %)
28 32
10 (17.2%)
48 (82.8%)
8 (13.8%)
50 (86.2%)
58 (100 %)
33 - 37
6 (19.4%)
25 (80.6%)
5 (16.1%)
26 (83.9%)
31 (100 %)
38 - 42
1 (8.3%)
11 (91.7%)
2 (16.7%)
10 (83.3%)
12 (100 %)
X2 = 1.45
P = 0.84
No Sign.
Fis E = 0.855
P = 0.93
No Sign.
Nuclear
Family
12 (11.4%)
93 (88.6%)
9 (8.6%)
96 (91.4%)
105 (100 %)
X2 = 7.97
P = 0.005
Sign.
X2 = 5.01
P = 0.025
Significant
Financial Status
Sufficient
31 (83.8 %)
14 (8.8 %)
17 (37.8%)
28 (62.2%)
45 (100 %)
Barely
Sufficient
4 (10.8 %)
111 (69.4%)
9 (7.8%)
106 (92.2%)
115 (100 %)
Insufficient
2 (5.4%)
35 (21.9%)
1 (2.7%)
36 (97.3%)
37 (100 %)
P = 0.0001
Highly
Sign.
Highly Sign.
X2= 29.2
X2 = 96.1
P = 0.0001
Total
37 (18.8 %)
160 (81.2%)
27 (13.7 %)
170 (86.3%)
197 (100 %)
Present study evaluated factors associated with women's knowledge and belief, and
showed that knowledge and belief in positive effect of physical exercise in pregnancy was
significantly higher among the women with better education, being in paid employment, lives
in extended family and had sufficient income, nevertheless, no statistically significant
association was found between the pregnant women age and neither knowledge or belief.
Regarding association of socio-demographic data previous study [16] found that the
knowledge level of the pregnant women who are between the age of (31-39), university
graduates pregnant was higher than the others, the researcher did not found association
between level of knowledge and obstetrics factors such as delivery and pregnancy number.
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Furthermore they reported that socio-economic status as a significant predictor of different
physical activity levels during pregnancy.
Socio-demographic factors such as education, income, and ethnicity, play a significant role
in physical activity level knowledge and performance during pregnancy. A positive
relationship between the level of education and exercise during pregnancy was consistent
across different populations [17]. Women with higher education and level tend to engage in
regular exercise more frequently as compared to those with lower education level. Ethnicity
also plays a significant role in exercise during pregnancy. Research shows that whites
exercise more than the non-white population [16].Differences in beliefs were most notable by
educational level, race/ethnicity, and whether they participated in regular exercise during
pregnancy[13].
The knowledge and belief of physical exercise during pregnancy was, however,
significantly higher among women who had no previous abortion as showed in Table.(3) , this
may result from wrong belief in our society that exercises and physical activities cause
abortion while there was no association between number of pregnancy, gestation age and
parity with each of knowledge and belief of physical exercises during pregnancy. Hegaard et
al [18] found no significant association between parity and exercise.
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Table.(3): Distribution of association between level of knowledge and belief levels with
(gestational age; pregnancy number, para and abortion)
Variables
Belief Levels
Knowledge Levels
Total
Adequate
N (%)
Inadequate
N (%)
Belief
N (%)
Don't Belief
N (%)
Para
0
19 (19.2 %)
80 (80.8 %)
13 (13.1 %)
86 (86.9 %)
99 (100 %)
1-2
16 (19 %)
68 (81 %)
11 (13.1 %)
73 (86.9 %)
84 (100 %)
≥ 3
2 (14.3 %)
12 (85.7 %)
3 (21.4 %)
11 (78.6 %)
14 (100 %)
X2 = 0.2
P = 0.91
X2= 0.76
P = 0.68
Gravida
1
18 (20.2%)
71 (79.8%)
13 (14.6%)
76 (85.4%)
89 (100 %)
≥2
19 (17.6%)
89 (82.4%)
14 (13.0%)
94 (87.0%)
108 (100%)
X2 = 0.22
P = 0.64
X2 = 0.11
P = 0.74
Abortion
0
29 (19.0%)
124 (81 %)
25 (16.3%)
128 (83.7%)
153 (100 %)
≥ 1
8 (18.2%)
36 (81.8%)
2 (4.5%)
42 (95.5%)
44 (100 %)
X2 = 0.013
P = 0.91
X2 = 0.4
P = 0.045
Total
31 (68.9%)
14 (31.1%)
27 (13.7 %)
170 (86.3%)
197 (100 %)
Main limitation of the present study refers to the definition of what constitutes adequate
knowledge. Defining adequate knowledge is a very complex matter, since it involves
perceptions of right and wrong, level of access to different means of communication and each
individual's life experience. For the purpose of this study, adequate knowledge was defined as
the woman having heard about the performance of physical exercise during pregnancy and her
being able to list which forms of exercise were appropriate and which should not be
performed at this time. This interpretation was based on the recommendations of the
American College of Obstetricians and Gynecologists (ACOG) on the practice of physical
activity during pregnancy. Despite this limitation, we believe that these findings may
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collaborate towards improving the guidance given during prenatal care, serving as a subsidy
for healthcare professionals, particularly those working in physical education, to enable them
to improve their programs for pregnant women.
3.CONCLUSIONS
Our results suggest that women's knowledge concerning the practice of physical exercise
during pregnancy is inadequate and their belief is doing not believe in positive effect of
exercises during pregnancy. The levels of knowledge and belief increase with increasing
income, education, paid employment, and extended family, the history of previous abortion
influence negatively the level of knowledge and belief. Maternal age, gestational age number
of pregnancy had no effect on levels of knowledge and belief of pregnant women regarding
exercises during pregnancy
4.RECOMMENDATIONS
1. Implement exercises and information regarding exercises and physical activities during
pregnancy in the maternal child health program that provide health care and follow up care for
pregnant women in the primary care health centers.
2. Since women's activities are affected by medical recommendations, doctors, nurse and
midwives should provide the necessary information about physical activity and exercises and
its benefits during prenatal care.
3. Health care providers should be aware of cultural myths that may prevent many women
from performing certain activities during pregnancy.
4. We recommend that this population should be given information about the benefits of the
practice of simple, regular physical exercise such as supervised walking preceded by
stretching exercises. Negative side effects would be insignificant and the return in terms of
gestational well-being and health would be considerable.
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ISSN 1992 - 0849
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AUTHOR
Atiya K. Mohammed:
B.sc
Nursing,
M.Sc.
and PhD Maternal
& Neonate Health Nursing, Head of Fundamental of Nursing
Branch & Dean of College of Nursing/University of Sulaimani.
... Likewise, there is a low level of awareness about exercise during pregnancy. Many previous studies indicated that information about antenatal exercise is inadequate among pregnant women [14,15,16,17]. This preliminary study assessed the pregnant women's knowledge and attitude regarding exercise during pregnancy. ...
... These results are consistent with a study conducted by Khatri et al. (2014), mentioned that most of the study sample they can attend an antenatal education program once weekly for half an hour [22]. Regarding the association between the age of pregnant women and overall knowledge related to exercise during pregnancy was not statistically significant, these results are consistent with findings of other studies, which showed that no statistically significant association between age of pregnant women's and overall knowledge [15,16,17]. There was a significant relationship between the level of education and pregnant women's overall exercises knowledge during pregnancy this results is agree with the findings of Loveness et al (in 2014), which reported that were significant associations between adequate knowledge of physical exercise during pregnancy and their education level [21] and also is in agreement with study conducted by Atiya & Muhammad in 2014 , who showed that level of knowledge about exercise increase with increasing level of education [22]. ...
Article
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Introduction: Physical activity plays an important role in the health of pregnant women. This study is aimed to determine the knowledge and performance of pregnant women on exercises during pregnancy and postpartum periods. Material and Methods: In this descriptive-analytic study, 200 women were assessed. Data including demographic characteristics and knowledge and performance of women about pregnancy and postpartum exercises were recorded through a questionnaire and analyzed with χ2 statistical test and then odds ratio (OR) and 95% confidence Interval (CI) were estimated. Results: The mean (±SD) knowledge score was 21.6±7.7. 60% of the women had moderate knowledge about pregnancy and postpartum exercises. Only 19% of the cases were recommended to perform exercise and in 68.4% of them it was done by a midwife. During pregnancy, only 39% of the women had physical activity and most of the exercise was walking. 48.7% of the women had continued to exercise till the 9th month of pregnancy. There was a significant difference between the participants' knowledge and physical activity during pregnancy (P=0.025) but there was no correlation with other variables. Conclusion: Most of the women had moderate knowledge about physical activities and did not have a good performance. Therefore, we emphasize educating women about the importance of exercise and its role in improving the women's performance during pregnancy.
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Pregnancy is a good time to develop healthy lifestyle habits including regular exercise and good nutrition. Programs of physical exercise for pregnant women have been recommended; however, there are few references on this subject in the literature. The objective of this study was to evaluate the knowledge, attitude and practice of pregnant women with respect to appropriate physical exercise during pregnancy, and also to investigate why some women do not exercise during pregnancy. A descriptive study was conducted in which 161 women of 18 to 45 years of age were interviewed in the third trimester of pregnancy. These women were receiving prenatal care at National Health Service (SUS) primary healthcare units and had no pathologies for which physical exercise would constitute a risk. The women were selected at an ultrasonography clinic accredited to the SUS in Campinas, São Paulo. A previously elaborated knowledge, attitude and practice (KAP) questionnaire was used to collect data, which were then stored in an Epinfo database. Statistical analysis was conducted using Pearson's chi-square test and Fisher's exact test to evaluate the association between the study variables (p < 0.05). Almost two-thirds (65.6%) of the women were sufficiently informed about the practice of physical exercise during pregnancy and the vast majority (93.8%) was in favor of it. Nevertheless, only just over 20% of the women in this sample exercised adequately. Significant associations were found between an adequate knowledge of physical exercise during pregnancy and education level (p = 0.0014) and between the adequate practice of physical exercise during pregnancy and having had fewer pregnancies (p = 0.0001). Lack of time and feeling tired and uncomfortable were the principal reasons given by the women for not exercising. These results suggest that women's knowledge concerning the practice of physical exercise during pregnancy is reasonable and their attitude is favorable; however, relatively few actually exercise during pregnancy.
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