The Association between Neighborhood Environments and Physical Activity from Pregnancy to Postpartum: a Prospective Cohort Study

  • Anna K. PorterEmail author
  • Daniel A. Rodríguez
  • Brian G. Frizzelle
  • Kelly R. Evenson


The objectives of this study were to determine if neighborhood measures were associated with physical activity cross-sectionally during late pregnancy (27–30 weeks’ gestation), 3 months postpartum, and 12 months postpartum, and longitudinally with an increase in physical activity from late pregnancy to 12 months postpartum. Data are from the Pregnancy, Infection, and Nutrition (PIN3) and Postpartum Prospective Cohort Study. Dichotomized self-reported recreation and total physical activity hours/week were explored cross-sectionally at three time points, and as an increase over time. Four factors from a neighborhood environmental audit were examined: arterial or thoroughfare, walkable neighborhood, physical incivilities, and decoration. Secondary spatial data included population density, hilliness, intersection density, distance to nearest major road, distance to nearest park, distance to nearest physical activity facility, and distance to nearest bus stop. Multilevel mixed-effects logistic regression models were used to assess the association between environmental variables and physical activity measures. A number of environmental variables were associated with total and recreation physical activity at the three time points in cross-sectional models. For increase in recreation physical activity over time, a moderate distance to nearest major road was significantly associated with increased recreation physical activity from 3 to 12 months postpartum (tertile 2 OR 2.13, 95% CI 1.08, 4.22). Living the furthest distance from the nearest park was inversely associated with an increase in recreation physical activity from pregnancy to 3 months postpartum (tertile 3 OR 0.50, 95% CI 0.29, 0.85). The findings of this study indicate that several aspects of the neighborhood environment, such as walkability, access to transit, distance to recreation facilities, and road networks, are associated with physical activity during different stages of pregnancy and postpartum. Since physical activity may result in long-term health benefits for both the woman and child, environments that support this activity should be encouraged.


Recreation GIS Audit Built environment Leisure-time physical activity Women 



The PIN Study was a joint effort of many investigators and staff members whose work is gratefully acknowledged. In particular, the authors thank Molly Wen and Amy Herring for their invaluable assistance with preparing the data and advising on analyses.


Funding for this study was provided by the National Institutes of Health (NIH)/National Cancer Institute (#CA109804). Data collection was supported by NIH/National Institute of Child Health and Human Development (#HD37584), NIH General Clinical Research Center (#RR00046), and NIH/National Institute of Diabetes and Digestive and Kidney Diseases (#DK 061981). AKP was supported by a National Research Service Award T32 post-doctoral research fellowship, funded by the NIH, National Heart, Lung, and Blood Institute (#T32HL007055). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.


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Copyright information

© The New York Academy of Medicine 2019

Authors and Affiliations

  1. 1.Department of Epidemiology, Gillings School of Global Public HealthUniversity of North CarolinaChapel HillUSA
  2. 2.Department of Public Health, School of Health ProfessionsUniversity of Southern MississippiHattiesburgUSA
  3. 3.Department of City and Regional Planning and Institute for Transportation StudiesUniversity of CaliforniaBerkeleyUSA
  4. 4.Carolina Population CenterUniversity of North CarolinaChapel HillUSA

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