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Research Article: Adherence to dietary and physical activity guidelines and influencing factors among pregnant women: a cross-sectional study in China

Date Published: 2026-04-16

Abstract:
The diet and physical activity of pregnant women are crucial for maternal and fetal health. Many countries have developed guidelines. Research shows higher adherence to dietary guidelines is associated with reduced risks of complications. However, pregnant women’s adherence to these guidelines remains low. Accurate assessment of current adherence levels is essential to characterize behavioral patterns, identify high-risk groups, and provide evidence for the development of targeted interventions aimed at supporting maternal–fetal health. The aim of this study was to investigate the adherence of pregnant women to dietary and physical activity guidelines and analyze factors associated with adherence, thereby providing a foundation for developing intervention strategies in clinical practice. Pregnant women who received routine prenatal care at the Department of Obstetrics, Women and Children’s Hospital, School of Medicine, Xiamen University, from January to June 2025 were enrolled as study participants. A cross-sectional survey was conducted using general information, Pregnant Women’s Dietary Guideline Compliance Index questionnaire, and physical activity guideline recommendations to analyze influencing factors. A total of 327 valid questionnaires were returned. The mean dietary and physical activity adherence score was 59.78 (SD = 16.04). Univariate analysis showed significant differences in adherence by ethnicity, stage of gestation, exercise habits during pregnancy, education level, occupation, personal monthly income, and family monthly income (all P < 0.05). Multiple linear regression analysis showed that stage of gestation and exercise habits during pregnancy remained significantly associated with adherence to guideline recommendations for diet and physical activity after adjusting for confounders (both P < 0.05). Pregnant women exhibited a moderate level of adherence to dietary and physical activity guidelines. These findings suggest that healthcare providers may consider developing personalized guidance plans based on individual profiles, though longitudinal intervention studies are needed to determine their impact on pregnancy outcomes.

Introduction:
The diet and physical activity of pregnant women are crucial for maternal and fetal health. Many countries have developed guidelines. Research shows higher adherence to dietary guidelines is associated with reduced risks of complications. However, pregnant women’s adherence to these guidelines remains low. Accurate assessment of current adherence levels is essential to characterize behavioral patterns, identify high-risk groups, and provide evidence for the development of targeted interventions aimed at supporting…

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