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J Womens Health (Larchmt). 2012 Mar;21(3):255-63. doi: 10.1089/jwh.2011.2931. Epub 2011 Nov 2.

Trends in health-related behavioral risk factors among pregnant women in the United States: 2001-2009.

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Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.



Unhealthy lifestyle behaviors during pregnancy often predispose women to multiple risks including adverse pregnancy outcomes and impaired health status for mothers. This study assessed the trends in the prevalence of health-related behavioral risk factors over time among U.S. pregnant women.


Data from 22,604 pregnant women aged 18-44 years who participated in the 2001-2009 Behavioral Risk Factor Surveillance System were analyzed to assess the trends in the prevalence of behavioral risk factors. Correlates of having individual or clustering healthy behaviors were also assessed among 2295 pregnant women in the 2009 survey.


From 2001 to 2009, among pregnant women, the age-adjusted prevalence of engaging in leisure-time exercise and receiving influenza vaccination increased significantly (p<0.05 for linear trends); the prevalence of any alcohol consumption decreased marginally (p=0.065 for linear trend); and the prevalence of binge drinking, smoking, and consuming fruits and vegetables ≥5 times/day varied little. Over the 9 years, the percentages of pregnant women who reported having all four healthy behaviors (i.e., not currently smoking, no alcohol consumption, engaging in leisure-time exercise, and receiving influenza vaccination) increased linearly from 7.3% in 2001 to 21.2% in 2009 (p<0.001). Sociodemographic characteristics, perceived health status, and health-care availability were differentially associated with certain individual or clustered healthy behaviors.


Increased efforts emphasizing multiple health-related behavioral risk factors including reducing alcohol use, binge drinking, and smoking and improving fruit and vegetable consumption during pregnancy are needed.

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