A Healthier Pregnancy in Four Words: Sit Less, Move More

By Akpobome Biakolo. MB.BS. Freelance Writer and DLHA Volunteer. Medically reviewed by The DLHA Team.

June 16, 2026

AI generated photo of an African lady sitting on a sofa in her living room and surfing the television channels with a remote control in hand. Click on image to enlarge.

A growing body of evidence including findings from a new study affirms that prolonged sitting during pregnancy may increase the likelihood of complications, highlighting sedentary behavior as an important but often overlooked risk factor in maternal health.

About the study

The recent study published in JAMA Network Open (2026) examined the relationship between sedentary time, light-intensity physical activity, and pregnancy outcomes.

The research was conducted in the United States using data from a special new Mothers-To-Be (nuMoM2b) Outcome Study, a large prospective cohort study involving over 2,100 pregnant women delivering for the first time. They were recruited across multiple centres.

Participants’ activity levels were objectively measured using wearable accelerometers, which allowed researchers to assess daily sitting time, light physical activity, and step counts. The study then evaluated associations with adverse pregnancy outcomes including gestational diabetes, hypertensive disorders, preterm birth, and small-for-gestational-age infants.

What the study found

The researchers found that pregnant individuals who spent more time sitting and had lower daily movement levels were at significantly higher risk of adverse pregnancy outcomes compared with those who sat less.

Participants with the highest sedentary time had about:

• 60% higher risk of gestational diabetes
• 65% higher risk of hypertensive disorders of pregnancy
• 35–40% higher risk of preterm birth
• 30–35% higher risk of delivering small-for-gestational-age infants

Notably, the study also demonstrated that even modest increases in light activity—such as walking or routine daily movement—were associated with reduced risks. This suggests that the benefits of movement extend beyond structured exercise.

Why the study matters

The findings reinforce the concept that sedentary behavior is not simply the absence of exercise but a distinct health risk. Even among individuals who meet recommended physical activity levels, prolonged uninterrupted sitting may still negatively affect metabolic and cardiovascular health. In pregnancy, this effect may be amplified due to physiological changes such as increased insulin resistance, altered vascular function, and changes in body composition.

Earlier research supports these observations. A systematic review examining sedentary behavior in pregnant women found that longer sitting time was associated with increased risks of gestational diabetes mellitus and prenatal or postpartum depression:

Similarly, a different review also highlighted associations between sedentary behaviour and adverse pregnancy outcomes:

Other studies have reported links between sedentary behavior and unfavorable metabolic markers, including elevated inflammatory markers and lipid abnormalities, which may contribute to adverse maternal and fetal outcomes.

Several biological mechanisms may explain these associations.

• Prolonged sitting reduces skeletal muscle activity, lowers muscle glucose and worsens insulin resistance; a central feature of gestational diabetes.

• Reduced movement may impair blood circulation, potentially contributing to impairment of blood vessel lining (endothelium), leading to hypertensive disorders.

• Prolonged sitting has also been linked to systemic inflammation, which is increasingly recognized as a contributor to complications such as preeclampsia and impaired fetal growth.

Importantly, the risks associated with prolonged sitting appear to be modifiable. The JAMA study emphasized that replacing sedentary time with light-intensity movement—rather than only moderate or vigorous exercise—can significantly improve outcomes. This is particularly relevant for pregnant women who may find structured exercise challenging due to fatigue, discomfort, or environmental and cultural barriers.

Limitations of the study

Despite its strengths, the study has some limitations. Activity data were collected during a specific period of pregnancy and may not reflect behavioral changes across all stages of pregnancy. The study population was based in the United States, which may limit generalisability to other regions, including African populations. Additionally, as an observational study, causality cannot be definitively established, and other confounding factors—such as diet, stress, or sleep—may influence outcomes.

What the study means for Africans

Modern lifestyles in many African urban centres have made prolonged sitting more common, especially with increasing desk-based jobs, long commutes, and screen-based leisure. However, awareness of sedentary behavior as a risk factor during pregnancy remains limited, and antenatal counseling often emphasizes diet and clinical care more than movement patterns.

The World Health Organization’s 2020 guidelines on physical activity and sedentary behaviour recommend that pregnant women without contraindications engage in regular moderate-intensity activity while minimizing prolonged sitting.

These recommendations align with broader evidence showing that excessive sitting is associated with adverse health outcomes, including increased risks of cardiovascular disease and mortality.

Clinically, these findings highlight the need to incorporate guidance on reducing sedentary time into routine antenatal care in African settings. Pregnant women should be encouraged to break up long periods of sitting with simple activities such as standing, stretching, or short walks. Even small, frequent movements throughout the day may provide meaningful benefits. These recommendations should always be individualized.

Women with high-risk pregnancies or specific medical conditions should consult healthcare providers before making changes to their activity levels. For most women, maintaining an active daily routine and reducing prolonged sitting is a safe and effective strategy for supporting a healthy pregnancy.

Conclusion

In conclusion, this study adds to growing evidence that how long a pregnant woman sits each day may be a pointer to possible adverse health outcomes. Reducing sedentary time and incorporating regular movement into daily life may offer a simple yet powerful approach to lowering the risk of pregnancy complications and improving outcomes for both mother and baby.

Source: Gibbs BB, Kim J, Gallagher J, et al. Adverse Pregnancy Outcomes and Sedentary Behavior, Light-Intensity Physical Activity, and Daily Steps. JAMA. Published Online May 27, 2026. Doi: 10.1001/jama.2026.6986. Abstract available here.

Related:

What Africans Need to Know about Antenatal Care

Social Factors Shaping African Women’s Health

Published: June 16, 2026.

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