Physical Activity and Its Predictors Among Women of Advanced Maternal Age in the First Trimester: A Cross-Sectional Study

Purpose: The number of pregnant women with advanced maternal age (AMA) is rising in China. Physical activity is a cost-effective mean of promoting health among pregnant women. This study aims to examine the prevalence, patterns, and predictors of physical activity among AMA women in the first trimester. Patients and Methods: A cross-sectional study was conducted in Guangzhou, China, between October 2024 and July 2025. Two hundred and forty-three AMA women in the first trimester completed the Pregnancy Physical Activity Questionnaire, Pregnancy Physical Activity Knowledge Scale, Pregnancy Physical Activity Self-Efficacy Scale, Pregnancy Physical Activity Social Support Scale, and a sociodemographic and obstetric data sheet. Multiple linear regression was used to identify predictors of physical activity. Results: Over half (53.1%) of AMA women did not meet the current physical activity guidelines. Sedentary behavior was the predominant intensity of physical activity, while sports accounted for the least time among activity types. The regression model explained 32.1% of the variance in physical activity and identified six predictors. Unplanned pregnancy ( β = − 0.11, p = 0.049), and primiparous ( β = − 0.12, p = 0.035) women were less active. Higher self-efficacy ( β = 0.18, p = 0.017), social support ( β = 0.17, p = 0.025), action planning ( β = 0.14, p = 0.035), and knowledge ( β = 0.14, p = 0.039) predicted higher physical activity. Conclusion: The prevalence of physical inactivity among Chinese AMA women was high. Early clinical efforts should prioritize unplanned pregnancy and primiparous women. Interventions targeting self-efficacy, social support, action planning, and knowledge may increase physical activity, prevent complications, and promote lifelong wellness. Keywords: advanced maternal age, physical activity, knowledge, self-efficacy, social support, action planning