Physical Activity in Bed Rest Hospitalized High-Risk Pregnant Women.

Loss of rectus femoris area (cm2) in a relaxed state, assessed by ultrasound

Time spent in moderate or vigorous activity (in minutes, summarized as average per day).

Total physical activity (average per day in mG).

Handgrip strength test (in kg, adjusted for gender and age).

GAD-7: Generalized Anxiety Disorder assessment scale (score ranging from 0 to 21). The higher the results, higher is the severity of anxiety.

Perceived Stress Scale (PSS-10) (score ranging from 0 to 40). The higher the results, higher is the perception of stress.

Edinburg Postpartum Depression Scale (EPDS) (score -ranging from 0 to 30- and percentage of score ≥9). The higher the total score, more intense is the emotional stress.

Sleep average per night (in minutes)

Abbreviated version of the World Health Organization Quality of Life Assessment scale (WHOQOL-BREF) (score ranging from 0 to 100). The higher the score, better is the perception of quality of life.

Visual standardized measure of emotional tone that covers 3 different affective domains (valence, arousal and sense of control). Responses are made by selecting the manikin that best represents the emotional state of the patient. The patient selection is afterwards converted into a numerical result with higher scores indicating more positive affective tone.

10-item questionnaire intended to measure rumination, tendency to worriedness and repetitive thinking in front of stressful situations. (score ranking from 10 to 40). Higher scores indicate a higher tendeny to ruminate and a vulnerability trait to psychological distress

Questionnaire to measuring depression at a cognitive, affective and behavioral level. For the present study only 4 items related to hedonic experience will be selected. Higher scores in each item indicate severity in the loss of hedonic capacity. Reponses are made by using a 4-point Likert scale.

Muscle ultrasound will be conducted weekly by blinded sonographers using a linear probe (7.5 - 10 MHz). All images will be acquired in triplicate, and the average value will be used for analysis.

Transthoracic echocardiography will be performed using standardised imaging protocols. All measurements will be performed in triplicate when feasible, and averaged for analysis. Standardization of acquisition settings and operator blinding to clinical data will be ensured to reduce measurement bias.

Time needed to recruit sample size (in days)

Number of women who declined to participate in the study

Number of women who give up participation in the study

Adherence to the program (number of days of actual performance of the exercise program while admitted)

A questionnaire made specifically for the case evaluating different domains (length of the sessions, hardness of the sessions, daily repetition of the sessions, difficulty in particular exercises, willingness to repeat in case of re-admission, overall satisfaction to be included in the program) - Likert scale (1 to 5, being 1 not satisfied at all, and 5 highly satisfied).

The questionnarie self-clasisfies how often and for how long the participant engages in light-, moderate-, or vigorous-intensity physical activity. It also assesses whether the participant should consult her obstetric health care provider before beginning or continuing physical activity during pregnancy. The GAQP is a screening and classification tool and does not generate a numerical summary score. Therefore, no minimun or maximum applies, and higher or lower scores do not indicate a better or worse outcome.

Maternal age (In years)

Maternal weight (In kg)

Ethnic group classified as: - White/European - Hispanic/latin American - Black/African Americans - Arabic - Asian

Gestational age at recruitment (in weeks + days)

Twin pregnancy (yes/no)

Fetal growth percentile at admission (customized for gender and multiplicity)

Medical condition that justifies hospital admission (hypertensive disorders, preterm labor, rupture of membranes, antepartum bleeding, others)

Musculoskeletal limitations (injuries or pathologies) (yes/no and description)

Medication while admitted (antihypertensive treatment, tocolysis, magnesium sulphate, antibiotics, corticosteroids, others)

Length of stay in the intermediate care unit (in days)

Length of hospital admission (in days)

Fetal CTG description

Diet during the admission (in Kcal and special needs)

Daily fluid intake (in mL)

Gestational age at delivery (in weeks + days

Birthweight (in grams) and percentile

SGA/growth restriction (yes/no) and classification, if any

Mode of delivery (spontaneous, assisted, cesarean section)

Composite adverse maternal outcome (yes/no considering any of the following: re-intervention, endometritis, infection of surgical wound, curettage, admission to intensive care unit, hysterectomy, need for transfusion, postpartum hemorrhage requiring medication other than oxytocin or ergometrine, maternal sepsis, death)

Neonatal admission to neonatal intensive care unit (yes/no)

Composite adverse neonatal outcome: (yes/no considering any of the following: respiratory morbidity - respiratory distress syndrome or transient tachypnea - requiring intubation, moderate-severe bronchopulmonary dysplasia, intraventricular hemorrhage grade III-IV, early-onset sepsis, periventricular leukomalacia, necrotizing enterocolitis, retinopathy requiring laser, fetal or neonatal death)

Breastfeeding rates