Albertsen K, Andersen AM, Olsen J, Grønbaek M Alcohol consumption during pregnancy and the risk of preterm delivery. Am J Epidemiol. 2004; 159:(2)155-61

Exercise during pregnancy and the postpartum period. ACOG Committee Opinion No. 267. Obstet Gynel. 2002; 99:(1)171-3

Beaudin AE, Stover PJ Insights into metabolic mechanisms underlying folate-responsive neural tube defects: a minireview. Birth Defects Res A Clin Mol Teratol. 2009; 85:(4)274-84

Bord Bia Irish Food Board. Feeding you and your baby right from the start. 2015. (accessed 16 November 2015)

Cioffi J, Schmied V, Dahlen H, Mills A, Thornton C, Duff M, Cummings J, Kolt GS Physical activity in pregnancy: women's perceptions, practices, and influencing factors. J Midwifery Womens Health. 2010; 55:(5)455-61

Dennedy MC, Dunne F The maternal and fetal impacts of obesity and gestational diabetes on pregnancy outcome. Best Pract Res Clin Endocrinol Metab. 2010; 24:(4)573-89

Dunney C, Muldoon K, Murphy DJ Alcohol consumption in pregnancy and its implications for breastfeeding. British Journal of Midwifery. 2015; 23:(2)126-34

Donnelly JC, Cooley SM, Walsh TA, Sarkar R, Durnea U, Geary MP Illegal drug use, smoking and alcohol consumption in a low-risk Irish primigravid population. J Perinat Med. 2008; 36:(1)70-2

Henderson J, Gray R, Brocklehurst P Systematic review of effects of low-moderate prenatal alcohol exposure on pregnancy outcome. BJOG. 2007; 114:(3)243-52

Health Service Executive. 2012. (accessed 16 November 2015)

Health Service Executive. Clinical Practice Guideline: Nutrition For Pregnancy. 2013. (accessed 11 November 2015)

McCowan LM, Dekker GA, Chan E, Stewart A, Chappell LC, Hunter M, Moss-Morris R, North RA Spontaneous preterm birth and small for gestational age infants in women who stop smoking early in pregnancy: prospective cohort study. BMJ. 2009; 338

Lifestyle changes for a healthy pregnancy: Caffeine, exercise, and more. 2013. (accessed 11 November 2015)

McGuire M, Cleary B, Sahm L, Murphy DJ Prevalence and predictors of periconceptional folic acid uptake––prospective cohort study in an Irish urban obstetric population. Hum Reprod. 2010; 25:(2)535-43

Mullally A, Cleary BJ, Barry J, Fahey TP, Murphy DJ Prevalence, predictors and perinatal outcomes of peri-conceptional alcohol exposure––retrospective cohort study in an urban obstetric population in Ireland. BMC Pregnancy Childbirth. 2011; 11:(27)27-33

Murphy DJ, Mullally A, Cleary BJ, Fahey T, Barry J Behavioural change in relation to alcohol exposure in early pregnancy and impact on perinatal outcomes––a prospective cohort study. BMC Pregnancy Childbirth. 2013a; 13

Murphy DJ, Dunney C, Mullally A, Adnan N, Deane R Population-based study of smoking behaviour throughout pregnancy and adverse perinatal outcomes. Int J Environ Res Public Health. 2013b; 10:(9)3855-67

Murphy DJ, Dunney C, Mullally A, Adnan N, Fahey T, Barry J A prospective cohort study of alcohol exposure in early and late pregnancy within an urban population in Ireland. Int J Environ Res Public Health. 2014; 11:(2)2049-63

National Institute for Health and Care Excellence. Antenatal care for uncomplicated pregnancies. 2008. (accessed 11 November 2015)

National Institute for Health and Care Excellence. Weight management before, during and after pregnancy. 2010. (accessed 11 November 2015)

Nykjaer C, Alwan NA, Greenwood DC, Simpson NA, Hay AW, White KL, Cade JE Maternal alcohol intake prior to and during pregnancy and risk of adverse birth outcomes: evidence from a British cohort. J Epidemiol Community Health. 2014; 68:(6)542-9

Caesarean Section and Maternal Obesity. 2012. (accessed 11 November 2015)

O'Keeffe LM, Kearney PM, Greene RA Surveillance during pregnancy: methods and response rates from a hospital based pilot study of the Pregnancy Risk Assessment Monitoring System in Ireland. BMC Pregnancy Childbirth. 2013; 13

O'Leary CM, Nassar N, Kurinczuk JJ, Bower C The effect of maternal alcohol consumption on fetal growth and preterm birth. BJOG. 2009; 116:(3)390-400

O'Neill JL, Keaveney EM, O'Connor N, Cox M, Regan A, Shannon E, Turner MJ Are women in early pregnancy following the national pyramid recommendations?. Ir Med J. 2011; 104:(9)270-2

Patra J, Bakker R, Irving H, Jaddoe VW, Malini S, Rehm J Dose-response relationship between alcohol consumption before and during pregnancy and the risks of low birthweight, preterm birth and small for gestational age (SGA)-a systematic review and meta-analyses. BJOG. 2011; 118:(12)1411-21

Pollack H, Lantz PM, Frohna JG Maternal smoking and adverse birth outcomes among singletons and twins. Am J Public Health. 2000; 90:(3)395-400

Royal College of Obstetricians and Gynaecologists. RCOG Statement No. 4: Exercise in Pregnancy. 2006. (accessed 11 November 2015)

Tarrant RC, Younger KM, Sheridan-Pereira M, Kearney JM Maternal health behaviours during pregnancy in an Irish obstetric population and their associations with socio-demographic and infant characteristics. Eur J Clin Nutr. 2011; 65:(4)470-9

Ward M, Hutton J, Mc Donnell R, Bachir N, Scallan E, O'Leary M, Hoey J, Doyle A, Delany V, Sayers G Folic acid supplements to prevent neural tube defects: trends in East of Ireland 1996-2002. Ir Med J. 2004; 97:(9)274-6

Walsh JM, McGowan C, Byrne J, McAuliffe FM Prevalence of physical activity among healthy pregnant women in Ireland. Int J Gynaecol Obstet. 2011; 114:(2)154-5

Wilcox AJ, Lie RT, Solvoll K, Taylor J, McConnaughey DR, Abyholm F, Vindenes H, Vollset SE, Drevon CA Folic acid supplements and risk of facial clefts: national population based case-control study. BMJ. 2007; 334:(7591)

Healthy lifestyle behaviours in pregnancy: A prospective cohort study in Ireland

02 December 2015
Volume 23 · Issue 12



Women attempting to conceive and those in early pregnancy are advised to alter their lifestyles to achieve and maintain a healthy pregnancy. This study aimed to determine women's reported health behaviours during pregnancy to identify ‘at risk’ groups of women and their pregnancy outcomes.


A cohort study of 907 women who booked for antenatal care and birth in a large maternity hospital in Dublin, was undertaken from 2010–2011. Eligible women completed an interview at the first visit, a postal questionnaire during the third trimester, and were followed-up until birth and hospital discharge.


Over 80% of women were found to have factors contributing to an unhealthy lifestyle during the first and third trimester of pregnancy. Clustering of unfavourable factors was evident, with 47% of women engaging in two or more unhealthy lifestyle behaviours during pregnancy. Women of Irish nationality, aged 35–39 years, or who had private health care, were identified as being more likely to have favourable factors for a healthy pregnancy. Women were more likely to engage in healthy lifestyle behaviours during the third trimester if they were having their first baby. Women with healthy lifestyles in pregnancy had better perinatal outcomes than unhealthy women.


Many women continue to make unhealthy lifestyle choices during pregnancy despite guidelines that recommend healthy behaviours in pregnancy. The ongoing challenge for health professionals is to encourage healthy behaviour modification in women who are planning to conceive or who are already pregnant, particularly young women and those with an unplanned pregnancy.

Women's lifestyle choices before and during pregnancy can have significant links to the health of both the mother and her unborn child (O'Keeffe et al, 2013). Women attempting to conceive and those in early pregnancy are encouraged to alter their lifestyles to achieve and maintain a healthy pregnancy (McKnight, 2013). Optimum pregnancy and infant health outcomes are associated with non-smoking, avoidance of alcohol consumption before and during pregnancy, a healthy balanced diet, regular exercise and compliance with periconceptional folic acid supplementation (Mullally et al, 2011; Health Service Executive (HSE), 2013; Murphy et al, 2013a; 2013b). Advice on lifestyle behavioural change in preparation for and during pregnancy is widely available from health professionals, magazines, television and the internet.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month