**5. Conclusions**

In conclusion, our study (the first study in Poland that has used reliable, internationally recognized questionnaires (PPAQ-PL and WHOQoL-Bref) makes an important contribution to the knowledge concerning the correlations between PA and QoL in women during different periods of pregnancy. The study showed that *total activity* and *total activity of light intensity and above* did not differentiate between women in the second and third trimesters of pregnancy. However, it indicated higher values of *moderate activity* in women in the second trimester of pregnancy and higher values of *sedentary activity* and *inactivity* in women in the third trimester. Our findings concerning the relationships between physical activity and quality of life should be approached with caution, due to the low values of correlation coefficients. The low MET values for sport/exercise recorded in both groups of women can indicate the need for improving the prenatal care, especially in terms of promotion of physical

activity programs for pregnan<sup>t</sup> women and encouraging women to participate in these programs. In terms of intervention activities, special attention should be given to barriers existing at the level of the provider, the patient, and practice [57]. Researchers [58] have specified concrete actions that should be taken by prenatal care providers in order to promote prenatal PA, suggesting, among other things, providing information by healthcare providers about both guidelines and contraindications for the involvement in physical activity during pregnancy. Most guidelines from around the world, gathered by Evenson et al. [59], promoted moderate-intensity physical activity during pregnancy and defined its frequency and duration/time. The latest physical activity guidelines published by the U.S. Department of Health and Human Services USDHHS in 2018 [60], indicate 150 min (2 h and 30 min) of moderate-intensity aerobic activity a week during pregnancy and the postpartum period. Recommending aerobic activity should be spread throughout the week.

Undoubtedly, our study does not exhaust the problems discussed but its findings emphasize the need for raising awareness of the importance of physical activity during pregnancy. We believe that further research on a larger sample with the consideration of socio-economic factors and a comprehensive inventory of pregnancy-related symptoms, along with a mechanism for assessing their effect on function [61] is needed to provide deeper understanding and identify correlations between PA and determinants of QoL in pregnan<sup>t</sup> women.

**Author Contributions:** J.K. prepared the study design, searched the literature, wrote the background and discussion of the study, gathered the necessary data, prepared it for analysis, described the results of the study and prepared the manuscript. D.S. searched the literature, refined the data, performed the statistical analysis, and described its results. E.B. searched the literature, corrected and improved the manuscript of the study for the final version. All authors have read and approved the final manuscript.

**Funding:** This research received no external funding.

**Acknowledgments:** The authors would like to thank all the women who participated in the study and Katarzyna Sempolska, who contributed to data acquisition.

**Conflicts of Interest:** The authors declare no conflict of interest.
