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Peer-reviewedCC BY 4.0PLOS One

Using cycling as transportation and related adverse events during pregnancy: An anonymous questionnaire survey in urban Japan

  • Mamoru Morikawa1
  • Yuki Morikawa2
  • Shintaro Yasuda3
  • Shuji Tei4
  • Ichiro Orino5
  • Hikari Akise6
  • Kozo Ashihara7
  • Takeshi Inoue8
  • Tadashi Okazaki9
  • Goichi Iito10
  • Kohei Osamura11
  • Yasuhisa Fujiwara12
3 more authors
  • Shun-ichiro Nakanishi13
  • Takao Kamiya14
  • Tomoo Yoshimura15
15 affiliations
  1. 1Department of Obstetrics and Gynecology, Kansai Medical University, Hirakata City, Osaka, Japan
  2. 2Graduate School of Health and Welfare Sciences, International University of Health and Welfare, Tokyo, Japan
  3. 3Department of Obstetrics and Gynecology, Narimoto Lady’s Hospital, Hirakata City, Osaka, Japan
  4. 4Department of Obstetrics and Gynecology, Fujimoto Hospital, Neyagawa City, Osaka, Japan
  5. 5Department of Obstetrics and Gynecology, Orino Obstetrics and Gynecology Clinic, Hirakata City, Osaka, Japan
  6. 6Department of Obstetrics and Gynecology, Akise Women’s Clinic, Hirakata City, Osaka, Japan
  7. 7Department of Obstetrics and Gynecology, Ashihara Obstetrics and Gynecology Clinic, Hirakata City, Osaka, Japan
  8. 8Department of Obstetrics and Gynecology, Inoue Obstetrics and Gynecology Clinic, Daito City, Osaka, Japan
  9. 9Department of Obstetrics and Gynecology, Hirakata City Hospital, Hirakata City, Osaka, Japan
  10. 10Department of Obstetrics and Gynecology, Iito Obstetrics and Gynecology Clinic, Kadoma City, Osaka, Japan
  11. 11Department of Obstetrics and Gynecology, Osamura Obstetrics and Gynecology Clinic, Yawata City, Kyoto, Japan
  12. 12Department of Obstetrics and Gynecology, Fujiwara Obstetrics and Gynecology Clinic, Katano City, Osaka, Japan
  13. 13Department of Obstetrics and Gynecology, Kayashima Ikuno Hospital, Kadoma City, Osaka, Japan
  14. 14Department of Obstetrics and Gynecology, Kamiya Obstetrics and Gynecology Clinic, Kadoma City, Osaka, Japan
  15. 15Department of Obstetrics and Gynecology, Kansai Medical University Medical Center, Moriguchi City, Osaka, Japan
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Abstract

Many pregnant women worldwide use bicycles as a mode of transportation. However, there is limited evidence regarding attitudes toward and the safety of cycling as a mode of transportation during pregnancy. This study aimed to clarify the prevalence of cycling as a mode of transportation before and during pregnancy and the adverse events associated with cycling during pregnancy. An anonymous questionnaire survey was conducted among pregnant women who owned a bicycle, were at 37 weeks of gestation, and agreed to participate in the study at 14 institutions managing deliveries in Japan in 2024. Participants were provided with request forms containing a QR code linking to an anonymous questionnaire on Google Forms™. Among 1,130 women, the proportion who cycled for transportation decreased significantly from 80.8% before pregnancy to 51.2% during pregnancy (P < 0.001). One-third (34.2%) of women who cycled during pregnancy continued cycling until 37 weeks of gestation. The incidences of threatened abortion and preterm labor were similar regardless of cycling status during pregnancy. Of the 579 women who cycled during pregnancy, 21 (3.6%) fell off a bicycle, of whom 15 were injured. Eight women (1.4%) were involved in a bicycle accident during pregnancy, of whom four were injured. These adverse events occurred irrespective of gestational age. Logistic regression analysis showed that women who cycled ≥5 days per week during pregnancy had a significantly higher risk of falling off a bicycle (odds ratio, 3.17). Pregnancy was associated with a significant decrease in cycling as a mode of transportation; however, cycling-related adverse events during pregnancy were uncommon. Women who cycle ≥5 days per week during pregnancy should exercise particular caution to avoid falls. Safe cycling practices and helmet use should be more widely promoted during pregnancy.

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Cite

BibTeXRIS
BibTeX
@article{morikawa2026using,
  title = {{Using cycling as transportation and related adverse events during pregnancy: An anonymous questionnaire survey in urban Japan}},
  author = {Mamoru Morikawa and Yuki Morikawa and Shintaro Yasuda and Shuji Tei and Ichiro Orino and Hikari Akise and Kozo Ashihara and Takeshi Inoue and Tadashi Okazaki and Goichi Iito and Kohei Osamura and Yasuhisa Fujiwara and Shun-ichiro Nakanishi and Takao Kamiya and Tomoo Yoshimura},
  journal = {PLOS One},
  year = {2026},
  month = sep,
  doi = {10.1371/journal.pone.0358856},
  url = {https://doi.org/10.1371/journal.pone.0358856},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Using cycling as transportation and related adverse events during pregnancy: An anonymous questionnaire survey in urban Japan
AU  - Mamoru Morikawa
AU  - Yuki Morikawa
AU  - Shintaro Yasuda
AU  - Shuji Tei
AU  - Ichiro Orino
AU  - Hikari Akise
AU  - Kozo Ashihara
AU  - Takeshi Inoue
AU  - Tadashi Okazaki
AU  - Goichi Iito
AU  - Kohei Osamura
AU  - Yasuhisa Fujiwara
AU  - Shun-ichiro Nakanishi
AU  - Takao Kamiya
AU  - Tomoo Yoshimura
PY  - 2026
DA  - 2026/09/22
JO  - PLOS One
DO  - 10.1371/journal.pone.0358856
UR  - https://doi.org/10.1371/journal.pone.0358856
AB  - Many pregnant women worldwide use bicycles as a mode of transportation. However, there is limited evidence regarding attitudes toward and the safety of cycling as a mode of transportation during pregnancy. This study aimed to clarify the prevalence of cycling as a mode of transportation before and during pregnancy and the adverse events associated with cycling during pregnancy. An anonymous questionnaire survey was conducted among pregnant women who owned a bicycle, were at 37 weeks of gestation, and agreed to participate in the study at 14 institutions managing deliveries in Japan in 2024. Participants were provided with request forms containing a QR code linking to an anonymous questionnaire on Google Forms™. Among 1,130 women, the proportion who cycled for transportation decreased significantly from 80.8% before pregnancy to 51.2% during pregnancy (P < 0.001). One-third (34.2%) of women who cycled during pregnancy continued cycling until 37 weeks of gestation. The incidences of threatened abortion and preterm labor were similar regardless of cycling status during pregnancy. Of the 579 women who cycled during pregnancy, 21 (3.6%) fell off a bicycle, of whom 15 were injured. Eight women (1.4%) were involved in a bicycle accident during pregnancy, of whom four were injured. These adverse events occurred irrespective of gestational age. Logistic regression analysis showed that women who cycled ≥5 days per week during pregnancy had a significantly higher risk of falling off a bicycle (odds ratio, 3.17). Pregnancy was associated with a significant decrease in cycling as a mode of transportation; however, cycling-related adverse events during pregnancy were uncommon. Women who cycle ≥5 days per week during pregnancy should exercise particular caution to avoid falls. Safe cycling practices and helmet use should be more widely promoted during pregnancy.
SN  - 1932-6203
ER  -