{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:50:15Z","timestamp":1792788615866,"version":"4.5.0"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The General Insurance Association of Japan","id":[{"id":"https:\/\/ror.org\/01zq5k385","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    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\u2122. Among 1,130 women, the proportion who cycled for transportation decreased significantly from 80.8% before pregnancy to 51.2% during pregnancy (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). 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 \u22655 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 \u22655 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.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0358856","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T17:24:36Z","timestamp":1790097876000},"page":"e0358856","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Using cycling as transportation and related adverse events during pregnancy: An anonymous questionnaire survey in urban Japan"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9816-5422","authenticated-orcid":true,"given":"Mamoru","family":"Morikawa","sequence":"first","affiliation":[{"name":"Kansai Medical University","place":["Hirakata City, Osaka, Japan"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Morikawa","sequence":"additional","affiliation":[{"name":"International University of Health and Welfare","place":["Tokyo, Japan"],"department":["Graduate School of Health and Welfare Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shintaro","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Narimoto Lady\u2019s Hospital","place":["Hirakata City, Osaka, Japan"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuji","family":"Tei","sequence":"additional","affiliation":[{"name":"Fujimoto Hospital","place":["Neyagawa City, Osaka, Japan"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Orino","sequence":"additional","affiliation":[{"name":"Orino Obstetrics and Gynecology Clinic","place":["Hirakata City, Osaka, Japan"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hikari","family":"Akise","sequence":"additional","affiliation":[{"name":"Akise Women\u2019s Clinic","place":["Hirakata City, Osaka, Japan"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kozo","family":"Ashihara","sequence":"additional","affiliation":[{"name":"Ashihara Obstetrics and Gynecology Clinic","place":["Hirakata City, Osaka, Japan"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Inoue","sequence":"additional","affiliation":[{"name":"Inoue Obstetrics and Gynecology Clinic","place":["Daito City, Osaka, Japan"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Okazaki","sequence":"additional","affiliation":[{"name":"Hirakata City Hospital","place":["Hirakata City, Osaka, Japan"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goichi","family":"Iito","sequence":"additional","affiliation":[{"name":"Iito Obstetrics and Gynecology Clinic","place":["Kadoma City, Osaka, Japan"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Osamura","sequence":"additional","affiliation":[{"name":"Osamura Obstetrics and Gynecology Clinic","place":["Yawata City, Kyoto, Japan"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhisa","family":"Fujiwara","sequence":"additional","affiliation":[{"name":"Fujiwara Obstetrics and Gynecology Clinic","place":["Katano City, Osaka, Japan"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun-ichiro","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Kayashima Ikuno Hospital","place":["Kadoma City, Osaka, Japan"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Kamiya","sequence":"additional","affiliation":[{"name":"Kamiya Obstetrics and Gynecology Clinic","place":["Kadoma City, Osaka, Japan"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoo","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Kansai Medical University Medical Center","place":["Moriguchi City, Osaka, Japan"],"department":["Department of Obstetrics and Gynecology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"issue":"5","key":"pone.0358856.ref001","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/j.amepre.2013.06.018","article-title":"Adverse pregnancy outcomes following motor vehicle crashes","volume":"45","author":"CJ Vladutiu","year":"2013","journal-title":"Am J Prev Med"},{"issue":"7","key":"pone.0358856.ref002","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1111\/jog.13001","article-title":"Seatbelt use and seat preference among pregnant women in Sapporo, Japan, in 2013","volume":"42","author":"M Morikawa","year":"2016","journal-title":"J Obstet Gynaecol Res"},{"issue":"9","key":"pone.0358856.ref003","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-031839","article-title":"Effect of an educational leaflet on the frequency of seat belt use and the rate of motor vehicle accidents during pregnancy in Japan in 2018: a prospective, non-randomised control trial with a questionnaire survey","volume":"9","author":"M Morikawa","year":"2019","journal-title":"BMJ Open"},{"issue":"12","key":"pone.0358856.ref004","doi-asserted-by":"crossref","first-page":"111094","DOI":"10.1016\/j.injury.2023.111094","article-title":"Risks of motor vehicle crash before and during pregnancy: A population-based controlled study in Taiwan","volume":"54","author":"Y-H Chang","year":"2023","journal-title":"Injury"},{"issue":"5","key":"pone.0358856.ref005","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1111\/j.1600-0838.2008.00840.x","article-title":"Correlates of regular exercise during pregnancy: the Norwegian Mother and Child Cohort Study","volume":"19","author":"KM Owe","year":"2009","journal-title":"Scand J Med Sci Sports"},{"issue":"1","key":"pone.0358856.ref006","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1111\/j.1600-0838.2010.01125.x","article-title":"Distribution and predictors of exercise habits among pregnant women in the Danish National Birth Cohort","volume":"22","author":"M Juhl","year":"2012","journal-title":"Scand J Med Sci Sports"},{"key":"pone.0358856.ref007","doi-asserted-by":"crossref","first-page":"710","DOI":"10.5603\/GP.a2022.0015","article-title":"Do women play sports while pregnant?","volume":"93","author":"N Misan","year":"2022","journal-title":"Ginekol Pol"},{"key":"pone.0358856.ref008","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.pmedr.2015.05.002","article-title":"Changes in mode of transportation to work or school from pre-pregnancy to early pregnancy in the Norwegian Fit for Delivery study","volume":"2","author":"M Skreden","year":"2015","journal-title":"Prev Med Rep"},{"issue":"5","key":"pone.0358856.ref009","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1080\/00016340601185301","article-title":"Physical activity level and weight gain in a cohort of pregnant Norwegian women","volume":"86","author":"LAH Haakstad","year":"2007","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"17","key":"pone.0358856.ref010","doi-asserted-by":"crossref","first-page":"6186","DOI":"10.3390\/ijerph17176186","article-title":"What is the best practice method for quantifying the health and economic benefits of active transport?","volume":"17","author":"H M\u00f6ller","year":"2020","journal-title":"Int J Environ Res Public Health"},{"issue":"4","key":"pone.0358856.ref011","article-title":"Physical activity and exercise during pregnancy and the postpartum period: ACOG Committee Opinion, Number 804","volume":"135","year":"2020","journal-title":"Obstet Gynecol"},{"key":"pone.0358856.ref012","doi-asserted-by":"crossref","first-page":"389","DOI":"10.2147\/IJWH.S34042","article-title":"Exercise in obese pregnant women: positive impacts and current perceptions","volume":"5","author":"Z Sui","year":"2013","journal-title":"Int J Womens Health"},{"issue":"1","key":"pone.0358856.ref013","doi-asserted-by":"crossref","first-page":"100758","DOI":"10.1016\/j.ajogmf.2022.100758","article-title":"Physical activity and pregnancy outcomes: An expert review","volume":"5","author":"EL Gascoigne","year":"2023","journal-title":"Am J Obstet Gynecol MFM"},{"issue":"7","key":"pone.0358856.ref014","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1097\/OGX.0000000000000458","article-title":"Physical activity assessment during gestation and its outcomes: A review","volume":"72","author":"W Forczek","year":"2017","journal-title":"Obstet Gynecol Surv"},{"issue":"1","key":"pone.0358856.ref015","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/jog.15438","article-title":"Guidelines for obstetrical practice in Japan: Japan Society of Obstetrics and Gynecology and Japan Association of Obstetricians and Gynecologists 2020 edition","volume":"49","author":"A Itakura","year":"2023","journal-title":"J Obstet Gynaecol Res"},{"issue":"6","key":"pone.0358856.ref016","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1016\/0002-9378(85)90505-8","article-title":"The effect of exercise on uterine activity in the last eight weeks of pregnancy","volume":"151","author":"JC Veille","year":"1985","journal-title":"Am J Obstet Gynecol"},{"issue":"7","key":"pone.0358856.ref017","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1093\/aje\/kwm364","article-title":"Physical exercise during pregnancy and the risk of preterm birth: A study within the Danish National Birth Cohort","volume":"167","author":"M Juhl","year":"2008","journal-title":"Am J Epidemiol"},{"issue":"2","key":"pone.0358856.ref018","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1097\/EDE.0b013e3181cb6267","article-title":"Is swimming during pregnancy a safe exercise?","volume":"21","author":"M Juhl","year":"2010","journal-title":"Epidemiology"},{"issue":"6","key":"pone.0358856.ref019","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1249\/MSS.0b013e3182442fc9","article-title":"Exercise during pregnancy and the gestational age distribution: a cohort study","volume":"44","author":"KM Owe","year":"2012","journal-title":"Med Sci Sports Exerc"},{"key":"pone.0358856.ref020","unstructured":"Japanese Government Statistics. e-Stat: Vital Statistics\/Vital Statistics of Japan Final Data Natality. Statistics code 0003411613. Vol. 1. 2023. pp. 4\u201324. [cited 2026 Feb 1]. Available from: https:\/\/www.e-stat.go.jp\/dbview?sid=0003411613"},{"key":"pone.0358856.ref021","unstructured":"National Police Agency. Topics II: Efforts to realize orderly bicycle traffic. The White Paper on Police 2024. 2024 [cited 2026 Feb 1]. Available from: https:\/\/www.npa.go.jp\/english\/publication\/r06_english_hakusyo.pdf"},{"key":"pone.0358856.ref022","unstructured":"National Police Agency. Head protection is important: bicycle helmets and head protection hats [in Japanese]. 2025 [cited 2026 Feb 1]. Available from: https:\/\/www.npa.go.jp\/bureau\/traffic\/anzen\/toubuhogo.html"},{"key":"pone.0358856.ref023","unstructured":"Metropolitan Police Department. Safety guidelines for cyclists: 5. Wear a helmet. 2023 [cited 2026 Feb 1]. Available from: https:\/\/www.keishicho.metro.tokyo.lg.jp\/multilingual\/english\/traffic_safety\/traffic_rules\/index.files\/SafetyGuidelinesforCyclists.pdf"},{"key":"pone.0358856.ref024","unstructured":"National Police Agency. Results of a survey on bicycle helmet use rates (July 2024) [in Japanese]. 2025 [cited 2026 Feb 1]. Available from: https:\/\/www.npa.go.jp\/bureau\/traffic\/anzen\/img\/toubuhogo\/R6jitenshaherumettochousa.pdf"},{"key":"pone.0358856.ref025","unstructured":"National Police Agency. Results of a survey on bicycle helmet use rates (July 2025) [in Japanese]. 2025 [cited 2026 Feb 1]. Available from: https:\/\/www.npa.go.jp\/bureau\/traffic\/anzen\/img\/toubuhogo\/R7jitenshaherumettochousa.pdf"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0358856","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T17:24:41Z","timestamp":1790097881000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0358856"}},"subtitle":[],"editor":[{"given":"David Chibuike","family":"Ikwuka","sequence":"first","affiliation":[{"name":"University of Rwanda College of Medicine and Health Sciences","place":["RWANDA"]}],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,22]]},"references-count":25,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,22]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0358856","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,22]]}}}