Domain-specific physical activity and sedentary behavior during pregnancy and postpartum depression risk in the French EDEN and ELFE cohorts

Association between physical activity and depression in adult prescription opioid users: A cross-sectional analysis based on NHANES 2007-2018

OBJECTIVE

This study was designed to examine the association between physical activity (PA) and depression among adult prescription opioid users.

METHOD

Data of adults who recently took prescription opioids were collected from NHANES 2007-2018. Participants were divided into two groups according to whether PA in each domain was ≥600 MET-min/week. According to weekly activity frequency, recreational physical activity (RPA) was divided into inactivity, insufficient activity, weekend warrior (WW), and regular activity. PHQ-9 scores ≥10 were identified as depression.

RESULTS

RPA of ≥600 MET-min/week was associated with a 40% (OR: 0.60, 95%CI: 0.38-0.96, P = 0.032) reduction in the risk of depression. Restricted Cubic Spline plots found a nonlinear dose-response relationship between RPA and depression (P = 0.045), and the turning point of depression risk was around 600 MET-min/week. There was no significant difference in the risk of depression between the WW and inactivity groups (OR: 0.65, 95%CI: 0.25-1.72, P = 0.382). The regular activity group had an 45% (OR: 0.55, 95%CI: 0.31-0.99, P = 0.046)lower risk for depression than the inactivity group.

CONCLUSION

Only regular RPA is associated with a reduced risk of depression, and RPA showed a nonlinear dose-response relationship. The antidepressant effect of the WW is not significant.

Factors relating to sustainability and scalability of the 'Food, Move, Sleep (FOMOS) for Postnatal Mental Health' program: Qualitative perspectives from key stakeholders across Australia

ISSUE ADDRESSED

Supporting healthy behaviours (quality diet, physical activity, sleep) through home-based interventions is feasible to improve postnatal mental health. Involving stakeholders in developing interventions is essential for maximising accessibility, implementation and scale-up. This study aimed to identify factors affecting the sustainable implementation and scalability of the Food, Move, Sleep (FOMOS) for Postnatal Mental Health program, including strategies to enhance research-practice translation.

METHODS

Stakeholders (n = 13) involved in promoting physical activity, healthy eating, postnatal and mental health, public health and/or policy participated in semi-structured interviews. Interviews, based on PRACTIS Guide recommendations for implementation and scale-up, explored perceptions of program design, implementation and scalability. Reflexive thematic analysis was undertaken. Identified implementation and scale-up strategies were mapped against the Expert Recommendations for Implementing Change compendium and PRACTIS Guide.

RESULTS

Individual-level: Targeting multiple systems (primary, tertiary, community-based care) and entry points (early, mid-postpartum) for uptake was important. For equity, screening women in public hospitals, engaging with community agencies and targeting most at-risk women, was suggested. Provider-level: Stakeholders identified strategies to enhance future roll-out (organisations assisting with recruitment). Factors impacting sustainability included high demand for the FOMOS program, and governance around screening and funding; online delivery, connecting with partners and providers and integration into existing services may enhance sustainability. Systems-level: Political support and community champions were perceived important for program dissemination. Nine strategies addressing program uptake, reach, implementation, potential scalability and sustainability were identified.

CONCLUSIONS

For sustainable implementation and potential scalability of a home-based multi-behaviour postnatal intervention, multi-level implementation and scale-up strategies, aligned with existing health systems, policies and initiatives to support postnatal mental health should be considered. SO WHAT?: This paper provides a comprehensive list of strategies that can be used to enhance sustainable implementation and scalability of healthy behaviour programs targeting postnatal mental health. Further, the interview schedule, systematically developed and aligned with the PRACTIS Guide, may serve as a useful resource for researchers conducting similar studies in future.

Effects of Sedentary Behavior on the Complications Experienced by Pregnant Women: A Systematic Review

Pregnant women are encouraged to reduce sitting time and replace it with physical activity. Complications arising during pregnancy include gestational hypertension, preeclampsia, gestational diabetes mellitus (GDM), and prenatal and postpartum depression. In this systematic review, we examined effects of sedentary behavior on the health of pregnant women. We conducted a systematic review with PubMed from year 2000 to identify the relationship between a sedentary lifestyle and psychological effects, occurrence of GDM, gestational hypertension, and preeclampsia. Data extracted included sedentary time of pregnant women, psychological effects, occurrence of GDM, gestational hypertension, and preeclampsia as outcomes. Among the 200 studies retrieved, 11 were finally included after screening. The mean age of eligible pregnant women ranged from 28.5 to 32.9 years. Five studies were extracted with outcomes of psychological effects on the mother, five with GDM, and one with gestational hypertension/preeclampsia. Longer sedentary time was associated with increased risks of prepartum/postpartum depression in three of five studies and GDM in three of five studies. No association was found between sedentary behavior and the risk for gestational hypertension/preeclampsia. Higher sedentary behavior in the second trimester of pregnancy was likely to be associated with postpartum depression. Longer sitting time may increase the risk of prenatal or postnatal depression and GDM, but no relationship was proven for gestational hypertension and preeclampsia in one study. High sedentary behavior in the second trimester may have psychological impacts. The number of studies was small and further research is needed to statistically evaluate impacts of sedentary behavior during pregnancy.

The Impact of Physical Activity on the Development of Postpartum Depression

Although the benefits of physical activity (PA) on mental well‐being are well established, the vulnerability of women during pregnancy and the postpartum period poses challenges in studying the effects of PA on postpartum depression (PPD). This study investigated the association between total and domain‐specific PA levels during pregnancy and postpartum depressive symptoms. The study included 105 healthy pregnant women whose PA status was evaluated by the Serbian version of the Physical Activity Questionnaire during Pregnancy (PPAQ‐SRB) and their postpartum mental health by the Edinburgh Postnatal Depression Scale. Multivariable logistic regression was used to explore the independent relationship between PPAQ‐SRB scores and the prediction of the PPD symptom occurrence. Our analysis revealed that the development of PPD symptomatology was associated with a lower “Total PPAQ‐SRB score” (odds ratio (OR) 0.81; 95% confidence interval (CI) [0.70–0.93]; p = 0.03) and “Total Activity score” (OR 0.82; 95% CI [0.71–0.93]; p = 0.03) as well as lower scores of light‐intensity PA (OR 0.81; 95% CI [0.69–0.96]; p = 0.013), moderate‐intensity PA (OR 0.82; 95% CI [0.71–0.94]; p = 0.005), “Household/care” (OR 0.85; 95% CI [0.73–0.98]; p = 0.028), and “Occupational” activities (OR 0.80; 95% CI [0.78–0.95]; p = 0.012). Lower levels of light‐to‐moderate‐intensity household and occupational activities appeared to increase the risk of PPD, indicating the importance of circumstances under which PA is performed. Hence, our findings indicate that PA during pregnancy can mitigate mood disorders in postpartum mothers. Moreover, reduced participation in light‐to‐moderate‐intensity household and occupational activities seemed to increase the risk of PPD.

Impact of parental lifestyle patterns in the preconception and pregnancy periods on childhood obesity

Introduction

High prevalence of overweight and obesity already observed in preschool children suggests the involvement of early-life risk factors. Preconception period and pregnancy are crucial windows for the implementation of child obesity prevention interventions with parental lifestyle factors as relevant targets. So far, most studies have evaluated their role separately, with only a few having investigated their potential synergistic effect on childhood obesity. Our objective was to investigate parental lifestyle patterns in the preconception and pregnancy periods and their association with the risk of child overweight after 5 years.

Materials and methods

We harmonized and interpreted results from four European mother-offspring cohorts participating in the EndObesity Consortium [EDEN, France; Elfe, France; Lifeways, Ireland; and Generation R, Netherlands] with data available for 1,900, 18,000, 1,100, and 9,500 families, respectively. Lifestyle factors were collected using questionnaires and included parental smoking, body mass index (BMI), gestational weight gain, diet, physical activity, and sedentary behavior. We applied principal component analyses to identify parental lifestyle patterns in preconception and pregnancy. Their association with risk of overweight (including obesity; OW-OB) and BMI z-scores between 5 and 12 years were assessed using cohort-specific multivariable logistic and linear and regression models (adjusted for potential confounders including parental age, education level, employment status, geographic origin, parity, and household income).

Results

Among the various lifestyle patterns derived in all cohorts, the two explaining the most variance were characterized by (1) "high parental smoking, low maternal diet quality (and high maternal sedentary behavior in some cohorts)" and, (2) "high parental BMI and low gestational weight gain." Patterns characterized by high parental BMI, smoking, low diet quality or high sedentary lifestyle before or during pregnancy were associated with higher risk of OW-OB in children, and BMI z-score at any age, with consistent strengths of associations in the main cohorts, except for lifeways.

Conclusion

This project provides insight into how combined parental lifestyle factors in the preconception and pregnancy periods are associated with the future risk of child obesity. These findings are valuable to inform family-based and multi-behavioural child obesity prevention strategies in early life.

The Impact of the COVID-19 Pandemic on the Level of Physical Activity, Emotional State, and Health Habits of Women in Late Pregnancy and Early Puerperium

The aim of the study was to determine the impact of the Covid-19 pandemic on the level of physical activity in the last trimester, the risk of developing postnatal depression, and general health habits in late pregnancy and the early postpartum period.

METHODS

The study population was women 1-8 days postpartum. Participants were divided into three groups depending on when they were recruited: (1) prepandemic (Ppan: n = 252, December 2019-March 2020), (2) COVID1 group (Cov1: n = 262, May 2020-September 2020), and (3) COVID2 group (Cov2: n = 226, June 2021-September 2021). The Ppan group included women from before the pandemic. The Cov1 group included patients after some restrictions were lifted. The Cov2 group included women after vaccinations became available. Research tools included a demographical questionnaire (age, education, childbirth details), the Pregnancy Physical Activity Questionnaire (PPAQ), the Edinburgh Postnatal Depression Scale (EPDS), and the Health Behavior Inventory (IZZ).

RESULTS

Regression analysis showed that regardless of other variables, women who gave birth during the pandemic spent less energy on total physical activity compared to the prepandemic group (Cov1: β = -18.930, 95%CI: -36.499 to -1.361; Cov2: β = -26.527, 95%CI: -44.322 to -8.733). We also found that as the risk of depression increased, engagement in general health habits decreased during the pandemic.

CONCLUSIONS

The Covid-19 pandemic decreased the level of some subdomains of physical activity in pregnant women, with a general negative correlation between emotional state and healthy habits.

Level of Physical Activity in Pregnant Populations from Different Geographic Regions: A Systematic Review

The aim of this study was to examine the level of physical activity during pregnancy in different populations worldwide. An intensive search was carried out from February until May 2021. The inclusion criteria were original studies of healthy pregnant women, and the main study variable was the assessment of physical activity. A total of 110 out of 1451 studies were assessed for inclusion, using the Newcastle–Ottawa Scale for quality, and for the risk of bias. The 44 analyzed articles were divided into 5 tables according to the characteristics of the intervention and the validated instrument used to measure physical activity (PA). A total of 59.09% of the studies indicated that participants had a low level of physical activity during pregnancy. In addition, the median quality score of the studies was 7.12, and 77.27% of the studies were cataloged as having a high-quality score. Although international guidelines recommend that women without a contraindication engage in prenatal physical activity, the results of the present study show that the level of PA is too low for women to achieve scientifically proven maternal-fetal benefits. Failure to achieve the recommended levels of weekly physical activity could pose significant risks to maternal well-being.

Physical activity before and during pregnancy and maternal mental health: A systematic review and meta-analysis of observational studies

OBJECTIVE

To examine the influence of physical activity before and during pregnancy on maternal mental health outcomes.

METHODS

Ten electronic databases were searched up to May 11, 2021. Studies of all observational designs (except case studies and reviews) were included, which contained information on the relevant population (women before and or during pregnancy), exposures (objective or subjective measures of physical activity), comparator (low or no physical activity), and outcomes (diagnosis and symptom severity of depression or anxiety, quality of life scores, stress and emotions).

RESULTS

Forty-four observational studies (N = 132,399) were included. 'Low' to 'very low' certainty evidence revealed that compared with low levels of PA during pregnancy, high levels of PA were associated with a reduced odds of developing prenatal depression (odds ratio (OR): 0.68, 95% confidence interval (CI): 0.58 to 0.80) and anxiety (OR: 0.67, 95% CI: 0.54 to 0.83). We also found a reduction in the severity of prenatal depressive symptoms (standardized mean difference (SMD): -0.37, 95% CI -0.57 to -0.17), prenatal anxiety symptoms (SMD: -0.45, 95% CI -0.64 to -0.27), and prenatal stress (SMD: -0.33, 95% CI -0.55 to -0.11), concurrent with improved quality of life (SMD: 0.38, 95% CI 0.23 to 0.54). PA before pregnancy did not impact the outcomes of interest.

CONCLUSION

Physical activity during pregnancy is associated with a reduction in the odds and severity of prenatal depression and anxiety, as well as reduced stress and improved quality of life. PROSPERO registration number: CRD42020208469.

Relationship between physical activity and mental health in women after childbirth: a cross-sectional exploratory study

Background

Physical activity (PA) is recommended for women after childbirth. However, it is unknown whether PA, such as housework and child-rearing, is associated with mental health. This study aimed to measure daily PA in women 2 months postpartum as well as investigate the relationship between daily PA and mental health.

Methods

In this cross-sectional quantitative exploratory study conducted between September 2017 and May 2018, 110 women were approached for participation. Mental health was evaluated using the General Health Questionnaire-28, and PA measurements were performed using accelerometers that the participants wore for 2 days. Welch’s t-test and linear regression analysis were performed to assess the relationship between PA and mental health.

Results

This study included 99 participants. The mean amount of daily activities from housework and child-rearing was 3.21 ± 1.14 metabolic equivalent of tasks (METs)-h/day and that of time spent sitting was at least 7.5 h/12.5 h. PA time spent in light child-rearing and housework activities was significantly longer among multiparous women than among primiparous women (t =  − 3.41). PA time comprising the duration of moderate (3 METs) or more vigorous PA was 73 min/day. No significant relationship between mental health and PA was observed. However, the amount of daily activities tended to increase with an improvement in mental health. The amount of daily activities exceeded 3 METs-h/day regardless of the mental health status.

Conclusions

No significant relationship was found between the amount of daily activities and mental health. The former increased as the latter improved. The amount of daily activities met the standard recommended by the World Health Organization, regardless of the mental health status.

The relationship between domain-specific physical activity and depressive symptoms in Korean adults: Analysis of the Korea National Health and Nutrition Examination Survey

BACKGROUND

This study aimed to investigate the associations of domain-specific physical activity (PA) with the prevalence of depressive symptoms.

METHODS

We analyzed data from 11,679 (5,056 men and 6,623 women) participants aged ³19 years in the Korea National Health and Nutrition Examination Survey (2016 and 2018 waves). Depressive symptoms were measured using the Korean version of the Patient Health Questionnaire-9 (PHQ-9), with a cut-off score for depression of 11. The participants were first categorized by sex, and then by their PA level in different PA domains into three different groups. We examined the correlations between domain-specific PA and depressive symptoms using logistic regression analysis after controlling for confounders.

RESULTS

Total amount of PA was not associated with depressive symptoms. However, in both sexes, those high in leisure and transport PA had lower levels of depressive symptoms compared with those with no leisure and transport PA (p for trend <0.001). After adjusting for covariates, those high in work PA showed a significantly higher likelihood of having depressive symptoms both in male (OR= 2.74, 95% CI 1.56-4.82) and female participants (OR= 2.84, 95% CI 1.70-4.49), compared to those with no work PA.

LIMITATION

Cross-sectional nature of the data prevents causal associations.

CONCLUSIONS

Although the total amount of PA participation was not associated with depressive symptoms, domain-specific PAs were differently associated with depressive symptoms. Specifically, higher amount of work PA was significantly associated with higher prevalence of depressive symptoms; this topic deserves further attention and future investigation.

Effect of physical activity on prevention of postpartum depression: A dose-response meta-analysis of 186,412 women

BACKGROUND

Physical activity (PA) is considered a favorable preventive intervention for postpartum depression (PPD), but evidence defining a corresponding dose-response relationship is lacking. This meta-analysis was conducted to assess the protective effects of PA on PPD and define a potential dose-response relationship between them.

METHODS

PubMed, Medline, Embase, and Web of Science were searched from 1968 to May 2022. Only randomized control trials (RCTs) and prospective studies were considered, and the PICOS tool was used to identify eligible articles based on the inclusion and exclusion criteria. Effect-size estimates were unified as odds ratio (OR) and 95% confidence interval (CI). We calculated the ORs and their 95% CI for studies that did not report them using the Practical Meta-Analysis Effect Size Calculator.

RESULTS

A total of 23 studies were eligible, including 14 RCTs and 9 prospective cohort studies. The overall analysis showed a statistically significant positive association between PA and PPD prevention (adjusted OR = 0.73; 95% CI: 0.61-0.87; P < 0.001). Subgroup analyses indicated that studies conducted in Europe demonstrated a significant correlation between PA and reduced PPD risk (adjusted OR = 0.85, 95% CI: 0.76-0.95, P = 0.004). Concerning PA type, sports activity was associated with relieving PPD symptoms (adjusted OR = 0.89, 95% CI: 0.78 to 1.00, P < 0.001), while work (adjusted OR = 1.05, 95% CI: 0.37-2.97, P = 0.065) and household activities (adjusted OR = 1.16, 95% CI: 0.89-1.52, P = 0.986) contributed to a greater risk of PPD. Our dose-response analysis revealed a reverse J-shaped trend between ascending PA duration and PPD incidence.

CONCLUSION

This meta-analysis identified PA as a potential intervention to reduce the risk of PPD. The dose-response analysis revealed that at least 90 min of PA per week could efficiently decrease the risk of PPD.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022335731.

Domain-Specific Physical Activity, Pain Interference, and Muscle Pain after Activity

PURPOSE

Using the Melbourne Collaborative Cohort Study, we examined the associations of occupation, household, transport, and leisure physical activity with pain interference with normal work and muscle pain after activity.

METHODS

This cross-sectional analysis included 7655 working and 11,766 nonworking participants. Physical activity was assessed using the long-form International Physical Activity Questionnaire. Pain interference was assessed with the Short-Form 12-Item Health Survey version 2.0, and muscle pain after activity was assessed using the 12-item Somatic and Psychological Health Report. Ordered logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI), and restricted cubic splines were used to graphically represent the shape of associations.

RESULTS

All physical activity domain-pain outcome associations were nonlinear. Compared with participants who reported the lowest level of activity, participants who reported the median level of transport physical activity (10 MET·h·wk) reported less pain interference (workers: OR, 0.86 [95% CI, 0.77-0.97]; nonworkers: OR, 0.88 [95% CI, 0.79-0.97]) and muscle pain after activity (workers: OR, 0.81 [95% CI, 0.70-0.95]; nonworkers: OR, 0.86 [95% CI, 0.77-0.95]). Higher levels of leisure time activity (20 MET·h·wk) were associated with less pain interference in nonworkers (OR, 0.87; 95% CI, 0.77-0.98) and muscle pain after activity in workers (OR, 0.67; 95% CI, 0.56-0.80). Workers who reported the median level of household activity (16 MET·h·wk) had increased pain interference (OR, 1.19; 95% CI, 1.07-1.32) and muscle pain after activity (OR, 1.23; 95% CI, 1.06-1.42) than did those who reported the least household activity.

CONCLUSIONS

Associations between domain-specific physical activity and pain outcomes were not uniform. Within the transport and leisure domains, physical activity was inversely associated with pain-related outcomes, whereas household physical activity was positively associated with pain scores within the working sample.

Reduction in physical activity significantly increases depression and anxiety in the perinatal period: a longitudinal study based on a self-report digital assessment tool

PURPOSE

Physical activity can reduce pregnancy-related complications and contributes substantially to improving maternal mental health. A reduction in activity encompassing exercise and daily household tasks throughout the course of pregnancy increases the risk of depression and anxiety. The following research examines the longitudinal interaction between exercise, general physical activity, and mental health outcomes in pregnant women.

METHODS

This prospective longitudinal study was conducted at the maternity departments of two major university hospitals in Germany. Self-reported data of 597 women were digitally assessed every 4 weeks from the second trimester until birth as well as 3 and 6 months postnatally. Depressive and anxiety symptoms were assessed using the EPDS, PRAQ, and STAI and physical activity levels were measured using the PPAQ questionnaire. Cross-sectional and longitudinal analyses using Pearson's correlation coefficient and multiple regression models were conducted.

RESULTS

We found a significant reduction in general physical activity in the period from the 20th to 32nd gestational week. Women who reported a greater decline during pregnancy showed significantly higher depression and anxiety scores. In stratified analyses, only baseline mental health scores proved to be variables with stronger impact on postnatal depression and anxiety outcomes.

CONCLUSION

General physical activity and maternal mental health significantly influence each other during and after pregnancy. Both physical activity and the prevention of perinatal mental disorders should be systematically encouraged during perinatal care to prevent adverse maternal and fetal birth outcomes.

mHealth Apps Assessment among Postpartum Women with Obesity and Depression

BACKGROUND

Pregnancy has become the main constituent for women to become overweight or obese during the postpartum phase. This could lead women to suffer from postpartum depression as well. Information technology (IT) has become more prevalent in the healthcare industry. It offers patients the opportunity to manage their health conditions via the use of several applications, one being the mHealth applications.

OBJECTIVE

The main purpose of this study is to experiment and understand the effects the mHealth applications (i.e., fitness and nutrition applications) have on the body mass index (BMI) and depression levels amongst postpartum women.

METHODS

Online questionnaires were sent to postpartum women within one year after their pregnancy, of which 819 completed questionnaires were returned. The frequency of the mHealth applications usage was categorized into daily, weekly, rarely and never streams. Therefore, the frequency of use of the mHealth applications for BMI and depression levels was analyzed based on the available statistical data. Descriptive statistics, ANOVA, and Dunnet tests were applied to analyze the experimental data.

RESULTS

Out of 819 respondents, 37.9% and 42.1% of them were overweight and obese, respectively. Almost 32.9% of the respondents were likely depressed, and 45.6% were at an increased risk. This study reports that only 23.4% and 28.6% of respondents never used the fitness and nutrition applications. The impact of the frequency of using the fitness applications on BMI and depression levels was obvious. This means that with the increased use of the fitness applications, there was also a significant effect in maintaining and decreasing the BMI and depression levels amongst Malaysians postpartum women. However, from the data of weekly and daily use of fitness applications, we found that the contribution toward the BMI and depression levels was high (p = 0.000). However, nutrition applications amongst the users were not significant within the main variables (p > 0.05). From the Dunnet test, the significance of using the fitness applications within the depression levels started from daily usage, whereas for BMI, it started from weekly usage.

CONCLUSION

The efficiency of the fitness applications toward the BMI and depression levels has been proven in this research work. While nutrition applications did not affect the BMI and depression levels, some of the respondents were still categorized as weekly and daily users. Thus, the improvements in BMI and depression levels are associated with the types of mHealth app that had been used.