Abstract
Background
Maternal mental health during pregnancy is important for both perinatal outcomes and long-term child health. Physical activity before and during pregnancy is a potential modifiable factor, yet population-based evidence on physical activity before and during pregnancy in relation to wellbeing and depressive symptoms in early pregnancy is scarce. The aim was to examine associations between physical activity before and during pregnancy with maternal mental health indicators in early pregnancy.
Methods
Cross-sectional analyses were based on 34,886 pregnant women completing a patient-reported questionnaire prior to their first midwife consultation (gestational weeks 7–12) across six Danish maternity units. Wellbeing was assessed using WHO-5 and depressive symptoms using MDI-2. Physical activity was self-reported for the three months prior to conception and during pregnancy. Associations were estimated using logistic regression adjusted for sociodemographic factors.
Results
Physical activity during pregnancy showed a clear gradient across wellbeing categories. Thus, 18.5% of women with very low wellbeing were physically active, which applied for 33.8% of those with low wellbeing, and 53.5% of those with moderate to high wellbeing. Compared with women with moderate to high wellbeing, women with very low and low wellbeing had significantly lower odds of being physically active both before pregnancy (OR = 0.64; 95% CI: 0.59–0.69 and OR = 0.71; 0.66–0.75) and during pregnancy (OR = 0.21; 0.19–0.23 and OR = 0.44; 0.41–0.47). For depressive symptoms, ORs were 0.80 (0.72–0.89) before pregnancy and 0.57 (0.50–0.64) during pregnancy.
Conclusions
Pregnant women with low wellbeing and depressive symptoms are substantially less physically active than pregnant women with moderate to high wellbeing. Although causality cannot be inferred, promoting physical activity may improve maternal mental health and further improve perinatal outcomes and children’s health.
Key messages
• Physical activity before and during pregnancy is associated with low wellbeing and depressive symptoms in early pregnancy.
• Although causality cannot be inferred, promoting physical activity may improve maternal mental health and further improve perinatal outcomes. Research on causality is however needed.