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Association of physical activity and sedentary behavior with depression and anxiety symptoms during pregnancy in a multiethnic cohort of Asian women

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Abstract

Objectives

This study aimed to investigate associations of physical activity (PA) and sedentary behavior (SB) with depression and anxiety symptoms during pregnancy among Chinese, Malay, and Indian women.

Methods

Women answered PA and SB (sitting time and television time) interview questions and self-completed the Edinburgh Postnatal Depression Scale (EPDS) and State-Trait Anxiety Inventory (STAI) questionnaires, at week 26–28 gestation. Sufficient levels of PA (≥600MET-minutes/week) and higher sitting time (≥7 h/day) were determined. Associations of PA and SB with probable antenatal depression (EPDS-score ≥15), higher state anxiety (score ≥42), and higher trait anxiety (score ≥43) were determined by logistic regression analysis.

Results

Among the 1144 pregnant women included in the study, 7.3, 22.5, and 23.6 % had probable antenatal depression, higher state anxiety, and higher trait anxiety symptoms, respectively. In the adjusted models, women with sufficient level of PA were less likely to have probable antenatal depression (OR 0.54, 95 % CI 0.31–0.94, p = 0.030) and higher trait anxiety symptoms (OR 0.68, 95 % CI 0.48–0.94, p = 0.022). PA was not associated with state anxiety symptoms. SB was not associated with any of the investigated outcomes.

Conclusions

Sufficient PA was associated with a reduced likelihood of probable antenatal depression and trait anxiety symptoms. Further investigation of these findings is warranted to determine cause-effect relationships and identify potential preventive strategies.

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Acknowledgments

This research is supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Program and administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore—NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014. Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore. K.M.G. is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre and by the European Union’s Seventh Framework Program (FP7/2007–2013), projects EarlyNutrition and ODIN under grant agreement numbers 289346 and 613977. We would like to thank the GUSTO study group, operational managers, research fellows, study coordinators, and data management team. We greatly appreciate voluntary participation of all participants and cooperation of maternity units in KK Women’s and Children’s Hospital and National University Hospital and their staff. The GUSTO study group includes Pratibha Agarwal, Arijit Biswas, Choon Looi Bong, Birit F.P. Broekman, Shirong Cai, Jerry Kok Yen Chan, Yiong Huak Chan, Cornelia Yin Ing Chee, Yin Bun Cheung, Amutha Chinnadurai, Chai Kiat Chng, Mary Foong-Fong Chong, Shang Chee Chong, Mei Chien Chua, Doris Fok, Marielle V. Fortier, Anne Eng Neo Goh, Yam Thiam Daniel Goh, Joshua J. Gooley, Wee Meng Han, Mark Hanson, Christiani Jeyakumar Henry, Joanna D. Holbrook, Chin-Ying Hsu, Neerja Karnani, Jeevesh Kapur, Ivy Yee-Man Lau, Bee Wah Lee, Yung Seng Lee, Ngee Lek, Sok Bee Lim, Iliana Magiati, Lourdes Mary Daniel, Cheryl Ngo, Krishnamoorthy Niduvaje, Wei Wei Pang, Anqi Qiu, Boon Long Quah, Victor Samuel Rajadurai, Mary Rauff, Salome A. Rebello, Jenny L. Richmond, Anne Rifkin-Graboi, Lynette Pei-Chi Shek, Allan Sheppard, Borys Shuter, Leher Singh, Shu-E Soh, Walter Stunkel, Lin Lin Su, Kok Hian Tan, Oon Hoe Teoh, Mya Thway Tint, Hugo P S van Bever, Rob M. van Dam, Inez Bik Yun Wong, P. C. Wong, Fabian Yap, and George Seow Heong Yeo.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Natarajan Padmapriya, Zhe Shen & Yap-Seng Chong

  2. Singapore Institute for Clinical Sciences, Agency for Science and Technology Research (A*STAR), Brenner Centre for Molecular Medicine, Singapore, Singapore

    Jonathan Y. Bernard, Peter D. Gluckman, Yap-Seng Chong & Michael J. Meaney

  3. Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Shen Liang

  4. KK Women’s and Children’s Hospital, Singapore, Singapore

    See Ling Loy, Kenneth Kwek & Helen Chen

  5. Duke-National University of Singapore, Singapore, Singapore

    Kenneth Kwek & Helen Chen

  6. Medical Research Council Lifecourse Epidemiology Unit, Southampton, UK

    Keith M. Godfrey

  7. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK

    Keith M. Godfrey

  8. Liggins Institute, University of Auckland, Auckland, New Zealand

    Peter D. Gluckman

  9. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

    Seang Mei Saw & Falk Müller-Riemenschneider

  10. Institute for Social Medicine, Epidemiology and Health Economics, Charite University Medical Centre, Berlin, Germany

    Falk Müller-Riemenschneider

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  1. Natarajan Padmapriya
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  2. Jonathan Y. Bernard
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Consortia

On behalf of the GUSTO Study Group

  • Pratibha Agarwal
  • , Arijit Biswas
  • , Choon Looi Bong
  • , Birit F. P. Broekman
  • , Shirong Cai
  • , Jerry Kok Yen Chan
  • , Yiong Huak Chan
  • , Cornelia Yin Ing Chee
  • , Yin Bun Cheung
  • , Amutha Chinnadurai
  • , Chai Kiat Chng
  • , Mary Foong-Fong Chong
  • , Shang Chee Chong
  • , Mei Chien Chua
  • , Doris Fok
  • , Marielle V. Fortier
  • , Anne Eng Neo Goh
  • , Yam Thiam Daniel Goh
  • , Joshua J. Gooley
  • , Wee Meng Han
  • , Mark Hanson
  • , Christiani Jeyakumar Henry
  • , Joanna D. Holbrook
  • , Chin-Ying Hsu
  • , Neerja Karnani
  • , Jeevesh Kapur
  • , Ivy Yee-Man Lau
  • , Bee Wah Lee
  • , Yung Seng Lee
  • , Ngee Lek
  • , Sok Bee Lim
  • , Iliana Magiati
  • , Lourdes Mary Daniel
  • , Cheryl Ngo
  • , Krishnamoorthy Niduvaje
  • , Wei Wei Pang
  • , Anqi Qiu
  • , Boon Long Quah
  • , Victor Samuel Rajadurai
  • , Mary Rauff
  • , Salome A. Rebello
  • , Jenny L. Richmond
  • , Anne Rifkin-Graboi
  • , Lynette Pei-Chi Shek
  • , Allan Sheppard
  • , Borys Shuter
  • , Leher Singh
  • , Shu-E Soh
  • , Walter Stunkel
  • , Lin Lin Su
  • , Kok Hian Tan
  • , Oon Hoe Teoh
  • , Mya Thway Tint
  • , Hugo P. S. van Bever
  • , Rob M. van Dam
  • , Inez Bik Yun Wong
  • , P. C. Wong
  • , Fabian Yap
  •  & George Seow Heong Yeo

Corresponding author

Correspondence to Natarajan Padmapriya.

Ethics declarations

The study protocol was approved by ethics committees of the hospitals involved: SingHealth Centralized Institutional Review Board and National Healthcare Group Domain Specific Review Board in Singapore. All participants gave written informed consent.

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Padmapriya, N., Bernard, J.Y., Liang, S. et al. Association of physical activity and sedentary behavior with depression and anxiety symptoms during pregnancy in a multiethnic cohort of Asian women. Arch Womens Ment Health 19, 1119–1128 (2016). https://doi.org/10.1007/s00737-016-0664-y

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