Few studies measure physical activity objectively or at multiple time points during postpartum. We describe physical activity at 3- and 12-months postpartum among a cohort of women using both self-reported and objective measures.
In total, 181 women completed the 3-month postpartum measures, and 204 women completed the 12-month postpartum measures. Participants wore an Actigraph accelerometer for one week and completed in-home interviews that included questions on physical activity. A cohort of 80 women participated at both time points. Poisson regression models were used to determine whether physical activity differed over time for the cohort.
For the cohort, average counts/minute were 364 at 3-months postpartum and 394 at 12-months postpartum. At both time periods for the cohort, vigorous activity averaged 1 to 3 minutes/day, and moderate activity (NHANES cutpoints) averaged 16 minutes/day. Sedentary time averaged 9.3 hours at 3-months postpartum and 8.8 hours at 12-months postpartum, out of a 19-hour day. Average counts/minute increased and sedentary behavior declined from 3- to 12-months postpartum.
Interventions are needed to help women integrate more moderate to vigorous physical activity and to capitalize on the improvements in sedentary behavior that occur during postpartum.
Parks are an integral part of a favorable built environment, and several studies have found a positive association between a favorable built environment and physical activity. Parks data are available to researchers from various sources; however, the accuracy of data sources in representing parks is unknown. This study compared secondary parks data obtained from a commercial vendor with data from municipal/county government records, all of which were verified by using Internet searches, telephone inquiries, or on-the-ground audits.
We studied large metropolitan areas in 3 states: North Carolina (1,837 sq mi), Maryland (1,351 sq mi), and New York (260 sq mi). We collected information on park land area (shapefiles) from municipal/county governments from 2009 through 2012 and from a commercial source in 2010.
Commercial parks data did not include 31.1% (119/383, 20.3 sq mi) of North Carolina, 42.9% (187/436, 21.8 sq mi) of Maryland, and 71.7% (640/892, 13.5 sq mi) of New York parks that we found and verified from municipal/county sources. Municipal/county data did not include 15.7% (60/383, 9.9 sq mi) of North Carolina parks, 27.5% (120/436, 74.6) of Maryland parks, and 9.0% (80/892, 6.3 sq mi) of New York parks that we found and verified from commercial sources.
In this study, the combination of commercial and municipal/county data sources that were verified provided the most complete and accurate shapefile. The quality of secondary sources of parks data should be checked prior to use and, if needed, methods incorporated to improve the capture of parks.
Prior assessments of emergency medical services (EMS) stroke capacity found deficiencies in education and training, use of protocols and screening tools, and planning for the transport of patients. A 2001 survey of North Carolina EMS providers found many EMS systems lacked basic stroke services. Recent statewide efforts have sought to standardize and improve prehospital stroke care. The objective of this study was to assess EMS stroke care capacity in North Carolina and evaluate statewide changes since 2001.
In June 2012, we conducted a web-based survey on stroke education and training and stroke care practices and policies among all EMS systems in North Carolina. We used the McNemar test to assess changes from 2001 to 2012.
Of 100 EMS systems in North Carolina, 98 responded to our survey. Most systems reported providing stroke education and training (95%) to EMS personnel, using a validated stroke scale or screening tool (96%), and having a hospital prenotification policy (98%). Many were suboptimal in covering basic stroke educational topics (71%), always communicating stroke screen results to the destination hospital (46%), and always using a written destination plan (49%). Among 70 EMS systems for which we had data for 2001 and 2012, we observed significant improvements in education on stroke scales or screening tools (61% to 93%, P < .001) and use of validated stroke scales or screening tools (23% to 96%, P < .001).
Major improvements in EMS stroke care, especially in prehospital stroke screening, have occurred in North Carolina in the past decade, whereas other practices and policies, including use of destination plans, remain in need of improvement.
To determine if neighborhood socio-economic status (SES) influences park use and park-based physical activity.
Cross sectional study
We systematically observed the use and characteristics of 24 neighborhood parks in Albuquerque NM, Chapel Hill/Durham NC, Columbus OH, and Philadelphia, PA in three seasons, (spring, summer and fall), observing nearly 36,000 park users; twelve were in high-poverty neighborhoods and 12 in low-poverty. We surveyed 3,559 park users and 3,815 local residents, assessed park incivilities, and interviewed park administrators about management practices.
The size and number of facilities in high poverty neighborhood parks were similar to those in low poverty neighborhood parks, but the former had more hours of programming. Neighborhood poverty level, perception of safety, and the presence of incivilities were not associated with the number of observed park users. However, programmed activities and the number of activity facilities were strongly correlated with park use and energy expended in the park.
The finding that park programming is the most important correlate of park use and park-based physical activity suggests that there are considerable opportunities for facilitating increased PA among both high and low poverty area populations.
Physical activity; socio-economic status; green space; direct observation; parks; safety
Little is known about neighborhood characteristics of workplaces, the extent to which they are independently and synergistically correlated with residential environments, and their impact on health.
This study investigated cross-sectional relationships between home and workplace neighborhood environments with body mass index (BMI) in 1,503 working participants of the Multi-Ethnic Study of Atherosclerosis (MESA) with mean age 59.6 (SD=7.4). Neighborhood features were socioeconomic status (SES), social environment (aesthetic quality, safety, and social cohesion), and physical environment (walking environment, recreational facilities, and food stores) derived from census data, locational data on businesses, and survey data. Paired t-tests and correlations compared environments overall and by distance between locations. Cross-classified multi-level models estimated associations with BMI.
Home neighborhoods had more favorable social environments while workplaces had more favorable SES and physical environments. Workplace and home measures were correlated (0.39–0.70) and differences between home and workplaces were larger as distance increased. Associations between BMI and neighborhood SES and recreational facilities were stronger for home environment (P≤0.05) but did not significantly differ for healthy food, safety, or social cohesion. Healthy food availability at home and work appeared to act synergistically (interaction P=0.01).
Consideration of workplace environment may enhance our understanding of how place affects BMI.
Neighborhood; Body Mass Index
Epidemiologic studies and surveillance systems of pregnant women often rely collection of physical activity through self-report. This systematic review identified and summarized self-reported physical activity assessments with evidence for validity and reliability among pregnant women.
Peer-reviewed articles published through 2011 were included if they assessed validity and/or reliability of an interviewer- or self-administered physical activity questionnaire or diary among pregnant women.
We identified 15 studies, including 12 studies that assessed questionnaires and 4 studies that assessed diaries, conducted in Australia, Finland, Norway, United Kingdom, United States, and Vietnam. For questionnaires, 92% (11/12) assessed mode, all assessed frequency and/or duration, and 58% (7/12) collected information on perceived intensity. All but one study (92%) assessed validity of the questionnaires. Questionnaires compared to objective measures (accelerometers, pedometers) ranged from slight to fair agreement, while comparison to other self-reported measures ranged from substantial to almost perfect agreement. Five studies (42%) assessed test-retest reliability of the questionnaires, ranging from substantial to almost perfect agreement. The four studies on diaries were all assessed for validity against objective measures, ranging from slight to substantial agreement.
Selection of valid and reliable physical activity measures that collect information on dose (type, frequency, duration, intensity) is recommended to increase precision and accuracy in detecting associations of physical activity with maternal and fetal outcomes.
diary; measurement; physical activity; pregnancy; questionnaire; reliability; review; validity
There is growing recognition that policymakers can promote access to healthy, affordable foods within neighborhoods, schools, childcare centers, and workplaces. Despite the disproportionate risk of obesity and type 2 diabetes among American Indian children and adults, comparatively little attention has been focused on the opportunities tribal policymakers have to implement policies or resolutions to promote access to healthy, affordable foods. This paper presents an approach for integrating formative research into an action-oriented strategy of developing and disseminating tribally led environmental and policy strategies to promote access to and consumption of healthy, affordable foods. This paper explains how the American Indian Healthy Eating Project evolved through five phases and discusses each phase’s essential steps involved, outcomes derived, and lessons learned.
Using community-based participatory research and informed by the Social Cognitve Theory and ecologic frameworks, the American Indian Healthy Eating Project was started in fall 2008 and has evolved through five phases: (1) starting the conversation; (2) conducting multidisciplinary formative research; (3) strengthening partnerships and tailoring policy options; (4) disseminating community-generated ideas; and (5) accelerating action while fostering sustainability. Collectively, these phases helped develop and disseminate Tools for Healthy Tribes—a toolkit used to raise awareness among participating tribal policymakers of their opportunities to improve access to healthy, affordable foods. Formal and informal strategies can engage tribal leaders in the development of culturally appropriate and tribe-specific sustainable strategies to improve such access, as well as empower tribal leaders to leverage their authority toward raising a healthier generation of American Indian children.
Present the immediate post-intervention results of Kids and Adults Now - Defeat Obesity!, a randomized controlled trial to enhance healthy lifestyle behaviors in mother-preschooler (2–5 years old) dyads in North Carolina (2007–2011). The outcomes include change from baseline in the child’s diet, physical activity and weight, and in the mother’s parenting behaviors, diet, physical activity, and weight.
The intervention targeted parenting through maternal emotion regulation, home environment, feeding practices, and modeling of healthy behaviors. 400 Mother-child dyads were randomized.
Mothers in the intervention arm, compared to the control arm, reduced instrumental feeding (−0.24 vs. 0.01, p<0.001) and TV snacks (−.069 vs. −0.24, p=0.001). There were also improvements in emotional feeding (p=0.03), mother’s sugary beverage (p=0.03) and fruit/vegetable (p=0.04) intake, and dinners eaten in front of TV (p=0.01); these differences were not significant after adjustment for multiple comparisons.
KAN-DO, designed to maximize the capacity of mothers as agents of change, improved several channels of maternal influence. There were no group differences in the primary outcomes, but differences were observed in the parenting and maternal outcomes and there were trends toward improvement in the preschoolers’ diets. Long-term follow-up will address whether these short-term trends ultimately improve weight status.
Obesity; randomized controlled trial; parenting; emotion regulation; physical activity; dietary intake
Correlates of prenatal physical activity can inform interventions, but are not well-understood.
Participants in the Pregnancy, Infection, and Nutrition 3 Study were recruited before 20 weeks gestation. Women self-reported frequency, duration, and mode of moderate and vigorous physical activities. We used logistic regression to identify correlates of any physical activity (≥10 minutes/week of any mode), any recreational activity (≥10 minutes/week), and high volume recreational activity (either ≥150 minutes/week of moderate or ≥75 minutes/week of vigorous). Our analysis included 1752 women at 19-weeks gestation and 1722 at 29 weeks.
Higher education, white race, and enjoyment of physical activity were positively correlated with all 3 outcomes. Any recreational activity was negatively associated with parity, body mass index, and history of miscarriage. The associations of history of miscarriage and body mass index differed at 19 weeks compared with 29 weeks. Single marital status, health professional physical activity advice, and time for activity were associated with high volume recreational activity only.
Correlates of physical activity differed by mode and volume of activity and by gestational age. This suggests that researchers planning physical activity interventions should consider the mode and amount of activity and the gestational age of the participants.
leisure activity; gestational age; intervention; barriers; psychosocial
motion sensors; physical activity; exercise
Current U.S. pregnancy-related physical activity recommendations do not provide specific guidance for vigorous intensity activity. Our objective was to examine the associations between vigorous physical activity during pregnancy and length of gestation and birthweight. Women were recruited before 10 weeks gestation. At 13-16 weeks gestation, participants reported the type, frequency, and duration of their typical weekly vigorous physical activities. Activity domains included recreational, occupational, household, and child/adult care. Infant birth date was obtained from medical or vital records; if unavailable, self-report was used. Birthweight (from vital records) was studied among term births. We analyzed gestational age among 1,647 births using discrete-time survival analysis. We used logistic and linear regression to analyze preterm birth (birth at <37 weeks) and birthweight, respectively. Vigorous recreational activity was associated with longer gestation (any vs. none, hazard ratio (HR) [95% CI]: 0.85 [0.70, 1.05]) and we did not detect any dose-response association. Higher frequency of vigorous recreational activity sessions (adjusted for total volume of activity) was associated with a decreased odds of preterm birth (≥ 4 sessions/week vs. 0 or 1, OR [95% CI]: 0.08 (0.006, 1.0). Birthweight was not associated with physical activity measures. In summary, vigorous physical activity does not appear to be detrimental to the timing of birth or birthweight. Our data support a reduced risk of preterm birth with vigorous recreational activity, particularly with increased frequency of recreational activity sessions. Future studies should investigate the components of physical activity (i.e. intensity, duration, and frequency) in relation to birth outcomes.
To determine the association between moderate and vigorous physical activities (MVPA) during midpregnancy and the risk of hyperglycemia.
Data were from 1437 pregnant women. Frequency, duration, and intensity of MVPA during the previous 7 days were collected via questionnaire at 17–22 weeks' gestation. Modes of MVPA included work, recreation, transportation, caregiving, and indoor and outdoor household activities. Hyperglycemia was defined as a glucose concentration ≥130 mg/dL on a 1-hour, 50-g glucose challenge test or gestational diabetes mellitus (GDM) assessed at ∼27 weeks' gestation. Multivariable Poisson regression estimated risks of hyperglycemia associated with total and mode-specific MVPA.
There were 269 women (18.7%) with hyperglycemia. Any metabolic equivalent (MET) hours/week of recreational MVPA was associated with a 27% lower risk of hyperglycemia (adjusted relative risk, [aRR] 0.73, 95% confidence interval [95%CI] 0.54-0.99). Multiplicative interaction terms were significant for prepregnancy body mass index (BMI) and recreational MVPA (p=0.01). Among women with prepregnancy BMI <25 kg/m2, recreational MVPA was associated with a 48% lower risk of hyperglycemia (aRR 0.52, 95%CI 0.33-0.83) compared to women who reported none. There was no association of hyperglycemia and recreational MVPA among women with prepregnancy BMI <25 kg/m2.
Recreational MVPA during pregnancy is associated with a lower risk of hyperglycemia, specifically among women with prepregnancy BMI <25 kg/m2. Further research is warranted to determine recommended amounts and intensities of physical activity and to discern whether there are differences in the effects of physical activity between specific modes of physical activity or among subgroups of women in relation to hyperglycemia.
The Systematic Observation of Play and Recreation in Communities (SOPARC) was designed to estimate the number and characteristics of people using neighborhood parks by assessing them 4 times/day, 7 days/week. We tested whether this schedule was adequate and determined the minimum number of observations necessary to provide a robust estimate of park user characteristics and their physical activity levels.
We conducted observations every hour for 14 hours per day during one summer and one autumn week in 10 urban neighborhood parks: 2 each in Los Angeles, CA, Albuquerque, NM, Columbus, OH, Durham, NC, and Philadelphia, PA. We counted park users by gender, age group, apparent race/ethnicity, and activity level. We used a standardized Cronbach’s alpha and intra-class correlation coefficients to test the reliability of using fewer observations.
We observed 76,632 individuals, an average of 547/day (range 155 – 786). Inter-observer reliability ranged from 0.80 to 0.99. Obtaining a robust estimate of park user characteristics and their physical activity required a schedule of 4 days/week, 4 times/day.
An abbreviated schedule of SOPARC was sufficient for estimating park use, park user characteristics, and physical activity. Applying these observation methods can augment physical activity surveillance.
Physical activity; parks; measurement; direct observation; surveillance
Studies that have combined accelerometers and global positioning systems (GPS) to identify walking have done so in carefully controlled conditions. This study tested algorithms for identifying walking trips from accelerometer and GPS data in free-living conditions. The study also assessed the accuracy of the locations where walking occurred compared to what participants reported in a diary.
A convenience sample of high school females was recruited (N=42) in 2007. Participants wore a GPS unit and an accelerometer, and recorded their out-of-school travel for six days. Split-sample validation was used to examine agreement in the daily and total number of walking trips with Kappa statistics and count regression models, while agreement in locations visited by walking was examined with geographic information systems.
Agreement varied based on the parameters of the algorithm, with algorithms exhibiting moderate to substantial agreement with self-reported daily (Kappa = 0.33–0.48) and weekly (Kappa = 0.41–0.64) walking trips. Comparison of reported locations reached by walking and GPS data suggest that reported locations are accurate.
The use of GPS and accelerometers is promising for assessing the number of walking trips and the walking locations of adolescent females.
walking behavior; physical activity measurement; self-reports; youth
The United States National Physical Activity Plan (NPAP; 2010), the country’s first national plan for physical activity, provides strategies to increase population-level physical activity to complement the 2008 physical activity guidelines. This study examined state public health practitioner awareness, dissemination, use, challenges, and recommendations for the NPAP.
In 2011–2012, we interviewed 27 state practitioners from 25 states. Interviews were recorded and transcribed verbatim. Transcripts were coded using a standard protocol, verified and reconciled by an independent coder, and input into qualitative software to facilitate development of common themes.
NPAP awareness was high among state practitioners; dissemination to local constituents varied. Development of state-level strategies and goals was the most frequently reported use of the NPAP. Some respondents noted the usefulness of the NPAP for coalitions and local practitioners. Challenges to the plan included implementation cost, complexity, and consistency with other policies. The most frequent recommendation made was to directly link examples of implementation activities to the plan.
These results provide early evidence of NPAP dissemination and use, along with challenges encountered and suggestions for future iterations. Public health is one of eight sectors in the NPAP. Further efforts are needed to understand uptake and use by other sectors, as well as to monitor long-term relevance, progress, and collaboration across sectors.
Evaluation; Intervention; National plan; Physical activity; Populations; Surveillance
We estimated the association between state policy changes and adolescent soda consumption and body mass index (BMI) percentile, overall and by race/ethnicity.
We obtained data on whether states required or recommended that schools prohibit junk food in vending machines, snack bars, concession stands, and parties from the 2000 and 2006 School Health Policies and Programs Study. We used linear mixed models to estimate the association between 2000-2006 policy changes and 2007 soda consumption and BMI percentile, as reported by 90730 students in 33 states and the District of Columbia in the Youth Risk Behavior Survey, and to test for racial/ethnic differences in the associations.
Policy changes targeting concession stands were associated with 0.09 fewer servings of soda per day among students (95% confidence interval [CI]=−0.17, −0.01); the association was more pronounced among non-Hispanic Blacks (0.19 fewer servings per day). Policy changes targeting parties were associated with 0.07 fewer servings per day (95% CI=−0.13, 0.00). Policy changes were not associated with BMI percentile in any group.
State policies targeting junk food in schools may reduce racial/ethnic disparities in adolescent soda consumption, but their impact appears to be too weak to reduce adolescent BMI percentile.
We examined the association between perceived neighborhood characteristics and transport and 2-year changes in accelerometer-determined nonschool MET-weighted moderate to vigorous physical activity (MW-MVPA) and sedentary behavior of adolescent girls. Reporting that children do not play outdoors in their neighborhood, that their neighborhood was well lit, and that there were trails in their neighborhood were each associated with significant decreases in nonschool MW-MVPA. None of the neighborhood or transportation measures was associated with changes in nonschool sedentary behavior. Further work is needed to understand the determinants of the decline in physical activity and the increase in sedentary behavior among adolescent girls.
environment; intervention; recreation; transportation; youth
The objective of this study was to document self-reported beliefs about physical activity and exercise among pregnant women.
The Pregnancy, Infection, and Nutrition (PIN3) Study asked 1306 pregnant women about beliefs regarding physical activity and exercise at 27-30 weeks' gestation.
While 78% of women agreed that most women can continue their regular exercise during pregnancy, fewer (68%) agreed that most women who never exercised could begin an exercise program during pregnancy. Most (89%) agreed that regular exercise was better than irregular exercise during pregnancy. While almost all women agreed with the benefits of light activity (98%), fewer agreed that there were benefits with moderate (73%) or vigorous exercise (13%). Differences in beliefs were most notable by educational level, race/ethnicity, and whether they participated in regular exercise during pregnancy.
Future studies can better elucidate the reasons behind the differences in beliefs, to explore whether cultural reasons are contributing to these differences and whether tailored messages would be more effective than general educational approaches.
This study provides information to create more successful interventions to help women understand concepts regarding the safety and benefits of physical activity during pregnancy.
pregnancy; exercise; recreational activity; beliefs; cohort; physical activity; recommendations
Locational data, logged on portable GPS units and matched with accelerometer data, was used to examine associations of the built environment with physical activity and sedentary behaviors of adolescent females. In a sample of 293 adolescent females ages 15 to 18 years old in Minneapolis and San Diego, the built environment around each GPS point and its corresponding sedentary, light, and moderate-to-vigorous intensity physical activity were examined using random intercept multinomial logistic regression models. The odds of higher physical activity intensity (3-level outcome: sedentary, light, MVPA) were higher in places with parks, schools, and high population density, during weekdays, and lower in places with more roads and food outlets. Understanding the places where physical activity and sedentary behaviors occur appears to be a promising strategy to clarify relationships and inform policy aimed at increasing physical activity and reducing sedentary behaviors.
built environment; adolescents; physical activity; accelerometer; GPS; sedentary behavior
Due to the inconsistent findings of prior studies, we explored the association of perceived safety and police-recorded crime measures with physical activity.
The study included 818 Chicago participants of the Multiethnic Study of Atherosclerosis 45 to 84 years of age. Questionnaire-assessed physical activity included a) transport walking; b) leisure walking; and c) non-walking leisure activities. Perceived safety was assessed through an interviewer-administered questionnaire. Police-recorded crime was assessed through 2-year counts of selected crimes (total and outdoor incivilities, criminal offenses, homicides) per 1000 population. Associations were examined using generalized estimating equation logistic regression models.
Perceiving a safer neighborhood was positively associated with transport walking and perceiving lower violence was associated with leisure walking. Those in the lowest tertile of total or outdoor incivilities were more likely to report transport walking. Models with both perceived safety and police-recorded measures of crime as independent variables had superior fit for both transport walking and leisure walking outcomes. Neither perceived safety nor police-recorded measures of crime were associated with non-walking leisure activity.
Perceived and police-recorded measures had independent associations with walking and both should be considered in assessing the impact of neighborhood crime on physical activity.
Crime; Environment; Geographic Information Systems; Leisure activities; Physical activity; Safety; Social environment; Walking
To test an original scale assessing perceived school climate for girls’ physical activity in middle school girls.
Confirmatory factor analysis (CFA) and structural equation modeling (SEM).
CFA retained 5 of 14 original items. A model with 2 correlated factors, perceptions about teachers’ and boys’ behaviors, respectively, fit the data well in both sixth and eighth graders. SEM detected a positive, significant direct association of the teacher factor, but not the boy factor, with girls’ self-reported physical activity.
School climate for girls’ physical activity is a measurable construct, and preliminary evidence suggests a relationship with physical activity.
adolescents; school; physical activity; exercise
Most studies on the local food environment have used secondary sources to describe the food environment, such as government food registries or commercial listings (e.g., Reference USA). Most of the studies exploring evidence for validity of secondary retail food data have used on-site verification and have not conducted analysis by data source (e.g., sensitivity of Reference USA) or by food outlet type (e.g., sensitivity of Reference USA for convenience stores). Few studies have explored the food environment in American Indian communities. To advance the science on measuring the food environment, we conducted direct, on-site observations of a wide range of food outlets in multiple American Indian communities, without a list guiding the field observations, and then compared our findings to several types of secondary data.
Food outlets located within seven State Designated Tribal Statistical Areas in North Carolina (NC) were gathered from online Yellow Pages, Reference USA, Dun & Bradstreet, local health departments, and the NC Department of Agriculture and Consumer Services. All TIGER/Line 2009 roads (>1,500 miles) were driven in six of the more rural tribal areas and, for the largest tribe, all roads in two of its cities were driven. Sensitivity, positive predictive value, concordance, and kappa statistics were calculated to compare secondary data sources to primary data.
699 food outlets were identified during primary data collection. Match rate for primary data and secondary data differed by type of food outlet observed, with the highest match rates found for grocery stores (97%), general merchandise stores (96%), and restaurants (91%). Reference USA exhibited almost perfect sensitivity (0.89). Local health department data had substantial sensitivity (0.66) and was almost perfect when focusing only on restaurants (0.91). Positive predictive value was substantial for Reference USA (0.67) and moderate for local health department data (0.49). Evidence for validity was comparatively lower for Dun & Bradstreet, online Yellow Pages, and the NC Department of Agriculture.
Secondary data sources both over- and under-represented the food environment; they were particularly problematic for identifying convenience stores and specialty markets. More attention is needed to improve the validity of existing data sources, especially for rural local food environments.
Food environment; Measurement; Ground-truth; Secondary data; Validity; American Indian; Rurality; Global Positioning Systems (GPS); Geographic Information Systems (GIS)
Postpartum women are at increased risk for developing depression, which can contribute to the ill health of the mother and her family. Previous research indicates that mothers who are physically active during leisure experience lower levels of postpartum depressive symptoms than do inactive mothers. The objective of this investigation was to examine the associations between total and domain-specific moderate to vigorous physical activity (MVPA) and depressive symptoms postpartum.
Data were obtained from 550 women who participated in the Pregnancy, Infection, and Nutrition (PIN) Postpartum Study, a prospective cohort of mothers who delivered liveborn infants from October 2002 to December 2005 in North Carolina. Three-month postpartum MVPA was investigated as a predictor of 12-month postpartum depressive symptoms.
Those who participated in MVPA had two times the odds of developing elevated depressive symptoms at 12 months postpartum than those with no MVPA (odds ratio [OR] 2.00, 95% confidence interval [CI] 0.71-6.75). Different associations were suggested when examining domain-specific MVPA. Those participating in adult and child care and indoor household MVPA at 3 months postpartum had more than double the odds of developing elevated depressive symptoms at 12 months postpartum (OR 2.66, 95% CI 1.03, 8.11 and OR 2.72, 95% CI 0.96-10.18, respectively). Work MVPA conferred a doubling of the odds (OR 1.95, 95% CI 0.46-7.13), but recreational and outdoor household MVPA showed no associations with depressive symptoms.
Associations between MVPA and depressive symptoms differed by domain among postpartum women. Future studies of postpartum depressive symptoms should explore reasons for differences in physical activity by domain.