Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2015

Open Access 01-12-2015 | Research article

Physical activity, depressed mood and pregnancy worries in European obese pregnant women: results from the DALI study

Authors: Linda de Wit, Judith G. M. Jelsma, Mireille N. M. van Poppel, Annick Bogaerts, David Simmons, Gernot Desoye, Rosa Corcoy, Alexandra Kautzky-Willer, Jürgen Harreiter, Andre van Assche, Roland Devlieger, Dirk Timmerman, David Hill, Peter Damm, Elisabeth R. Mathiesen, Ewa Wender-Ozegowska, Agnieszka Zawiejska, Pablo Rebollo, Annunziata Lapolla, Maria G. Dalfrà, Stefano Del Prato, Alessandra Bertolotto, Fidelma Dunne, Dorte M. Jensen, Liselotte Andersen, Frank J. Snoek

Published in: BMC Pregnancy and Childbirth | Issue 1/2015

Login to get access

Abstract

Background

The purpose of this study was to examine the association between mental health status (i.e. depressed mood and pregnancy-related worries) and objectively measured physical activity levels in obese pregnant women from seven European countries.

Methods

Baseline data from the vitamin D and lifestyle intervention for the prevention of gestational diabetes mellitus (DALI) study were used. Time spent in moderate-to-vigorous physical activity (MVPA) and sedentary behaviour was measured with accelerometers. Depressed mood was measured with the WHO well-being index (WHO-5) and pregnancy-related worries with the Cambridge Worry Scale (CWS). In addition, socio-demographic characteristics, lifestyle factors, and perceptions and attitude regarding weight management and physical activity were measured. Linear regression analyses were performed to assess the association of mental health status with MVPA and sedentary behaviour.

Results

A total of 98 obese pregnant women from Austria, Belgium, Ireland, Italy, Poland, Spain and the Netherlands were included. Women had a mean age of 31.6 ± 5.8 years, a pre-pregnancy BMI of 34.1 ± 4.3 kg/m2, and were on average 15.4 ± 2.8 weeks pregnant. WHO-5 scores indicative of depressed mood (<50) were reported by 27.1 % of the women and most frequently endorsed pregnancy-related worries pertained to own and the baby’s health. Women with good well-being spent 85 % more time in MVPA compared to women with a depressed mood (P = 0.03). No differences in MVPA levels were found for women with no, some, or many pregnancy worries. Depressed mood and pregnancy-related worries were not associated with sedentary behaviour.

Conclusions

These findings suggest that in pregnant women who are obese, a depressed mood, but not pregnancy-related worries, may be associated with less physical activity. The combined risk of poor mental health and low physical activity levels makes women vulnerable for pregnancy complications. Whether a depressed mood may be a barrier for improving physical activity warrants further study.
Literature
1.
Han S, Middleton P, Crowther CA. Exercise for pregnant women for preventing gestational diabetes mellitus. Cochrane Database Syst Rev. 2012;7, CD009021.PubMed
2.
Goodwin A, Astbury J, McMeeken J. Body image and psychological well-being in pregnancy. A comparison of exercisers and non-exercisers. Aust N Z J Obstet Gynaecol. 2000;40:442–7.CrossRefPubMed
3.
Artal R. Exercise: the alternative therapeutic intervention for gestational diabetes. Clin Obstet Gynecol. 2003;46:479–87.CrossRefPubMed
4.
Dye TD, Knox KL, Artal R, Aubry RH, Wojtowycz MA. Physical activity, obesity, and diabetes in pregnancy. Am J Epidemiol. 1997;146:961–5.CrossRefPubMed
5.
Claesson IM, Klein S, Sydsjo G, Josefsson A. Physical activity and psychological well-being in obese pregnant and postpartum women attending a weight-gain restriction programme. Midwifery. 2014;30:11–6.CrossRefPubMed
6.
Downs DS, DiNallo JM, Kirner TL. Determinants of pregnancy and postpartum depression: prospective influences of depressive symptoms, body image satisfaction, and exercise behavior. Ann Behav Med. 2008;36:54–63.CrossRefPubMed
7.
Demissie Z, Siega-Riz AM, Evenson KR, Herring AH, Dole N, Gaynes BN. Physical activity and depressive symptoms among pregnant women: the PIN3 study. Arch Womens Ment Health. 2011;14:145–57.CrossRefPubMed
8.
Poudevigne MS, O’Connor PJ. Physical activity and mood during pregnancy. Med Sci Sports Exerc. 2005;37:1374–80.CrossRefPubMed
9.
Artal R, O’Toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br J Sports Med. 2003;37:6–12.CrossRefPubMedPubMedCentral
10.
Petersen AM, Leet TL, Brownson RC. Correlates of physical activity among pregnant women in the United States. Med Sci Sports Exerc. 2005;37:1748–53.CrossRefPubMed
11.
Althuizen E, van Poppel MN, Seidell JC, van Mechelen W. Correlates of absolute and excessive weight gain during pregnancy. J Womens Health (Larchmt). 2009;18:1559–66.CrossRef
12.
Amezcua-Prieto C, Olmedo-Requena R, Jimenez-Mejias E, Hurtado-Sanchez F, Mozas-Moreno J, Lardelli-Claret P, et al. Changes in leisure time physical activity during pregnancy compared to the prior year. Matern Child Health J. 2013;17:632–8.CrossRefPubMed
13.
Kulie T, Slattengren A, Redmer J, Counts H, Eglash A, Schrager S. Obesity and women’s health: an evidence-based review. J Am Board Fam Med. 2011;24:75–85.CrossRefPubMed
14.
Heslehurst N, Simpson H, Ells LJ, Rankin J, Wilkinson J, Lang R, et al. The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis. Obes Rev. 2008;9:635–83.CrossRefPubMed
15.
Stuebe AM, Oken E, Gillman MW. Associations of diet and physical activity during pregnancy with risk for excessive gestational weight gain. Am J Obstet Gynecol. 2009;201:58.PubMedPubMedCentral
16.
Tobias DK, Zhang C, van Dam RM, Bowers K, Hu FB. Physical activity before and during pregnancy and risk of gestational diabetes mellitus: a meta-analysis. Diabetes Care. 2011;34:223–9.CrossRefPubMed
17.
Weir Z, Bush J, Robson SC, McParlin C, Rankin J, Bell R. Physical activity in pregnancy: a qualitative study of the beliefs of overweight and obese pregnant women. BMC Pregnancy Childbirth. 2010;10:18.CrossRefPubMedPubMedCentral
18.
Poudevigne MS, O’Connor PJ. A review of physical activity patterns in pregnant women and their relationship to psychological health. Sports Med. 2006;36:19–38.CrossRefPubMed
19.
van Gool CH, Kempen GI, Bosma H, van Boxtel MP, Jolles J, van Eijk JT. Associations between lifestyle and depressed mood: longitudinal results from the Maastricht aging study. Am J Public Health. 2007;97:887–94.CrossRefPubMedPubMedCentral
20.
Penedo FJ, Dahn JR. Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Curr Opin Psychiatry. 2005;18:189–93.CrossRefPubMed
21.
Cooney GM, Dwan K, Greig CA, Lawlor DA, Rimer J, Waugh FR, et al. Exercise for depression. Cochrane Database Syst Rev. 2013;9, CD004366.PubMed
22.
Williams A, Reilly T, Campbell I, Sutherst J. Investigation of changes in responses to exercise and in mood during pregnancy. Ergonomics. 1988;31:1539–49.CrossRefPubMed
23.
Da Costa D, Rippen N, Dritsa M, Ring A. Self-reported leisure-time physical activity during pregnancy and relationship to psychological well-being. J Psychosom Obstet Gynaecol. 2003;24:111–9.CrossRefPubMed
24.
Amador N, Juarez JM, Guizar JM, Linares B. Quality of life in obese pregnant women: a longitudinal study. Am J Obstet Gynecol. 2008;198:203–5.CrossRefPubMed
25.
Molyneaux E, Poston L, Ashurst-Williams S, Howard LM. Obesity and mental disorders during pregnancy and postpartum: a systematic review and meta-analysis. Obstet Gynecol. 2014;123:857–67.CrossRefPubMedPubMedCentral
26.
Furber CM, McGowan L. A qualitative study of the experiences of women who are obese and pregnant in the UK. Midwifery. 2011;27:437–44.CrossRefPubMed
27.
28.
Green JM, Kafetsios K, Statham HE, Snowdon CM. Factor structure, validity and reliability of the Cambridge Worry Scale in a pregnant population. J Health Psychol. 2003;8:753–64.CrossRefPubMed
29.
30.
Alder J, Fink N, Bitzer J, Hosli I, Holzgreve W. Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med. 2007;20:189–209.CrossRefPubMed
31.
Hegaard HK, Kjaergaard H, Damm PP, Petersson K, Dykes AK. Experiences of physical activity during pregnancy in Danish nulliparous women with a physically active life before pregnancy. A qualitative study. BMC Pregnancy Childbirth. 2010;10:33.CrossRefPubMedPubMedCentral
32.
Jelsma JG, van Poppel MN, Galjaard S, Desoye G, Corcoy R, Devlieger R, et al. DALI: Vitamin D and lifestyle intervention for gestational diabetes mellitus (GDM) prevention: an European multicentre, randomised trial - study protocol. BMC Pregnancy Childbirth. 2013;13:142.CrossRefPubMedPubMedCentral
33.
Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PA, Damm P, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010;33:676–82.CrossRefPubMed
34.
Lee KY, Macfarlane DJ, Cerin E. Comparison of three models of actigraph accelerometers during free living and controlled laboratory conditions. Eur J Sport Sci. 2013;13:332–9.CrossRefPubMed
35.
Sasaki JE, John D, Freedson PS. Validation and comparison of ActiGraph activity monitors. J Sci Med Sport. 2011;14:411–6.CrossRefPubMed
36.
Kelly LA, McMillan DG, Anderson A, Fippinger M, Fillerup G, Rider J. Validity of actigraphs uniaxial and triaxial accelerometers for assessment of physical activity in adults in laboratory conditions. BMC Med Phys. 2013;13:5.CrossRefPubMedPubMedCentral
37.
Trost SG, McIver KL, Pate RR. Conducting accelerometer-based activity assessments in field-based research. Med Sci Sports Exerc. 2005;37:S531–43.CrossRefPubMed
38.
39.
Freedson PS, Melanson E, Sirard J. Calibration of the Computer Science and Applications, Inc. accelerometer. Med Sci Sports Exerc. 1998;30:777–81.CrossRefPubMed
40.
McParlin C, Robson SC, Tennant PW, Besson H, Rankin J, Adamson AJ, et al. Objectively measured physical activity during pregnancy: a study in obese and overweight women. BMC Pregnancy Childbirth. 2010;10:76.CrossRefPubMedPubMedCentral
41.
Ainsworth BE, Haskell WL, Herrmann SD, Meckes N, Bassett Jr DR, Tudor-Locke C, et al. Compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011;2011(43):1575–81.CrossRef
42.
Esliger DW, Copeland JL, Barnes JD, Tremblay MS. Standardizing and optimizing the use of accelerometer data for free-living physical activity monitoring. J Phys Act Health. 2005;3:366–83.CrossRef
43.
Lowe B, Spitzer RL, Grafe K, Kroenke K, Quenter A, Zipfel S, et al. Comparative validity of three screening questionnaires for DSM-IV depressive disorders and physicians’ diagnoses. J Affect Disord. 2004;78:131–40.CrossRefPubMed
44.
Hajos TR, Pouwer F, Skovlund SE, Den Oudsten BL, Geelhoed-Duijvestijn PH, Tack CJ, et al. Psychometric and screening properties of the WHO-5 well-being index in adult outpatients with Type 1 or Type 2 diabetes mellitus. Diabet Med. 2013;30:e63–9.CrossRefPubMed
45.
Schwarzer R, Lippke S, Luszczynska A. Mechanisms of health behavior change in persons with chronic illness or disability: the Health Action Process Approach (HAPA). Rehabil Psychol. 2011;56:161–70.CrossRefPubMed
46.
47.
Plasqui G, Bonomi AG, Westerterp KR. Daily physical activity assessment with accelerometers: new insights and validation studies. Obes Rev. 2013;14:451–62.CrossRefPubMed
48.
Claesson IM, Josefsson A, Sydsjo G. Prevalence of anxiety and depressive symptoms among obese pregnant and postpartum women: an intervention study. BMC Public Health. 2010;10:766.CrossRefPubMedPubMedCentral
49.
Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782–6.CrossRefPubMed
50.
Pottinger AM, Trotman-Edwards H, Younger N. Detecting depression during pregnancy and associated lifestyle practices and concerns among women in a hospital-based obstetric clinic in Jamaica. Gen Hosp Psychiatry. 2009;31:254–61.CrossRefPubMed
51.
Foxcroft KF, Rowlands IJ, Byrne NM, McIntyre HD, Callaway LK. Exercise in obese pregnant women: the role of social factors, lifestyle and pregnancy symptoms. BMC Pregnancy Childbirth. 2011;11:4.CrossRefPubMed
52.
Kinnunen TI, Tennant PW, McParlin C, Poston L, Robson SC, Bell R. Agreement between pedometer and accelerometer in measuring physical activity in overweight and obese pregnant women. BMC Public Health. 2011;11:501.CrossRefPubMedPubMedCentral
53.
Connolly CP, Coe DP, Kendrick JM, Bassett Jr DR, Thompson DL. Accuracy of physical activity monitors in pregnant women. Med Sci Sports Exerc. 2011;43:1100–5.CrossRefPubMed
Metadata
Title
Physical activity, depressed mood and pregnancy worries in European obese pregnant women: results from the DALI study
Authors
Linda de Wit
Judith G. M. Jelsma
Mireille N. M. van Poppel
Annick Bogaerts
David Simmons
Gernot Desoye
Rosa Corcoy
Alexandra Kautzky-Willer
Jürgen Harreiter
Andre van Assche
Roland Devlieger
Dirk Timmerman
David Hill
Peter Damm
Elisabeth R. Mathiesen
Ewa Wender-Ozegowska
Agnieszka Zawiejska
Pablo Rebollo
Annunziata Lapolla
Maria G. Dalfrà
Stefano Del Prato
Alessandra Bertolotto
Fidelma Dunne
Dorte M. Jensen
Liselotte Andersen
Frank J. Snoek
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2015
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-015-0595-z

Other articles of this Issue 1/2015

BMC Pregnancy and Childbirth 1/2015 Go to the issue

Research article

Screening for iron deficiency and iron deficiency anaemia in pregnancy: a structured review and gap analysis against UK national screening criteria

Research article

Reproductive healthcare utilization in urban poor settlements of Delhi: Baseline survey of ANCHUL (Ante Natal and Child Health care in Urban Slums) project

Research article

A cross-sectional analysis of perinatal depressive symptoms among Punjabi-speaking women: are they at risk?

Research article

Two sides of the same coin – an interview study of Swedish obstetricians’ experiences using ultrasound in pregnancy management

Case report

What should we do to optimise outcome in twin pregnancy complicated with placenta percreta? A case report

Research article

Barriers and facilitators related to use of prenatal care by inner-city women: perceptions of health care providers