Physical activity during early pregnancy and antenatal depression: A prospective cohort study

Background: Despite the known health benefits of physical activity, its impact on depression during pregnancy remains inconclusive, especially in Asian populations. A large prospective cohort study was conducted to ascertain the association between total and domain-specific physical activity during early pregnancy and antenatal depression in Chinese women. Methods: Information was collected prospectively from a cohort of 1440 pregnant women in Chengdu, Western China. Habitual physical activities (total, domain-specific and intensity level) were measured by the validated Chinese version of the Pregnancy Physical Activity Questionnaire during the first trimester. Antenatal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS) at 32-37 weeks of gestation. Multivariable linear and logistic regression analyses were undertaken, modelling EPDS as both continuous score and binary variable, respectively. Results: Overall, the mean EPDS score was 9.3 (SD 3.7) and the prevalence of antenatal depression (EPDS >= 13) was 17.5% (n = 252). The mean total physical activity was 149.1 (SD 84.2) MET-hours/week. A high level of occupational activity ( > 73 MET-hours/week) was associated with a reduced risk of antenatal depression (odds ratio 0.57; 95% CI 0.37 to 0.94). A similar inverse association was evident for the continuous EPDS score. However, no apparent associations with EPDS were observed for total, other domains and intensities of physical activity exposures. Limitations: Lack of information on history of major depression. Use of self-reported questionnaires instead of objective measures of physical activity and clinical diagnosis of antenatal depression. Conclusions: Being active at work during early pregnancy may reduce antenatal depressive symptoms for Chinese women.