Impact of sedentary behavior and emotional support on prenatal psychological distress and birth outcomes during the COVID-19 pandemic

• Type of Material: Article
• Authors: Alison E. Hipwell, University of Pittsburgh; Irene Tung, California State University Dominguez Hills; Phillip Sherlock, Northwestern University; Xiaodan Tang, Northwestern University; Kim McKee, University of Michigan, Ann Arbor; Monica McGrath, Johns Hopkins University; Akram Alshawabkeh, Northeastern University; Tracy Bastain, University of Southern California; Carrie v. Breton, University of Southern California; Whitney Cowell, New York University; Dana Dabelea, University of Colorado, Aurora; Cristiane S, Duarte, Columbia University; Anne Lang Dunlop, Emory University; Assiamira Ferrera, Kaiser Permanente Northern California; Julie B. Herbstman, Columbia University; Christine W. Hockett, University of South Dakota; Margaret R. Karagas, Dartmouth College; Kate Keenan, University of Chicago; Robert T. Krafty, Emory University; Catherine Monk, Columbia University; Sara S. Nozadi, University of New Mexico, Albuquerque; Thomas g. O'Connor, University of Rochester; Emily Oken, Harvard University; Sarah S. Osmundson, Vanderbilt University; Susan Schantz, Beckman Institute for Advanced Science and Technology; Rosalind Wright, Icahn School of Medicine at Mount Sinai; Sarah S. Comstock, Michigan State University
• Language: English
• Date: 2023-03-08
• Publisher: Cambridge University Press
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2023
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): https://doi.org/10.1017%2FS0033291723000314
• Title of Journal or Parent Work: Psychological Medicine
• Volume: 53
• Issue: 14
• Start Page: 6792
• End Page: 6805
• Grant/Funding Information: Research reported in this publication was supported by the Environmental influences on Child Health Outcomes (ECHO) program, Office of the Director, National Institutes of Health, under Award Numbers U2COD023375 (Coordinating Center), U24OD023382 (Data Analysis Center), U24OD023319 (PRO Core) and UH3OD023251, UH3OD023287, UH3OD023313, UH3OD023248, UH3OD023328, UH3OD023318, UH3OD023279, UH3OD023289, UH3OD023282, UH3OD023290, UH3OD023244, UH3OD023275, UH3OD023349, UH3OD023285, UH3OD023272 and UH3OD023337 (Pediatric Cohorts).
• Keywords: pregnancy; depression; stress; pandemic; Birth outcomes
• Research Categories: Health Sciences, Obstetrics and Gynecology; Health Sciences, Public Health

Abstract

Background Studies have reported mixed findings regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on pregnant women and birth outcomes. This study used a quasi-experimental design to account for potential confounding by sociodemographic characteristics. Methods Data were drawn from 16 prenatal cohorts participating in the Environmental influences on Child Health Outcomes (ECHO) program. Women exposed to the pandemic (delivered between 12 March 2020 and 30 May 2021) (n = 501) were propensity-score matched on maternal age, race and ethnicity, and child assigned sex at birth with 501 women who delivered before 11 March 2020. Participants reported on perceived stress, depressive symptoms, sedentary behavior, and emotional support during pregnancy. Infant gestational age (GA) at birth and birthweight were gathered from medical record abstraction or maternal report. Results After adjusting for propensity matching and covariates (maternal education, public assistance, employment status, prepregnancy body mass index), results showed a small effect of pandemic exposure on shorter GA at birth, but no effect on birthweight adjusted for GA. Women who were pregnant during the pandemic reported higher levels of prenatal stress and depressive symptoms, but neither mediated the association between pandemic exposure and GA. Sedentary behavior and emotional support were each associated with prenatal stress and depressive symptoms in opposite directions, but no moderation effects were revealed. Conclusions There was no strong evidence for an association between pandemic exposure and adverse birth outcomes. Furthermore, results highlight the importance of reducing maternal sedentary behavior and encouraging emotional support for optimizing maternal health regardless of pandemic conditions.