Reduction in physical activity significantly increases depression and anxiety in the perinatal period: a longitudinal study based on a self-report digital assessment tool

Arch Gynecol Obstet. 2020 Jul;302(1):53-64. doi: 10.1007/s00404-020-05570-x. Epub 2020 May 5.


Purpose: Physical activity can reduce pregnancy-related complications and contributes substantially to improving maternal mental health. A reduction in activity encompassing exercise and daily household tasks throughout the course of pregnancy increases the risk of depression and anxiety. The following research examines the longitudinal interaction between exercise, general physical activity, and mental health outcomes in pregnant women.

Methods: This prospective longitudinal study was conducted at the maternity departments of two major university hospitals in Germany. Self-reported data of 597 women were digitally assessed every 4 weeks from the second trimester until birth as well as 3 and 6 months postnatally. Depressive and anxiety symptoms were assessed using the EPDS, PRAQ, and STAI and physical activity levels were measured using the PPAQ questionnaire. Cross-sectional and longitudinal analyses using Pearson's correlation coefficient and multiple regression models were conducted.

Results: We found a significant reduction in general physical activity in the period from the 20th to 32nd gestational week. Women who reported a greater decline during pregnancy showed significantly higher depression and anxiety scores. In stratified analyses, only baseline mental health scores proved to be variables with stronger impact on postnatal depression and anxiety outcomes.

Conclusion: General physical activity and maternal mental health significantly influence each other during and after pregnancy. Both physical activity and the prevention of perinatal mental disorders should be systematically encouraged during perinatal care to prevent adverse maternal and fetal birth outcomes.

Keywords: Birth anxiety depression; Maternal mental health; Physical activity; Postnatal; Prenatal.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety / diagnosis
  • Anxiety / epidemiology*
  • Anxiety / psychology
  • Cross-Sectional Studies
  • Depression / diagnosis
  • Depression / epidemiology*
  • Depression / psychology
  • Depression, Postpartum / diagnosis
  • Exercise / psychology*
  • Female
  • Germany / epidemiology
  • Humans
  • Longitudinal Studies
  • Mental Health / statistics & numerical data*
  • Pregnancy
  • Pregnancy Complications / psychology
  • Pregnant Women / psychology*
  • Prenatal Care
  • Prospective Studies
  • Self Report
  • Self-Assessment