@article{6b0fd13b777240b1bb9f3528fde07276,
title = "Impact of sedentary behavior and emotional support on prenatal psychological distress and birth outcomes during the COVID-19 pandemic",
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.",
keywords = "Birth outcomes, depression, pandemic, pregnancy, stress",
author = "Hipwell, {Alison E.} and Irene Tung and Phillip Sherlock and Xiaodan Tang and Kim Mckee and Monica Mcgrath and Akram Alshawabkeh and Tracy Bastain and Breton, {Carrie V.} and Whitney Cowell and Dana Dabelea and Duarte, {Cristiane S.} and Dunlop, {Anne L.} and Assiamira Ferrera and Herbstman, {Julie B.} and Hockett, {Christine W.} and Karagas, {Margaret R.} and Kate Keenan and Krafty, {Robert T.} and Catherine Monk and Nozadi, {Sara S.} and O'connor, {Thomas G.} and Emily Oken and Osmundson, {Sarah S.} and Susan Schantz and Rosalind Wright and Comstock, {Sarah S.}",
note = "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). The authors wish to thank our ECHO colleagues; the medical, nursing and program staff, and the children and families participating in the ECHO cohorts. We also acknowledge the contribution of the following ECHO program collaborators: ECHO Components - Coordinating Center: Duke Clinical Research Institute, Durham, North Carolina: Smith PB, Newby KL. Data Analysis Center: Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland: Jacobson LP: Research Triangle Institute, Durham, North Carolina: Parker CB. Person-Reported Outcomes Core: Northwestern University, Evanston, Illinois: Gershon R, Cella D. Pediatric Cohorts: Northeastern University, Boston, Massachusetts: Alshawabkeh AN, University of Southern California, Los Angeles: Breton CV, Bastain T, Farzan S, Habre R, Memorial Hospital of Rhode Island, Pawtucket: Deoni S, D Sa VA, University of Colorado Denver, Denver, CO: Dabelea D, New York State Psychiatric Institute at Columbia University, New York: Duarte CS, Canino GJ, Monk CE, Posner JE, Emory University, Atlanta, Georgia: Dunlop AL, Brennan PA, Corwin EJ, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota: Elliott AJ, Kaiser Permanente, Oakland, California: Ferrara A, Croen LA, University of Wisconsin- Madison: Gern J, Columbia University Medical Center, New York, NY: Herbstman J, University of Pittsburgh, Pennsylvania: Hipwell AE, Keenan KE, Dartmouth College, Hanover, New Hampshire: Karagas MR, University of Rochester, New York: O Connor TG, Buss C, Miller RK, Simhan H, Wadhwa PD, Michigan State University, East Lansing, Michigan: Paneth N, Kerver JM, Ruden DM, University of Illinois, Urbana: Schantz SL, and Icahn School of Medicine at Mount Sinai, New York, New York: Wright RJ, Wright RO. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. 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).",
year = "2023",
month = oct,
day = "8",
doi = "10.1017/S0033291723000314",
language = "English (US)",
volume = "53",
pages = "6792--6805",
journal = "Psychological Medicine",
issn = "0033-2917",
publisher = "Cambridge University Press",
number = "14",
}