Sedentary Behavior Intervention During Pregnancy Does Not Impact Measures Of Psychological Wellbeing

PURPOSE: Moderate-to-vigorous intensity physical activity in pregnancy positively impacts psychological wellbeing, but the effect of reducing sedentary time is less clear. We describe the effect of a pregnancy sedentary behavior reduction intervention on psychological wellbeing including depressive symptoms, perceived stress, and mood disturbance. METHODS: The Sedentary Behavior Reduction in Pregnancy Intervention (SPRING) randomized pilot trial aimed to reduce sitting time and increase daily standing and steps across pregnancy. Participants in the 1st trimester were allocated 2:1 to a multi-level behavioral intervention (n = 33, mean + SD age 31.8 + 4.76 years) or usual care control (n = 16, 32.0 + 3.18 years). Participants completed the Centers for Epidemiology Depression Scale (CESD-10, range 0-30), the Perceived Stress Scale (PSS, range 0-40), and total mood disturbance (TMD) from the Profile of Mood States (range -44 - 116) once in each trimester with higher scores indicating worse outcomes. Linear mixed effects models accounting for baseline score and trimester examined the effect of the intervention on each outcome after randomization. Cohen’s d effect sizes evaluated clinical meaningfulness. RESULTS: SPRING reduced prolonged sedentary behavior by 1.05 hours per day (p = 0.019), replacing it with light-intensity activities. No significant effect of intervention vs. control was found in any psychological outcome across three trimesters of pregnancy with small effect sizes (see Table). Combining groups, mean CESD and TMD were within normal limits, decreasing in the 2nd trimester and rebounding in the 3rd. PSS was stable and indicated moderate stress. CONCLUSION: Sedentary behavior reduction did not significantly impact psychological wellbeing outcomes during pregnancy. Small effect sizes indicating improved depressive symptoms and perceived stress in this pilot intervention suggest that modest benefits might be observed in a larger sample. - Psychological Wellbeing across Pregnancy comparing Intervention (n = 33) to Control (n = 16) First Trimester (baseline) Second Trimester (follow-up) Third Trimester (follow-up) Estimate (SE) p-value Cohen’s d CESD-10 -0.60 (1.28) 0.64 -0.14 Intervention 8.6 + 4.72 7.7 + 5.78 8.9 + 5.76 Control 7.6 + 3.24 7.9 + 4.19 8.2 + 5.50 Total 8.2 + 4.22 7.7 + 5.25 8.6 + 5.61 PSS -0.76 (1.63) 0.64 -0.15 Intervention 15.3 + 5.53 14.6 + 5.75 14.8 + 6.30 Control 13.6 + 4.60 15.4 + 4.67 14.9 + 6.32 Total 14.7 + 5.16 14.7 + 5.40 14.8 + 6.23 TMD 0.33 (4.42) 0.94 0.03 Intervention 6.9 + 12.19 5.5 + 17.56 10.1 + 18.63 Control 7.6 + 11.12 7.2 + 17.95 7.2 + 17.95 Total 6.9 + 11.66 5.6 + 17.62 9.3 + 17.13 AHA 20TPA35490099