Association Of Accelerometer-derived Physical Activity And Sleep Measures With Depressive Symptoms And Anxiety During Pregnancy

PURPOSE: To investigate the predictive relationship between depressive and anxiety symptoms in the second trimester of pregnancy and physical activity and sleep parameters in the third trimester of pregnancy. METHODS: This multicenter prospective study was a part of the Japan Pregnancy Eating and Activity Cohort and recruited participants from three regions of Japan: Yamagata, Tokyo, and Fukuoka. Second-trimester maternal physical activity data and sleep data (with the ACCEL algorithm) were objectively collected through waist-worn and arm-worn accelerometers, respectively. The subjective physical activity and sleep data were collected through validated scales and 7-day diaries. The outcome measures, third-trimester maternal depressive symptoms, and anxiety were examined using the Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder-7 (GAD-7) scale. Between-group differences for the two groups based on the presence or absence of depressive symptoms and anxiety were examined. RESULTS: Out of 180 consented participants, 165 completed the accelerometer measurements. A total of 129 women with valid accelerometer measurement data of at least three days were included in the analysis. Second-trimester subjective sleep duration <6 hours (OR [95% confidence interval]: 21.1 [2.38-186.25]), a higher proportion of days feeling tired on waking (6.63 [1.34-32.85]), a higher proportion of days falling asleep latency >30 min (5.98 [1.07-33.51]), objective sleep onset time after midnight (5.51 [1.21-25.06]) and a higher inter-day variation in waking time (13.73 [2.29-82.31]) were significant predictors of third-trimester pregnancy depressive symptoms. However, second-trimester physical activity was not a predictor of third-trimester depressive symptoms. Moreover, neither sleep nor physical activity in mid-pregnancy was associated with anxiety in late pregnancy. CONCLUSIONS: The results suggest that second-trimester pregnancy sleep indicators predict depressive symptoms in third-trimester pregnancy. The findings of physical activity on anxiety and depressive symptoms should be further investigated with larger sample sizes. Supported by: The JSPS KAKENHI Grant Numbers 19H03940, 19 K22741, 22H03399, 23 K24657, 24 K23710