(1079) The Impact of Physical Activity During Pregnancy on Peripartum Depression

Objective: Physical activity during pregnancy reduces perinatal depression in low risk patients, however, its effect in patients with medical co-morbidities is not known. We aimed to evaluate this association.

Study Design: Retrospective cohort of patients included in the Nulliparous Pregnancy Outcomes Study Monitoring Mothers-to-Be with ≥1 medical comorbidity (Table footnote). Activity logs reporting type and amount of activity for the previous month were completed at 3 study visits: 6.0-13.6, 14.0-21.6, and 22.0-29.6 weeks. Patients were characterized based on if they met ACOG recommendation of 150 minutes of moderate or 75 minutes of vigorous activity per week averaged across all visits (active versus not active). The primary outcome was EPDS score >10 (indicating perinatal depression) at visit 3. Secondary outcomes included change in EPDS score between visit 1 and 3, treatment for depression, and perinatal outcomes. Outcomes were compared between groups and multivariable logistic regression was used to adjust for covariates.

Results: Overall, 7,486 patients were included, 4092 (55%) were active and 3394 (45%) were not active during pregnancy. History and treatment of mental health disorder before pregnancy, chronic hypertension, and pregestational diabetes were less common in those who were active compared to those who were not. EPDS score >10 was 15% less likely in those who were active compared to those who were not (aOR 0.85 [95% CI 0.72-0.99]; Table). The average change in EPDS score from visit 1 to 3, treatment for perinatal depression, and adverse perinatal outcomes including preterm birth and SGA did not differ by activity (Table).

Conclusion: Patients with medical co-morbidities who were active during pregnancy had lower odds of depression than those who were not active. Treatment of perinatal depression did not differ between groups, however there was not an increase in adverse perinatal outcomes with physical activity. Prospective studies are needed to evaluate the potential benefits of physical activity during pregnancy for perinatal depression in patients with medical co-morbidities.