A newly published study found that pregnant women whose exercise routines were disrupted by the COVID-19 pandemic reported significantly higher depression scores than those whose routines did not change. In this Q&A, researchers Theresa Gildner, PhD, MA, and Zaneta Thayer, PhD, explain the impetus for the research, details of the findings, and their clinical significance as the pandemic continues.
Q: What led you and your colleagues to research the link between exercise routines and depression scores in pregnant women during the COVID-19 pandemic?
A: We started the COVID-19 and Reproductive Effects (CARE) Study in April 2020 to investigate how the COVID-19 pandemic has affected the well-being of pregnant women living in the United States. One outcome of particular interest is depression, since pregnant women experience an increased risk of depression, compared with the general public. We were primarily interested in understanding how pandemic-associated disruptions to daily life have impacted mental health among pregnant women in the US.
The pandemic has affected many aspects of daily life, but in this study we focused specifically on pandemic-related exercise disruptions. Moderate exercise is recommended during pregnancy to support both physical and mental health. But regular exercise routines have likely been affected by the pandemic, especially for those living in densely populated areas where space to exercise safely indoors or outdoors is limited. We therefore tested whether exercise disruptions were associated with higher depression symptom scores, and whether this varied according to living in a metropolitan or nonmetropolitan area.
Q: Please briefly describe the study method and your key finding(s).
A: To test whether exercise disruptions were linked with depression scores, we used data from an online survey of 1862 pregnant women in the United States. Participants were recruited April-June 2020 on social media platforms (eg, Facebook and Twitter) and via contacts working in maternity care and public health. Depression symptoms were screened using the Edinburgh Postnatal Depression Scale (EPDS), the gold standard for measuring maternal depression. Participants were also asked “has your exercise routine changed at all since the COVID-19 pandemic began?”. Finally, we collected ZIP code data so we could assess whether location influenced the likelihood of exercise disruption; specifically, we used the ZIP code information to determine each participant’s Rural-Urban Continuum Code (ie, a classification of “metro” or “nonmetro” based on population size in the given ZIP code).
We found that women who reported exercise changes during the pandemic exhibited significantly higher depression scores, compared with those reporting no changes. Moreover, individuals living in metro areas of all sizes were approximately 2 times more likely to report exercise changes as women living in nonmetro areas.
Q: Were any of the outcomes particularly surprising?
A: We thought participants might report walking more as an alternative form of exercise during the pandemic. While we didn’t ask about this explicitly, respondents were asked to describe how their exercise routines had changed and only a handful of women reported that they were walking more now. Rather, a high percentage of participants (47.2%) stated they were exercising less following the onset of the pandemic. Several respondents stated that they were not comfortable going outside to walk during the pandemic, especially those in metropolitan areas.