Examining the Impact of Body Satisfaction and Physical Activity Change on Postpartum Depressive Symptoms

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Rebecca A. Schlaff
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Meghan Baruth
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Faith C. LaFramboise
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Samantha J. Deere
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Background: Relationships among moderate to vigorous physical activity (MVPA), body satisfaction, and postpartum depressive symptoms are not well understood. The purpose of this study is to examine the (1) impact of postpartum body satisfaction and changes in MVPA on postpartum depressive symptoms and (2) moderating effect of changes in MVPA over time on the relationship between postpartum body satisfaction and depressive symptoms. Methods: Participants (N = 269) self-reported body satisfaction, MVPA (prepregnancy through postpartum), and postpartum depressive symptoms. Differences in MVPA at 3 time points (prepregnancy, third trimester, and postpartum) were calculated to create change scores. Main effects and interactions (body satisfaction × MVPA change) were examined using multiple regression. Results: A majority of the sample did not meet MVPA recommendations at all time points. All body satisfaction measures were inversely related to postpartum depressive symptoms (P = .01 to <.001). MVPA change did not predict postpartum depressive symptoms (P = .43–.90) or moderate the relationship between body satisfaction and postpartum depressive symptoms (P = .14–.94). Conclusions: Given the relationship between postpartum body satisfaction and depressive symptoms, intervention research should include strategies that promote positive postpartum body image; clinicians should consider screening for body dissatisfaction. Although not a predictor or moderator, pregnancy and postpartum MVPA promotion should continue, as it has numerous other benefits.

Schlaff and Baruth are with the Department of Health Science, Saginaw Valley State University, University Center, MI. LaFramboise and Deere are with the Department of Kinesiology, Saginaw Valley State University, University Center, MI.

Schlaff (raschlaf@svsu.edu) is corresponding author.
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  • 1.

    O’Hara MW, McCabe JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol. 2013;9:379407. doi:10.1146/annurev-clinpsy-050212-185612

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Patel M, Bailey RK, Jabeen S, Ali S, Barker NC, Osiezagha K. Postpartum depression: a review. J Health Care Poor Underserved. 2012;23(2):534542. PubMed ID: 22643605 doi:10.1353/hpu.2012.0037

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Ko JY, Rockhill KM, Tong VT, Morrow B, Farr SL. Trends in postpartum depressive symptoms—27 states, 2004, 2008, and 2012. MMWR Morb Mortal Wkly Rep. 2017;66(6):153158. PubMed ID: 28207685 doi:10.15585/mmwr.mm6606a1

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Hahn-Holbrook J, Cornwell-Hinrichs T, Anaya I. Economic and health predictors of national postpartum depression prevalence: a systematic review, meta-analysis, and meta-regression of 291 studies from 56 countries. Front Psychiatry. 2017;8:248. PubMed ID: 29449816 doi:10.3389/fpsyt.2017.00248

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Moshki M, Kharazmi A, Cheravi K, Beydokhti TB. The prediction of postpartum depression: the role of the PRECEDE model and health locus of control. J Family Med Prim Care. 2015;4(3):454460. PubMed ID: 26288792 doi:10.4103/2249-4863.161354

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Da Silva Tanganhito D, Bick D, Chang YS. Breastfeeding experiences and perspectives among women with postnatal depression: a qualitative evidence synthesis [published online ahead of print June 10, 2019]. Women Birth. PubMed ID: 31196830 doi:10.1016/j.wombi.2019.05.012

    • Search Google Scholar
    • Export Citation
  • 7.

    Balbierz A, Bodnar-Deren S, Wang JJ, Howell EA. Maternal depressive symptoms and parenting practices 3-months postpartum. Matern Child Health J. 2015;19(6):12121219. PubMed ID: 25374288 doi:10.1007/s10995-014-1625-6

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Craft LL, Perna FM. The benefits of exercise for the clinically depressed. Prim Care Companion J Clin Psychiatry. 2004;6(3):104111. PubMed ID: 15361924 doi:10.4088/PCC.v06n0301

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Goodwin RD. Association between physical activity and mental disorders among adults in the United States. Prev Med. 2003;36(6):698703. PubMed ID: 12744913 doi:10.1016/S0091-7435(03)00042-2

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Kolomanska D, Zarawski M, Mazur-Bialy A. Physical activity and depressive disorders in pregnant women—a systematic review. Medicina. 2019;55(5):212. doi:10.3390/medicina55050212

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Downs DS, DiNallo JM, Kirner TL. Determinants of pregnancy and postpartum depression: prospective influences of depressive symptoms, body image satisfaction, and exercise behavior. Ann Behav Med. 2008;36(1):5463. PubMed ID: 18773252 doi:10.1007/s12160-008-9044-9

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Howell EA, Bodnar-Deren S, Balbierz A, et al. An intervention to reduce postpartum depressive symptoms: a randomized controlled trial. Arch Womens Ment Health. 2014;17(1):5763. PubMed ID: 24019052 doi:10.1007/s00737-013-0381-8

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Demissie Z, Siega-Riz AM, Evenson KR, Herring AH, Dole N, Gaynes BN. Associations between physical activity and postpartum depressive symptoms. J Womens Health. 2011;20(7):10251034. doi:10.1089/jwh.2010.2091

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Daley A, Jolly K, MacArthur C. The effectiveness of exercise in the management of post-natal depression: systematic review and meta-analysis. Fam Pract. 2009;26(2):154162. PubMed ID: 19126829 doi:10.1093/fampra/cmn101

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    US Department of Health and Human Services. U.S. physical activity guidelines for Americans. 2008. http://www.health.gov/paguidelines. Accessed from October 2, 2018.

    • Search Google Scholar
    • Export Citation
  • 16.

    Evenson KR, Moos MK, Carrier K, Siega-Riz AM. Perceived barriers to physical activity among pregnant women. Matern Child Health J. 2009;13(3):364375. PubMed ID: 18478322 doi:10.1007/s10995-008-0359-8

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Evenson KR, Wen F. National trends in self-reported physical activity and sedentary behaviors among pregnant women: NHANES 1999–2006. Prev Med. 2010;50(3):123128. PubMed ID: 20053370 doi:10.1016/j.ypmed.2009.12.015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Coker E, Abraham S. Body weight dissatisfaction before, during and after pregnancy: a comparison of women with and without eating disorders. Eat Weight Disord. 2015;20(1):7179. PubMed ID: 24906550 doi:10.1007/s40519-014-0133-4

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Fuller-Tyszkiewicz M, Skouteris H, Watson BE, Hill B. Body dissatisfaction during pregnancy: a systematic review of cross-sectional and prospective correlates. J Health Psychol. 2013;18(11):14111421. PubMed ID: 23188921 doi:10.1177/1359105312462437

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Meireles JF, Neves CM, de Carvalho PH, Ferreira ME. Body dissatisfaction among pregnant women: an integrative review of the literature. Cien Saude Colet. 2015;20(7):20912103. PubMed ID: 26132248 doi:10.1590/1413-81232015207.05502014

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Silveira ML, Ertel KA, Dole N, Chasan-Taber L. The role of body image in prenatal and postpartum depression: a critical review of the literature. Arch Womens Ment Health. 2015;18(3):409421. PubMed ID: 25895137 doi:10.1007/s00737-015-0525-0

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Yin S, Njai R, Barker L, Siegel PZ, Liao Y. Summarizing health-related quality of life (HRQOL): development and testing of a one-factor model. Popul Health Metr. 2016;14:22. PubMed ID: 27408606 doi:10.1186/s12963-016-0091-3

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Ben-Tovim DI, Walker MK. The development of the Ben-Tovim Walker Body Attitudes Questionnaire (BAQ), a new measure of women’s attitudes towards their own bodies. Psychol Med. 1991;21(3):775784. PubMed ID: 1946865 doi:10.1017/S0033291700022406

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System Questionnaire. 2009 . https://www.cdc.gov/brfss/questionnaires/pdf-ques/2009brfss.pdf. Accessed from May 1, 2017.

    • Search Google Scholar
    • Export Citation
  • 25.

    Strath SJ, Bassett DR Jr, Ham SA, Swartz AM. Assessment of physical activity by telephone interview versus objective monitoring. Med Sci Sports Exerc. 2003;35(12):21122118. PubMed ID: 14652510 doi:10.1249/01.MSS.0000099091.38917.76

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385401. doi:10.1177/014662167700100306

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Irwin M, Artin KH, Oxman MN. Screening for depression in the older adult: criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Arch Intern Med. 1999;159(15):17011704. PubMed ID: 10448771 doi:10.1001/archinte.159.15.1701

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10(2):7784. PubMed ID: 8037935 doi:10.1016/S0749-3797(18)30622-6

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    Carleton RN, Thibodeau MA, Teale MJ, et al. The center for epidemiologic studies depression scale: a review with a theoretical and empirical examination of item content and factor structure. PLoS One. 2013;8(3):e58067. PubMed ID: 23469262 doi:10.1371/journal.pone.0058067

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Shrive FM, Stuart H, Quan H, Ghali WA. Dealing with missing data in a multi-question depression scale: a comparison of imputation methods. BMC Med Res Methodol. 2006;6:57. PubMed ID: 17166270 doi:10.1186/1471-2288-6-57

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Smits N, Cuijpers P, Beekman AT, Smit JH. Reducing the length of mental health instruments through structurally incomplete designs. Int J Methods Psychiatr Res. 2007;16(3):150160. PubMed ID: 17849433 doi:10.1002/mpr.223

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Dipietro JA, Millet S, Costigan KA, Gurewitsch E, Caulfield LE. Psychosocial influences on weight gain attitudes and behaviors during pregnancy. J Am Diet Assoc. 2003;103(10):13141319. PubMed ID: 14520249 doi:10.1016/S0002-8223(03)01070-8

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    Roomruangwong C, Kanchanatawan B, Sirivichayakul S, Maes M. High incidence of body image dissatisfaction in pregnancy and the postnatal period: associations with depression, anxiety, body mass index and weight gain during pregnancy. Sex Reprod Healthc. 2017;13:103109. PubMed ID: 28844350 doi:10.1016/j.srhc.2017.08.002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Rauff EL, Downs DS. Mediating effects of body image satisfaction on exercise behavior, depressive symptoms, and gestational weight gain in pregnancy. Ann Behav Med. 2011;42(3):381390. PubMed ID: 22015436 doi:10.1007/s12160-011-9300-2

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 35.

    Green K, Broome H, Mirabella J. Postnatal depression among mothers in the United Arab Emirates: socio-cultural and physical factors. Psychol Health Med. 2006;11(4):425431. PubMed ID: 17129919 doi:10.1080/13548500600678164

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36.

    Walker L, Timmerman GM, Kim M, Sterling B. Relationships between body image and depressive symptoms during postpartum in ethnically diverse, low income women. Women Health. 2002;36(3):101121. PubMed ID: 12539795 doi:10.1300/J013v36n03_07

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 37.

    Watson B, Broadbent J, Skouteris H, Fuller-Tyszkiewicz M. A qualitative exploration of body image experiences of women progressing through pregnancy. Women Birth. 2016;29(1):7279. PubMed ID: 26342758 doi:10.1016/j.wombi.2015.08.007

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Rallis S, Skouteris H, Wertheim EH, Paxton SJ. Predictors of body image during the first year postpartum: a prospective study. Women Health. 2007;45(1):87104. PubMed ID: 17613464 doi:10.1300/J013v45n01_06

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Clark A, Skouteris H., Wertheim E.H., Paxton S.J., Milgrom J. The relationship between depression and body dissatisfaction across pregnancy and the postpartum: a prospective study. J Health Psychol. 2009;14:2735. PubMed ID: 19129334 doi:10.1177/1359105308097940

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40.

    Johnson S, Burrows A, Williamson I. ‘Does my bump look big in this?’ The meaning of bodily changes for first-time mothers-to-be. J Health Psychol. 2004;9(3):361374. PubMed ID: 15117536 doi:10.1177/1359105304042346

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Hodgkinson EL, Smith DM, Wittkowski A. Women’s experiences of their pregnancy and postpartum body image: a systematic review and meta-synthesis. BMC Pregnancy Childbirth. 2014;14:330. PubMed ID: 25248649 doi:10.1186/1471-2393-14-330

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 42.

    Demissie Z, Siega-Riz AM, Evenson KR, Herring AH, Dole N, Gaynes BN. Physical activity and depressive symptoms among pregnant women: the PIN3 study. Arch Womens Ment Health. 2011;14(2):145157. PubMed ID: 21107623 doi:10.1007/s00737-010-0193-z

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43.

    Heh SS, Huang LH, Ho SM, Fu YY, Wang LL. Effectiveness of an exercise support program in reducing the severity of postnatal depression in Taiwanese women. Birth. 2008;35(1):6065. PubMed ID: 18307489 doi:10.1111/j.1523-536X.2007.00192.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 44.

    Armstrong K, Edwards H. The effectiveness of a pram-walking exercise programme in reducing depressive symptomatology for postnatal women. Int J Nurs Pract. 2004;10(4):177194. PubMed ID: 15265228 doi:10.1111/j.1440-172X.2004.00478.x

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 45.

    Da Costa D, Lowensteyn I, Abrahamowicz M, et al. A randomized clinical trial of exercise to alleviate postpartum depressed mood. J Psychosom Obstet Gynaecol. 2009;30(3):191200. PubMed ID: 19728220 doi:10.1080/01674820903212136

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 46.

    Craike MJ, Coleman D, MacMahon C. Direct and buffering effects of physical activity on stress-related depression in mothers of infants. J Sport Exerc Psychol. 2010;32(1):2338. PubMed ID: 20167950 doi:10.1123/jsep.32.1.23

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 47.

    Impact of physical activity during pregnancy and postpartum on chronic disease risk. Med Sci Sports Exerc. 2006;38(5):9891006. doi:10.1249/01.mss.0000218147.51025.8a

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 48.

    Leddy MA, Jones C, Morgan MA, Schulkin J. Eating disorders and obstetric-gynecologic care. J Womens Health. 2009;18(9):13951401. doi:10.1089/jwh.2008.1183

    • Crossref
    • Search Google Scholar
    • Export Citation
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