Physical Activity and Its Relationship with Preterm Birth in the Presence of Depressive Symptomology

Devon Sneed, Purni M. Abeysekara, Jaime C. Slaughter-Acey, Carmen Giurgescu, Rhonda Dailey, Dawn P. Misra

Research output: Contribution to journalArticlepeer-review


Objective: To examine the relationship between physical activity (PA) and preterm birth (PTB) within the context of depressive symptoms (DS). Methods: Data are from the Life-course Influences of Fetal Environments (LIFE) Study, a cohort comprised of 1410 Black women, age 18–45 years who delivered a singleton in Metropolitan Detroit, MI. DS were measured with the Center for Epidemiologic Studies Depression Scale (CES-D); a score > 23 indicates severe DS. Traditional leisure time PA (LTPA) and non-LTPA during pregnancy (walking for a purpose, climbing stairs) were both measured. Modified Poisson regression models were used to estimate the association between PTB and PA. Effect modification by severe DS was assessed via stratification. Results: Approximately 16% of women had a PTB; 20% had CES-D scores > 23. Walking for a purpose was the most frequently reported type of PA (79%), followed by any LTPA (37.7%) and climbing stairs (13.5%). Compared with women who reported no PA, women who reported walking for a purpose (PR = 0.70, 95% CI 0.61, 1.10), partaking in LTPA (PR = 0.67, 95% CI 0.50, 0.90), or climbing stairs (PR = 0.61, 95% CI 0.45, 0.81) were less likely to have PTB. Results stratified by severe DS show the association between LTPA and PTB was more pronounced in women with severe DS, while the non-LTPA relationship with PTB was more heterogeneous. Conclusions: Women who participated in traditional LTPA (any or walking only) and non-LTPA experienced improved birth outcomes. LTPA may buffer against PTB among pregnant Black women with severe DS as well as none or mild DS.

Original languageEnglish (US)
JournalJournal of Racial and Ethnic Health Disparities
StateAccepted/In press - 2021

Bibliographical note

Funding Information:
This study was funded by NIH grant no. 335 [R01HD058510] to Dawn P Misra.

Funding Information:
The LIFE study was funded by NIH grant no. [R01HD058510] to Dr. Misra. Any opinions expressed are those of the author(s) alone and should not be construed as representing the opinions of the NIH. We would like to thank all of the women who participated in the LIFE study.

Publisher Copyright:
© 2021, W. Montague Cobb-NMA Health Institute.


  • African American
  • Depressive symptoms
  • Physical activity
  • Preterm birth

PubMed: MeSH publication types

  • Journal Article


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