Determinants of pregnancy and postpartum depression: Prospective influences of depressive symptoms, body image satisfaction, and exercise behavior

Background: Limited research has prospectively examined women's exercise and psychological health behaviors before, during, and after pregnancy. Purpose: The purpose of this study was to examine the associations between and the extent to which depressive symptoms (DS), body image satisfaction (BIS), and exercise behavior (EB) prospectively explained trimester-specific and postpartum depression. Methods: Participants (N=230 pregnant women) completed self-reported measures midway through their first, second, and third trimesters and at 6-weeks postpartum from 2005 to 2007. Women were also classified based on current activity guidelines as active and somewhat active to examine the moderating influence of pre-pregnancy EB on the contributions of the study variables for explaining DS. Results: We found that : (a) DS, BIS, and EB were associated across the three pregnancy time points and postpartum, (b) DS and BIS were main determinants of later depression in pregnancy and postpartum, and (c) the moderating influence of pre-pregnancy EB was evident in early pregnancy. Conclusions: These preliminary findings suggest that DS and BIS are important psychological factors for intervention to improve women's pregnancy and postpartum psychological health and that EB in the pre-pregnancy period may offer women protective effects against DS in early pregnancy.