title: Physical activity and depressive symptoms after stillbirth: informing future interventions.
abstract: BACKGROUND
  In the United States, approximately one in 110 pregnancies end in stillbirth affecting more than 26,000 women annually. Women experiencing stillbirth have a threefold greater risk of developing depressive symptoms compared to women experiencing live birth. Depression contributes negatively to health outcomes for both mothers and babies subsequent to stillbirth. Physical activity may improve depression in these women, however, little is known about acceptable physical activity interventions for women after stillbirth. This is the purpose of this descriptive exploratory study.
  
  
  METHODS
  Eligible women were between ages 19 and 45, and experienced stillbirth within one year of the study. An online survey was used to ask questions related to 1) pregnancy and family information (i.e., time since stillbirth, weight gain during pregnancy, number of other children) 2) physical activity participation, 3) depressive symptomatology, and 4) demographics.
  
  
  RESULTS
  One hundred seventy-five women participated in the study (M age = 31.26 ± 5.52). Women reported participating in regular physical activity (at least 150 minutes of moderate activity weekly) before (60%) and during (47%) their pregnancy, as well as after their stillbirth (61%). Only 37% were currently meeting physical activity recommendations. Approximately 88% reported depression (i.e., score of >10 on depression scale). When asked how women cope with depression, anxiety, or grief, 38% said physical activity. Of those that reported using physical activity to cope after stillbirth, they did so to help with depression (58%), weight loss (55%), and better overall physical health (52%). To cope with stillbirth, women used walking (67%), followed by jogging (35%), and yoga (23%). Women who participated in physical activity after stillbirth reported significantly lower depressive symptoms (M = 15.10, SD = 5.32) compared to women who did not participate in physical activity (M = 18.06, SD = 5.57; t = -3.45, p = .001).
  
  
  CONCLUSIONS
  Physical activity may serve as a unique opportunity to help women cope with the multiple mental sequelae after stillbirth. This study provides data to inform healthcare providers about the potential role of physical activity in bereavement and recovery for women who have experienced stillbirth. Additional research is necessary in this vulnerable population.
authors.affiliation: Exercise and Wellness, Arizona State University, Phoenix, AZ, USA. Jhuberty@asu.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Huberty
authors.affiliation: Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, USA. Jenn.leiferman@ucdenver.edu.
authors.forename: Jenn A
authors.initials: JA
authors.lastname: Leiferman
authors.affiliation: Department of Family Medicine, University of Michigan, Ann Arbor, MI, USA. ktgold@umich.edu.|Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA. ktgold@umich.edu.
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Gold
authors.affiliation: Exercise and Wellness, Arizona State University, Phoenix, AZ, USA. Lacey.rowedder@asu.edu.
authors.forename: Lacey
authors.initials: L
authors.lastname: Rowedder
authors.affiliation: School of Social Work, Arizona State University, Phoenix, AZ, USA. jcaccia@me.com.
authors.forename: Joanne
authors.initials: J
authors.lastname: Cacciatore
authors.affiliation: College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA. Darya.mcclain@asu.edu.
authors.forename: Darya Bonds
authors.initials: DB
authors.lastname: McClain
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001007:Anxiety; D001601:Bereavement; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006117:Grief; D006801:Humans; D007590:Jogging; D008603:Mental Health; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D009043:Motor Activity; D011247:Pregnancy; D050497:Stillbirth / Q000453:epidemiology*; D013315:Stress, Psychological; D014481:United States; D016138:Walking; D015013:Yoga; D055815:Young Adult