title: Physical activity, depressed mood and pregnancy worries in European obese pregnant women: results from the DALI study.
abstract: BACKGROUND
  The purpose of this study was to examine the association between mental health status (i.e. depressed mood and pregnancy-related worries) and objectively measured physical activity levels in obese pregnant women from seven European countries.
  
  
  METHODS
  Baseline data from the vitamin D and lifestyle intervention for the prevention of gestational diabetes mellitus (DALI) study were used. Time spent in moderate-to-vigorous physical activity (MVPA) and sedentary behaviour was measured with accelerometers. Depressed mood was measured with the WHO well-being index (WHO-5) and pregnancy-related worries with the Cambridge Worry Scale (CWS). In addition, socio-demographic characteristics, lifestyle factors, and perceptions and attitude regarding weight management and physical activity were measured. Linear regression analyses were performed to assess the association of mental health status with MVPA and sedentary behaviour.
  
  
  RESULTS
  A total of 98 obese pregnant women from Austria, Belgium, Ireland, Italy, Poland, Spain and the Netherlands were included. Women had a mean age of 31.6 ± 5.8 years, a pre-pregnancy BMI of 34.1 ± 4.3 kg/m(2), and were on average 15.4 ± 2.8 weeks pregnant. WHO-5 scores indicative of depressed mood (<50) were reported by 27.1 % of the women and most frequently endorsed pregnancy-related worries pertained to own and the baby's health. Women with good well-being spent 85% more time in MVPA compared to women with a depressed mood (P = 0.03). No differences in MVPA levels were found for women with no, some, or many pregnancy worries. Depressed mood and pregnancy-related worries were not associated with sedentary behaviour.
  
  
  CONCLUSIONS
  These findings suggest that in pregnant women who are obese, a depressed mood, but not pregnancy-related worries, may be associated with less physical activity. The combined risk of poor mental health and low physical activity levels makes women vulnerable for pregnancy complications. Whether a depressed mood may be a barrier for improving physical activity warrants further study.
authors.affiliation: Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands. lindadewit88@gmail.com.
authors.forename: Linda
authors.initials: L
authors.lastname: de Wit
authors.affiliation: Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands. j.jelsma@vumc.nl.
authors.forename: Judith G M
authors.initials: JG
authors.lastname: Jelsma
authors.affiliation: Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Centre, Van der Boechorststraat 7, 1081BT, Amsterdam, The Netherlands. mnm.vanpoppel@vumc.nl.|Institute for Sport Science, University of Graz, Graz, Austria. mnm.vanpoppel@vumc.nl.
authors.forename: Mireille N M
authors.initials: MN
authors.lastname: van Poppel
authors.affiliation: Department of Healthcare Research, PHL University College, Limburg Catholic University College, Hasselt, Belgium. annick.bogaerts@ucll.be.
authors.forename: Annick
authors.initials: A
authors.lastname: Bogaerts
authors.affiliation: Institute of Metabolic Science, Addenbrookes Hospital, Cambridge, UK. dsworkster@gmail.com.
authors.forename: David
authors.initials: D
authors.lastname: Simmons
authors.affiliation: Department of Obstetrics and Gynecology, Medizinische Universität Graz, Graz, Austria. gernot.desoye@medunigraz.at.
authors.forename: Gernot
authors.initials: G
authors.lastname: Desoye
authors.affiliation: Institut de Recerca de L'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. rcorcoy@santpau.cat.|CIBER Bioengineering, Biomaterials and Nanotechnology, Instituto de Salud Carlos III, Madrid, Spain. rcorcoy@santpau.cat.
authors.forename: Rosa
authors.initials: R
authors.lastname: Corcoy
authors.affiliation: Medical University of Vienna, Vienna City, Austria. alexandra.kautzky-willer@meduniwien.ac.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kautzky-Willer
authors.affiliation: Medical University of Vienna, Vienna City, Austria. juergen.harreiter@meduniwien.ac.at.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Harreiter
authors.affiliation: KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium. andre.vanassche@uzkuleuven.be.
authors.forename: Andre
authors.initials: A
authors.lastname: van Assche
authors.affiliation: KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium. roland.devlieger@uzleuven.be.
authors.forename: Roland
authors.initials: R
authors.lastname: Devlieger
authors.affiliation: KU Leuven Department of Development and Regeneration: Pregnancy, Fetus and Neonate, Gynaecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium. dirk.timmerman@uz.kuleuven.ac.be.
authors.forename: Dirk
authors.initials: D
authors.lastname: Timmerman
authors.affiliation: Recherche en Santé Lawson SA, Bronschhofen, Switzerland. david.hill@lhrionhealth.ca.
authors.forename: David
authors.initials: D
authors.lastname: Hill
authors.affiliation: University Hospital of Copenhagen - Rigshospitalet, Copenhagen, Denmark. peter.damm@regionh.dk.
authors.forename: Peter
authors.initials: P
authors.lastname: Damm
authors.affiliation: University Hospital of Copenhagen - Rigshospitalet, Copenhagen, Denmark. elisabeth.mathiesen@regionh.dk.
authors.forename: Elisabeth R
authors.initials: ER
authors.lastname: Mathiesen
authors.affiliation: Akademia Medyczna im Karola Marcinkowskiego, Poznan, Poland. ewozegow@ump.edu.pl.
authors.forename: Ewa
authors.initials: E
authors.lastname: Wender-Ozegowska
authors.affiliation: Akademia Medyczna im Karola Marcinkowskiego, Poznan, Poland. agazaw@post.home.pl.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Zawiejska
authors.affiliation: BAP Health Outcomes Research SL, Oviedo, Spain. pablo@baphealth.com.
authors.forename: Pablo
authors.initials: P
authors.lastname: Rebollo
authors.affiliation: Universita Degli Studi di Padova, Padova, Italy. annunziata.lapolla@sanita.padova.it.
authors.forename: Annunziata
authors.initials: A
authors.lastname: Lapolla
authors.affiliation: Universita Degli Studi di Padova, Padova, Italy. mariagrazia.dalfra@sanita.padova.it.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Dalfrà
authors.affiliation: Università di Pisa, Pisa, Italy. stefano.delprato@med.unipi.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Del Prato
authors.affiliation: Università di Pisa, Pisa, Italy. a.bertolotto@ao-pisa.toscana.it.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bertolotto
authors.affiliation: National University of Ireland, Galway, Ireland. fidelma.dunne@nuigalway.ie.
authors.forename: Fidelma
authors.initials: F
authors.lastname: Dunne
authors.affiliation: Odense University Hospital, Odense, Denmark. dortemj@dadlnet.dk.
authors.forename: Dorte M
authors.initials: DM
authors.lastname: Jensen
authors.affiliation: Odense University Hospital, Odense, Denmark. ll.torvin@dadlnet.dk.
authors.forename: Liselotte
authors.initials: L
authors.lastname: Andersen
authors.affiliation: Department of Medical Psychology, EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. fj.snoek@vumc.nl.|Department of Medical Psychology, Academic Medical Centre, Amsterdam, The Netherlands. fj.snoek@vumc.nl.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Snoek
mesh_terms: D061725:Accelerometry; D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D001294:Attitude to Health; D001317:Austria / Q000453:epidemiology; D001530:Belgium / Q000453:epidemiology; D003718:Denmark / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005060:Europe / Q000453:epidemiology; D015444:Exercise / Q000523:psychology*; D005260:Female; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D016014:Linear Models; D009043:Motor Activity; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology / Q000523:psychology*; D011044:Poland / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000523:psychology*; D057185:Sedentary Behavior; D013030:Spain / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult