Zhang Huan, Yue Youcheng, Mei Yundan, Zhang Yulu, Lu Qile, Chen Qiang, Lei Xun, Yu Lili, Zhou Mingfang, Fan Yao
School of Public Health, Chongqing Medical University, Chongqing, 400016, China; Research Center for Medicine and Social Development, Chongqing, 400016, China.
Maternity Center, the Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, China.
Soc Sci Med. 2025 Feb;367:117745. doi: 10.1016/j.socscimed.2025.117745. Epub 2025 Jan 23.
Prenatal mental health is an increasing public concern. At present, it has been shown that increasing physical activity (PA) is effective in promoting mental health of pregnant women. However, mental health may depend not only on the amount of time spent on a specific activity, but also on the intensity and type of the activity that it replaces. This study is aimed to explore the impact of replacing 60 min of one health behavior with another on the mental health of pregnant women.
The cross-sectional study recruited 983 pregnant women from Chongqing, China between June and December 2021. The pregnant women self-reported their movement behaviors using the Pregnancy Physical Activity Questionnaire-Chinese version (PPAQ-C). Participants also completed three measures of mental health: Childbirth Attitudes Questionnaire (CAQ), 9-item Patient Health Questionnaire (PHQ-9) and the Positive affect sub-scale. An Isotemporal Substitution Model was used to evaluate mental health after replacing one movement behavior.
The analysis showed that replacing 60 min of sedentary behavior (SB) with moderate-to-vigorous intensity PA (MVPA) promoted positive emotions, and replacing SB with light intensity PA (LPA) reduced childbirth fear. Regarding PA types, replacing inactivity with household, occupational, or transport PA could reduce fear, and replacing inactivity, occupational, household or transport PA with sport PA could improve positive emotions and alleviate depression.
An active pregnancy lifestyle with higher levels of moderate-to-vigorous physical activity and light physical activity and less sedentary behavior time and other inactive states may improve mental health. Future health promotion for pregnant women should consider the flexibility of physical activity types and intensities.
产前心理健康日益受到公众关注。目前，已有研究表明增加身体活动（PA）对促进孕妇心理健康有效。然而，心理健康可能不仅取决于在特定活动上花费的时间，还取决于所替代活动的强度和类型。本研究旨在探讨用一种健康行为替代另一种健康行为60分钟对孕妇心理健康的影响。
这项横断面研究于2021年6月至12月在中国重庆招募了983名孕妇。孕妇使用中文版孕期身体活动问卷（PPAQ-C）自我报告其运动行为。参与者还完成了三项心理健康测量：分娩态度问卷（CAQ）、9项患者健康问卷（PHQ-9）和积极情感子量表。使用等时替代模型评估一种运动行为被替代后的心理健康状况。
分析表明，用中等至剧烈强度的身体活动（MVPA）替代60分钟的久坐行为（SB）可促进积极情绪，用轻度强度的身体活动（LPA）替代SB可减少分娩恐惧。关于PA类型，用家务、职业或交通PA替代不活动状态可减少恐惧，用运动PA替代不活动、职业、家务或交通PA可改善积极情绪并减轻抑郁。
积极的孕期生活方式，包括较高水平的中等至剧烈身体活动和轻度身体活动，以及较少的久坐行为时间和其他不活动状态，可能会改善心理健康。未来针对孕妇的健康促进应考虑身体活动类型和强度的灵活性。
