Hurwitz Eric, Meltzer-Brody Samantha, Butzin-Dozier Zachary, Patel Rena C, Elhadad Noémie, Haendel Melissa A
Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC, United States.
JMIR Form Res. 2025 May 23;9:e67585. doi: 10.2196/67585.
Postpartum depression (PPD) is a mood disorder affecting 1 in 7 women after childbirth that is often underscreened and underdetected. If not diagnosed and treated, PPD is associated with long-term developmental challenges in the child and maternal morbidity. Wearable technologies, such as smartwatches and fitness trackers (eg, Fitbit), offer continuous and longitudinal digital phenotyping for mood disorder diagnosis and monitoring, with device wear time being an important yet understudied aspect.
We aimed to suggest that wear time of a wearable device may provide additional information about perinatal mental health to facilitate screening and early detection of PPD. We proposed that wear time of a wearable device may also be valuable for managing other mental health disorders.
Using the All of Us Research Program dataset, we identified females who experienced childbirth with and without PPD using computational phenotyping. We compared the percentage of days and number of hours per day females with and without PPD wore Fitbit devices during prepregnancy, pregnancy, postpartum, and PPD periods, determined by electronic health records. Comparisons between females with and without PPD were conducted using linear regression models. We also assessed the correlation between Fitbit wear time consistency (measured as the maximum number of consecutive days the Fitbit was worn) during prepregnancy and PPD periods in females with and without PPD using the Pearson correlation. All analyses were run with Bonferroni correction.
Our findings showed a strong trend, although nonsignificant after multiple testing correction, that females in the PPD cohort wore their Fitbits more than those in non-PPD cohort during the postpartum (PPD cohort: mean 69.9%, 95% CI 42.7%-97%; non-PPD cohort: mean 50%, 95% CI 25.5%-74.4%; P=.02) and PPD periods (PPD cohort: mean 66.6%, 95% CI 37.9%-95.3%; non-PPD cohort: mean 46.4%, 95% CI 20.5%-72.2%; P=.02). We found no difference in the number of hours per day females in the PPD and non-PPD cohorts wore their Fitbit during any period of pregnancy. Finally, there was no relationship between the consistency of Fitbit wear time during prepregnancy and PPD periods (r=-0.05, 95% CI -0.46 to 0.38; P=.84); however, there was a trend, though nonsignificant, in Fitbit wear time consistency among females without PPD (r=0.25, 95% CI -0.02 to 0.49; P=.07).
We hypothesize that increased Fitbit wear time among females with PPD may be attributed to hypervigilance, given the common co-occurrence of anxiety symptoms. Future studies should assess the link between PPD, hypervigilance, and wear time patterns. We envision that wear time patterns of a wearable device combined with digital biomarkers such as sleep and physical activity could enhance early PPD detection using machine learning by alerting clinicians to potential concerns and facilitating timely screenings, which may have implications for other mental health disorders.
产后抑郁症（PPD）是一种情绪障碍，影响着七分之一的产后女性，常常筛查不足且诊断不及时。若未得到诊断和治疗，PPD会导致儿童长期发育问题以及产妇发病。可穿戴技术，如智能手表和健身追踪器（如Fitbit），可为情绪障碍的诊断和监测提供持续且纵向的数字表型分析，而设备佩戴时间是一个重要但研究不足的方面。
我们旨在表明可穿戴设备的佩戴时间可能会提供有关围产期心理健康的额外信息，以促进PPD的筛查和早期发现。我们提出，可穿戴设备的佩戴时间对于管理其他心理健康障碍可能也有价值。
利用“我们所有人”研究计划数据集，我们通过计算表型分析确定了有和没有PPD的分娩女性。我们比较了有和没有PPD的女性在孕前、孕期、产后和PPD期间佩戴Fitbit设备的天数百分比和每天的小时数，这些数据由电子健康记录确定。使用线性回归模型对有和没有PPD的女性进行比较。我们还使用Pearson相关性评估了有和没有PPD的女性在孕前和PPD期间Fitbit佩戴时间一致性（以Fitbit连续佩戴的最大天数衡量）之间的相关性。所有分析均进行了Bonferroni校正。
我们的研究结果显示出一种强烈趋势，尽管在多次检验校正后不显著，即PPD队列中的女性在产后（PPD队列：平均69.9%，95%CI 42.7%-97%；非PPD队列：平均50%，95%CI 25.5%-74.4%；P=0.02）和PPD期间（PPD队列：平均66.6%，95%CI 37.9%-95.3%；非PPD队列：平均46.4%，95%CI 20.5%-72.2%；P=0.02）佩戴Fitbit的时间比非PPD队列中的女性多。我们发现，在孕期的任何阶段，PPD和非PPD队列中的女性每天佩戴Fitbit的小时数没有差异。最后，孕前和PPD期间Fitbit佩戴时间的一致性之间没有关系（r=-0.05，95%CI -
