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Participants reported on perceived stress, depressive symptoms, sedentary behavior, and emotional support during pregnancy. Infant gestational age (GA) at birth and birthweight were gathered from medical record abstraction or maternal report.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291723000314_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>After adjusting for propensity matching and covariates (maternal education, public assistance, employment status, prepregnancy body mass index), results showed a small effect of pandemic exposure on shorter GA at birth, but no effect on birthweight adjusted for GA. Women who were pregnant during the pandemic reported higher levels of prenatal stress and depressive symptoms, but neither mediated the association between pandemic exposure and GA. Sedentary behavior and emotional support were each associated with prenatal stress and depressive symptoms in opposite directions, but no moderation effects were revealed.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291723000314_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>There was no strong evidence for an association between pandemic exposure and adverse birth outcomes. Furthermore, results highlight the importance of reducing maternal sedentary behavior and encouraging emotional support for optimizing maternal health regardless of pandemic conditions.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291723000314","type":"journal-article","created":{"date-parts":[[2023,3,8]],"date-time":"2023-03-08T07:01:11Z","timestamp":1678258871000},"page":"6792-6805","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":4,"title":["Impact of sedentary behavior and emotional support on prenatal psychological distress and birth outcomes during the COVID-19 pandemic"],"prefix":"10.1017","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7179-1151","authenticated-orcid":false,"given":"Alison 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