{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T12:10:38Z","timestamp":1779106238379,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Depression and post-traumatic stress disorder (PTSD) are prevalent in pregnancy, especially among military members. These conditions can lead to adverse birth outcomes, yet, there's a paucity of evidence for prevention strategies. Optimizing physical fitness is one understudied potential intervention. We explored associations between prepregnancy physical fitness and antenatal depression and PTSD in soldiers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>\n                      This was a retrospective cohort study of active-duty U.S. Army soldiers with live births between 2011 and 2014, identified with diagnosis codes from inpatient and outpatient care. The exposure was each individual's mean Army physical fitness score from 10 to 24 months before childbirth. The primary outcome was a composite of active depression or PTSD during pregnancy, defined using the presence of a code within 10 months before childbirth. Demographic variables were compared across four quartiles of fitness scores. Multivariable logistic regression models were conducted adjusting for potential confounders selected\n                      <jats:italic toggle=\"yes\">a priori<\/jats:italic>\n                      . A stratified analysis was conducted for depression and PTSD separately.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 4,583 eligible live births, 352 (7.7%) had active depression or PTSD during pregnancy. Soldiers with the highest fitness scores (Quartile 4) were less likely to have active depression or PTSD in pregnancy (Quartile 4 vs. Quartile 1 adjusted odds ratio 0.55, 95% confidence interval 0.39\u20130.79). Findings were similar in stratified analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this cohort, the odds of active depression or PTSD during pregnancy were significantly reduced among soldiers with higher prepregnancy fitness scores. Optimizing physical fitness may be a useful tool to reduce mental health burden on pregnancy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jwh.2022.0538","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T14:49:56Z","timestamp":1684334996000},"page":"816-822","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Physical Fitness in Relationship to Depression and Post-Traumatic Stress Disorder During Pregnancy Among U.S. Army Soldiers"],"prefix":"10.1177","volume":"32","author":[{"given":"Danielle M.","family":"Panelli","sequence":"first","affiliation":[{"name":"Division of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University, Stanford, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. Alan","family":"Nelson","sequence":"additional","affiliation":[{"name":"Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Wagner","sequence":"additional","affiliation":[{"name":"Division of Maternal-Fetal Medicine and Obstetrics, Department of Obstetrics and Gynecology, Stanford University, Stanford, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan G.","family":"Shaw","sequence":"additional","affiliation":[{"name":"VA HSR&amp;D Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, California, USA."},{"name":"VA Health Economics Resource Center (HERC), VA Palo Alto Health Care System, Menlo Park, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ciaran S.","family":"Phibbs","sequence":"additional","affiliation":[{"name":"VA HSR&amp;D Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, California, USA."},{"name":"VA Health Economics Resource Center (HERC), VA Palo Alto Health Care System, Menlo Park, California, USA."},{"name":"Department of Pediatrics, Stanford University, Stanford, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lianne M.","family":"Kurina","sequence":"additional","affiliation":[{"name":"VA Health Economics Resource Center (HERC), VA Palo Alto Health Care System, Menlo Park, California, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,7,13]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2018.12.129"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/wps.20769"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2019.6"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2014.03.016"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.whi.2022.09.005"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12349"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/den342"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/14767050701209560"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp1102730"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000542"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-017-2285-0"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12909"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-015-0393-1"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2022.0609"},{"key":"e_1_3_8_16_2","unstructured":"Lee J. Army replaces decades-old fitness exam with more rigorous test. NBC News. Published 2021. Available from: https:\/\/www.nbcnews.com\/news\/us-news\/army-replaces-decades-old-fitness-exam-more-rigorous-test-n1285329 [Last accessed: December13 2022]."},{"key":"e_1_3_8_17_2","unstructured":"Standards of medical fitness. Dep Army Hqrs 2019;Regulation(6). Available from: https:\/\/armypubs.army.mil\/ProductMaps\/PubForm\/Details.aspx?PUB_ID=1004688 [Last accessed: December13 2022]."},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwy003"},{"key":"e_1_3_8_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-020-05570-x"},{"issue":"757","key":"e_1_3_8_20_2","first-page":"208","article-title":"Committee opinion: Screening for perinatal depression","volume":"132","author":"ACOG","year":"2018","unstructured":"ACOG. Committee opinion: Screening for perinatal depression. Replace Comm Opin, 2018; 132(757):208\u2013212.","journal-title":"Replace Comm Opin"},{"key":"e_1_3_8_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2021.100847"},{"key":"e_1_3_8_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-017-2402-0"},{"key":"e_1_3_8_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.2009.01466.x"},{"key":"e_1_3_8_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwn084"},{"issue":"804","key":"e_1_3_8_25_2","first-page":"178","article-title":"Committee opinion 804: Physical activity and exercise during pregnancy and the postpartum period","volume":"804","author":"Birsner ML","year":"2015","unstructured":"Birsner ML, , Gyamfi-Bannerman C. Committee opinion 804: Physical activity and exercise during pregnancy and the postpartum period. Am Coll Obstet Gynecol, 2015; 804(804):178\u2013188.","journal-title":"Am Coll Obstet Gynecol"},{"key":"e_1_3_8_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2016.05.023"}],"container-title":["Journal of Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/jwh.2022.0538","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jwh.2022.0538","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jwh.2022.0538","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T11:16:37Z","timestamp":1779102997000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/jwh.2022.0538"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":25,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1089\/jwh.2022.0538"],"URL":"https:\/\/doi.org\/10.1089\/jwh.2022.0538","relation":{},"ISSN":["1540-9996","1931-843X"],"issn-type":[{"value":"1540-9996","type":"print"},{"value":"1931-843X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7]]}}}