{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T05:54:05Z","timestamp":1781762045536,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Little is known about the negative impacts of the COVID\u201019 pandemic on health behaviors among postpartum women. We aimed to assess self\u2010reported changes in physical activity, sitting time, and sleep among postpartum women early in the pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted an online survey of postpartum women in the United States (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009809) during May and June of 2020. Multiple logistic regression models were used to examine associations between socio\u2010demographic, medical, and COVID\u201019\u2010related factors (e.g., COVID\u2010related worries and stressors) and self\u2010reported changes in health behaviors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of being less physically active, sitting for longer times, and sleeping less since the pandemic started were 57.4%, 64.9%, and 26.3%, respectively. Medicaid\u2010insured recipients reported more reduced physical activity and longer sitting time than privately insured women. Breastfeeding was associated with higher odds of being less physically active. Worse health status was strongly associated with adverse changes in the three behaviors (All P\n                      <jats:sub>trend<\/jats:sub>\n                      &lt;\u20090.05). A higher score on social connection with family members was associated with reduced physical activity and longer sitting time, while those with a higher social connection score with community\/neighbors\/friends were more physically active. COVID\u201019\u2010related worries were associated with lower odds of being less physically active but greater likelihood of sitting longer and sleeping less. COVID\u201019\u2010related stressors were associated with higher odds of sleeping less.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early in the COVID\u201019 pandemic, adverse changes in health behaviors were prevalent among US postpartum women. Intervention programs optimizing multiple health behaviors among postpartum women and high\u2010risk groups are needed during pandemic situations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/birt.70086","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T05:15:58Z","timestamp":1781759758000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Physical Activity, Sitting Time, and Sleep Among Postpartum Women During the\n                    <scp>COVID<\/scp>\n                    \u201019 Pandemic"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9254-1952","authenticated-orcid":false,"given":"Longgang","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health University of South Carolina  Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, and Rural and Minority Health Research Center, Arnold School of Public Health University of South Carolina  Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2343-4162","authenticated-orcid":false,"given":"Kara M.","family":"Whitaker","sequence":"additional","affiliation":[{"name":"Department of Health and Human Physiology and Department of Epidemiology University of Iowa  Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1529-0819","authenticated-orcid":false,"given":"Peiyin","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Health Services Policy and Management and Rural and Minority Health Research Center, Arnold School of Public Health University of South Carolina  Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8559-5717","authenticated-orcid":false,"given":"Nicole","family":"Hair","sequence":"additional","affiliation":[{"name":"Department of Health Services Policy and Management, Arnold School of Public Health University of South Carolina  Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eileen L.","family":"Chen","sequence":"additional","affiliation":[{"name":"Trinity College of Arts and Sciences Duke University  Durham South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J.","family":"Alberg","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health University of South Carolina  Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"issue":"2","key":"e_1_2_12_2_1","doi-asserted-by":"crossref","DOI":"10.1093\/jtm\/taaa020","article-title":"Isolation, Quarantine, Social Distancing and Community Containment: Pivotal Role for Old\u2010Style Public Health Measures in the Novel Coronavirus (2019\u2010nCoV) Outbreak","volume":"27","author":"Wilder\u2010Smith A.","year":"2020","journal-title":"Journal of Travel Medicine"},{"key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"105019","DOI":"10.1016\/j.appet.2020.105019","article-title":"Physical Activity, Dietary Habits and Sleep Quality Before and During COVID\u201019 Lockdown: A Longitudinal Study","volume":"158","author":"Martinez\u2010de\u2010Quel O.","year":"2021","journal-title":"Appetite"},{"key":"e_1_2_12_4_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.appet.2020.104853","article-title":"Obesity, Eating Behavior and Physical Activity During COVID\u201019 Lockdown: A Study of UK Adults","volume":"156","author":"Robinson E.","year":"2021","journal-title":"Appetite"},{"issue":"1","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"44","DOI":"10.5993\/AJHB.45.1.4","article-title":"Health Behaviors at the Onset of the COVID\u201019 Pandemic","volume":"45","author":"Weaver R. H.","year":"2021","journal-title":"American Journal of Health Behavior"},{"key":"e_1_2_12_6_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.midw.2021.102929","article-title":"Variations in Health Behaviors Among Pregnant Women During the COVID\u201019 Pandemic","volume":"95","author":"Whitaker K. M.","year":"2021","journal-title":"Midwifery"},{"issue":"5","key":"e_1_2_12_7_1","doi-asserted-by":"crossref","DOI":"10.1097\/AOG.0000000000002633","article-title":"ACOG Committee Opinion No. 736: Optimizing Postpartum Care","volume":"131","author":"McKinney J.","year":"2018","journal-title":"Obstetrics and Gynecology"},{"key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1002\/ijgo.13803","article-title":"Giving Birth During a Pandemic: From Elation to Psychopathology","volume":"153","author":"Puertas\u2010Gonzalez J. A.","year":"2021","journal-title":"International Journal of Gynaecology and Obstetrics"},{"issue":"1","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.ypmed.2011.04.014","article-title":"Prevalence and Correlates of Objectively Measured Physical Activity and Sedentary Behavior Among US Pregnant Women","volume":"53","author":"Evenson K. R.","year":"2011","journal-title":"Preventive Medicine"},{"issue":"1","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1123\/jpah.2019-0377","article-title":"Sedentary Behavior and Chronic Disease: Mechanisms and Future Directions","volume":"17","author":"Dempsey P. C.","year":"2020","journal-title":"Journal of Physical Activity & Health"},{"key":"e_1_2_12_11_1","unstructured":"World Health Organization \u201cGlobal Recommendations on Physical Activity for Health. Geneva 2010 \u201d(2010) http:\/\/www.who.int\/dietphysicalactivity\/publications\/9789241599979\/en."},{"key":"e_1_2_12_12_1","unstructured":"American College of Obstetricians and Gynaecologists (ACOG) \u201cPhysical Activity and Exercise During Pregnancy and the Postpartum Period \u201d(2020) https:\/\/www.acog.org\/clinical\/clinical\u2010guidance\/committee\u2010opinion\/articles\/2020\/04\/physical\u2010activity\u2010and\u2010exercise\u2010during\u2010pregnancy\u2010and\u2010the\u2010postpartum\u2010period."},{"key":"e_1_2_12_13_1","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/1472-6874-9-32","article-title":"Physical Activity Patterns During Pregnancy Through Postpartum","volume":"9","author":"Borodulin K.","year":"2009","journal-title":"BMC Women's Health"},{"issue":"1","key":"e_1_2_12_14_1","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1186\/s12916-018-1062-2","article-title":"A Cut\u2010Off of Daily Sedentary Time and All\u2010Cause Mortality in Adults: A Meta\u2010Regression Analysis Involving More Than 1 Million Participants","volume":"16","author":"Ku P. 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E.","year":"2008","journal-title":"American Journal of Epidemiology"},{"key":"e_1_2_12_16_1","doi-asserted-by":"crossref","first-page":"151","DOI":"10.2147\/NSS.S134864","article-title":"Short\u2010 and Long\u2010Term Health Consequences of Sleep Disruption","volume":"9","author":"Medic G.","year":"2017","journal-title":"Nature and Science of Sleep"},{"key":"e_1_2_12_17_1","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.psyneuen.2019.05.010","article-title":"Sleep Quality Is Associated With Vasopressin Methylation in Pregnant and Postpartum Women With a History of Psychosocial Stress","volume":"107","author":"Solomonova E.","year":"2019","journal-title":"Psychoneuroendocrinology"},{"key":"e_1_2_12_18_1","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1111\/birt.12554","article-title":"Mental Health Among Pregnant Women With COVID\u201019\u2010Related Stressors and Worries in the United States","volume":"48","author":"Liu J.","year":"2021","journal-title":"Birth"},{"issue":"5","key":"e_1_2_12_19_1","doi-asserted-by":"crossref","first-page":"e208","DOI":"10.1097\/AOG.0000000000002927","article-title":"ACOG Committee Opinion No. 757: Screening for Perinatal Depression","volume":"132","author":"ACOG Committee","year":"2018","journal-title":"Obstetrics and Gynecology"},{"key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1192\/bjp.150.6.782","article-title":"Detection of Postnatal Depression. Development of the 10\u2010Item Edinburgh Postnatal Depression Scale","volume":"150","author":"Cox J. L.","year":"1987","journal-title":"British Journal of Psychiatry: The Journal of Mental Science"},{"key":"e_1_2_12_21_1","volume-title":"The Pandemic Stress Index","author":"Harkness A.","year":"2020"},{"issue":"7","key":"e_1_2_12_22_1","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1007\/s10461-020-02862-w","article-title":"Understanding the Impact of COVID\u201019 on Latino Sexual Minority Men in a US HIV Hot Spot","volume":"24","author":"Harkness A.","year":"2020","journal-title":"AIDS and Behavior"},{"issue":"1","key":"e_1_2_12_23_1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1186\/s12966-021-01161-4","article-title":"Cross\u2010Sectional Study of Changes in Physical Activity Behavior During the COVID\u201019 Pandemic Among US Adults","volume":"18","author":"Watson K. 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Stress, Anxiety, and Sleep Among Adult Twins","volume":"15","author":"Tsang S.","year":"2021","journal-title":"Frontiers in Neuroscience"},{"key":"e_1_2_12_29_1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.sleep.2018.03.011","article-title":"The Bidirectional Relationship Between Sleep Duration and Depression in Community\u2010Dwelling Middle\u2010Aged and Elderly Individuals: Evidence From a Longitudinal Study","volume":"52","author":"Sun Y.","year":"2018","journal-title":"Sleep Medicine"},{"key":"e_1_2_12_30_1","doi-asserted-by":"crossref","first-page":"e150","DOI":"10.1093\/geronb\/gbab110","article-title":"Associations Between Changes in Daily Behaviors and Self\u2010Reported Feelings of Depression and Anxiety About the COVID\u201019 Pandemic Among Older Adults","volume":"77","author":"Robbins R.","year":"2021","journal-title":"Journals of Gerontology Series B"},{"issue":"17","key":"e_1_2_12_31_1","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph17176268","article-title":"Health Behavior Changes During COVID\u201019 Pandemic and Subsequent \u201cStay\u2010At\u2010Home\u201d Orders","volume":"17","author":"Knell G.","year":"2020","journal-title":"International Journal of Environmental Research and Public Health"},{"issue":"7","key":"e_1_2_12_32_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2018-025927","article-title":"Factors Associated With Maternal Postpartum Fatigue: An Observationalstudy","volume":"9","author":"Henderson J.","year":"2019","journal-title":"BMJ Open"},{"key":"e_1_2_12_33_1","doi-asserted-by":"crossref","unstructured":"J. A.Martin B. E.Hamilton andM. J.Osterman \u201cBirths: Final Data for 2019 \u201d(2021).","DOI":"10.15620\/cdc:104993"}],"container-title":["Birth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.70086","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/birt.70086","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.70086","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T05:16:03Z","timestamp":1781759763000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/birt.70086"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,17]]},"references-count":32,"alternative-id":["10.1111\/birt.70086"],"URL":"https:\/\/doi.org\/10.1111\/birt.70086","archive":["Portico"],"relation":{},"ISSN":["0730-7659","1523-536X"],"issn-type":[{"value":"0730-7659","type":"print"},{"value":"1523-536X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,17]]},"assertion":[{"value":"2021-11-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"birt.70086"}}